Inspection on 02/10/08 for Waterloo House Care Home Ltd

This inspection was carried out on 2nd October 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

Waterloo House Care Home Ltd 09/10/09

Waterloo House Care Home Ltd 13/07/07

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 13/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Waterloo House Care Home Ltd 36 Waterloo Road Bedford Bedfordshire MK40 3PQ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Ann Wiseman     Date: 0 2 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Waterloo House Care Home Ltd 36 Waterloo Road Bedford Bedfordshire MK40 3PQ 01234351608 F/P01234351608 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Waterloo House Care Home Ltd Name of registered manager (if applicable) Mrs Patricia White Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 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 Care Homes for Older People Page 4 of 26 care home 24 Over 65 24 24 0 0 Brief description of the care home of the person. Additional charges are made for hairdressing, barber services and newspapers. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection, we arrived at 10.45 in the morning and stayed for 5 hours. The manager was on duty and facilitated the inspection, which she did in an open and helpful manner. Whatever files and documents we asked to see were quickly produced and were well ordered. During the day we had a look around the home and talked to some of the staff and the people living in the home. We looked at information belonging to three people and the available information of three of the staff. We also assessed some of the homes policies and procedures and sampled a random selection of the health and safety files and records. Before the inspection the manager has sent us the Annual Quality Assurance Care Homes for Older People Page 6 of 26 Assessment (AQAA) she had completed. The AQAA is a self-assessment that focuses on how well outcomes are being met for people living in the home. It also gave us some numerical information about the service. The AQAA was sent to us within our set timescales and showed that the home recognised areas that need further improvement. We had sent surveys to the home for distribution amongst the people in the home, their relatives and the staff. We had a good response with replies from eight people living in the home, one of their relatives and six staff members. All of the comments we received were positive with comments like, We work as a team and if we have any problems they are sorted straight away by our manager. And The staff are excellent always happy, nothing is too much trouble, they are very helpful. The house was clean and tidy and the atmosphere was friendly and congenial, interaction between the staff and the people living in the home was observed to be friendly and open. When talking about the people they did so in a supportive and respectful manner and written notes were also written appropriately. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Care Homes for Older People Page 9 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using 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. Assessments are carried out and people are encouraged to visit the house before they move in. 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 Care Homes for Older People Page 11 of 26 Evidence: 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. We examined three peoples files during the inspection and we saw that detailed assessments are carried out before people move in and people are encouraged to visit the home before they decide to move in. Intermediate care is not provided at this home. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using 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 are good at supporting people to access health care support so that their health needs. Care plans are in place and medication is managed to requirement. People are respected and have their privacy upheld. Evidence: We looked at three care plans and found that, peoples support needs were recorded and they were written in a way that reflected peoples personal preferences. The care plans were reviewed regularly. We found evidence, in the files we examined, that people have access to medical practitioners as and when they need to, they also get support from specialists such as speech and language therapy, psychology, psychiatric, dentists and Care Homes for Older People Page 13 of 26 Evidence: opticians. We examined the medication and its records and found that they were as required. Since the last inspection the manager has introduced a system where the medication and its recording is checked on a daily basis. Our professional website is available to everyone and contains guidance on many topics including medication. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using 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 in a way that was relaxed and dignified. Many of the people living at the home commented that the food was good and they enjoyed their meals. The home has employed an activities co-ordinator since the last inspection. Information seen within the individual care records of people and the people themselves confirmed that a programme of activities were in place. Examples included going to the local pub, gardening, music and movement and quizs, a chart detailing the time and date of all the activities is on display in the home. People living at the home spoke of the flexibility in when their friends and families Care Homes for Older People Page 15 of 26 Evidence: could visit them at the home. 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. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using 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 us 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, its reflected the local authority guidance. The management had sought a copy of the local protocols and these were seen. The staff demonstrated through discussion an understanding of the need to refer any allegation or suspected abuse. People are given copies of the complaints procedure and it is displayed around the home. 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. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using 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 home is a comfortable, safe and well-maintained environment. The home is kept clean, pleasant and hygienic. Evidence: We had a tour of the building and we found that it was comfortable, clean and well maintained. The conservatory had proved to be very hot in the summer and the owners have had a solid ceiling fitted to shade the room from the sun. This has made it easier to regulate the temperature and has made it more comfortable. The garden, with a patio area, is accessible from the conservatory, which allows 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. Lighting in the dinning room has been improved since the last inspection by the installation of new lights. Bedrooms seen contained many personal items, televisions, teddy bears, photographs and ornaments. Grab rails were installed on the stairway. A fire exit was secured with a key that had been removed and hung on a hook by the Care Homes for Older People Page 18 of 26 Evidence: door. This contravenes fire safety regulations, because if the key was not easily available in an emergency people may become trapped. When this was explained to the manager she immediately asked someone carrying out some maintenance work to change the lock to one that could be locked without the use of a removable key. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using 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 recruitment of staff is as required and training arrangements for staff are sufficient and staff demonstrated 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. We examined three staff personnel files and we found that the homes recruitment policy and procedures 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. Senior care workers, care assistants, activities co-ordinator, catering and Care Homes for Older People Page 20 of 26 Evidence: 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. People 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, they demonstrated a good level of understanding of the needs of people. One staff member had a very good level of knowledge and was able to describe peoples 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. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using 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 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 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 Care Homes for Older People Page 22 of 26 Evidence: 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. Receipts are kept for any expenditure and records kept. 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. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 32 The home does not have Internet access. There is a great wealth of information, guidance and support that can be quickly assessed thorough the Internet, not least of which can be found on our professionals website. Having Internet access will also improve communication between local other professional and families.We strongly recommend that the owners consider installing an Internet connection in the home. Care Homes for Older People Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 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. 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!