Inspection on 20/09/07 for Waterloo House

This inspection was carried out on 20th September 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 07/06/06

Waterloo House 12/09/05

Waterloo House 25/04/05

Waterloo House 06/09/04

Waterloo House 04/05/04

Similar services:

Trevayler Residential Care Home

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

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

CARE HOMES FOR OLDER PEOPLE Waterloo House Walesby Road Market Rasen Lincs LN8 3EX Lead Inspector Ken Hague Unannounced Inspection 08:30 20 September 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 DS0000002470.V340687.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 DS0000002470.V340687.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Waterloo House Address Walesby Road Market Rasen Lincs LN8 3EX 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) 01673 842343 waterloohousecare@surf3.net Platinum Care (Lincoln) Limited Mrs Isobel Elizabeth Sugden Care Home 35 Category(ies) of Dementia - over 65 years of age (5), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (5), Old age, not falling within any other category (30) Waterloo House DS0000002470.V340687.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The total number of service users in categories DE(E) & MD(E) together will not exceed 5. 7th June 2006 Date of last inspection Brief Description of the Service: The home is in a residential area of Market Rasen, within five minutes walking distance of the local shops and amenities. The home provides personal care for up to thirty five residents in the category of mental disorder/dementia (older people) and old age, over sixty five years of age. Bedrooms are located on the ground and first floors; with lounge areas being available on both floors and the dining room is located on the ground floor. The rooms on the first floor are accessed by a shaft lift. At the time of the inspection the home confirmed that the weekly fees ranged from £348 - £550 depending on the residents assessed needs. Additional charges are made for services such as chiropody, hairdressing and toiletries. Information about these costs as well as the day-to-day operation of the home, including a copy of the last inspection report, can be found in the reception area or from the home’s office. The home has a statement of purpose and service user guide, which sets out resources and services offered, by the care home. These documents are made available to all new potential residents. The homes Website Address is www.waterloohousecarehome.co.uk Waterloo House DS0000002470.V340687.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 6 hours. The registered manager was provided with feedback at the end of the inspection. The main method of inspection used was called ‘case tracking’ which involved selecting three residents and tracking the care they receive through the checking of their records, discussion with them and the staff, and where more appropriate observation of interaction between staff and residents and related care practices. A sample of care records was inspected. Two members of staff were interviewed and the opinions of four residents were sought. An (AQAA) Annual quality assurance assessment was completed by the care home and sent to the Commission for Social Care Inspection prior to the site visit. This is a selfassessment document completed by the providers of the care home. It sets out evidence from the provider to demonstrate that they are meeting the Care Home Regulations. It is normal procedure to obtain written feedback from residents prior to the site visit using a document called “have your say”. This document sets out a number of questions for residents to answer which invites them to give their views of the services offered by the home. In the case of this key inspection five forms were returned. The opinions and views expressed in these “Have you say” documents are reflected within this report. What the service does well: What has improved since the last inspection? What they could do better: The care home should continue to maintain its present standards of providing services. Waterloo House DS0000002470.V340687.R01.S.doc Version 5.2 Page 6 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 DS0000002470.V340687.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 DS0000002470.V340687.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): Standards 3 & 6 Quality in this area is Good. This judgement has been made using available evidence including a visit to this service. There are procedures in place which are used for the assessment of new residents to the service. This ensures that all of their personal care needs, health care and social needs are met. A dedicated intermediate care service is not provided by the home EVIDENCE: Residents are invited to visit the home, look around, and discuss the services offered. The home’s statement of purpose sets out the resources available for residents and is found in the reception area of the home. Waterloo house offers a free day for residents to come and meet staff. The registered manager described the assessment process. Care needs are identified by completing a detailed assessment. Written confirmation is then given to the residents that the resources of the care home can meet their needs. All new residents are offered a trial period. Waterloo House DS0000002470.V340687.R01.S.doc Version 5.2 Page 9 The care records for three residents being case tracked were found to contain a detailed assessment carried out prior to the person being admitted to the care home. The records contained the identified needs of each resident including care and social needs. Risk assessments had been carried out AND W here a risk had been identified the management of the risk was recoded on care records. Residents spoken to during this site visit confirmed that an assessment had been carried out prior to the admission to the care home. Waterloo House DS0000002470.V340687.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7,8,9 &10 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Care plans identify all areas of need and provide detailed care instructions for staff; this enables staff to provide appropriate care. Residents’ health needs will be met. EVIDENCE: Three resident’s care records were studied each had a comprehensive care plan on their individual file. Residents confirmed that they been involved in the writing of their individual care plans. These were signed and dated by both resident and the assessor. Care plans included the dietary needs of each resident. Their likes and dislikes in respect of food. Social life opportunities had been discussed with each resident and their choices of activities recorded. There was a comprehensive risk assessment, which identified any potential risk to the resident in each care record. Where a risk had been identified the management of that risk was transferred onto their care plan. Care plans were being reviewed with the resident in line with National Guidelines. Waterloo House DS0000002470.V340687.R01.S.doc Version 5.2 Page 11 Three files of residents being case track all contained the health care needs of each resident. The assessments included nutrition and skincare. Records provided evidence of visits by community Healthcare visitors including general practitioners and district nurses. Chiropody and opticians services are provided. Residents confirmed that they are provided with eye, dental, and foot care. Quality assurance documents supplied by the care home substantiated that residents were happy with the health care services provided to them. Staff are trained by outside agencies in the administration and storage of medication. Medication records are being completed in accordance with the national guidelines. Drugs are being stored correctly. Staff and the registered manager stated that resident’s can self medicate if they wish and a risk assessment confirms this would be safe practice. Boots inspected the pharmacy systems on the 27th of March 2007 and 19th of June 2007. The report states that no problems were identified and all records were being kept to a good standard. The registered manager states in the Annual Quality Assurance Assessment (AQAA) that resident’s dignity and privacy is always respected. The staff induction and ongoing training stress the importance of ensuring outcomes and demonstrate that the privacy and dignity of residents is respected at all times. Residents spoken to at the site visit confirmed staff treat them with courtesy and respect. Observations made on the day supported the statement. A resident stated, “I feel that staff are really kind and considerate”. The evidence from the returned “have your say’’ documents sows that residents feel their dignity and privacy is being respected. Waterloo House DS0000002470.V340687.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14 &15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A range of activities are provided for residents which enables them to have an active and interesting social life. The home’s menu offer choices and meets the dietory needs of residents. EVIDENCE: The registered manager stated the choices the wishes of the residents regarding their social life are identified at the initial assessment. She described the range of activities, which are made available for residents to participate in. Residents are involved in the planning of activities. Daily games/activities are posted on the notice board and staff provide residents with the details of the activity of the day. Entertainers visit the home weekly. There are weekly keep fit sessions organised for residents. In the summer trips to places of interest are organised on a monthly basis using the community minibus. Residents are assisted to attend local religious services. Services are held in the home for those who had not able to go into the community. The registered manager supplied a copy of the menu, which demonstrated that choices are available. The Inspector had lunch with residents and comments Waterloo House DS0000002470.V340687.R01.S.doc Version 5.2 Page 13 from residents regarding the meal were all positive. A resident stated, “the food is excellent here you could not ask for better”. The inspector found the food to be well presented of good quality and sufficient in quantity. A question in the “have your say” documents which asked residents opinion of the food were all answered with positive comments. Waterloo House DS0000002470.V340687.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 &18 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents’ benefit from updated comprehensive complaints and adult protection procedures. Care workers have been trained to ensure residents are protected from any possible abuse. EVIDENCE: The home has a detailed up-to-date complaints procedure given to all residents and displayed in the care home. Discussion with residents and have your say documents provides evidence that residents know how to make a complaint. The home holds residents meeting on a regular basis where any concerns can be raised. The residents being case tracked confirmed that they were confident and comfortable in being able to raise any concerns with any member of staff or the registered manager. The Inspector had lunch with residents during which positive comments were made by all residents regarding the staff. One resident said, “It is wonderful here staff really do look after us”. A Second resident stated, “I feel very safe living at this care home”. Residents confirmed that they could talk to any member of the staff or manager if they are unhappy. Staff confirmed that they were aware of the home’s whistle blowing policy and stated that they use it if they have any concerns about care practice. The registered manager stated that all staff have been trained in the prevention and recognition of abuse. Staff confirmed Waterloo House DS0000002470.V340687.R01.S.doc Version 5.2 Page 15 that this statement is correct. There have been no complaints, concerns or investigations carried out since the last key inspection. Waterloo House DS0000002470.V340687.R01.S.doc Version 5.2 Page 16 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): Standards 19 7 26 Quality in this outcome area is Excellent. This judgement has been made using available evidence including a visit to this service. Residents live in a clean well maintained care home, which provides them with safe comfortable accommodation. EVIDENCE: The home has an ongoing maintenance program, which includes an improvement plan. Since the last inspection extensive work is being carried out on the hot water system to ensure safe temperatures are maintained. Carpets have been replaced in ground floor corridors. Bedrooms are decorated prior to any new resident moving into the room. Special equipment has been purchased for a terminal ill resident. The home was clean and tidy and free from any odour. The registered manager confirmed that the infection control policy of the care home was being followed. No health and safety issues were identified during the site visit. Staff stated that they were happy with the environment of the care home. Residents stated their satisfaction with the environment of the Waterloo House DS0000002470.V340687.R01.S.doc Version 5.2 Page 17 care home in the “have your say” document. There were no negative comments made by staff or residents regarding the environment. Waterloo House DS0000002470.V340687.R01.S.doc Version 5.2 Page 18 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): Standards 27,28,29 & 30 Quality in this outcome area is Excellent. This judgement has been made using available evidence including a visit to this service. Residents are supported by well-trained staff, who are recruited safely using the updated recruitment policy of the care home EVIDENCE: The registered manager stated that the recruitment policy of the home is being followed. The inspection of a sample of new staff’s files confirmed this statement to be correct. The personal files contained CRB, two written references and proof of identity for all new staff. There was evidence of an induction been provided to new staff. Residents stated there is always sufficient staff on duty to meet their needs. They said, “staff are sensitive and kind and “if I use my call bell someone will come to help me very quickly”. Staff confirmed that the staffing rota is always maintained. Staff said that they feel they are able to meet resident’s needs with the numbers of staff on duty. The home has a training programme which demonstrates that specialised training as well as essential core training is provided. Staff interviewed confirmed that training does take place and that the staff team are encouraged to take all training opportunities included NVQ training. Waterloo House DS0000002470.V340687.R01.S.doc Version 5.2 Page 19 The AQAA state that a 83 of staff are qualified to NVQ level 2 in care. In addition 53 of staff have obtained a NVQ3 qualification in care. All staff are taking part in NVQ training. Waterloo House DS0000002470.V340687.R01.S.doc Version 5.2 Page 20 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): Standards 31,33,35 7 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Leadership, guidance and direction are provided to staff to ensure that residents receive a good standard of care. Residents are happy with the service they receive EVIDENCE: The care home has a qualified registered manager in post. Staff stated the manager is supportive and committed to ensuring good care practice is maintained. She provides good leadership and found to be very approachable by staff and residents. The inspection of care records, discussion with staff provided evidence of good positive leadership and direction to all staff members. Residents stated they could go to her office at any time if they were concerned. The evidence from the quality assurance documents and discussions with residents who were Waterloo House DS0000002470.V340687.R01.S.doc Version 5.2 Page 21 being case tracked provided evidence that in their opinion residents feel the home is being run in their best interest. The registered manger demonstrated in discussions that the home has appropriate policies and procedures in place to protect the financial interests of residents. The registered manager said that supervision sessions and appraisals are being carried out appropriately. Staff concerned confirmed in formal interviews that supervision is being provided on a one-to-one basis in accordance with National Guidelines. Staff records demonstrated that supervision is being provided to staff No health and safety issues or infection control issues were identified during the site visit. The registered manager demonstrated, a detailed knowledge and understanding of the needs of people within the category of the home’s registration. Waterloo House DS0000002470.V340687.R01.S.doc Version 5.2 Page 22 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 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 Waterloo House DS0000002470.V340687.R01.S.doc Version 5.2 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Waterloo House DS0000002470.V340687.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 DS0000002470.V340687.R01.S.doc Version 5.2 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!