Inspection on 22/06/07 for Waterloo House

This inspection was carried out on 22nd June 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Waterloo House 01/08/08

Waterloo House 12/06/06

Waterloo House 29/11/05

Waterloo House 29/09/05

Waterloo House 23/11/04

Waterloo House 23/06/04

Similar services:

22 Sandown Road

The Highlands

Turret Villa Retirement Home

Dilston College Of Further Education

West View House

Moor House

Prince Bishop Court

Park View (15)

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

CARE HOMES FOR OLDER PEOPLE Waterloo House Waterloo Road Blyth Northumberland NE24 1BY Lead Inspector Carole McKay Key Unannounced Inspection 22nd June, 9th July 2007 09:30 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 DS0000000639.V338228.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 DS0000000639.V338228.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Waterloo House Address Waterloo Road Blyth Northumberland NE24 1BY 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) 01670 351992 01670 356328 Mr Sewa Singh Gill Mrs Brenda Nicholson Care Home 46 Category(ies) of Dementia - over 65 years of age (12), Learning registration, with number disability over 65 years of age (1), Old age, not of places falling within any other category (33) Waterloo House DS0000000639.V338228.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th June 2006 Brief Description of the Service: Waterloo House is a two storey adapted building. The home does not have gardens, though a small sitting out area is located near the front entrance to the home. Parking for a small number of cars is available at the front of the home within a general amenity area. The home is well located, in walking distance of the centre of Blyth. Bedrooms and communal areas are distributed across both floors and the office/reception area is immediately inside the main entrance hallway. The home has a large established staff team of ancillary, care, and senior care staff plus one manager Waterloo House is registered to care for older people and people with dementia who are also over 65. Fees for the home range from £356.30 to £361.24. Hairdressing, newspapers, taxis and private chiropody are charged for separately. This information was given on the 4th July 2006. Waterloo House DS0000000639.V338228.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The manager of the home provided the inspector with written information. This was used to help plan the inspection. Ten surveys were sent out to people living at the home and to relatives and other representatives of service users. One survey was returned from service users. Two relatives surveys were returned. Three relatives spoke to the inspector. The home was visited on three occasions. Three staff and four service users were spoken with. What the service does well: What has improved since the last inspection? Waterloo House DS0000000639.V338228.R01.S.doc Version 5.2 Page 6 An attractive easy read version of the service user guide has been produced. Copies are available in the home, so that people can make an informed decision about living there. The people who live at the service now have a choice of bath or shower. Service user surveys have been introduced. These have given the people who live at the home a chance to voice their opinions about the service. More staff are now employed. This means that service users can get out more and can have one to one social support more often. The staff team have worked well with an outside agency. This means that the staff are better able to support very vulnerable service users. What they could do better: The manager should keep more up to date with good practice guidance to do with health care for older people. So that new tools for assessing and delivering care are introduced promptly. This will make sure that the good health of service users is promoted at all times. The presentation and maintenance of the building must be given higher priority. Money must be more wisely spent so that the building is easier to keep clean, easier to maintain and more pleasing for service users, staff and visitors to use. Communal areas could be used more imaginatively. This will give service users more choice and demonstrate that service users and staff are valued. Bed making and laundry arrangements must be overseen so that damaged, soiled and worn linens are replaced promptly and service users receive only their own clothes. This will ensure the dignity of service users. Record keeping to do with staff recruitment must be better, so that the service can demonstrate that it protects service users’ interests. Staff must be supported through formal supervision so that they can confidently develop their caring skills. This will be important in supporting service users as they become more dependent. Waterloo House DS0000000639.V338228.R01.S.doc Version 5.2 Page 7 Hold more regular meetings with service users and their representatives, so that the people who use the service can contribute their ideas forg future plans and improvements. 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 DS0000000639.V338228.R01.S.doc Version 5.2 Page 8 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 DS0000000639.V338228.R01.S.doc Version 5.2 Page 9 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): 1,3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information is available so that people can make an informed decision about living at the home. Service users have their needs assessed before they come to live at the home and during the first few weeks of living there, so that they can expect staff to understand their needs. The home does not provide intermediate care. EVIDENCE: Since the last inspection the information available to people whom use the service has been updated. This is now much easier to read and eye catching. The manager said that the new version of the Service User Guide had been issued to each service user. Copies are available in the home for prospective service users to take away with them. Waterloo House DS0000000639.V338228.R01.S.doc Version 5.2 Page 10 Service users’ files contain assessments. Care managers have provided these and the home has its own assessment for new service users. An assessment is carried out before and during the admission period. The home’s assessment is thorough and covers all aspects of dependency and well-being. Several service users have been admitted since the last inspection. One person was recently admitted. This person’s needs had been assessed by a care manager and by the home. A service user plan was in place. This identifies the risks to safety and the immediate physical needs of the person as well as their social and emotional needs. Waterloo House DS0000000639.V338228.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users will have their health needs monitored and addressed. The most up to date guidance is available but not yet in use in the home. Service users can expect better heath promotion in the future. The medication arrangements make sure service users are safe. EVIDENCE: The service user plans are comprehensive and very clearly written out. The actions staff are expected to take to deliver care are clearly described. For example, where a service user neglects to self-care, the plan describes how the staff should support the person with this. Routine health checks are arranged and recorded. Some good practice to do with preventative health care is recorded. For example, following admission it is practice that a person’s food intake is monitored for the first two weeks. But some of these were out of date. People Waterloo House DS0000000639.V338228.R01.S.doc Version 5.2 Page 12 who live at the service have an opportunity to be weighed each month. Records are kept so that staff can monitor weight gain or loss. The home uses a tool for scoring how at risk a person is for poor nutrition, but where the risk is scored as significant there is nothing on the tool to indicate what action should be taken. The manager of the home has obtained a new up to date tool for promoting good nutrition in older people. This is not in use yet. The home uses a falls risk assessment and this also produces a risk score. This is followed through in the service user plan as an indication that the person is at risk of falls. Action to minimise risk is described. The tool does not indicate the kind of action that should be taken. Some of the staff have attended falls awareness training recently. From this, new assessments have been obtained. The manager said that she would be introducing these in the near future. The home uses a pressure sore risk assessment. Senior staff carry this out and refer to a community nurse where the score indicates that this should happen. The input of the nurse is described in the service user plan. The manager of the home is not aware of recent guidance to do with area of care. But there is information and guidance in the home to do with pressure area care and prevention. Routine health checks are recorded clearly. Sensory loss is also clearly described in service user plans. Care plans are devised for a person who is registered blind to support this person in moving around independently. Adaptations are used so that people can maintain independence at mealtimes, such as special plates and cutlery. There is evidence that staff have received training in low vision. There is evidence in care files that the staff make sure that appointments for health checks are made and followed through. Such as, attendance at hearing aid clinics. The manager has identified that the service could do more to promote physical activity and exercise. The home makes use of outside agencies for support with special needs of service users. For example the County Blind Association is involved and a local specialised team for people who challenge services. The senior staff reported that they found this service very helpful. The input has had good results for the care of this service user. All relatives that were spoken to commented on how very caring, welcoming and helpful the staff are. The senior staff oversees the storage and administration of medication. One staff takes responsibility for ordering and returning medications and keeping in touch with the pharmacist. There are no unusually high stocks of medication. Waterloo House DS0000000639.V338228.R01.S.doc Version 5.2 Page 13 And no out of date medication, other than that awaiting disposal. The medication is securely stored and records are up to date and well maintained. The medication administration records do not have a means of identifying the service users. Some people at the home may not be able to give their name. Photographs of service users are held on the service user plan, but not on the medication record. These records are held in separate places. The home does not have a designated treatment room. This means that the storage area is rather cramped. However it is kept tidy and free from clutter. There is no hand washing facility in the room where medication is stored, but the manager said that the staff procedures include the use of anti bacterial hand gel. Waterloo House DS0000000639.V338228.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home meets service users’ social needs and expectations. It supports service users to maintain contact with friends and family. Independence and choice is encouraged. Some organised small group activity has stopped since the last inspection. This leaves the more dependent people, who do not get out so often, with fewer opportunities. The home offers flexible mealtimes and these are valued as part of service users’ health and social well-being. Support with social contact and relationships is given in a sensitive manner EVIDENCE: People who use this service are nearly all local people from Blyth or Cramlington and the surrounding area. The home receives a high level of visitors. All of whom are greeted in a friendly manner and asked to sign the visitors’ book. The home has a relaxed and friendly atmosphere. Service users said that they could get up when they want to and can spend their time where they prefer. For some people this is in the main lounge, for others this in their own room. Waterloo House DS0000000639.V338228.R01.S.doc Version 5.2 Page 15 The smaller, quieter lounges get very little use, apart from when the hairdresser visits. The home has various communal areas on both floors, but most of it is under used. Most people use the main lounge on the ground floor, or the dining room. A relative of one of the service users told the inspector that this can sometimes mean that there is nowhere for people to sit when visiting, especially at weekends. During one of the visits two of the smaller lounges and first floor dining room were not being used at all. Brenda, the manager, confirmed that these areas had fallen out of use lately. The records to do with the care of the people who live at the home are kept in the dining room, in a lockable cabinet. There is no room for these in the office. The staff need to be able to get to these records easily, but using a communal area for this makes it difficult to maintain confidentiality. The home has a visitors’ book and there is evidence that it receives a high level of visitors. People call through the day, in the evenings and at weekends. The visitors who called during the inspection were made welcome by the staff and the manager. Refreshments and meals are offered. A regular craft group activity has unfortunately come to an end, due to loss of community funding. The care staff organise social activities in the afternoons, but not all of the service users are able to participate in these. Brenda Nicholson said that she plans to employ an activities organiser. The care files identify the social interests and hobbies of individual service users, but social activity, at an individual level, is not clearly planned. The manager, Brenda has identified a need to improve in this area. This is particularly important for people who have dementia. Better use could be made of the communal areas for this purpose. Service users are supported to go out of the home. During the site visit one to one support was provided to two service users so that they could go to the local shops. A relative commented on how friendly and willing the staff are to support visitors and service users in getting out of the home together. Brief outings into Blyth are everyday occurrences and were observed during the visits to the service. A hairdresser visits the home two days each week. There is evidence that seasonal open days and outings have been organised in the past. The staff described the arrangements for this year’s summer outing and said that these were popular with the people who live at Waterloo House. Meetings with relatives and the people who live at the service take place informally, rather than in a regularly organised way. The manager has identified that this is an area for improvement in the future. Waterloo House DS0000000639.V338228.R01.S.doc Version 5.2 Page 16 The menus at the home offer a good choice and are varied. Relatives and service users were full of praise for the meals. One relative commented on how flexible the home is with the timing of meals, where service users can take a meal and in offering alternatives to the menu. Waterloo House DS0000000639.V338228.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information is available to service users about how to complain. Surveys have been introduced for service users to make their opinions known about the service. The service has good procedures for the protection of service users and will implement these when necessary. Staff will act to raise concerns about the safety of service users. This means that service users interests will be protected. EVIDENCE: The home has procedures for equality and diversity, anti bullying and harassment. The service has a clear complaints procedure and record. The procedure is openly displayed and Brenda prides herself on having an ‘ open door’ policy. No complaints have been entered in the record since December 2003. The Commission for Social Care Inspection has received no complaints since the last inspection. The home has policies and procedures for safeguarding vulnerable adults. These are written down and are included in the introductory staff training. The procedures encourage staff to ‘whistle blow’ on bad practice. There is evidence Waterloo House DS0000000639.V338228.R01.S.doc Version 5.2 Page 18 that staff will use these procedures to protect service users from abuse. The manager has responded appropriately to recent concerns. Where necessary staff disciplinary procedures have been invoked to protect service users where there has been any doubt or suspicion about staff conduct. One person has been dismissed since the last inspection. Waterloo House DS0000000639.V338228.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,26 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The service manager and service users have identified that the premises let the service down. The building is maintained to a safe level, but is poorly serviced and presented. This means that the service continually gives a poor immediate impression and this detracts from the comfort and dignity of service users. EVIDENCE: The manager, Brenda Nicholson, has a maintenance plan for the home. The action plan does not keep pace with the wear and tear on the premises. Where repair and refurbishment is required, Brenda said that the funding is too slow in coming. Also some work has had to be re done due to poor workmanship. For example the shower room was taken out of use for several months until remedial work was arranged and funded. Waterloo House DS0000000639.V338228.R01.S.doc Version 5.2 Page 20 The home has several areas for communal use, but most people use the main lounge on the ground floor. The other sitting/dining areas have poor quality furniture, old carpets and the décor is worn and grubby in places. One of these rooms was previously a smoking area and shows signs of nicotine staining. The main lounge on the ground floor is very popular with service users. And so is the main dining room. The alternative lounges and dining areas are under used. A relative commented that at weekends, during visiting, it is very difficult to get a seat in the main lounge. The main corridors were repainted last year, but these are already showing signs of wear. The white paintwork is badly chipped, exposing the darker paintwork beneath. This is especially noticeable on the handrails around the home and the doorjambs. Giving a poor presentation throughout the building. There is damage to the door of a bedroom 16 on the first floor. Doors to toilets on the ground floor are also damaged with gouges in the paintwork and marks on the floors from wheelchairs scuffing against them. The bathrooms are due to be redecorated and one of these has damage to the plasterwork and paintwork. The skirting in the staff toilet is coming away from the wall. In surveys a relative described the home as ‘shabby’. Since the last inspection the home has started using an infection control audit tool and one of the care staff acts as an infection control link worker. This means that this person is up to date with current guidance and training in infection control. The cleaning staff do well under difficult circumstances. The home was clean on the day of the visit. There were no bad odours detected. The cleaning staff described their work schedule and how they prioritise their work. Attention is given to the management of odour and where necessary carpets are regularly washed. Most of the bathrooms and en suites do not have easy clean wall finishes. New carpets have been laid in two of the bedrooms. Two rooms have been redecorated and the home now has a shower room. The home lacks storage space. Incontinence aids, when not in use, are stored in open view in bedrooms. A tank room is used as an alternative store, but the shelves have been removed to access the tank and these have not been replaced. The representatives of one of the service users said that the home provides poor quality bedding and linens and as a result they have decided to provide this themselves for their relative. Bed linens were examined as part of the inspection visit. The quality of these varies. The manager has recently replaced some of the bed linen. But there are sheets and duvet covers in use that are Waterloo House DS0000000639.V338228.R01.S.doc Version 5.2 Page 21 very worn and thin and one valance sheet was torn. Some of the beds and mattresses are in good condition but others are worn, lumpy and stained. There are some problems with laundry systems. A relative said that his Mother often gets the wrong clothes returned to her. One of the rooms was unoccupied because the service user had been admitted to hospital in an emergency. Soiled sheets had been left on the bed. The manager said that she felt that this oversight was due to the circumstances of this person’s discharge to hospital. The staff do what they can to keep the main entrance as inviting as possible. Repairs and repainting has been carried out by the handyman to the railings and to the outdoor seating. The ramp leading to the front door has attractive container plants growing there. Externally the home has little amenity area. There is no garden. There are two flowerbeds at the main entrance with large mature trees growing in them. The home does not have a regular gardener, but the handyman keeps the beds tidy. These could be cultivated to better effect. There is a raised patio area. The manager has recently obtained some garden furniture for this so that the people who live at the service can sit out here. It has the advantage of being located away from the utility and main bin store area but houses overlook it across the street. The patio has no attractive features. The bin store is not screened from view and it is one of the things a visitor first sees on approaching the home. On one of the visits three items of broken furniture were left here awaiting collection. This is a matter outstanding from previous inspections. Waterloo House DS0000000639.V338228.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff turnover is low and staffing levels have kept pace with the increasing dependency of service users. This means that the service users can continue to rely on staff being available to support them with their individual needs and to get out and about regularly. Staff recruitment processes and training keep service user safe from harm, but the records of this are not very well kept. The staff have opportunities for special training so that they understand how best to care for service users who have special needs such as dementia. EVIDENCE: Staffing levels have always been good at Waterloo House and these have increased since the last inspection. Now the home has six staff on duty throughout the day, Monday to Friday, and five at weekends and during the night. Nineteen care staff are employed. Staff turnover has returned to a low level since the last inspection. Two staff have left. The duty rotas are organised so the staffing levels are concentrated around the care needs of service users. Where it is possible extra hours are provided to cover for service users’ appointments. Senior staff are on duty at each shift. Waterloo House DS0000000639.V338228.R01.S.doc Version 5.2 Page 23 The manager said that she has plans to employ an activities organiser. This will make up for losing a community based activity organiser, who visited the home weekly. The home has a contract with a training provider for induction and all mandatory training and refresher training. This is provided through an ongoing programme The files show that staff receive introductory training as well as ongoing updates to the essential training they need to carry out their work. The manager has identified that she needs to detail the induction training more clearly in the records. Eleven care staff hold a national vocational qualification (NVQ) level 2 or above. Five care staff are working toward this qualification. All of the senior staff and most of the care staff carried out a three-month training event in positive caring for people with dementia in 2006. Most of the staff have attended a course in Equality and Diversity. Other training includes challenging behaviour, and mental health. A small group of staff are receiving training and support from a specialist in managing challenging behaviour. This person is based at a local hospital and is visiting the home at least once per week to help them provide specialised support to one of the people living at the home. New staff have been recruited since the last inspection. The recruitment process has improved in parts, but staff files are not very well organised. Some have loose papers and not all have file dividers. So information can be difficult to find and can get lost. Staff files contain application forms, references and criminal record bureau checks. The procedures for making sure that the most relevant references and checks are received on time are not working. One volunteer has been recruited with one written reference. There are some gaps and irregularity in some of the employment history on application forms. There is no written evidence that these have been followed up. The application form is now out of date and does not take account of equality and diversity matters. Waterloo House DS0000000639.V338228.R01.S.doc Version 5.2 Page 24 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The management arrangements keep service users safe. People living at the service are being consulted about how well the service is doing. Areas for improvement are identified but these take too long to be addressed. Some quality issues go overlooked and this detracts from the dignity of service users. Staff do not receive formal supervision. EVIDENCE: The manager, Brenda Nicholson, and the senior team lead the service. The seniors deputise for Brenda in her absence and carry delegated duties to do with recruitment, training, medication, delivery of care and contact with families and other professionals. Service users and their representatives speak highly of these staff by name. Waterloo House DS0000000639.V338228.R01.S.doc Version 5.2 Page 25 The Manager, Brenda Nicholson, has been employed at the home for several years. Brenda has undertaken The Registered Managers’ Award. In the past year Brenda has undertaken one training course in equality and diversity. Recently Brenda has begun a quality assurance process for the home. Surveys have been given out to service users. Brenda said that these identify that the home needs to improve activity and the premises. The provider delegates his monthly visits to his representatives. Brenda has developed positive working relationships with these people. Reports are produced from these visits. These identify service users’ and staff opinions, as well as areas for improvement. The service produces written action plans also. None of the staff, including seniors, receive regular recorded formal supervision. The manager has produced a supervision record but has not implemented this process. Brenda said that she feels she needs support with the administration of this and other processes. The home does not have any information technology. Service users are encouraged to keep control of their own monies, with the assistance of the home, when necessary, for the safe keeping of cash. Good procedures are in place for supporting people to use their money as they wish but at the same time, safeguarding their interests. Service users who prefer to have money held for them know how their money is looked after and how they can access it. The home has contracts for routine safety checks of electrical appliances, gas appliances, fire and lifting equipment. These are up to date and the certificates are available. The Manager has organised for the handyman to have up dated competent person fire training. The handyman provides instruction to staff and fire safety checks of the building. A record is kept of these. Risk assessments are carried for the building and for use of hazardous substances. These are recorded and up dated. Staff receive First Aid, Food Hygiene and Moving and Handling training with updates. This is part of an on going training programme through a training organisation. Waterloo House DS0000000639.V338228.R01.S.doc Version 5.2 Page 26 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 3 x 3 x x N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 2 x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x 3 2 x 3 Waterloo House DS0000000639.V338228.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? Yes 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 OP19 Regulation 23(2)(o) Requirement The registered person must arrange for improvements to screen the bin store area. This is outstanding, original timescale 30/09/06 and 31/12/06 not met. 2. OP8 12,13 The registered manager must introduce up to date methods for assessment and promotion of good nutrition, in line with current guidance. The registered manager must introduce up to date methods of assessing the risk and prevention of falls, in line with current guidance. The registered manager must introduce up to date methods of assessing the risk and prevention of pressure sores, in line with current guidance. The registered manager must introduce new activities and opportunities for exercise for service users. The registered manager must ensure that people who use the DS0000000639.V338228.R01.S.doc Timescale for action 30/09/07 31/10/07 3. OP8 12,13 31/10/07 4. OP8 12,13 31/10/07 5. OP8 12,13 31/10/07 6. OP10 12 31/10/07 Waterloo House Version 5.2 Page 28 7. OP12 OP19 8. OP19 9. OP19 service always receive their own clothes and the service user plans are stored away from the communal areas of the home must preserve the dignity and privacy of service users. 12, 16, 23 Better use to be made of the communal areas. More choice in social activity in the home to be offered to service users. 23 The door to room 16 must be replaced. The skirting board in the staff toilet must be replaced. The walls in the bathroom must be repaired and this room to be redecorated. The second bathroom must be redecorated. The walls, and doors in the ground floor toilets must be repaired and re painted 23 The doors, doorjambs and handrails in the main corridors must be repaired and re painted. 16(1)(c ) 23 The registered manager must replace all worn and damaged beds, mattresses and bed linen. The first floor dining room, first floor sitting room and ground floor sitting room must be redecorated. Worn and damaged furniture and carpets must be replaced. The registered manager must undertake training in good recruitment practice. Staff files must be kept in good order. The employment application form must be updated. The registered person must provide the manager with support with administration. The registered manager must provide formal supervision to staff at least six times per year. DS0000000639.V338228.R01.S.doc 31/12/07 31/10/07 31/10/07 10. 11. OP19 OP19 31/10/07 30/11/07 12. OP29 10,19 31/12/07 13. 14. OP31 18 18 30/04/08 30/04/08 OP36 Waterloo House Version 5.2 Page 29 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 OP12 Good Practice Recommendations The Registered Manager should identify suitable social activity for people who are isolated by their dementia. 2. 3. OP9 OP20 Photographs of service users should be kept on the MAR sheets, with permission of service users. Improve the landscaping to the flower beds and improve the patio by use of planters and some screening. Waterloo House DS0000000639.V338228.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 DS0000000639.V338228.R01.S.doc Version 5.2 Page 31 - 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!