Inspection on 30/10/07 for Waterloo House

This inspection was carried out on 30th October 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Waterloo House 05/12/06

Waterloo House 25/01/06

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

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

CARE HOME ADULTS 18-65 Waterloo House, Stoke 3 Nelson Gardens Stoke Plymouth Devon PL1 5RH Lead Inspector Kim Fowler Unannounced Inspection 30th October 2007 9:10 Waterloo House, Stoke DS0000066199.V349812.R01.S.doc Version 5.2 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, Stoke DS0000066199.V349812.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Waterloo House, Stoke DS0000066199.V349812.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Waterloo House, Stoke Address 3 Nelson Gardens Stoke Plymouth Devon PL1 5RH 01752 567199 01752 567199 waterloocare@tiscali.co.uk 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) Vivacare Limited Vacancy Care Home 20 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (20), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (20) Waterloo House, Stoke DS0000066199.V349812.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service must only accommodate service users over the age of 30 Date of last inspection 5th December 2006 Brief Description of the Service: The care home was purchased by Vivacare Ltd on 19/12/05. The home is a large terraced building, approximately 150 years old, on a small private road close to Stoke village in central Plymouth. A full range of amenities and facilities are within walking distance of the home. The home can accommodate up to twenty residents over three floors. There are two communal bathrooms and two communal shower rooms. There is a shaft lift providing access to the first and second floors. There is a large lounge to the rear of the building on the ground floor and this opens through patio doors onto a large enclosed garden. A further lounge room is provided on the first floor for residents who wish to smoke. There is only one shared bedroom in the home all the others being single bedrooms. Due to the age of the building all the rooms have high ceilings which help the rooms and the home in general to feel spacious. The service offered by the home is primarily for people with long standing mental health issues of various types. The residents group has a mixed range of abilities from highly independent to more significantly disabled. The Fee’s start at £560. Waterloo House, Stoke DS0000066199.V349812.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over 1 day and started at 9.10am and finished at 3.15pm. The manager Mrs Cheryl Broom was available throughout the inspection. The inspector made a tour of the building and spoke to most of the people living at the home. Documentation relating to the care planning process and the management of the home were examined. All the people living at the home and four staff members were spoken with and any comments are discussed in the relevant section of the report. What the service does well: What has improved since the last inspection? What they could do better: A manager who is Registered with the Commission would ensure the home is managed for the best interest of the people living at the home and staff. Thus providing the home with a manager who is qualified and experienced to run the home. Waterloo House, Stoke DS0000066199.V349812.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, Stoke DS0000066199.V349812.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Waterloo House, Stoke DS0000066199.V349812.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2/4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The completion of pre-admission assessments ensures that any prospective resident’s needs are known prior to admission. EVIDENCE: The files examined showed that all previous admission to the home had a preadmission assessment completed providing evidence that people admitted to the home had been fully assessed prior to admission. The placing authority’s Care Plan supports these assessments. This ensured that the care staff were aware of people’s needs and the home is suitable and appropriate to met individual needs. Before admission people are invited to visit the home and stay for a few days before making decisions about moving into the home. Two of the people currently living at the home said they had visited and one stayed overnight before deciding to move in. Waterloo House, Stoke DS0000066199.V349812.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6/7/9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home are encouraged and supported to make decisions about their own lives to maintain their independence. EVIDENCE: The care plans examined showed detailed descriptions of each persons needs. Each care plan is comprehensive and supported by an additional file for staff to access. This file contains a weekly spreadsheet for staff to complete and details everyday activities undertaken by the staff including weight chart, diet and medication. All medical and family visits are also recorded. The manager stated that she talks through each section of the care plan with individual were possible and several care plans held signature from individuals. All people living at the home are encouraged to make everyday decisions about their own lives. Observation during the inspection showed individuals discussing with staff about going out to the local shops and another person discussion getting a local bus to visit friends. Waterloo House, Stoke DS0000066199.V349812.R01.S.doc Version 5.2 Page 10 One care plan showed that the home had involved the CPN (Community Psychiatric Nurse) and a Solicitor to assist them and the person living at the with a Guardianship order. The manager and staff stated that many people living at the home make their own decisions about what they do and when and have staff support were needed. This information is recorded into individual files. Risk Assessments are in place and held on each file and these risk assessments includes one person who has a kettle in their bedroom and others when people access the community. The inspector spoke to most of the people living at the home and those able to comment directly about their experiences of living at Waterloo House said that they were very well cared for and comments received included, “I love it here” and another “The staff here now are very nice”. Observed during the inspection were staff treating people respectfully and interacting well with each other. Waterloo House, Stoke DS0000066199.V349812.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12/13/15/16/17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home can be confident that the home will provide support for them to access the local community and many leisure activities. This promotes the their independence. EVIDENCE: Many of the people living at the home were observed coming and going freely from the home and the home has introduced a book for people to sign in and out. This ensures the care staff are aware of peoples whereabouts. Some people stated that they are assisted by the staff and are enabled to do things they are interested in including going to the shops, pubs and the local park. Some people spoken to preferred to spend time away from the communal areas and this was respected. Waterloo House, Stoke DS0000066199.V349812.R01.S.doc Version 5.2 Page 12 Two people were observed going out to a local club and one informed the inspector that he goes to this club regularly and a taxi is arranged to take him their. One person informed the inspector that they were going to the local shops and another was catching a bus to a shopping centre on the other side of town. Evidence was recorded that some people have family and friends visiting. This information was recorded into individuals care plans and weekly spread sheets. One person stated, “I go to the local café and met my friends their”. Many of the people living at the home have keys to their own bedrooms and some are unable to hold a key to their rooms. This information was not recorded and the inspector recommended that this information be recorded into individual files. The staff were observed interacting with each other and people were coming and going freely throughout the home. A cook is employed and was observed baking fresh cakes and a home cooked meal for lunchtime. A 4 weekly menu was displayed and the meal served today was a choice of sausages or beef burgers with mash potatoes and vegetables. The meal served was freshly prepared and cooked and was well presented and the menu showed a varied choice was offered. The cook and several people living at the home said there was always another choice if required and drinks are available throughout the day. All people spoken with about the food made positive comments included, “I really like the food”, and “ I can have what I want” and the “food is very good and I can have tea and coffee whenever I want”. Waterloo House, Stoke DS0000066199.V349812.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18/19/20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home health, personal and social care needs are being met and people are treated respectfully. EVIDENCE: Everyone currently living at the home has his or her own bedroom and all personal care is carried out private. All personal support is clearly recorded and a file is accessible for staff to show the level of care required to meet individual needs. Several people spoken with were able to confirm that the staff provides good personal care. Most agreed that the staff provide all personal care in private and promote their dignity and privacy at all times and some people were able to state that they were able to chose which staff work with them. Most people were able to say that they are able to make choices about what time they go to bed and get up in the morning. All care plans have recorded medical and professional visits and information given by the manager showed the input of medical support being received by people living in the home. This information noted the input of Community Waterloo House, Stoke DS0000066199.V349812.R01.S.doc Version 5.2 Page 14 Psychiatric Nurses, Psychiatric consultants, dieticians, the incontinence service, speech and language therapists, district nursing and GPs. The home uses the Blister pack system for medication and a local chemist is used to assist with staff training. Medication is stored safely, records are well maintained and those staff with responsibility for medication administration has received training from the local pharmacist ensuring they have knowledge of safe medication practices. Recorded into the homes diary was a date for two staff to attend medication training next week. However medication dispensed at breakfast was not signed until 11.45 am. The inspector recommended that medication be signed for immediately by one of the two staff carrying out this procedure. Waterloo House, Stoke DS0000066199.V349812.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22/23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The welfare of the people living at the Waterloo is protected through the proper management of concerns and complaints and thorough adult protection procedures. EVIDENCE: The manager has not received any complaints recently and one old verbal complaint had been recorded and included the action, outcomes and timescale of this resolved complaint. The homes complaints procedure is displayed in the main entrance and a copy is available in the homes Service Users Guide. Most of the people spoken with confirmed that they were aware of the homes complaints procedure and that they would approach the management or staff of the home if they had any complaints or concerns. Several also stated that they would have confidence that the management and staff would deal with a complaint. The home currently has four staff members suspended and these staff are under investigation by the Devon Adult Protection team and this investigation remains open. It was clear from the information recorded about this Adult Protection alert that the home is managing the situation well. Waterloo House, Stoke DS0000066199.V349812.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24/30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living at Waterloo benefit from a homely, comfortable, clean home that is currently being upgraded and adapted to meet their needs. EVIDENCE: The home was found to be clean and tidy and the communal areas and bedrooms are comfortable and pleasantly decorated. At the time of the inspection a vacant bedroom on the first floor was being decorated and all communal areas have been decorated since the last inspection. The home is due to receive new carpets in all the communal areas, the main hallway and two bedrooms. Thus indicating the Registered Provider’s commitment to ensure the home is well maintained. A separate lounge room is provided for people who wish to smoke. Waterloo House, Stoke DS0000066199.V349812.R01.S.doc Version 5.2 Page 17 All bedrooms have been personalised and decorated to different degrees. The manager and handyman employed stated that all the baths and sinks have been fitted with temperature control valves. These valves prevent the hot water temperature at hot taps becoming too hot reducing the risk of scalds. The manager also stated that new window restrictors had been ordered after a mix up over a previous order and this currently leaves some window without restrictors in place at present. The manager also said that two door need replacing and these are also on order. One person living at the home commented that the owners are “doing a lot of work around the home”. Waterloo House, Stoke DS0000066199.V349812.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32/33/34/35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home are supported by well-motivated and caring staff in sufficient numbers to meet the needs of those currently living at the home. Staff training and supervision are carried out regularly to all staff to ensure that all assessed needs of the people living at the home are met. EVIDENCE: The people living at the home that were able to stated that the home has sufficient staff on duty and the staff members interviewed agreed this. Some of the people living at the home confirmed that staff are available when they call and at times extra staff are made available when trips out are organised. The homes care staff are supported by a number of ancillary staff including cooks, cleaners and a handyman. Most staff currently employed holds an NVQ certificate and several new staff members are due to commence this training. One staff member confirmed they had started their NVQ training recently. Waterloo House, Stoke DS0000066199.V349812.R01.S.doc Version 5.2 Page 19 Other training has been put on hold due to staff shortages and the new manager only being in post 6 months. However some training has been booked in the coming months and includes medication and Infection control training. Examination of staff files showed that all had the required pre-employment checks, including CRB (Criminal Record Bureau Disclosure) in place ensuring as far as possible unsuitable staff are not employed. The supervision records provided evidence that this is carried out regularly and the staff spoken with confirmed they receive regular supervision from the manager. The staff members on duty were spoken with and one staff member had started their induction on the day of the inspection. This staff member confirmed that they were shadowing experienced staff members. The people living at the home spoken highly of the staff currently working in the home and comments included, “They are lovely”, “Alright, some are very nice” and “The staff treat me lovely”. Waterloo House, Stoke DS0000066199.V349812.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37/39/42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Waterloo House would benefit from having a manager Registered with the Commission to ensure the home is managed for the best outcomes for the people who live their. EVIDENCE: The manager, Mrs Cheryl Broom, has been employed at the home for 6 months but is not Registered or started the Registration process with the Commission. Mrs Broom holds a degree in Health and Social Care and continues with her own professional development and has an Infection control course booked to attend. Waterloo House, Stoke DS0000066199.V349812.R01.S.doc Version 5.2 Page 21 Most of the staff and people living at the home spoken with spoke highly of Mrs Broom and found her friendly, approachable and professional. One staff member said of Mrs Broom, “she is brilliant”. The manager stated that any Quality Assurance issues are raised at the regular meeting arranged for people living in the home. A number of quality assurance forms had been completed based on staffing issues and the manager plans to carry out a full quality assurance survey in the near future. The owner of Waterloo has delegated a family member to visit the home regularly to meet with people living there and discuss the care they receive then provide feedback to the home via the owner. One person living at the home stated that the manager comes in “for one to one talks”. Sampling of servicing records indicated that most equipment is serviced regularly and maintained in good working order, including the fire alarm system. Certificates were available on all Health and Safety equipment i.e. hoist ensuring all have been checked. Electrical appliances were being routinely serviced and checked. The fire protection system was well maintained. Maintenance checks are being carried out by the home handyman. Staff are receiving appropriate fire protection training to ensure they have the skills to deal with emergencies. However no certificate to confirm that the Gas boiler system had been serviced had been found. The manager contacted the Commission the day after the inspection to confirm that this had not been carried out and the manager would arrange the serviceing of the Gas appliances as soon as possible. Good health and safety practices reduce any unreasonable risk, affecting people living at the home, to an acceptable level. Waterloo House, Stoke DS0000066199.V349812.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 Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X 3 X Waterloo House, Stoke DS0000066199.V349812.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. 1. Standard YA37 Regulation 8 Requirement The home must recruit a manager who is Registered by the Commission. This would ensure the home is managed for the best outcomes of the service users Timescale for action 31/12/07 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 2 Refer to Standard YA42 YA20 Good Practice Recommendations The Gas boiler should be serviced and maintained regularly. Medication should be signed for immediately after dispensing. Waterloo House, Stoke DS0000066199.V349812.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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, Stoke DS0000066199.V349812.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!