Inspection on 18/04/05 for Evelyn Wright House

This inspection was carried out on 18th April 2005.

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 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

Evelyn Wright House 23/11/06

Evelyn Wright House 01/12/05

Evelyn Wright House 27/01/05

Evelyn Wright House 12/08/04

Evelyn Wright House 26/02/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE EVELYN WRIGHT HOUSE 32 Badby Road Daventry Northants NN11 4AP Lead Inspector Pat Harte Unannounced 18th April 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. EVELYN WRIGHT HOUSE C51 S34870 Evelyn Wright House V217166 180405 stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Evelyn Wright House Address 32 Badby Road Daventry Northampton NN11 4AP 01327 703140 01327 312775 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Philip Jones, Northants County Council, Oxford House, West Villa Road,Wellingborough, Northants NN8 4JR Mrs Sharon Towers CRH 29 Category(ies) of OP - Old Age - 29 places registration, with number PD(E) - Physical Disablility over 65yrs - 4 places of places DE(E) - Dementia over 65yrs - 11 places EVELYN WRIGHT HOUSE C51 S34870 Evelyn Wright House V217166 180405 stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: No person falling within the category OP can be admitted where there are already 29 persons of category OP already in the home. No person falling within the category DE(E) can be admitted where there are 11 persons of category DE(E) already in the home No person falling within the category PD(E) can be admitted where there are 4 persons of category PD(E) already in the home To be able to continue to accommodate the named person of category MD(E) who was accommodated in the home prior to registration in 2002 Total number of service users in the home must not exceed 29 Date of last inspection 27th January 2005 Brief Description of the Service: Evelyn Wright House is owned by Northants County Council. The Manager is Mrs. S. Towers. The Home provides personal care, without nursing, for older people over the age of 65 years, including up to 4 people who have a Physical Disability and up to 11 People who may have a diagnosed Dementia. The Home is situated close to the town centre of Daventry and there is easy access to a range of community services and facilities. The premises provide ground floor accomodattion for all Residents with single bedrooms. There are a variety of communal lounges and Residents have access to graden areas. EVELYN WRIGHT HOUSE C51 S34870 Evelyn Wright House V217166 180405 stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for Service Users and their views of the service provided. The primary method of inspection used was ‘case tracking’ which involved selecting 3 Residents and tracking the care they receive through review of their records, discussion with them, the care staff and observation of care practices. 6 staff, 10 Residents and two visiting Relatives were spoken with. Positive written comments were also received from 26 Residents and 13 Relatives. A partial tour of the premises took place and a selection of records was inspected. The Inspection took place during the late morning and afternoon over a period of 5 hours and was carried out on an unannounced basis What the service does well: What has improved since the last inspection? What they could do better: Care planning for Residents must be improved to ensure that staff know what to do for each Resident and how to support them. The Medication Administration practice must be improved to ensure medication cabinets are locked at all times when unattended by staff. EVELYN WRIGHT HOUSE C51 S34870 Evelyn Wright House V217166 180405 stage 4.doc Version 1.20 Page 6 Consideration must be given to the layout of the building to ensure that Residents with Physical Disabilities can easily access the appropriate toilets and Residents with Dementia are appropriately supervised and monitored. Bathing facilities must be improved for Residents dependent on the use of a hoist. Garden areas must be made secure and safe. Staffing levels must be improved to ensure the needs of Residents are met in full. The activities programme must be improved especially for Residents with Dementia. The testing of the Home’s Fire systems must be improved to ensure weekly testing. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. EVELYN WRIGHT HOUSE C51 S34870 Evelyn Wright House V217166 180405 stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection EVELYN WRIGHT HOUSE C51 S34870 Evelyn Wright House V217166 180405 stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3, 4, & 5 Documentation provided to Prospective Residents is in need of revision to provide accurate information to enable them to make informed choice regarding their placement. The pre-admission assessment is thorough and effective in ensuring that the needs of people admitted to the home can be met. EVIDENCE: Information given to Residents, including the Statement of Purpose, is currently being revised to accurately reflect the Home’s services, facilities and Aims and Objectives. The admission process ensures that all prospective Residents are visited and assessed by staff from the Home to ensure their needs can be met. Residents and their relatives have opportunities to visit the Home before admission. Residents spoken with felt that staff were aware of their needs and the care to be provided at the point of their admission to the Home. EVELYN WRIGHT HOUSE C51 S34870 Evelyn Wright House V217166 180405 stage 4.doc Version 1.20 Page 9 Staff spoken with felt that they were given information on new Residents needs, routines and wishes. Individual records are kept for each of the Residents and inspection of the records showed that the assessment process has been revised, specific assessment tools are used to identify needs and risk and needs are documented. EVELYN WRIGHT HOUSE C51 S34870 Evelyn Wright House V217166 180405 stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 Little progress has been made in the development of Care plans to adequately provide staff with detailed information they need to fully met the Residents needs. . EVIDENCE: Individual plans of care are available for all Residents. The plans inspected showed that account is taken of Residents wishes and preferred routines. References to personal care needs remained limited. Instructions and guidance for staff on how the care was to be provided was not fully detailed. Information gathering on Life histories, to aid understanding of the conditions and behaviours of Residents with Dementia, was limited and not crossreferenced to the care plans. Strategies for the management of behaviours and anxieties were not detailed. The approach to Dementia care is still fragmented, as the Home does not have specialised Dementia care units with trained staff concentrated in specific areas to meet specialised needs. There is a risk that Residents with Dementia can be EVELYN WRIGHT HOUSE C51 S34870 Evelyn Wright House V217166 180405 stage 4.doc Version 1.20 Page 11 isolated, that their needs are not being met in full and that they could be put at risk through a lack of supervision and monitoring. The documentation of Health care needs was also limited in detail though staff showed that they responded quickly to any changes to their Residents’ health and made referrals to medical professionals. The administration of medication was not safe as the staff member administrating the midday medication left the medication cupboard open and unattended, signed the administration record prior to ensuring the medication had been taken and passed medication, after dispensing, to another staff member to give out. Service Users felt that they were treated as individuals and were respected by staff. Staff ensured that their privacy and dignity was protected when personal care was carried out. EVELYN WRIGHT HOUSE C51 S34870 Evelyn Wright House V217166 180405 stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 & 15 Residents are enabled to maintain their independence as much as possible and exercise choice in the way they wish to lead their lives. Whilst group activities are provided there is little provision for individual, meaningful activities for people with dementia. EVIDENCE: A number of Residents were spoken to and everyone who commented on the food said it was good, they had choice and their special and likes and dislikes were catered for and respected. However, some Residents commented that they felt they were limited in quantity on certain meals. For example when bacon rolls or sausages were served they stated that they could only have one. The cook confirmed that Residents could have more, however it was clear that there had been a failure to record the individual’s preferences for quantity on the menu sheets supplied to the Kitchen Staff. The midday meal was efficiently served and nicely presented. Staff helped Residents with their meals where necessary. Residents felt routines were relaxed and flexible and that their preferences on rising and going to bed times were respected. They felt that they were free to decide on how and where they wished to spend their time. EVELYN WRIGHT HOUSE C51 S34870 Evelyn Wright House V217166 180405 stage 4.doc Version 1.20 Page 13 Whilst the Home has an activities programme activities were taking place during the Inspection. The programme is limited to group activities and Residents commented that staff had little time to provide for individual interests or just sit and talk with them. There is little in the way of meaningful individual activities for Residents with dementia. The Home has an open visiting policy. Visiting Relatives commented that they were made welcome, extended hospitality and that staff made time to discuss their Residents needs, health and progress with them. Residents confirmed that they were enabled to receive their visitors in private if they wished. EVELYN WRIGHT HOUSE C51 S34870 Evelyn Wright House V217166 180405 stage 4.doc Version 1.20 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 17, 18 Systems are in place to ensure that complaints are listened to and acted upon and that Residents are protected and their rights are upheld. EVIDENCE: Residents confirmed that they had been given the Home’s complaints procedure which is also displayed in the Home. Those spoken with felt confident and able to raise any issues or concerns with staff. A complaints record is maintained showing that any issues raised are taken seriously, investigated with action taken to improve the service where necessary. No complaints have been received by the CSCI in the last year. Whilst staff have received training in the Protection of Vulnerable Adults there has been a failure in reporting a recent incident of Resident-to-Resident abuse to the relevant Authorities. Residents are supported to vote and postal votes are obtained. EVELYN WRIGHT HOUSE C51 S34870 Evelyn Wright House V217166 180405 stage 4.doc Version 1.20 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 -26 The internal layout of the Home does not provide dedicated, safe and secure garden facilities for Residents with dementia. Appropriate Bathing facilities are not provided for Residents reliant on the use of a hoist and the accommodation for these residents is not appropriately sited to easily access the adapted toilet. EVIDENCE: Since the last Inspection there has been considerable renewal of furniture and carpets and some redecoration work. The Home is comfortably furnished to a good standard. The rear garden area is not securely fenced. Residents with Dementia, if unsupervised, could easily go through the side of the home and access the busy main road. Residents with Physical Disabilities are accommodated in a unit at the rear of the Home. The one toilet able to accommodate a hoist is situated at the front of the Home, some distance away from the unit. This results in Residents having to use commodes in their rooms, particularly at night. Residents reliant EVELYN WRIGHT HOUSE C51 S34870 Evelyn Wright House V217166 180405 stage 4.doc Version 1.20 Page 16 on the use of a hoist are unable to have a bath as none of the existing baths can accommodate the hoist . Residents are able to personalise their rooms and have their furnishings and belongings about them. EVELYN WRIGHT HOUSE C51 S34870 Evelyn Wright House V217166 180405 stage 4.doc Version 1.20 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 & 28 The deployment and numbers of both day and night staff is insufficient resulting in a risk to Residents and delays in meeting their needs. EVIDENCE: Residents spoken with said that the staff were very kind, committed and caring. Residents and Relatives comments indicated that they felt the Home was short staffed and that there were delays in meeting their needs. Staff rotas showed that 4 care staff are on duty in the mornings with the level dropping to 3 from 1.30 pm to 5.30 pm. There are five lounge areas, which cannot be appropriately supervised and monitored. 2 care staff provide night cover, this means that when both staff are engaged in personal care tasks with a Residents who requires 2 people for movement and handling there is no one to respond to other Residents’ needs. Residents with Dementia are accommodated throughout the Home and not in specific units. There were times when staff were occupied in other areas and the Residents were not supervised or monitored. Staff records were not accessible on the day of Inspection. EVELYN WRIGHT HOUSE C51 S34870 Evelyn Wright House V217166 180405 stage 4.doc Version 1.20 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 34, 35 & 38 The Manager is easily accessible to both Residents and Staff and holds regular meetings to seek Residents views on the service. The testing of the Home’s Fire Alarm system was poor creating a potential risk to Residents from a possible systems failure. EVIDENCE: Staff spoken with felt that the Manager was easily accessible to them and was willing to discuss any issues and guide them in practice. Residents felt the Manager was readily available to them. They commented that regular Residents meetings were held and that the Manager also sought their individual views. They felt that their opinions were listened to, valued and acted upon and that they had trust and confidence in the staff group as a whole. EVELYN WRIGHT HOUSE C51 S34870 Evelyn Wright House V217166 180405 stage 4.doc Version 1.20 Page 19 The systems for the management of Residents moneys and items deposited for safekeeping were carefully maintained and regularly audited. Residents’ comments and the review of records confirmed that they had access to their moneys at all times. Records showed that the Home’s Fire Alarm system is not being tested on a weekly basis. Records concerning the overall maintenance of the Fire system and fire equipment were well maintained. EVELYN WRIGHT HOUSE C51 S34870 Evelyn Wright House V217166 180405 stage 4.doc Version 1.20 Page 20 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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 2 3 2 2 3 3 3 3 STAFFING Standard No Score 27 2 28 2 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 2 3 x 3 x 3 3 x x 2 EVELYN WRIGHT HOUSE C51 S34870 Evelyn Wright House V217166 180405 stage 4.doc Version 1.20 Page 21 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard 9 9. Regulation 13 (2) 18.1.(a) 13 (2) Requirement Medication Cabinets must be kept locked at all times when left unattended. The Staff member responsible for administrating medication must personally ensure it is taken and sign the record only after this procedure. An action plan must be submitted with proposals for appropriate accomodation for Residents with Dementia and Physical Disabilities. Written confirmation must be submitted on the arrangements made to ensure Residents are consulted and provided with their preferred quantities of food. Attention must be given to providing suitable and meaningful activities for all Resident s including those with Dementia. Prompt referrals must be made to the Relevant Authorities to ensure the Protection os Vulnerable Adults where Resident to Resident abuse occurs. The Garden areas must be made safe and secure. Timescale for action 18.4.2005 18.4.2005 3. 19 23. (1) (a), (2) (a) 16 (2) (i) 5.6.2005 4. 15 5.6.2005 5. 12. 2 16. (2) (n) 7. 7.2005 6. 18 13 (6) & 37. (1) (e) 18.4.2005 7. 19 23 (2)(a) & (b) 5.6.2005 Page 22 EVELYN WRIGHT HOUSE C51 S34870 Evelyn Wright House V217166 180405 stage 4.doc Version 1.20 8. 19 23 (2) (a) & (j) 18 (1)(a) & 12.1.(a) 9. 27, 28 10. 38 23. (4) (v) An action plan must be submitted detailing proposals to alter the Bathing facilities to enable the use of a hoist. Staffing levels must be increasedto meet the needs of the Residents and provide adequate supervision and monitoring. Testing of the Homes Fire Alarm system must be carried out and recorded on a weekly basis. 5.6.2005 5.6.2005 18.4.2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations EVELYN WRIGHT HOUSE C51 S34870 Evelyn Wright House V217166 180405 stage 4.doc Version 1.20 Page 23 Commission for Social Care Inspection Newland House, First Floor Cambell Square Northampton NN1 3EB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI EVELYN WRIGHT HOUSE C51 S34870 Evelyn Wright House V217166 180405 stage 4.doc Version 1.20 Page 24 - 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!