Inspection on 02/06/05 for Inspirations

This inspection was carried out on 2nd June 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

Inspirations 13/07/06

Inspirations 12/09/05

Inspirations 24/08/04

Inspirations 18/05/04

Inspirations 06/02/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Westmead

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Inspirations 171 Tettenhall Road Tettenhall Wolverhampton WV6 0BZ Lead Inspector Ian Harris Announced 2 June 2005 08:00 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. Inspirations E56 000020893 Inspirations v225680 AI 020605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Inspirations Address 171 Tettenhall Road, Tettenhall, Wolverhampton, WV6 0BZ 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) 01902 710938 01902 566067 Mrs Patricia Hayward Mrs Patricia Hayward Care Home - Older People 15 Category(ies) of Dementia (5) registration, with number Old Age (15) of places Inspirations E56 000020893 Inspirations v225680 AI 020605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1) Females aged 60 years and above and males aged 65 years and above. 2) No number division between categories. 3) Maximum number of Service Users is fifteen (15). 4) The maximum nuber of service users with dementia that can be accomodated at any one time is three (3). Date of last inspection 24/08/2004 Brief Description of the Service: Inspirations is a care home providing accommodation for 15 older people. It is a large, semi-detached building, situated on the Tettenhall Road about one and a half miles from Wolverhampton City centre. The accommodation is arranged over three floors and there is a passenger lift to each floor. There are various amenities nearby, including churches, pubs, a library and shops. West Park is a short distance away. There is limited parking to the front of the property and a larger car park at the rear. All bedrooms are single, seven having an en suite facility. The registered persons operate an ongoing programme of routine maintenance and renovation and the property is tastefully decorated. Inspirations E56 000020893 Inspirations v225680 AI 020605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and took place over 5 hours. The main purpose of the inspection was to check the progress made by the home regarding the recommendations and requirements made in the last inspection report. The fullest co-operation was given to the inspection officer by the Care Manager staff and residents. During the inspection a tour of the premises took place and staff and care records were inspected. Also staff rotas and general records regarding the maintenance of the home were checked. 5 of the 15 staff were on duty, and 10 of the 15 residents and 2 residents relatives were spoken to. On the day of inspection the atmosphere within the home was found to be warm, friendly and comfortable and safe with contented residents. What the service does well: Inspirations continues to provide a high standard of care. The Care Manager and staff are to be commended on their efforts to encourage the residents to maintain their independence through social activities both within and outside the home. In particularly the work that the home is carrying out through a designated member of staff to assisting people with cognitive impairment is to be commended. Observations during the inspection saw very attentive staff providing for the individual needs of the residents. A number of residents and relatives confirmed that the care staff are very kind and caring. The home has a very good staff- training programme, which all staff are involved in, this ensures that they are improving their knowledge and skills. Inspirations E56 000020893 Inspirations v225680 AI 020605 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: 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. Inspirations E56 000020893 Inspirations v225680 AI 020605 Stage 4.doc Version 1.30 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 Inspirations E56 000020893 Inspirations v225680 AI 020605 Stage 4.doc Version 1.30 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) 3 and 6 Appropriate assessments of need are in place and are carried out. The home does not provide intermediate care. EVIDENCE: There is evidence on the files that all the residents who are funded by the Local Authority undergo a full multi-disciplinary assessment prior to admission. The residents, who are self funding are assessed by the Care Manager, using the homes assessment forms. All the residents are permanent. The home does not provide intermediate care. Inspirations E56 000020893 Inspirations v225680 AI 020605 Stage 4.doc Version 1.30 Page 9 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, and 9 Each resident has a comprehensive, individual care plan that is reviewed on a monthly basis. The home has good contact with local G.P. s. local hospitals and paramedical services, which ensures that resident’s health needs are met. The systems for the administration of medication are good with clear and comprehensive recording arrangements being in place to ensure resident’s medication needs are met. EVIDENCE: The home provides a comprehensive Care Plan for each individual resident based on the initial assessment. The Care Plans are drawn up by the Care Staff in consultation with the resident and their family. There was evidence on the files to show the care Plans are being carried out and reviewed on a monthly basis. The home is well supported by local G. P. s. and all of the paramedical services. Wherever possible, the residents are encouraged to retain their own G. P s, Opticians, and Dentists. It was noted that if the resident has moved out of their area the Care Manager ensures that, these services are provided by local practitioners. The records indicate that resident’s medical needs are being met. Inspirations E56 000020893 Inspirations v225680 AI 020605 Stage 4.doc Version 1.30 Page 10 Medication is administered by means of a Boot’s monitored dosage system. The system appears to be working very well. The home receives good support from the Boot’s pharmacist who does a three monthly audit of the homes medication. All care Senior Staff have been trained to use the system before they are allowed to administer medication. The home has very good policies and procedures, which have recently been updated and are used as an integral part of the staff induction programme. Inspirations E56 000020893 Inspirations v225680 AI 020605 Stage 4.doc Version 1.30 Page 11 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 and 15 The home provides a good programme of social activities within and outside of the home, which are designed to meet the resident’s capabilities. EVIDENCE: The Care Manager stated that the residents are consulted regarding the dayto-day running of the home through residents’ meetings and by feedback from their Care Staff. The routines and activities within the home are flexible and are built around the needs of the residents. The Care Staff also identify interests that the residents wish to pursue. A regular programme of musical evenings, Art and Craft sessions, board- games, keep fit and sing-a-longs is organised within the home. Also regular outings to garden centres, City Centre and Pub lunches are arranged throughout the summer months. The observations made, examination of menus and the comments received from the residents and their relatives confirmed that particular attention is given to the residents’ individual preferences. Comments made by residents regarding the quality, quantity and variety of food provided were highly complimentary. Inspirations E56 000020893 Inspirations v225680 AI 020605 Stage 4.doc Version 1.30 Page 12 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 and 18 The home has a good complaints procedure with some evidence that residents’ views are listened to and acted upon. The home has good policies and procedures regarding protection from abuse, which includes a whistle blowing policy. EVIDENCE: The home has a comprehensive complaints procedure. The residents and relatives are made aware of the procedure through the statement of their terms and conditions of residence and a notice on the notice board in the hall. The home has a complaints book in which all complaints are recorded. It was noted that the home has not received any formal complaints since the last inspection all minor complaints are dealt with appropriately and quickly. The home has good policies and procedures regarding Restraint, dealing with Aggressive Behaviour and Prevention of Abuse, which, includes a WhistleBlowing policy. These issues are also covered in the N.V.Q. training, which the Staff is undergoing. All staff have received training via a Video. There have been no incidents that have needed to be recorded or reported. Inspirations E56 000020893 Inspirations v225680 AI 020605 Stage 4.doc Version 1.30 Page 13 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 and 26 The standard of the environment within the home and the garden is very high providing the residents with a very attractive, comfortable, homely and safe place to live. The home was found to be clean tidy and free of unpleasant odour. EVIDENCE: The home is long established and has undergone alterations over the years in order to provide appropriate accommodation for older people. The home is maintained to a very high standard, as are the gardens and grounds and provides a very comfortable homely and safe atmosphere. It was noted that the top floor bathroom, bedroom 5 and 6 have been refurbished. Also a new Television has been provided for the lounge and a new ramp to improve access to the home has been installed since the last inspection. The home was found to be clean and tidy and free from odour. The home has good policies and procedures regarding infection control and the staff have received training in food hygiene and Infection Control. All staff appeared to be conscious of the dangers of cross infection. Inspirations E56 000020893 Inspirations v225680 AI 020605 Stage 4.doc Version 1.30 Page 14 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) 27,28.29, and 30. The home is well staffed with adequate numbers and skill mix of staff. The staff have a very good understanding of the resident’s support needs this is evident from the positive relationships which have been formed between staff and residents. The home has good policies and procedures regarding the recruitment of staff, which includes all the appropriate checks and references. There is a good training programme in place that ensures that the staff are competent to do their job. EVIDENCE: The inspection of staff rotas and discussions with residents indicated that the home is well staffed. There is a good balance within the staff group, which includes experience, mature and younger staff who are embarking on a new career. The home operates an efficient procedure and has registered with the West Midlands Care Homes Association in order to complete the appropriate checks on staff. There was evidence within the home that all the checks are being carried out. All staff at the home are committed to developing their knowledge and skills through training and have regular opportunities to do so through external and internal training activities. The home has introduced a programme of N.V.Q. training has now exceeded the minimum standard. Also the care staff have attended courses on Safe handling of medication, Risk assessment, Dementia care, and Moving and lifting, First Aid, Infection Control and Fire Prevention. Inspirations E56 000020893 Inspirations v225680 AI 020605 Stage 4.doc Version 1.30 Page 15 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) 33, 35, 37, and 38 The routines and activities within the home are flexible and are built around the needs of the residents. The home is operating a good system to assist residents with the safe handling and keeping of their personal finances and good records are being kept of all transactions made. All the general records that was inspected, were found to be well ordered and maintained. The home has good policies and procedures regarding Health and safety and the care manager and staff demonstrated that they are aware of their responsibilities to promote health and safety. In regards to accidents these have been minimal and dealt with appropriately. EVIDENCE: Discussions with the residents and two visiting relatives confirmed that the home is run in the best interests of the residents. Also the involvement an independent Residents Association ensures that the residents’ views are voiced. Inspirations E56 000020893 Inspirations v225680 AI 020605 Stage 4.doc Version 1.30 Page 16 All the records and administrative procedures within the home that were, inspected were found to be well ordered and maintained. The home has a good heath and safety policy and all staff are aware of their responsibilities regarding these issues and a number of staff have received training. Inspirations E56 000020893 Inspirations v225680 AI 020605 Stage 4.doc Version 1.30 Page 17 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x x x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 4 x x x x x x 4 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 x 3 3 Inspirations E56 000020893 Inspirations v225680 AI 020605 Stage 4.doc Version 1.30 Page 18 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 Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Inspirations E56 000020893 Inspirations v225680 AI 020605 Stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection 2nd Floor, St Davids Court Union Street Wolverhampton WV1 3JE 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 Inspirations E56 000020893 Inspirations v225680 AI 020605 Stage 4.doc Version 1.30 Page 20 - 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!