Inspection on 13/09/05 for Inwood House

This inspection was carried out on 13th September 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

Inwood House 20/03/08

Inwood House 15/01/07

Inwood House 27/02/06

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Inwood House 10 Bellamy Lane Salisbury Wiltshire SP1 2SP Lead Inspector Sally Walker Announced 13 September 2005 th 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. Inwood House D51_D01_S63485_InwoodHouse_V239205_130905_Stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Inwood House Address 10 Bellamy Lane Salisbury Wiltshire SP1 2SP 01722 501402 01722 3417216 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 Alan Butchers Mr Alan Butchers Care Home 20 Category(ies) of MD Mental Disorder (1) registration, with number MD(E) Mental Disorder - over 65 (10) of places OP Old Age (20) Inwood House D51_D01_S63485_InwoodHouse_V239205_130905_Stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 No more than 20 service users with old age, over 65 years of age at anyone time. 2 No more than 10 service users with a mental disorder, over 65 years of age at anyone time 3 No more than 1 male service user with a mental disorder at anyone time. Date of last inspection New Service Provider Brief Description of the Service: Mr Butchers was registered to Inwood House on 1st April 2005. The home is an established care home in Salisbury near the city centre. It is registered to provide personal care to up to 20 older people 10 of whom may also have additional mental health needs; one of whom is under the age of 65. accommodation is to three floors accessed by a passenger lift and stairs. All but one of the single bedrooms has en-suite toilet facilities. There are 2 bathrooms and one shower room with toilets to the ground floor near the sitting room and dining room. The staffing rota provides for a minimum of 4 care staff during the mornings, three during the afternoon and evening, with one waking night staff and one member of staff sleeping in. Inwood House D51_D01_S63485_InwoodHouse_V239205_130905_Stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Inwood House was registered to Mr Butchers on 1st April 2005. This announced inspection was the first under his ownership and took place between 9.30am and 5.45pm. Mr Butchers was present during the inspection. Four residents were spoken with. The care records, complaints record and staff records were examined. The inspector made a tour of the building. What the service does well: What has improved since the last inspection? Mr Butchers has ensured that proper recording systems are in place. New policies and procedures have been introduced. Staff have good access to regular, relevant training. Residents are consulted about the service. Staff Inwood House D51_D01_S63485_InwoodHouse_V239205_130905_Stage4.doc Version 1.40 Page 6 support residents rights to privacy and dignity. Residents and their families appear very satisfied in the improved quality of the service. 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. Inwood House D51_D01_S63485_InwoodHouse_V239205_130905_Stage4.doc Version 1.40 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 Inwood House D51_D01_S63485_InwoodHouse_V239205_130905_Stage4.doc Version 1.40 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 Good assessments ensure that residents care and social needs can be discussed so that residents and their families can know whether the home can meet their needs. EVIDENCE: All potential residents have a comprehensive pre-admission assessment in order that the home can decide whether their needs can be met and to compile the initial care plan. Information is also gained from the care manager, community psychiatric nurse if relevant, previous placement, hospital or family. The home does not provide intermediate care. Inwood House D51_D01_S63485_InwoodHouse_V239205_130905_Stage4.doc Version 1.40 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, 9 & 10 Care plans direct the care and show good evidence of how social as well as physical and health needs are met and regularly monitored. Residents have good access to healthcare professionals and may take charge of their own medication if they want. Staff value residents’ rights to privacy and dignity and have friendly but professional relationships with them. EVIDENCE: Mr Butchers had implemented the care planning system used in the other home. It enables staff to record all aspects of residents current care need, including social interests as well as physical or medical care. These records identify any risks, regular monitoring and guidance on how the care and support should be carried out. The plans show residents’ preferred routines for getting up and retiring and for the giving of intimate personal care. There is guidance for dealing with behaviours. The plans are regularly reviewed and updated when care needs change or if residents spend a period of time in hospital. Residents were all well groomed with staff clearly paying particular attention to residents having clean glasses, teeth, fingernails, hearing aids in place if necessary and watches and clocks showing the correct time. One resident said their bath was not rushed with staff allowing them to ‘have a good soak.’ Residents’ weights were regularly monitored and any loss reported to the GP. Nutritional assessments and monitoring was in place. The Inwood House D51_D01_S63485_InwoodHouse_V239205_130905_Stage4.doc Version 1.40 Page 10 daily reports showed good detail that the care plans directed the care and that staff were communicating with residents on a regular basis. One resident said that the district nurse came regularly to change dressings. Residents’ risk of developing pressure sores was being assessed with pressure relieving equipment in place if indicated. None of the residents had pressure sores. Staff were being trained in tissue viability and pressure sore risk assessment. The inspector advised that body maps would support recording wounds. Mr Butchers said he intended to record wounds with photographs and residents permission and the inspector agreed that this is best practice. The medication administration record was being satisfactorily completed. A weekly audit was carried out of the medication held in the home. The home kept data sheets on all prescribed medication and information on nutrition, diabetes and homely remedies easily accessible to staff in the medication administration record. Mr Butchers and the care manager had recently undertaken training in the safe handling of medicines. One resident showed the inspector the arrangements for the safe keeping of their medications which they administered themselves. The care manager said that currently 4 residents were administering their own medication and this was confirmed by risk assessments on their files. This medication was regularly audited with the resident to monitor whether they were taking their medication. Residents said they had good access to their GPs and only had to ask staff who would immediately make an appointment. Inwood House D51_D01_S63485_InwoodHouse_V239205_130905_Stage4.doc Version 1.40 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, 14 & 15 Great efforts have been made to provide a varied activities programme for residents both at the home and in the locality following consultation with the residents and their families. Residents could influence the menu planning with comments about their favourite foods. Concerns about nutrition were monitored and addressed. EVIDENCE: The home had obtained life histories from residents or their relatives to support the care planning and to consider relevant activities. Mr Butchers said he had changed some of the routines in the home to allow more time for activities. Residents said they could come and go as they wished and spend their day where they wanted. There was a programme of activities which may include: bingo, entertainers, a film night, painting, staff reading newspapers or books to residents, scrabble, sing songs and people coming to play the piano or a guitarist. The programme also allows for some one to one activities with residents; they may go with staff for a coffee in a nearby supermarket restaurant. Many comments were received about the improvement in activities. Residents said they could join in with activities if they wanted to but there was no pressure, some residents followed their own routines. Mr Butchers said he aims for residents to be involved in developing new menus. A meeting had been held with residents the previous week to discuss the menus amongst other things. One resident said they were always asked what they wanted for meals and regularly had a cooked breakfast. Residents Inwood House D51_D01_S63485_InwoodHouse_V239205_130905_Stage4.doc Version 1.40 Page 12 were offered a glass of sherry before lunch. One resident was brought their lunch in their room. They said they preferred to eat alone. The meal looked well presented and ‘home made’ with two vegetables and potatoes. The courses were served one at a time and the portion served according to the resident’s appetite. All of the residents in their bedrooms had jugs of juice or water within easy reach and there were also jugs of juice and water in the sitting rooms for residents use. It was noted this was changed during the day. Nutritional monitoring was in place where indicated. Inwood House D51_D01_S63485_InwoodHouse_V239205_130905_Stage4.doc Version 1.40 Page 13 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 The home has a robust complaints procedure and residents or their families can be sure that any complaints or concerns will be considered, investigated and actioned. EVIDENCE: The home has a complaints procedure and keeps a log of all complaints and concerns raised. The log shows that the home welcomes concerns and deals with them in a professional manner letting the complainant know of outcomes of any investigations and actions taken. Most residents felt that they could discuss their concerns with staff and Mr Butchers. Inwood House D51_D01_S63485_InwoodHouse_V239205_130905_Stage4.doc Version 1.40 Page 14 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 home is well maintained and clean with no unpleasant odours detected at any time during the inspection. EVIDENCE: The home has two sitting rooms and a conservatory. Mr Butchers talked about the plans he had for the building including moving the toilet which was off the dining room and redesignating the staff toilet nearby for residents use. There was a separate washing machine for those residents who wished to launder their own clothing and linens. The main laundry was separate and residents reported their satisfaction with the system for prompt returning of their linen. The home was cleaned to a good standard and there were no unpleasant odours noted at any time during the inspection. Inwood House D51_D01_S63485_InwoodHouse_V239205_130905_Stage4.doc Version 1.40 Page 15 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) 27,29 & 30 Residents are supported by sufficient staff who have a caring attitude and are well trained in relevant subjects. There is a robust recruitment process in order to protect residents. EVIDENCE: The care staffing rota provided for a minimum of four care staff during the morning and three for the afternoon and evening. At night there is one waking night staff and a member of staff sleeping in. Residents said the staff were very friendly and would do anything for them. The comment cards provided many positive references to friendly and caring staff. Staff were seen to have a friendly but professional attitude with residents and particular sensitivity when supporting residents with privacy when using the toilet which was off the dining room when other people were present. It was clear from the daily reports that staff regularly spoke to residents and discussed their care or how they were feeling. All staff had job descriptions and contracts. Some new staff had been recruited since Mr Butchers took over the home. All staff were employed subject to a robust recruitment policy with POVA and Criminal Records Bureau checks and induction into the work. Mr Butchers said that he was ensuring that all staff were up to date with the core training with a training plan for the year. Other training included a skills course in dementia care. The community psychiatric nurse had agreed to provide some training in mental health. Staff were expected to undertake NVQ training and 4 staff were about to start NVQ Level 2 with one half way to completing the award. Inwood House D51_D01_S63485_InwoodHouse_V239205_130905_Stage4.doc Version 1.40 Page 16 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) 31, 33 & 38 Mr Butchers has made significant improvements in how the home is managed and how residents are supported and cared for. The home is run in the best interests of the residents. EVIDENCE: Mr Butchers has put great effort into ensuring good standards of care are being provided. He had introduced new policies and procedures and was in the process of introducing them to staff, getting them to sign up to them. Residents said that Mr Butchers would come and enquire after their health. A number of comment cards from residents and their relatives were received as part of the inspection process and details can be seen in the summary of this report. Mrs Butchers was a trained trainer in moving and handling and first aid and had recently provided updated training. There is some work to do to ensure that the tests, checks and fire instruction is being carried out and recorded in the fire logbook. Mr Butchers reported that the tests were being carried out but the person with the delegated Inwood House D51_D01_S63485_InwoodHouse_V239205_130905_Stage4.doc Version 1.40 Page 17 responsibility was not filling out the log and he would be addressing the matter with them. Risk assessments of the environment had been carried out in February 2005. A new accident recording system had been implemented and Mr Butchers reviews every record. Inwood House D51_D01_S63485_InwoodHouse_V239205_130905_Stage4.doc Version 1.40 Page 18 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 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 x 3 x x x x 2 Inwood House D51_D01_S63485_InwoodHouse_V239205_130905_Stage4.doc Version 1.40 Page 19 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 OP 37 Regulation 17(2) Schedule 4 para 14 Requirement The person registered must ensure that regular tests, checks and instruction are carried out and recorded in the fire log in line with the requirements of the Fire Authority. Timescale for action 13th September 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 Inwood House D51_D01_S63485_InwoodHouse_V239205_130905_Stage4.doc Version 1.40 Page 20 Commission for Social Care Inspection Avonbridge House Bath Road Chippenham Wiltshire, SN15 2BB 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 Inwood House D51_D01_S63485_InwoodHouse_V239205_130905_Stage4.doc Version 1.40 Page 21 - 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. 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