Inspection on 29/06/05 for Inwood House

This inspection was carried out on 29th June 2005.

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

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

Other inspections for this house

Inwood House 16/12/08

Inwood House 11/01/07

Inwood House 25/11/05

Inwood House 17/02/05

Inwood House 10/06/04

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

CARE HOMES FOR OLDER PEOPLE Inwood House 142 Wakefield Road Benton Hill Horbury WF4 5HG Lead Inspector Susan Vardaxi Announced 29 June 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. Inwood House J51J01_s6191_Inwood House_v225144_290605.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Inwood House Address 142 Wakefield Road Benton Hill Horbury WF4 5HG 01924 272159 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 Richard Barraclough and Mrs Wendy Barraclough Ms Deborah Nightingale Care Home 35 Category(ies) of 35 x Old age (over 65 years), 35 x Mental registration, with number disorder (over 65 years), 35 x Physical disability of places (over 65 years), 35 x Dementia (over 65 years) Inwood House J51J01_s6191_Inwood House_v225144_290605.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Conditions of this registration are listed on the registration certificate displayed at the service. Date of last inspection 17 February 2005 Brief Description of the Service: Inwood House is situated on the main road close to the centre of Horbury approximately two miles from Wakefield. Set back in its own grounds the large Victorian house provides personal care for 35 older people who may also have dementia, mental health needs or physical disabilities. The home provides mostly single accommodation, however there are some shared facilities available. There are 6 lounges including a large television lounge and smaller quiet lounges. There are handrails throughout the building. There is also a shaft lift and a number of assisted baths for the use of service users who have difficulties with mobility. The home is on a main bus route and there are shops a few minutes walk from the home. The centre of Horbury is close by with easy access to all local facilities and amenities. Inwood House J51J01_s6191_Inwood House_v225144_290605.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out on 29 June 2005 over a six-hour period and involved a tour of the building and checking some records. Eleven service users and three staff were spoken with and the interaction between staff and residents was observed throughout the inspection. The comments made by service users and relatives on questionnaires sent to the Commission have been incorporated into the report. The inspector would like to thank all concerned for their hospitality and cooperation throughout this inspection. What the service does well: What has improved since the last inspection? What they could do better: The overall standard of record keeping is generally good, however some care plans need to be developed further so that all assessed needs are fully included within the plan so that care staff are enabled to meet those needs Inwood House J51J01_s6191_Inwood House_v225144_290605.doc Version 1.40 Page 6 identified. The daily records need to include how the service users needs have been met. CRB checks had been completed, however some staff had commenced employment prior to a response to the CRB check being received and the POVA first list had not been checked. This must be completed to ensure that service users are protected. The need for advocacy arrangements should be determined at the time of admission to the home or at care management reviews for current service users to ensure the safe handling of their finances. 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 J51J01_s6191_Inwood House_v225144_290605.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 J51J01_s6191_Inwood House_v225144_290605.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) 1,2,3,4,5 Accurate information is provided for service users and their representatives about the service provided at the point of admission to the home. Pre admission and admission arrangements are satisfactory and staff receive training appropriate to service users needs. Intermediate care is not provided. EVIDENCE: The statement of purpose and service users guide were not seen on this visit. However, information received from the providers prior to the inspection identified that no changes to the service had been made since the documents were last reviewed that would require changes being made. It was seen in a file that a service user’s guide had been given to them on their admission to the home. Copies of the homes terms and conditions and pre admission assessment records were seen on the service users’ files seen. Records seen showed staff training had been provided during the past 12 months, which included Challenging Behaviour, Understanding Aggression and Violence and Dementia Care. NVQ level 2 training is ongoing. Inwood House J51J01_s6191_Inwood House_v225144_290605.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) 7,8,10 The service users appeared to be well cared for and the interaction between staff and service users is good. Further attention is needed to care planning and risk assessment processes to ensure that all their needs are clearly identified and ensure their safety. The menus seen and meal provided on the day demonstrate that the provision of meals is to a good standard. EVIDENCE: Some of the care plans seen contained all information in relation to needs assessments and detailed information was included. An activities care plan included the service user’s request not to join in activities. However a care plan seen did not include the outcome of a completed risk assessment and a risk assessment had not been completed for a service user who had fallen out of bed. It was observed that a service user was becoming agitated and irritable with another service user. The service user’s aggressive behaviour had been included in their care plan for personal hygiene rather than a separate care plan about how staff should respond appropriately to deal with any aggressive behaviour. Inwood House J51J01_s6191_Inwood House_v225144_290605.doc Version 1.40 Page 10 Records of GP, district nurse, chiropody visits and hospital outpatient’s appointments were seen on records checked. However, not all weight checks had not been completed monthly. The daily records did not state that the assessed needs had been met. The medication records were not checked on this visit however a member of staff was seen giving service users assistance to take their medication and she stayed with them offering support until she was sure that the medication had been taken. The service users were joined in the lounge from 10.30 am until lunch was served at noon. Staff were seen coming into the lounge regularly, however service users, some who are highly dependant, were not asked if they needed to access the toilet before lunch. Staff escorted a service user who was sitting in the lounge to their own bedroom when a GP visited. The service users seen looked clean and comfortable; attention had been given to manicures. Inwood House J51J01_s6191_Inwood House_v225144_290605.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) 12,13,14,15 Service users are encouraged to join in the activities and outings provided. The provision of meals is satisfactory. Advocacy arrangements need to be confirmed to ensure the safe handling of their finances. EVIDENCE: The provision of activities was discussed with the providers and manager as some service users views varied. A service user said they go out daily. A service user’s choice not to join in in-house activities was seen in their records. However, one file did not include a service user’s preference not to be included in house activities. A record of activities was seen and was satisfactory. Some service users said that entertainers visit the home and they had been on an outing to a local fish restaurant. Inwood House J51J01_s6191_Inwood House_v225144_290605.doc Version 1.40 Page 12 Service users were joined in a small dining room for lunch. The environment was pleasant and staff were seen to assist service users appropriately. Plate guards were used where necessary. Service users were not encouraged to rush their meals and the interaction between them and the staff was good. The meal was hot when served, it was nutritious, the portions were adequate and it was seen that there was little wastage. The providers said that relatives are invited to meals. Information received prior to the inspection stated that two service users handle their own finances and advocacy arrangements for a service user are in place for one service user. Inwood House J51J01_s6191_Inwood House_v225144_290605.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) 16,18 Appropriate action is taken when complaints are made and it is identified that service users are could be at risk from abuse. EVIDENCE: It was seen on a relatives’ questionnaire that they did not know the home’s complaints procedure. This was discussed with the providers and manager, the complaints procedure is in the service users guide and was seen displayed in the hallway at the home. The providers and manager discussed an issue regarding the handling arrangements for a service user’s finances that they had been concerned about and had therefore referred their concerns to the local authority for investigation through Adult Protection Procedures. The records for two complaints that were made to the home since the last inspection were seen. The complainants had been satisfied with the outcome. Inwood House J51J01_s6191_Inwood House_v225144_290605.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) 19,20,21,22,23,24,25,26 The layout of the home and facilities are suitable for older people to live in, it is clean and decorated and maintained to a high standard. Priority needs to be given replacing a service user’s bedroom carpet to ensure their safety. EVIDENCE: The gardens seen are well stocked and very well maintained. They provide pleasant areas for service users to sit in or, to look out onto from their bedrooms. Those service users’ bedrooms seen were cleaned to a high standard and were well decorated. Service users had taken some of their own personal possessions into the home. Lifting equipment was seen in the bathrooms checked. Inwood House J51J01_s6191_Inwood House_v225144_290605.doc Version 1.40 Page 15 A service user spoken with said that they “kept tripping over the carpet in their bedroom”. When the bedroom was checked it was seen that the carpet was slightly worn in two places. The providers said that the carpet was in the home’s rolling programme of renewal and replacement. Inwood House J51J01_s6191_Inwood House_v225144_290605.doc Version 1.40 Page 16 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) 27.28,29.30 The current staffing levels and provision of training are considered to be satisfactory to meet the service users’ needs. The homes recruitment procedures in relation to CRB checks do not ensure service users’ safety. EVIDENCE: The providers and manager said that care staff’s duties are specific to providing personal care. The home employs two domestic assistants and cooks. It was seen on two of eleven questionnaires completed by relatives that they felt that occasionally staffing levels were not sufficient. However positive comments were also made which included that all were “satisfied with the care provided, staff will always assist when requested and are always polite”. These comments were discussed with the providers and manager. The staff rosters were seen and were only affected by last minute notification of sickness. The home aims to provide four carers on each daytime shift. The providers and managers work in the home from Monday to Friday and are available to assist if staffing levels are depleted. The files of two staff recruited to the home since the last inspection were checked and CRB checks had not been completed prior to them starting work. A record of their induction programme was seen. Inwood House J51J01_s6191_Inwood House_v225144_290605.doc Version 1.40 Page 17 Evidence of regular staff training was seen in the records checked. The providers said that the home have achieved 50 of qualified staff but said that this is difficult to maintain due to staff leaving their employment. Seven staff have NVQ Level 2, 2 are due to complete in July 2004 and 5 are working towards it. Inwood House J51J01_s6191_Inwood House_v225144_290605.doc Version 1.40 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) 31,35,38. The manager is competent and qualified to manage the home and staff receive training appropriate to the work they do. Advocacy arrangements need to be confirmed to ensure the safe handling of their finances. EVIDENCE: There had not been any changes to the management of the home since the last inspection. The manager has considerable care and management experience having achieved the NVQ 4 management qualification and is supported by the providers on a regular basis. Some service users’ records of personal allowances held by the home on their behalf were seen, two signatures had been obtained for all transactions. The arrangements for the handling of service users’ personal allowance were Inwood House J51J01_s6191_Inwood House_v225144_290605.doc Version 1.40 Page 19 discussed with the providers and manager who said that generally relatives deal this. One bedroom carpet is worn in places and the providers said that this would be replaced. No other Health and Safety issues were observed at this inspection. First Aid and Food Hygiene training is being arranged for staff. Inwood House J51J01_s6191_Inwood House_v225144_290605.doc Version 1.40 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. 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 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x x x 3 x x 2 Inwood House J51J01_s6191_Inwood House_v225144_290605.doc Version 1.40 Page 21 YES 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 7 Regulation 15(1) Requirement Care plans must include all assessed needs including risk assessment outcomes and be written in in a format that clearly identifies specific needs. Staff must not commence employment until satisfactory CRB and POVA checks have been completed. If a satisfactory POVA First check is obtained staff may, within Department of Health guidance, work under supervision pending receipt of the CRB disclosure. The worn carpet in a service users bedroom must be replaced. Timescale for action 29 June 2005 & Ongoing 29 June 2005 & Ongoing 2. OP29 19(4)(c) 3. OP38 13(4)(a) 31 August 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. 2. Refer to Standard OP 7 OP8 Good Practice Recommendations The daily records should include how the needs identified in the care plans have been met. Service users weights should be checked monthly and records kept. J51J01_s6191_Inwood House_v225144_290605.doc Version 1.40 Page 22 Inwood House 3. OP14 4. Advocay arrangements to ensure the safe handling of service users finances should be confirmed at the time of admission to the home or for current service users at their care management reviews, particularily when they are unable to make infomed choices. - Inwood House J51J01_s6191_Inwood House_v225144_290605.doc Version 1.40 Page 23 Commission for Social Care Inspection Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB 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 J51J01_s6191_Inwood House_v225144_290605.doc Version 1.40 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. 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