CARE HOMES FOR OLDER PEOPLE
New Wycliffe Home 111 Gleneagles Avenue Rushey Mead Leicester Leicestershire LE4 7YJ Lead Inspector
Keith Williamson Key Unannounced Inspection 4th April 2007 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address New Wycliffe Home DS0000006413.V333804.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. New Wycliffe Home DS0000006413.V333804.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service New Wycliffe Home Address 111 Gleneagles Avenue Rushey Mead Leicester Leicestershire LE4 7YJ 0116 266 7093 0116 266 7093 julie.rudd@vistablind.org.uk www.vistablind.org.uk VISTA Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Julie Rudd Care Home 46 Category(ies) of Dementia - over 65 years of age (20), Physical registration, with number disability over 65 years of age (1), Sensory of places impairment (46), Sensory Impairment over 65 years of age (46) New Wycliffe Home DS0000006413.V333804.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. 5. 6. New Wycliffe care home is registered to provide personal care to male and female service users who fall within the following categories (SI) 46 (SI (E)) 46 (DE(E) 20 (PD(E) 1 Sensory Impairment over 65 years of age (SI (E) 46 No persons can be accommodated at New Wycliffe care home with dementia, unless they also have a sensory impairment. No persons under the DE (E) category can be accommodated at New Wycliffe care home when there are already 20 persons within this category residing at the home. New Wycliffe care home can accommodate one person named in variation application V37966 under the PD (E) category, who also has sensory impairment. The maximum number of persons to be accommodated at New Wycliffe care home is 46. 18th November 2005 Date of last inspection Brief Description of the Service: New Wycliffe Home for the Blind offers care for up to 46 older people who have a visual impairment. The home is also registered to provide care for up to 20 people who have a dual impairment i.e. people who have sensory impairment and dementia. The home is situated close to the Rushey Mead area in Leicestershire. The home is set in its own large grounds, which are designed to enable service users with a visual impairment to use them fully. The accommodation is provided on the ground and first floor. This home has been extensively refurbished. There are lounge areas on both the floors. All the communal areas are colour coded to enable service users to identify their surroundings. A passenger lift or the stairs can access the first floor. All bedrooms are single rooms with en-suite facility. There are choices of communal sitting areas for Service Users use. The home is a smoke free area except for one lounge where service users are able to smoke. The range of charges falls between £425 and £ 506 per week, this information was provided at the site visit. New Wycliffe Home DS0000006413.V333804.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The focus of the 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 involves selecting Service Users from information provided prior to the site visit and tracking the care the selected Service Users received; through looking at individual records, talking with Service Users where possible, and looking at their accommodation. This inspection took place over one day, commencing at 9.00am and took six and one half hours to complete. One inspector conducted the inspection (or site visit). An opportunity was taken to look around the home, view records, policies and care plans and to talk to Service Users and staff. Information was gathered prior to the site visit form sources such as Service User, their relatives and staff comment cards; the pre inspection questionnaire from the manager and in some cases complaint information. The majority of Service Users were seen and nine spoken with during the inspection process, though due to the frailty of the resident group, few comments were made, some have been included in this report. What the service does well: Verbal comments received from service users include “The food is great I don’t like big meals or fruit, but the apple pie is great” “I can read my own mail, some (Service Users) need it read to them, they’ll do that where you want” “It was my birthday some weeks back, I got presents and a cake” the staff “are very good, they give most of their attention to them that needs it” Verbal and written comments received from relatives include (the care home) “liaises with the family, and takes a genuine interest in the wellbeing of the user” “We are very satisfied with the level of care given. The staff are friendly and considerate. The facilities are clean and comfortable” “X is kept nice and clean and the meals seem nice. X has settled well”
New Wycliffe Home DS0000006413.V333804.R01.S.doc Version 5.2 Page 6 The information provided to Service Users prior to moving into the home, was accurate and concise. The information in the Statement of Purpose and Service User Guide, supplied to Service Users and their families prior to moving into the home, is available in written and other formats such as cd-rom. The staff refer to the care plans as support plans and these are well written. Plans are reviewed regularly, are signed by the Service User or relative and provide staff with clear instruction how to deliver individual personalised care. Health care and medication are regularly monitored, and nutritional assessments are in place. Issues around Service Users privacy and dignity were adequately dealt with staff. An activities organiser has recently commenced employment in the home; this has enhanced the social care offered to Service Users. Service Users religious preferences are individually recognised. Meals are nutritionally balanced appealing and ethnically appropriate. Information on activities and menus are available in the home in a number of ways, ensuring Service Users with a sight impairment have access to the information. Service Users who were spoken with stated that they felt comfortable discussing any concerns with the home’s manager or staff. Service Users spoken with felt they were safe and protected, further training has been undertaken by the staff on the Adult Protection procedure. The home is decorated and furnished to a standard that creates a comfortable homely atmosphere. On the day of the unannounced site visit there were adequate numbers of staff to provide a caring service to the Service Users. The staff spoken with were clear about their individual roles in the provision of care within the home. Twenty-two of the thirty-six care staff having gained a nationally recognised training award, the National Vocational Qualification at level two or above. The staff recruitment practices are secure with all pre-employment checks being in place prior to staff commencing employment. Staff files also included an individual training plan. The current manager undertakes quality assurance in various ways, and presents findings back to Service Users and their relatives through the Service User Guide. Service User and staff meetings, staff supervision and appraisal and visits made by the board of trustees are all well established, these all adding to the quality systems in the home. A number of records were sampled and checks are in place to ensure safe practices prevail in the home New Wycliffe Home DS0000006413.V333804.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. New Wycliffe Home DS0000006413.V333804.R01.S.doc Version 5.2 Page 8 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 Outcomes Statutory Requirements Identified During the Inspection New Wycliffe Home DS0000006413.V333804.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 & 6. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The assessment process for Service Users is detailed and effective; resulting in accurate and detailed information for staff to ensure care needs shall be met. Standard 6, the home does not provide services for Service Users with Intermediate Care needs. EVIDENCE: Three Service Users were “case tracked”. One of the Service Users was admitted “privately” and is self-funding, the other two Service Users were Social Service funded, and all had an appropriate contract in place, all being signed by the resident or a relative. Therefore Service Users had the appropriate information supplied by the Responsible Person of the terms and conditions in the home, prior to moving in.
New Wycliffe Home DS0000006413.V333804.R01.S.doc Version 5.2 Page 10 The Inspector viewed the assessment information for three Service Users. The information gathered by the Manager for the Service Users was full and detailed, and was an excellent basis from which a plan of care could be compiled. The information supplied to Service Users in the Statement of Purpose, which sets out the latest aims, objectives and philosophy of the home, about its services, facilities, and current staffing, was viewed. This was supplied to Service Users and their families prior to moving into the home. This was again well detailed and available in written and other formats such as cd-rom. This ensures the information is available to suit the needs of all prospective Service Users and their families. Verbal and written comments received from relatives include “we did not receive a copy of a contract” New Wycliffe Home DS0000006413.V333804.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users are looked after well in respect of their health, medication and personal care needs, areas of risk are assessed appropriately, resulting in Service Users being safe in the home. EVIDENCE: The staff refer to the care plans as support plans and these are written in such a way that all the Service Users needs are taken into consideration. Personal healthcare needs including specialist health, nursing and dietary requirements are clearly recorded in each resident’s plan. The delivery of personal care is individual and is flexible, consistent and reliable. Care plans are regularly reviewed and reviews include the Service Users and on occasion, their families. Daily records are not filled in regularly, but this does not detract from the high level of care provided.
New Wycliffe Home DS0000006413.V333804.R01.S.doc Version 5.2 Page 12 Health care is well detailed with regular monitoring of Service Users health being evidenced by the Inspector. Nutritional assessments are in place, and Service Users have regular visits from the General Practitioner who does a twice weekly “surgery” in the home. Medication is well ordered and managed. The admission or assessment information contained details about the Service Users’ medication at that time. Records were well managed with no omissions in the medication administration records (mar charts). The home has an efficient medication policy supported by procedures and practice guidance, which staff understand and follow. Regular management checks are recorded to monitor compliance. Issues around privacy and dignity were adequately dealt with in the plans of care, and staff witnessed knocking and waiting for an answer prior to entering Service Users’ bedrooms. New Wycliffe Home DS0000006413.V333804.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service Users are offered a varied lifestyle resulting in a stimulating environment. EVIDENCE: Service Users social activities have been enhanced with the commencement of an activities organiser. This is a relatively new appointment and the person is still collecting information from Service Users and their families, with the hope of including detailed social care information in the main care or support plan. There are a number of volunteers at the home, who assist the activity coordinator, Service Users Easter bonnets were being completed and were a topic of conversation at the time of the Inspection. There continue to be regular Service Users and relatives meeting held at the home. New Wycliffe Home DS0000006413.V333804.R01.S.doc Version 5.2 Page 14 Service Users’ religious preferences are dealt with well, with a multi denominational chapel being used by the majority of Service Users in the home. One resident indicated their preference to continue to visit a temple, used prior to admission to the home. Menus were viewed and demonstrated that meals provided are nutritionally balanced appealing and ethnically appropriate. The cook now produces the ethnically appropriate meals, to compliment the variety of diets previously on offer. The cook has also been active in enquiring from the Service Users their current taste and choices, this has positively effected the meal choice in the home. The menu is displayed on the notice board outside the dining area giving a choice of two main meals. There is a talking notice board, which has been specifically designed for this home to inform people with a visual impairment what meals are available. This is also used to inform Service Users what activities are being offered during the week. A number of Service Users were observed discreetly being assisted with their meals. The interaction between the Service Users and staff was very positive. Comments made by Service Users on the day included “The food is great I don’t like big meals or fruit, but the apple pie is great” “I can read my own mail, some (Service Users) need it read to them, they’ll do that where you want” “It was my birthday some weeks back, I got presents and a cake” the staff “are very good, they give most of their attention to them that needs it” Verbal and written comments received from relatives include (the care home) “liaises with the family, and takes a genuine interest in the wellbeing of the user” “We are very satisfied with the level of care given. The staff are friendly and considerate. The facilities are clean and comfortable” “X is kept nice and clean and the meals seem nice. X has settled well” the manager could “allocate staff for Service Users attending hospital appointments” New Wycliffe Home DS0000006413.V333804.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users are protected by appropriate complaints and adult protection policies. EVIDENCE: Service Users who were spoken with stated that they feel very comfortable discussing any concerns with the home’s manager or staff. The complaints procedures are available for Service Users and visitors, and are included in the Statement of Purpose and Service User Guide. Service Users spoken with felt they were safe and protected. The Adult Protection procedure has been introduced and staff spoken with confirmed their recent training and were aware of their duties to alert a senior member of staff of any concerns. New Wycliffe Home DS0000006413.V333804.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. A comfortable and safe standard of accommodation is provided for the Service Users. EVIDENCE: Service Users live in a homely, comfortable and clean environment. The home is decorated and furnished to a standard that creates a comfortable homely atmosphere, and takes into consideration the needs of the majority of sightimpaired people in the home. There are several lounges on the ground and first floor of the home. There is a large dining room and conservatory close to the kitchen. Entry to the home and to the garden is wheelchair friendly. Both internal and external areas of the home are designed to be suitable for people who have a visual impairment.
New Wycliffe Home DS0000006413.V333804.R01.S.doc Version 5.2 Page 17 The garden area is flat with climbing plants, potted plants and seating areas, and is designed to include a sensory area to stimulate all senses. The grounds are well maintained. The home is clean staff are aware of cross infection and cross contamination issues, and this increases Service Users safety in the home. New Wycliffe Home DS0000006413.V333804.R01.S.doc Version 5.2 Page 18 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users are supported and protected by a well-trained and competent staff group, and by appropriate recruitment practices. EVIDENCE: On the day of the visit there were seven members of care staff on duty to provide care for the Service Users. In addition to this there were the Manager, her Deputy, senior care staff, the cook, domestic staff, groundsman and handy person. At present there are forty-three Service Users for whom care is provided. There are also volunteers to assist in the promoting Service Users interests and hobbies along with the employed staff. The responsibilities of the staff in the home are specific and there are job descriptions for all of these different roles. The staff spoken with were clear about their individual roles in the provision of care within the home. Twenty-two of the thirty-six care staff having gained the National Vocational Qualification at level two or above, more staff are currently undertaking the training. The recruitment practices within the home were viewed. Three staff files were viewed, two being for staff who have commenced since the last inspection at
New Wycliffe Home DS0000006413.V333804.R01.S.doc Version 5.2 Page 19 the home. All staff files had the appropriate legalistic checks, current Criminal Records Bureau clearance, and appropriate references. Staff files also included an individual training plan. These are compiled following a staff appraisal interview, and the training completed contained the statutory training essential for staff in this type of home. New Wycliffe Home DS0000006413.V333804.R01.S.doc Version 5.2 Page 20 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The management approach promotes effective care practice in the home so ensuring Service Users’ care and protection. EVIDENCE: The current manager is qualified and experienced to run the home. Quality assurance is well developed in the home with a number of questionnaires being distributed to Service Users, their relatives, staff and other interested parties visiting the home. Findings from these have been
New Wycliffe Home DS0000006413.V333804.R01.S.doc Version 5.2 Page 21 entered into the Service User Guide so informing prospective Service Users of the quality initiatives used in the home. Resident and staff meetings and staff supervision and appraisal are well established, these also adding to the quality systems in the home. These issues are good practice and go some way to ensure the home is run in the best interests of the resident group. The home is visited periodically by the Responsible Person and records of those visits are kept in the home. Further visits are made by the board of trustees who oversee the running of all homes within the group, and add a further tier to the quality management structure within the home. Three Service Users personal allowance records were sampled, and found to be correct. Staff supervision is well established with all the senior management team involved in the process. Practice and performance are discussed during supervision, staff training and team meetings, with individual Service Users cases being discussed in detail at supervision and changes to care plans made accordingly A number of records were sampled and checks are in place to ensure safe practices for fire and testing of the fire alarm and warning system. The monitoring of hot water temperatures and a sample of risk assessments were seen in place. The homes systems are audited at least twice a year, to ensure Service Users safety in the home. These records were seen and remedial work was noted in a number of entries so ensuring standards were maintained throughout the home. There is full recording of accidents, with these correlating to the daily records of Service Users. New Wycliffe Home DS0000006413.V333804.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X 3 3 X 3 New Wycliffe Home DS0000006413.V333804.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes 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. 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. Refer to Standard Good Practice Recommendations New Wycliffe Home DS0000006413.V333804.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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