Inspection on 27/07/05 for Padgate House

This inspection was carried out on 27th July 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

Padgate House 18/04/07

Padgate House 09/11/05

Padgate House 05/11/04

Padgate House 24/06/04

Padgate House 09/03/04

Padgate House 07/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Littledale Hall Therapeutic Community

Dystlegh Grange

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

CARE HOMES FOR OLDER PEOPLE Padgate House Vulcan Close Padgate Warrington WA2 0HL Lead Inspector Wendy Smith Announced Inspection 27 July 2005 09:30 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. Padgate House F51 F01 S36225 Padgate House V231137 270705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Padgate House Address Vulcan Close Padgate Warrington WA2 0HL 01925 821639 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) Warrington Borough Council Mrs Ann Bodie Care Home 36 Category(ies) of OP - Old Age (36) registration, with number DE(E) - Dementia over 65 (6) of places DE - Dementia (6) MD(E) - Mental Disorder over 65 (2) Padgate House F51 F01 S36225 Padgate House V231137 270705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 The home is registered for a maximum of 36 service users to include:* * * * * * * * * 2 Up to 36 service users in the category OP (old age, not falling within any other category) Up to 6 service users aged over 65 years with dementia (DE(E)) Up to 6 service users under 65 years with dementia (DE) Up to 2 service users aged over 65 years with a mental disorder (MD(E)) Up to 2 service users under 65 years with a mental disorder (MD) Up to 2 service users aged over 65 years with past or present dependence (A(E)) Up to 2 service users aged under 65 years with a past or present alcohol dependence (A) 1 service user aged over 65 years with a past or present drug dependence (D(E)) 1 service user aged under 65 years with a past or present drug dependence (D) The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Date of last inspection 5th November 2005 Brief Description of the Service: Padgate House is a modern single storey building located in a residential area of Warrington. It is within easy reach of local shops and other amenities and is served by public transport. It is owned and managed by Warrington Borough Council. A total of 36 places are registered for older people, however a maximum of 35 people are accommodated. These are made up of two long stay places, intermediate care for 24 people, step up care for five people and short stay respite care for four people. Service users in receipt of intermediate care are admitted under the care of a medical consultant, other service users receive medical services from local GP practices. Nursing input is provided by nursing staff employed by the local Primary Care Trust. An office in the centre is used as the base for the evening and night nursing service, and the nurses are available for advice and support as needed. Input from physiotherapy and occupational therapy is provided by staff based within the home. Two social workers are also based at the home.The premises was purpose built and designed to meet the needs of older people. There are four lounge/dining areas, each of which has a kitchenette. The bedrooms are single, with the exception of one twin room which is available for service users who may wish to share. Toilets and assisted bathrooms are located near to the bedrooms and living areas. Padgate House F51 F01 S36225 Padgate House V231137 270705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was carried out by an inspector, accompanied by a regulations manager, on 27th July 2005 between 9:30am and 2pm. Two long stay residents were living at the home and a further 23 people were receiving short term care. A tour of the building was conducted, including all communal areas and some bedrooms. Time was spent in conversation with the service manager and other staff. Five service users and two visitors were spoken with. A sample of records was inspected. Some of the information contained in this report was taken from the pre-inspection questionnaire that had been completed by the manager. Two relatives had completed comments cards. One wrote that ‘we couldn’t have asked for better care for our Mum’ and the other remarked on ‘a good friendly atmosphere at all times’. A GP’s comments card contained wholly positive responses. What the service does well: Padgate House provides short term care services for older people leaving hospital, or requiring a period of additional support, to meet a need that has been identified by research. The service is flexible and constantly evolving to respond to changing needs. The service brings together the local authority, the primary care trust and the acute trust in collaboration. A multi-disciplinary team is based within the home, which ensures that service users have access to specialist services on a daily basis. Two residents, who have lived at Padgate House for several years, continue to be supported in their chosen environment. A range of social activities is provided on a regular planned basis. A good choice of meals is offered. The building is clean and well maintained throughout. The local authority provides regular training for staff. Padgate House F51 F01 S36225 Padgate House V231137 270705 Stage 4.doc Version 1.30 Page 6 There is a good standard of record keeping. 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. Padgate House F51 F01 S36225 Padgate House V231137 270705 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 Padgate House F51 F01 S36225 Padgate House V231137 270705 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. Service users are assessed by a suitably qualified person before admission to ensure that their needs can be met. Service users admitted for intermediate care are helped to regain their independence, however facilities can be further improved. EVIDENCE: Padgate House no longer admits people for long term care. Service users admitted for intermediate care usually spend a maximum of six weeks at Padgate House, however this may sometimes extended. A total of 366 older people had been admitted to the home during the last year. Service users may be referred for step up care or respite care by their doctor or social worker. Step up care can only be provided with the agreement of their doctor. One of the nurses working in the home goes out to assess anyone who is referred and may take a social worker with them to contribute to the assessment. These arrangements also apply at the weekend. Admissions after 8pm are discouraged but occasionally occur. Padgate House F51 F01 S36225 Padgate House V231137 270705 Stage 4.doc Version 1.30 Page 9 Residents admitted for intermediate care are assessed by a social worker prior to admission being agreed. They must have minimal nursing needs. If any wound care is needed, the district nurses are consulted prior to admission being agreed Rehabilitation is provided by therapy staff working in the home. Care staff also work towards promoting self care and independence. The service manager said that one of the lounge/dining rooms is going to be used for service users to make their own drinks and snacks and prepare their own breakfast. Two social workers are based at the home and provide support for service users returning home or transferring to residential care. Padgate House F51 F01 S36225 Padgate House V231137 270705 Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 10. Each service user has a care plan that details their needs and how they should be met. Service users health needs are met in full. Service users privacy and dignity are respected. EVIDENCE: Each service user has a care plan that is based on the assessment carried out by the nurse or social worker. The care plans are kept brief, and work alongside records kept by the nurses and therapy staff. The service manager tried to develop a system of integrating all of these records into one folder, but encountered many practical difficulties in implementing this. Three nurse are employed by the primary care trust to provide nursing care, including administration of medicines, to service users in ‘step up’ places. District nurses provide services for service users receiving intermediate care, respite care, and for the two permanent residents if needed. Padgate House F51 F01 S36225 Padgate House V231137 270705 Stage 4.doc Version 1.30 Page 11 Two medical consultants visit the home weekly and a general practitioner visits on most days. Physiotherapy and occupational therapy are provided on a daily basis. Other services such as optician, chiropodist, dentist, are contacted as and when needed. The home receives a weekly visit from a pharmacist and the manager said that this is very helpful as there is a rapid turnover of medicines entering and leaving the home. Arrangements have been made so that the visiting medical consultants are now able to write prescriptions during their visits to the home. The service users spoken with said that staff treat them with respect and are always polite and kind. All bedroom doors are fitted with locks and service users are provided with a key for their door. A letter received from the family of a recently deceased service user thanked the home for the person’s ‘last days in comfort, peace and dignity’. Padgate House F51 F01 S36225 Padgate House V231137 270705 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 15 Service users are able to exercise choice in daily living routines and social activities are provided. Visitors are welcomed at any reasonable time. Service users have a good choice of meals in small dining rooms. EVIDENCE: Service users spoken with said that they are able to choose what time they would like to get up and go to bed. They have a choice of sitting areas, and some people prefer to stay in their own room. An activities organiser is employed and a programme of social activities is available for all who wish to participate. A hairdresser visits weekly. The home has a payphone. This is situated in the smoking area, which may not be acceptable to all service users, and does not provide any privacy for people making calls. See recommendation Padgate House F51 F01 S36225 Padgate House V231137 270705 Stage 4.doc Version 1.30 Page 13 Breakfast is served on an individual basis at any time during the morning. Cooked breakfast is available between 8am and 9:30am. Lunch is at 12, tea at 4pm, and supper, which includes sandwiches and snacks, is at 7:30pm. Night staff have access to all food supplies. There is a choice of three main courses at lunchtime. Hot and cold drinks are made in the kitchenette areas whenever service users would like them and biscuits are always available. The inspectors had the opportunity to sit with residents at lunch time and the standard of the meal was very good. Padgate House F51 F01 S36225 Padgate House V231137 270705 Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18. Complaints are dealt with appropriately. Service users are protected from abuse. EVIDENCE: The home has a complaints procedure to meet the required standard that is provided by Warrington Borough Council. Two complaints had been recorded since the last inspection. Records were available in a complaints file and these demonstrated that the complaints had been fully investigated by the local authority. The local authority also provides policies and procedures for the protection of vulnerable adults, and staff working in the home have received training about abuse. Padgate House F51 F01 S36225 Padgate House V231137 270705 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26. The home is clean and well-maintained. EVIDENCE: The building is divided into four living areas each comprising a lounge/dining room, an assisted bathroom, toilets and bedrooms. All areas of the home were found to be clean and well maintained. There are outdoor sitting areas planted with flowers and shrubs. A canopy was due to be fitted in the garden on the following day to provide shade for residents sitting outside. Car parking spaces are limited. The kitchen was inspected by the environmental health officer on the same day as this inspection and a small number of minor issues were identified as needing attention. Padgate House F51 F01 S36225 Padgate House V231137 270705 Stage 4.doc Version 1.30 Page 16 The home has a laundry for bedding and towels and for personal items belonging to the two permanent residents. Service users receiving short term care usually make their own arrangements for personal laundry, however this can be done in the home in special cases. The laundry is operated by the general assistants who have allocated hours for this. Padgate House F51 F01 S36225 Padgate House V231137 270705 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 28. The number and skill mix of staff meets the needs of the service users. The home is working towards having 50 of care staff having an NVQ qualification. EVIDENCE: The staff rota showed that there is always a senior carer on duty during the morning and afternoon shifts and usually at night. In addition to this, a third senior carer works a ‘short shift’ on most days in order to carry out specific duties. Care staff work a four weekly rota, with four carers on duty between 8am and 10pm. There are usually three staff on duty during the night, but sometimes only two. General assistants provide housekeeping services and also carry out some care tasks. Staff do not usually work in excess of 37 hours per week and overtime in excess of this has to be authorised by a senior manager. Warrington Borough Council has an NVQ centre. NVQ assessors are now available to work with the home’s staff out of office hours. Six members of care staff have enrolled to start working towards NVQ level 2. Senior care staff have either achieved, or are working towards, NVQ level 3. The administration manager is working towards a Registered Manager Award. Padgate House F51 F01 S36225 Padgate House V231137 270705 Stage 4.doc Version 1.30 Page 18 The local authority provides training programmes for all grades of staff and the home’s training records have been improved so that they show what training each member of staff has received and when. Padgate House F51 F01 S36225 Padgate House V231137 270705 Stage 4.doc Version 1.30 Page 19 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, 36 The home is managed by a suitably qualified and experienced person. Quality assurance processes are implemented. Health and safety safeguards are in place. EVIDENCE: Following re-structuring, Padgate House is now part of the Community Services department of Warrington Borough Council. The service manager is an experienced practitioner in the field of social care and has experience working in a senior management capacity in a variety of social care settings. She has a social work qualification and a professional qualification in management. Padgate House F51 F01 S36225 Padgate House V231137 270705 Stage 4.doc Version 1.30 Page 20 Monthly visits required by regulation 26 of the Care Homes Regulations are carried out by a principal officer employed by the local authority. Service users and their relatives are surveyed following their visits and the results of these surveys are published. At the time of the inspection the service manager was re-designing the survey forms used to ensure that as much information as possible is gleaned from them. Medical staff working in the home also provide feedback. The local authority provides training for staff relating to health and safety matters, and there is a health and safety notice-board in the staff room. Risk assessments are in place for all working tasks and for the building. The home will become a no smoking building for staff in the near future. All COSHH products are kept in locked store room. The manager provided evidence that all equipment used in the home had been serviced and maintained within the last year. Some service users may be admitted with infections such as MRSA. Staff have received training regarding infection control and dispensers containing hand disinfecting gel were installed. However it was noticed during the inspection that there were soaps and other toiletries in the bathrooms. These should not be shared between service users and should always be returned to the bedroom after bathing. See recommendation. Fire doors in the corridors are fitted with magnetic catches that close the doors automatically when the fire alarm is activated. Bedroom doors are not fitted with these devices, so must be kept closed. See recommendation. Padgate House F51 F01 S36225 Padgate House V231137 270705 Stage 4.doc Version 1.30 Page 21 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 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 4 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 2 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 3 x x x x 3 Padgate House F51 F01 S36225 Padgate House V231137 270705 Stage 4.doc Version 1.30 Page 22 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. 2. 3. Refer to Standard OP12 OP38 OP38 Good Practice Recommendations Improve telephone facilities for service users. Make sure that toiletries are not shared. Consider fitting automatic closers to bedroom doors. Padgate House F51 F01 S36225 Padgate House V231137 270705 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Unit D, Off Rudheath Way Gadbrook Park Northwich Cheshire, CW9 7LT 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 Padgate House F51 F01 S36225 Padgate House V231137 270705 Stage 4.doc Version 1.30 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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