Inspection on 07/04/05 for Rosemead Care Home

This inspection was carried out on 7th April 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

Rosemead Care Home 28/04/10

Rosemead Care Home 10/08/09

Rosemead Care Home 10/05/07

Rosemead Care Home 07/11/06

Rosemead Care Home 14/06/06

Rosemead Care Home 06/09/05

Rosemead Care Home 29/09/04

Rosemead Care Home 27/04/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Wynthorpe Rest Home 10-12 Rectory Road Walthamstow London E17 Lead Inspector Rob Cole Announced Inspection 7th April 2005 10:00am 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. Wynthorpe Rest Home Version 1.10 Page 3 SERVICE INFORMATION Name of service Wynthorpe Rest Home Address 10-12 Rectory Road, Walthamstow, London E17 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) 020 8520 6027 020 8520 6027 sagecare@hotmail.com Mr Saeed Ahmed Ms Dorett May (aka Dee) Buchanan Care Home 14 Category(ies) of Old age, not falling within any other category registration, with number (14) of places Wynthorpe Rest Home Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th September 2004 Brief Description of the Service: Wynthorpe Rest Home is registered to provide support and accommodation to fourteen service users over the age of sixty five. The home is situated in a residential area of Walthamstow in the London Borough of Waltham Forest, and is close to shops, transport links and other local ammenities. The home consists of two houses that have been converted in to one, and is built over two floors. The home is privatly run. Wynthorpe Rest Home Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on the 7/4/05 and was announced. The homes manager was present throughout the course of the inspection. The inspector also had the opportunity of speaking with service users and their relatives, members of the staff team, and the homes proprietor. The inspection also included an examination of policies and procedures, along with record keeping, and a tour of the premises. The manager also completed a pre inspection questionnaire prior to inspection, and the inspector received several feedback cards from service users and their relatives. What the service does well: What has improved since the last inspection? What they could do better: Despite some improvements, the inspector still has some serious concerns about the home, and believes there is much room for improvement. Staffing levels have increased since the last inspection, but they are still not adequate to meet service users needs. Further, the manager is still not given enough time to carry out their management functions. Wynthorpe Rest Home Version 1.10 Page 6 Service users and staffs health and safety is at risk, staff have not been trained in food hygiene, manual handling and first aid, and the home is in desperate need of an appropriate hoist to help lift service users. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Wynthorpe Rest Home Version 1.10 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 Wynthorpe Rest Home Version 1.10 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 and 5 The inspector was satisfied that prospective service users are provided with sufficient information about the home to enable them to make an informed choice as to move in or not, through written documentation and visits to the home. EVIDENCE: The home had key documents in place to help enable service users to make an informed choice about the home prior to admission. Both the Statement of Purpose and Service User Guide were available, and written in plain English, although the Guide still needs updating to include all information required by National Minimum Standards, for example information on room sizes. All service users are given an individual written and signed contract/statement of terms and conditions. The home has an admissions procedure, which stated that service users would be able to visit the home before making any decisions as to move in or not, and that they would initially move in on a six week trial basis, after which they would hold a meeting specifically to review the placement. The inspector was informed by service users and their families that they did indeed have the opportunity of visiting the home before making a decision as to move in or not. Wynthorpe Rest Home Version 1.10 Page 9 There have been new admissions to the home since the previous inspection, and the inspector was pleased to note that thorough pre admission assessments were undertaken before admission, thus meeting a requirement set at the previous two inspections. The home does not provide intermediate care. Wynthorpe Rest Home Version 1.10 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) 7,8,9,10 and 11 While the inspector believes that service users will benefit from the improved care plans now in place, they have serious concerns over the safety of service users with regard to medication, and the poor standard of risk assessments, which suggests not enough thought has been given to reducing and managing risks within the home. EVIDENCE: The inspector was pleased to note that service user’s care plans have improved considerably since the last inspection, and now include information on personal care, mobility, medication and social and leisure needs. Plans were regularly reviewed, and drawn up with the involvement of the service users. However, as at the last inspection, service users risk assessments are still very basic. For example, one service user has epilepsy, and on the day before the inspection had a seizure which resulted in a fall, which necessitated hospital treatment, yet there was no risk assessments in place for this service user around falling or epilepsy. Service users are all registered with a GP, and since the last inspection the home now maintains records of medical appointments and any follow up action required, however, there was no evidence that some service users have had any access to dental treatment in the past three years, and it is required that Wynthorpe Rest Home Version 1.10 Page 11 service users have access to medical treatment including dental care as appropriate. The home has a medication policy in place, and staff receive training from the supplying pharmacist before they are able to administer medications. However, the inspector had a number of concerns over medication in the home. There were no records of medications returned to the pharmacist, MAR charts contained unexplained gaps in them, while other medications had been signed as been given when they had no in fact been given, and there were no guidelines in place for the administration of medications prescribed on a PRN basis. All of this must be addressed. Wynthorpe Rest Home Version 1.10 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) 12,13,14 and 15 Although the home makes efforts to provide social and leisure activities for service users, these should be tailored to meet individual service users needs. The home needs adequate kitchen appliances to meet service users needs. EVIDENCE: There was evidence that service users have a large measure of control over their every day lives, for instance they informed the inspector that they are able to get up and go to bed as they wished, and service users were observed to move freely around communal areas. The inspector also spoke with relatives of service users, who said that they are able to visit when they like, and are always made welcome. In house the home provides a variety of social and leisure interests, for example bingo, quizzes and reminisance groups. At the previous inspection the inspector noted a gentle exercise class been held, which was well attended by service users, who appeared to be enjoying it. At this inspection the manager informed the inspector that this session has been withdrawn due to financial reasons, however, service users spoken to informed the inspector that they would like this to be provided again, and it is required that the home meets service users social and leisure needs in line with their assessed needs and stated preferences. Records are kept of menus, and these indicated that service users are offered a varied, balanced and nutritious diet, and service users informed the inspector Wynthorpe Rest Home Version 1.10 Page 13 that they are generally satisfied with the standard and quantities of food provided. However, the staff informed the inspector that the homes oven was not suitable to meet the needs of service users, in that it was not adequate to cook meals for thirteen people in one sitting. The proprietor informed the inspector that he was in the process of purchasing a new oven for the home. Further, the kitchen fridge is not suitable for the home, as the seals are broken and it leaks. It is required that the home has adequate kitchen appliances to meet the needs of service users. Wynthorpe Rest Home Version 1.10 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) 16,17 and 18 The inspector has concerns that the home has not taken sufficient steps to safeguard service users from abuse, in that staff are not all trained in adult protection issues. EVIDENCE: Since the previous inspection the home has updated its complaints procedure, this now makes appropriate reference to the CSCI and has timescales in place for responding to complaints. The home has a complaints log. The home had a copy of the Local Authorities adult protection procedures, and also its own adult protection procedure. However, staff questioned by the inspector showed only a limited understanding of the issues involved with adult protection, and several staff have not received any training in this issue. It is a repeat requirement that all staff employed at the home receive training in adult protection. The inspector was satisfied that legal rights of service users are safe guarded, for example the manager informed the inspector that all service users are on the electoral register, and service users spoken to informed the inspector that they are ale to vote in elections. Wynthorpe Rest Home Version 1.10 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) 19,20,21,22,23,24,25 and 26 Overall, the home appears to suitable to meet its stated purpose, and the inspector considers bathroom/toilet facilities, communal spaces and bedrooms sufficient to meet service users needs. However, staff and service users are been placed at risk through the routine practice of manually transferring and lifting service users. EVIDENCE: The home is situated in a residential area of Walthamstow in the London Borough of Waltham Forest, close to shops, transport links and other local amenities. The home was generally well maintained, both internally and externally, and the inspector was pleased to note that the damaged bathroom tiles and missing radiator had been addressed since the last inspection. The communal areas consist of one sitting room, two dinning areas, a conservatory and a garden with garden furniture. All service users have their own bedrooms, which met National Minimum Standards on size requirements and were decorated to service users individual tastes, for example with family photographs. Bedrooms had adequate natural light and ventilation, and all had Wynthorpe Rest Home Version 1.10 Page 16 heating systems installed. All bedrooms have a hand basin in them. The home had adequate bathing and toilet facilities to meet service users needs. The home has a policy in place on infection control, and protective clothing such as latex gloves were available to staff. COSHH products were stored securely. The home has arranged for an assessment of the premises by a suitably qualified occupational therapist since the last inspection, and at the next inspection the inspector will be looking to see if any recommendations made have been adopted were appropriate. The home has some adaptations in place, such as handrails, and there is a hoist. However, staff informed the inspector that this hoist was not suitable to meet service users needs, and staff were routinely expected to transfer service users manually in and out of bed, thus presenting a health and safety risk to staff and service users. It is required that the home provides adequate mechanical aids for the lifting of service users. The home has an emergency alarm call point system, but this was not installed in all bedrooms, and this must be addressed. Wynthorpe Rest Home Version 1.10 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) 27,28,29 and 30 The inspector believes that service users are been put at risk by a mixture of dangerously low staffing levels and staff that have not received adequate health and safety training. EVIDENCE: The home has policies in place on equal opportunities and recruitment and selection. However, through checking staff files there was evidence that new staff have been employed in the home without satisfactory pre employment checks been carried out, including CRB’s, passports and birth certificates. Repeat requirements have been set around this. Of the eight care staff employed at the home, six either have or are currently working towards a relevant NVQ Care qualification. Training is on going, and records evidenced recent staff training in infection control and fire safety. However, several staff have not received all mandatory health and safety training, including first aid, food hygiene and manual handling, which is particularly worrying in light of the level of manual handling currently expected of staff. It is required that all staff receive all necessary statutory training. The home provides 24-hour staff support, and staffing levels have increased since the last inspection, in that there is now a third staff member on duty between 3pm and 6pm Monday to Friday. However, although staff informed the inspector that this has improved the staffing situation, they still do not think staffing levels are adequate, particularly at weekends. The home only has two staff working from 3pm until 10pm on weekends, even though three of the service users require the support of two staff when going to bed, thus no staff are available at these times to support the rest of the service users. Further, Wynthorpe Rest Home Version 1.10 Page 18 the manager is expected to be on shift every day they work, and have to fit in their administrative duties around their care duties, and they informed the inspector that they did not have sufficient time to satisfactorily complete all their administrative duties. Repeat requirements have been set around these issues, and continued failure to comply may lead the CSCI to take enforcement action against the home. Wynthorpe Rest Home Version 1.10 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) 31,32,33,35,36,37 and 38 The inspector believes that although the homes manager is sufficiently experienced to manage the home, they are not given sufficient time to carry out their duties, and this has led to shortfalls in health and safety issues and record keeping. EVIDENCE: The manager has fourteen years experience of working with this client group, including the last seven in a managerial capacity, and they have successfully completed an NVQ Level 4 in Care. Staff and service users both informed the inspector that they found the manager to be approachable and accessible, and were observed to interact with her in a relaxed manner. However, due to the lack of time allocated to carry out administrative duties, they are unable to maintain all required paperwork in line with National Minimum Standards and Regulations, for example supervisions and risk assessments have not been kept up to date. Wynthorpe Rest Home Version 1.10 Page 20 The home issues questionnaires to staff on the running of the home, and since the last inspection these are now issued to service users as well. Copies of previous inspection reports were available in the home, and there was a poster on display advertising this inspection. However, there was still no evidence that Regulation 26 visits are taking place. The inspector discussed this issue with the homes proprietor during the course of the inspection, the proprietor informed the inspector that he would start to do monthly unannounced Regulation 26 visits. The home holds monies on behalf of service users, this is stored in a locked safe, and records and receipts are maintained of financial transactions, those checked by the inspector appeared satisfactory. However, the records indicated that some service users have not received any personal monies in the past two years, the manager explained that this was because the service users family collected their money on behalf of the service user, but did not pass it on to the home, despite requests from the home for money. It is required that the home makes every reasonable effort to ensure that service users get full access to all monies they are entitled to. Since the last inspection the home has had an electrical installation safety inspection, and now records hot water temperatures, but these indicated that temperatures were often in excess of 43 degrees Celsius and this must be addressed. Other health and safety issues need to be addressed, including replacing the fire blanket in the kitchen which is in a poor state of repair, and ensuring that PAT testing is carried out at least once every twelve months. Wynthorpe Rest Home Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 3 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 3 3 3 1 3 3 3 3 STAFFING Standard No Score 27 1 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 3 2 2 3 2 x 2 2 x 2 Wynthorpe Rest Home Version 1.10 Page 22 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 OP8 Regulation 13 Requirement Timescale for action 30/6/05 2. OP18 13 3. OP29 19 The registered person must ensure that all service users have access to appropriate health care, including regular access to dental and eye care, and that records are maintained of all appointments. (Timescale 31/1/05 not met) The registered person must 30/6/05 ensure that all staff who work in the home are aware of their responsibilities with regard to adult protection issues, and are familiar with any relevant policies and procedures, and that they receive appropriate training in adult protection issues. (Timescale 31/1/05 not met) The registered person must 30/6/05 ensure that all documentation required by Schedule 2 of the Care Homes Regulations 2001 is in place for all staff working in the home. (Timescale 31/1/05 not met) The registered person must ensure that the home tests and records on a weekly basis all hot water temperatures used for personal care to ensure they do Version 1.10 4. 5. OP38 138 30/6/05 Wynthorpe Rest Home Page 23 6. OP27 18 7. OP7 OP38 13 8. OP1 5 9. OP9 13 10. OP9 13 11. OP9 13 12. OP1216 16 13. OP15 23 not exceed 43 degrees Celsius. (Timescale 31/1/05 not met) The registered person must ensure that sufficient staff are on duty at all times to meet the assessed needs of the service users. (Timescale 31/1/05 not met) The registered person must ensure that risk assessments are undertaken for safe working practices and for service users undertaking any activities that involve risk taking. The risk assessments must be placed on service users files and be subject to regular review. (Timescale 31/1/05 not met) The registered person must ensure that the Service User Guide contains all information required by National Minimum Standards. The registered person must ensure that records are maintained of all medications that are returned to the pharmacist. The registered person must ensure that MAR charts are accuratly maintained, and that all medications administered are accounted for. The registered person must ensure that written guidelines are in place for the administration of all medications prescribed on an as required basis. The registered person must ensure that the home provides appropriate social and leisure activities in line with service users assessed needs and stated preferences. The registered person must ensure that the home has kitchen appliances, including Version 1.10 30/6/05 30/6/05 30/6/05 30/6/05 30/6/05 30/6/05 30/6/05 30/6/05 Wynthorpe Rest Home Page 24 ovens and fridges, that are in full working order and adequate to meet the needs of service users. 14. 15. 16. OP22 13 The registered person must ensure that the home has appropriate mechanical lifting devices in place suitable to meet the needs of service users. The registered person must ensure that emergency call point alarm systems are fitted in all bedrooms. The registered person must ensure that all staff receive statutory health and safety training in moving and handling, first aid and food hygiene. The registered person must ensure that monthly Regulation 26 visits are carried out, and that a copy of the report of these visits is sent to the CSCI and a copy retained in the home. The registered person must make every reasonable effort to ensure that all service users receive all monies that they are entitled to. The registered person must ensure that staff receive regular formal supervision, at least six times a year. The registered person must ensure that the fire blanket in the kitchen is in a good state of repair. The registered person must ensure that the home undertakes Portable Appliances Testing at least once every tweleve months. 30/6/05 17. OP22 13 30/6/05 18. OP30 13 30/6/05 19. OP33 26 30/6/05 20. OP35 12 30/6/05 21. OP36 18 30/6/05 22. OP38 13 and 23 30/6/05 23. OP38 13 and 23 30/6/05 Wynthorpe Rest Home Version 1.10 Page 25 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 Wynthorpe Rest Home Version 1.10 Page 26 Commission for Social Care Inspection 4th Floor, Gredley House 1-11 Broadway, Stratford London E15 4BQ 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 Wynthorpe Rest Home Version 1.10 Page 27 - 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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