Inspecting for better lives Random inspection report
Care homes for older people
Name: Address: Ross Wyld Nursing Home Ross Wyld 458 Forest Road Walthamstow London E17 4PZ The quality rating for this care home is: The rating was made on: one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Caroline Mitchell Date: 1 6 0 1 2 0 0 9 Information about the care home
Name of care home: Address: Ross Wyld Nursing Home Ross Wyld 458 Forest Road Walthamstow London E17 4PZ 02085218773 02085200690 ross.wyld@fshc.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Tamaris (South East) Limited (a wholly owned subsidiary of Four Seasons Health Care Limited) care home 54 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability 0 0 7 Over 65 22 25 0 Conditions of registration: To allow the home to provide continuous care for two named service users and to permit admission of one named service user with mental health needs. Date of last inspection Brief description of the care home Ross Wyld is a care home registered to provide care for a maximum of 54 residents. This includes 25 places for those requiring nursing care, 22 places for older people with dementia and 7 places for younger adults with physical disabilities. The registered provider is Tamaris Ltd, part of the Four Seasons Health Care Group. The home is a large purpose built, three storey detached house with 48 single bedrooms and three Care Homes for Older People
Page 2 of 10 double bedrooms located across all three floors. All floors are accessible via a lift. The home is situated on Forest Road, in the London Borough of Waltham Forest. Situated in the Walthamstow area and is close to shops, transport networks and other local amenities. The William Morris Museum and Lloyd Park are local landmarks just opposite the care home. The fees are normally between £450 to £736 for each placement per week, and the people who use the service are expected to pay separately for items such as hairdressing, outings and clothes. Following Inspecting for Better Lives the provider must make information available about the service, including inspection reports, to the people who use the services and other stakeholders. Care Homes for Older People Page 3 of 10 What we found:
This was an unannounced inspection carried out on 15th and 16th January 2009. The inspection was unannounced so the manager was not aware that we were coming. The inspection was carried out in the light of a number of concerns raised by the local authority the London borough of Waltham Forest. (LBWF) These concerns included, doubts about the staffs ability to know if a person living there was ill, poor hygiene, and consequently unpleasant smells in the home, poor standards in care planning, poor standards of care and consequently people looking unkempt and being low, the possibility of people being left unsupervised or neglected. There were concerns that staff may not be provided with training en There were concerns about the attitude of the temporary manager in responding to a specific issue, concerns about the number of safeguarding issues that have arisen in the home over the past year and about a high management turnover. The first inspection visit took around five and a half hours to complete and we returned the following evening for an hour. We looked generally at the concerns raised, although we did not conduct a formal investigation into these concerns. The inspection did not look at the outstanding requirements that were made at the last inspection. It is intended that these be tested as part of the next key inspection of the home. What the care home does well:
We looked at the care plans and risk assessments for two people, one person being cared for on the nursing unit and one person living in the residential unit. Both peoples plans and risk assessments were of a reasonable standard and had been reviewed regularly. There was evidence that the staff in the residential unit regularly sought the input of other professionals, such as the GP and District Nurses about peoples health care needs. We also spoke briefly to three social workers who were visiting two people living in the home. They said that they did not have concerns about the care plans for the people they were visiting. One social worker said that some minor changes were necessary to one persons care plan, and that this was in relation to continence management. We discussed the staffs ability to recognise if someone became ill with the temporary manager and he did not consider this a concern. He was clear that there are qualified nurses on duty at all times, in the nursing unit. We looked at the staff rota for a two week period around the time of the inspection and found that this was the case. The temporary manager was also clear that he had not found the home short staffed, there being sufficient staff for the numbers and needs of the people living there. Feedback from the relatives we spoke to was that they sometimes have to wait for some time for a second staff member in the nursing unit, if two staff are required to lift their relative. It is recommended that the registered person undertake a review of staffing at key times of the day, to make sure that there are staff available to meet peoples needs. We were able to move freely around the home, unaccompanied by staff and spoke to several people in the main lounge and to some people who were in their rooms. All looked clean and were appropriately dressed. All, who were able to talk to us, said they were happy in the home. We noted that people were under staff supervision as there were staff available on all floors, some engaging with people and some Care Homes for Older People
Page 4 of 10 responding when needed. There have been three safeguarding issues in the home since October 2008 and the Commission is aware that two of these are as a result of members of Four Seasons management team reporting and dealing with issues of bad practice. A temporary manager was dismissed in December 2008. This was because of her involvement in an incident which resulted in a person using the service being injured. Two staff in the home used the whistle blowing process to report their concerns to the senior managers of Four Seasons and copied the information to the Commission. Four Seasons alerted the local authority and this was dealt with through the safeguarding process. We toured all communal areas of the building and did not detect any unpleasant odours in the lounges or the corridors. Some carpets have been replaced and the home smelled clean and fresh at the time of the visit. The Commission is aware that there is an ongoing issue for one person living in the home, as they are reluctant to allow staff access to their room. We have previously seen the care plan for this person and evidence of the various interventions that staff use to address this. We were told that carpet tape was being used until recently, to prevent trip hazards, as a result of the alterations being made to the home, and prior to the new carpets being laid. The beds that we saw had suitable bed linen. We looked at the linen store and found plenty of bed linen and towels, and these were in good condition. In addition, we looked at the laundry facilities and found them suitably equipped to wash and dry laundry in the home. We looked at the kitchen and the food stores. The kitchen has been greatly improved and there was food of sufficient quantity and quality for the number and needs of people living in the home. There have been real improvements to the building. The management team produced an improvement plan prior to the last inspection in April 2008 and they have made very good progress with the planned refurbishment of the home. The staff training records show that staff are having access to the training that they need and there is generally a good take up. There was also evidence of improvement in the way that falls are monitored, in the storage and recording of medication and in the way the use of bed rails is monitored. There was evidence that, on the invitation of the manager, specialist health care professionals had come into the home to talk about the prevention of falls with the staff. At the time that the temporary manager was dismissed Four Seasons put other arrangements in place to manage the home and informed the Commission of these arrangements. The temporary manager who was running the home at the time of this inspection provided a CV to the Commission showing that he has the necessary experience and qualifications to run the home. During the inspection he came across as professional and proactive. It was also evident that there was additional support being provided by the Regional Manager. The home has been consistent in fulfilling their responsibility of reporting incidents to the Commission. At the time of the second visit we were informed that a safeguarding alert had been made for one person who was admitted to hospital the previous day. Care Homes for Older People Page 5 of 10 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 10 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set.
No. Standard Regulation Requirement Timescale for action 1 12 12 The registered person must 01/09/2008 make sure that the management team continue to develop assessment round peoples social, leisure and occupational activities and develop services in the home that are suitable for each person?s background, interests, developmental needs and lifestyle. The registered person must 01/09/2008 make sure that the management team continue to focus on supporting residents to use resources in the local community that provide social, cultural, occupational and educational activities that are suitable for each persons background, interests, developmental needs and lifestyle. The registered person must 30/06/2008 make sure that the 2 external fire doors that were not connected to the door alarm system are connected and operating. The registered person must make sure that bedroom 10 and 11 are free from unpleasant odours. 30/05/2008 2 12 12 3 19 13 4 26 16 Care Homes for Older People Page 7 of 10 Care Homes for Older People Page 8 of 10 Requirements and recommendations from this inspection
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No. Refer to Standard Good Practice Recommendations 1 27 It is recommended that the registered person undertake a review of staffing at key times of the day to make sure that there are sufficient staff available to meet peoples needs. Care Homes for Older People Page 9 of 10 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 10 of 10 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
