Inspection on 15/05/06 for The Wakefield Centre

This inspection was carried out on 15th May 2006.

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

Other inspections for this house

The Wakefield Centre 18/08/08

The Wakefield Centre 17/09/07

The Wakefield Centre 28/11/06

Similar services:

Ashlong House

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

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

CARE HOMES FOR OLDER PEOPLE The Wakefield Centre Ravenscourt Gardens Hammersmith London W6 0AE Lead Inspector Tony Lawrence Unannounced Inspection 15th May 2006 09:30 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 The Wakefield Centre DS0000066841.V291598.R01.S.doc Version 5.1 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. The Wakefield Centre DS0000066841.V291598.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Wakefield Centre Address Ravenscourt Gardens Hammersmith London W6 0AE 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) 020 8222 7800 020 8222 7801 Ganymede Care PLC Mr Visnoo Chengun Care Home 102 Category(ies) of Old age, not falling within any other category registration, with number (54), Physical disability (36), Terminally ill (12) of places The Wakefield Centre DS0000066841.V291598.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: The Wakefield Centre is a registered care home that provides nursing care and accommodation for 66 elderly men and women. 31 places are provided for people with a physical disability and 5 palliative care beds are also provided. The home is located in a residential area of Stamford Brook, with easy access to transport links, local shops and other amenities in the Chiswick High Road. Care is provided on the ground, first and second floors and toilets, bathrooms, communal lounges and dining areas are situated on each floor. The third floor of the building houses the West London Clinic and this service is regulated by the Healthcare Commission. Care is provided by a staff team comprising nurses, care assistants, cleaning, catering, administrative and maintenance staff. The Wakefield Centre DS0000066841.V291598.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on Monday 15th and Tuesday 16th May 2006. Two Inspectors were in the home from 09:30 – 16:00 on Monday 15th. One Inspector returned on Tuesday 16th from 09:00 – 14:30. The Inspectors spent time talking with service users, staff and the home’s Manager. They also checked care records and staff recruitment records. The care received by 8 people living in the home was tracked by talking with them and staff responsible for their care and reviewing their care plans. While the home provides a good standard of accommodation and is well staffed, there is a need to improve care standards, especially for younger adults and people with dementia. The home’s fees range from £640 - £1,500 per week. What the service does well: 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 Wakefield Centre DS0000066841.V291598.R01.S.doc Version 5.1 Page 6 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 The Wakefield Centre DS0000066841.V291598.R01.S.doc Version 5.1 Page 7 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 the following standard(s): 1, 2, 3 and 5. Quality in this outcome area is poor. This judgement has been made using available evidence, including a visit to this service. There is a need to make sure that the home has information about each person’s care needs before they move into the home. EVIDENCE: Ganymede Care has applied to the Commission for a change in the home’s registration to include care for people with dementia and mental health care needs. The Manager confirmed that the home’s Statement of Purpose would be amended to reflect the change in registration. Inspectors checked the care plan files for 8 people living in the home. None of the files included a copy of a contract or statement of terms and conditions, detailing the care and support that service users will receive in the home. The home’s Manager must make sure that a contract or statement of terms and conditions is included as part of the care plan file for each person living in the home. The contract or statement of terms and conditions must include all of the information detailed in Standard 2 of the National Minimum Standards for Older People. The Wakefield Centre DS0000066841.V291598.R01.S.doc Version 5.1 Page 8 Comment from the home Individual contracts are kept centrally and are available for inspection. None of the files included a care needs assessment completed by a qualified person. Staff told the Inspectors that when a phone referral is received from Social Services, a member of staff from the home visits the service user to assess whether or not their care needs can be met in the home. If the person is then admitted, staff in the home complete a baseline assessment during the first few days of their stay. None of the files seen by the Inspectors included a care needs assessment from a social worker or care manager and there were no written assessments completed by staff from the home when they visited people at home or in hospital. It is important that staff have a current care needs assessment and any other information about each service user before they move into the home. The home’s Manager must make sure that health and social care professionals provide full information about each person referred to the home. If staff from the home visit people to make an assessment, a written record must be kept on the care plan file. Some of the service users who spoke with the Inspectors said that they had no choice about moving into the home. One person said that she was in hospital one day and the ambulance came and took her to the home. Two other people said that they were told by their social workers they would be moving. People who are responsible for making placements in the home should make sure that service users are supported to make meaningful choices about the home they move into. Wherever possible, visits to the home should be arranged before a person moves in. The Wakefield Centre DS0000066841.V291598.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is poor. This judgement has been made using available evidence, including a visit to this service. Service users’ healthcare needs are well recorded and appropriate referrals are made, but there is a need to make sure that standards of medication management are improved. EVIDENCE: Care plans seen by the Inspectors included goals covering individual’s health care needs. The home’s own assessment / care planning forms include sections on breathing, eating and drinking, toileting and mobility. Goals seen in each section were usually clear and measurable. There was also evidence that referrals are made to the GP, Tissue Viability Nurse, Community Psychiatric Nurse, Occupational Therapist and other health professionals when needed. Staff who spoke with the Inspectors were able to describe each service user’s main care needs and how these are met in the home. Many of the home’s Care Assistants are qualified nurses from other countries and they are able to provide very good standards of care. The major issue in this outcome area that needs to be addressed is the management and recording of service users’ prescribed medication. The Wakefield Centre DS0000066841.V291598.R01.S.doc Version 5.1 Page 10 Medication on all three floors is administered by qualified nurses and is securely stored in lockable trolleys that are kept in the clinical room on each floor, close to the nurses’ station. The home’s pharmacist delivers most prescribed medication in blister packs. Nurses told the Inspectors that the pharmacist provides a very good service and is always available for advice if required. Staff said that the temperature of clinical rooms and medication fridges are checked and recorded daily. Temperatures in the ground and second floors clinical rooms were within the accepted range for storing medication. On the first floor, temperatures in the clinical room are frequently recorded as above 25°C, in some cases rising to 30°C. This may affect the efficacy of medication and staff must make sure that storage temperatures do not exceed 25°C. During this visit, the Inspectors checked the medication systems on all three floors. On the ground floor, the Inspector checked 7 Medication Administration Record (MAR) sheets and found errors or omissions on each sheet. Medication in the fridge was also checked. One vial of insulin had been opened on 07/04/06 and had not been discarded after four weeks, as recommended by the manufacturer. The date of opening was not recorded on a second vial of insulin. This was dispensed on 31/03/06 and may also have been past its use by date. On the first floor, an Inspector checked 15 MAR sheets. The records were well completed and the Inspector found no errors or omissions. On the second floor the inspector checked the MAR sheets for all 33 service users. Five sheets contained errors or omissions. This standard of medication management and recording is not acceptable from qualified nurses and standards must be improved. On one service user’s care plan, an Inspector saw a consent form signed by the service user, agreeing to medication being hidden in food and/or drinks. There was no evidence that this issue has been considered by the person’s GP, relatives and others involved in their care. Staff must make sure that Nursing and Midwifery Council guidelines are followed if medication needs to be administered covertly. Each person living in the home has a single room with either an ensuite shower and toilet or a toilet. Assisted bath and shower rooms are available on each floor for service users who do not have ensuite facilities. Service users were very positive about the help and support they receive from nurses and care staff. Comments included ‘ staff are good and I’m well cared for’, ‘the staff here are lovely, first class’, ‘the staff are very friendly and I’m lucky to be here’, ‘nurses look after my dressings and do a very good job’. The Wakefield Centre DS0000066841.V291598.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is poor. This judgement has been made using available evidence, including a visit to this service. While the home provides acceptable standards of daily life and social activities for some service users, other people have a poor quality of life, especially some younger people with physical disabilities and people with dementia. EVIDENCE: During this visit an Inspector spoke with one of the home’s Activities Organisers. The home currently has two Activities Organisers in post and attempts are being made to recruit to a third post. The member of staff said that she has a programme of activities. Men living in the home mostly enjoy playing dominoes and card games or sitting chatting. Other activities include knitting, board games, art and patchwork. Service users have also been able to spend time in the home’s garden and the member of staff said that some people enjoyed having their tea there. On the ground and first floors, Inspectors saw art materials, daily newspapers and magazines. During the afternoon on the ground floor, the Activities Organiser involved service users in a gentle exercise session. Other service users spent time in the lounges, knitting, watching TV or listening to music. During this inspection the care of one person with dementia was reviewed in some detail. The care plan file did not include a care needs assessment from The Wakefield Centre DS0000066841.V291598.R01.S.doc Version 5.1 Page 12 the placing authority that may hold valuable information with regards to the person’s history, personality and social networks. The home’s assessment does not specify the type of dementia diagnosed or the person’s awareness of their diagnosis. The person’s life history with important facts and events was not recorded. The assessment was not strength-focused and did not cover care preferences, choices and lifestyle (including preferred times for getting up and going to bed). The plan did not summarise how existing strengths and abilities would be encouraged and maintained. There was no communication plan for the service user, the assessment and care plan did not include clues as to the possible meaning of non-verbal communication / behaviours or any explanation as to what the message behind certain words could mean. It was not clear from the care plan what skills the person retains to manage their own personal care and there are no guidelines in place to enable staff to support this person to maintain their independence. There was no information in relation to possible psychological support the service user might need and no information about how advanced their loss of memory was and what they still remembered i.e. events from their past. There was limited evidence that the service user or their representative had been involved in the care planning process. The Inspector saw an individualised activities plan on the care plan file. This included reminiscence and art sessions, but there was no evidence available to show that these activities take place. Daily care notes completed by staff on each shift concentrate on the person’s physical care. Care notes did not inform the care team of day-to-day changes, including whether any activities had taken place and if the service user had enjoyed these. The home is registered to provide accommodation and care for men and women aged under 65 with a physical disability. At the time of this inspection, 15 younger adults were living on the second floor of the home. Staffing levels on this floor are lower than levels on the ground and first floors. On both days of the inspection the floor was staffed by one registered nurse, an adaptation nurse, four care staff and a domestic. The ground and first floors both have two nurses and five care staff on duty and staffing levels on the second floor must be increased to at least this level. Three people on the second floor told an Inspector that activities are organised but they are aimed at older people. One person did say that they were happy with the activities provided. The Inspector felt that more could be done to offer activities that are appropriate to younger adults. One person said that all he wanted to do was visit his mother, but he relied on relatives to take him. This was discussed with the home’s manager who explained that when this person is offered support to go out, he refuses. However, there was no evidence on the care plan file that 1:1 support is ever offered or available. Staff told the Inspector that some people go to bed as early as 4:30 pm and most service users are in bed by 9:00 pm. Some people living in the home are The Wakefield Centre DS0000066841.V291598.R01.S.doc Version 5.1 Page 13 aged 40 – 50 and there was no evidence that they are encouraged to stay up later or go out in the evenings, unless they can manage this independently. One person told the Inspector that they always go to bed at 9:00, as there is nothing to do and they are ‘fed up’ after watching TV all day. The Manager did say that he is planning to provide a large screen TV and a bar to enable service users to watch World Cup matches, but with appropriate support, some people could go to local pubs and become more involved in the community. Another service user told the Inspector that they enjoyed having their hair and make up done, but this all takes place in the home. Staff could not explain to the Inspector why this person could not be supported to visit a local hairdressers / salon. Staff did say this person visit local cafes, but this was with support from relatives, not staff in the home. Service users and staff did mention a cinema trip and a pub lunch in recent months and one person did say that a trip to Kew gardens was planned, but the Inspectors felt that much more could be done to provide age appropriate activities for younger adults. One service user said that he used to enjoy going to church but has not been since moving into the home. He said that other members of the congregation ‘probably think I’m dead’. When asked, this person said that he would really enjoy the opportunity to go back to is church and the home must make sure that this support is provided when needed. Details of service users’ relatives and friends are recorded as part of the care plan and there is some evidence that staff support people to maintain contact with significant people. Service users who spoke with the Inspectors said that they enjoy the food that is provided in the home. People said that the food is well cooked, plentiful, varied and well presented. Service users can eat meals in their rooms or the dining room on each floor. Meal times are flexible and there are tea/coffee breaks in the morning and afternoon. The home should consider ways of enabling service users to make snacks and drinks for themselves, outside meal times. The Wakefield Centre DS0000066841.V291598.R01.S.doc Version 5.1 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 the following standard(s): 16, 17 and 18. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The home has clear complaints procedures and service users are cared for safely. EVIDENCE: The home’s complaints and whistle blowing policies and procedures are displayed on the notice boards on each floor, a requirement of the last inspection report. The Manager confirmed that there have been four formal complaints since the last inspection. The Inspector reviewed the home’s records and each complaint was well recorded and investigated. All four complainants were satisfied with the outcome of their complaint. There has been one adult protection investigation since the last inspection. The home cooperated with the investigation and attended the resulting strategy meetings. The Manager is aware of the local authority’s adult protection procedures and the need to inform the Commission of any significant incidents affecting service users’ welfare. The Wakefield Centre DS0000066841.V291598.R01.S.doc Version 5.1 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 the following standard(s): 19, 20, 21, 23, 24, 25 and 26. Quality in this outcome area is excellent. This judgement has been made using available evidence, including a visit to this service. The home provides very good standards of private and communal accommodation and all service users have ensuite facilities. EVIDENCE: The home is located in a residential area close to Hammersmith and Shepherds Bush. A very good standard of accessible accommodation for service users is provided on the ground, first and second floors. Each service user has a single room, with ensuite shower and toilet or toilet. There are shared communal areas, bath and shower rooms and toilets on each floor. Since the last inspection all communal parts of the home have been redecorated. Service users’ bedrooms are well decorated and furnished. Most rooms are well personalised with the service user’s own possessions, photographs of family members etc. The Wakefield Centre DS0000066841.V291598.R01.S.doc Version 5.1 Page 16 Communal areas seen during the inspection were comfortably furnished and well decorated. Toilets are located close to the main lounge / dining room on each floor. Staff should ensure that bathrooms are not used as storage areas for wheelchairs, walking frames and other items of equipment. During this visit Inspectors found all parts of the home to be clean, tidy and hygienic. The Wakefield Centre DS0000066841.V291598.R01.S.doc Version 5.1 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. The home is well staffed by an experienced, qualified and enthusiastic team but there is a need to ensure that all checks are completed to make sure staff are suitable to work with vulnerable people. EVIDENCE: The home is staffed by a team of qualified nurses, care staff, domestic, catering and administrative staff. There is a nurse in charge of each floor during each shift, supported by other nurses and carers. The nurse –in-charge of the floor makes sure that staff are assigned responsibility for individual service users. Staff said that they are usually responsible for 6 or 7 service users, including some people who may need 2:1 support. All staff said that they felt this system works well. During this inspection all staff were welcoming, helpful and friendly. The Inspectors felt that staff on all three floors worked well together to meet service users’ care needs. The Inspectors noted that nurses and care staff were mainly concerned with individual’s personal and health care needs. Staff were busy at all times and there was little opportunity for them to carry out social care tasks such as chatting or reading newspapers with service users. While all staff were consistently friendly and courteous towards service users, it was left to the Activities Organiser to plan and run any activities. When asked about their daily routines, care staff only spoke about supporting people with their personal care and there was no mention of activities, outings etc. The Wakefield Centre DS0000066841.V291598.R01.S.doc Version 5.1 Page 18 On the second floor, there are places for 31 people aged 40-65 with a physical disability and 5 people receiving terminal care. At the time of this inspection, 15 younger adults were living in the home. There is a need to increase the staffing levels on this floor to make sure their social care needs are met appropriately (see Standard 12). During this visit an Inspector checked the personnel files for four care staff and nurses working in the home. The files were well organised and information was easy to locate. Each file included a copy of the member of staff’s application form. Two files included a completed induction checklist. One file included a partially completed checklist. The fourth induction checklist was blank. Senior staff responsible for the induction of new staff must make sure that the checklist is fully completed. Previous inspection reports have highlighted the need to ensure that copies of references are verified and kept on the person’s file. One care worker’s file contained only one written reference. A second file contained two references but one was not on headed notepaper and did not contain an official stamp from the referee’s organisation. There was no evidence on any of the references seen by the Inspector that staff from the Wakefield had checked their authenticity. The requirement that the home’s Manager must make sure that references are obtained and checked for all staff is repeated in this report. The home’s Manager showed the Inspector letters written by officers from the Immigration Service during 2005. Immigration officers visited the home twice during the year to check staff records and they confirmed that all staff are eligible to work in the UK. Immigration officers also congratulated the home on the standard of their staff records. Previous inspection reports have also included a requirement that Criminal Record Bureau (CRB) Enhanced Disclosures are obtained for all staff. Information provided by the home before this inspection is evidence that seven staff do not have a CRB Disclosure. This was discussed with the Manager who also checked with the staff concerned. Three members of staff said that they had received their CRB Disclosure, but the Manager must make sure that these are brought into the home and details recorded. The Manager explained that the staff concerned are student nurses working under supervision. Their CRB checks are not obtained through the Wakefield but the Manager must make sure that these are checked and verified before the students start their placement. Four staff do not have a CRB Disclosure and the Manager confirmed they would not work unsupervised with service users until a Disclosure has been obtained. Staff who spoke with the Inspectors said that there were very happy with the training opportunities that are offered in the home. The home is registered to The Wakefield Centre DS0000066841.V291598.R01.S.doc Version 5.1 Page 19 employ foreign nurses who are completing an adaptation course to enable them to work in the UK. Many of the care assistants are qualified nurses who are waiting to begin their adaptation training. All staff said that they had completed a range of training courses in the home, including manual handling, mental health and dementia awareness training. The home provides NVQ training for staff and should meet the target for 50 NVQ qualified staff during 2006. The Wakefield Centre DS0000066841.V291598.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 37 and 38. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The home has a registered Manager and appropriate management arrangements are in place to ensure continuity of care. EVIDENCE: The home’s Manager is a qualified nurse who was appointed in October 2004. He had previously managed another home operated by ANS. The Commission has registered the Manager as a fit person to manage the home. During this two-day visit, the Inspectors noted that the Manager spent time on the floors, talking with service users and staff. Staff spoke very positively about the Manager. They said he always makes sure they have the equipment they need and that appropriate training opportunities are provided. Staff said that the Manager is accessible and all were clear about management arrangements when the Manager is not on duty in the home. The Wakefield Centre DS0000066841.V291598.R01.S.doc Version 5.1 Page 21 The home has all of the policies and procedures required to meet these Standards. Evidence provided by the Manager before this inspection shows that policies and procedures are regularly reviewed. The home and the service provider respond promptly and efficiently to issues raised by the Commission, either in inspection reports or as the result of complaints investigations. The Manager was able to describe ways in which service users are consulted about the care and support they receive. The Manager should make sure that the results of service user consultations are published and made available to current and prospective service users and their representatives. The Manager must also make sure that the Commission is supplied with copies of reports written following monthly monitoring visits by the Person-in-Control. The Manager confirmed that service users’ personal monies are kept in a joint bank account managed by the home. Individuals can access their money but the account does not earn interest. The Manager should review this practice and service users should be enabled to earn interest on their savings. Nurses told the Inspectors that clinical supervision takes place and care staff said they have an appraisal meeting with their manager every two months. During these sessions, any anxieties are discussed with the line manager and any training needs are reviewed. Four staff files checked during this inspection all included records of recent staff supervision sessions. Standards of record keeping in the home are satisfactory, although improvements are needed to the recording of medication (see Standard 9). No health and safety issues were noted during this inspection. The Wakefield Centre DS0000066841.V291598.R01.S.doc Version 5.1 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 3 2 2 X 2 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 3 3 X 3 3 3 3 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 2 3 3 3 The Wakefield Centre DS0000066841.V291598.R01.S.doc Version 5.1 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. 1. Standard OP2 Regulation 5 Requirement The home’s Manager must make sure that a contract or statement of terms and conditions is included as part of the care plan file for each person living in the home. The home’s Manager must make sure that health and social care professionals provide full information about each person referred to the home. If staff from the home visit people to make an assessment, a written record must be kept on the care plan file. Staff must make sure that Nursing and Midwifery Council guidelines are followed if medication needs to be administered covertly. This is a repeat requirement. Staff must make sure that storage temperatures for medication do not exceed 25°C. Standards of medication management and recording must be improved. The provision of social care for people with dementia and DS0000066841.V291598.R01.S.doc Timescale for action 31/07/06 2. OP3 14 30/06/06 3. OP3 14 30/06/06 4. OP9 13 30/06/06 5. 6. 7. OP9 OP9 OP12 13 13 16 30/06/06 30/06/06 30/06/06 The Wakefield Centre Version 5.1 Page 24 8. OP12 18 9. 10. OP12 OP27 16 18 11. OP29 18 12. OP29 19 13. OP33 26 younger adults with a physical disability must be improved. Staffing levels on the second floor must be increased to make sure that service users are supported appropriately. Service users must be supported to attend church services if they wish. Senior staff responsible for the induction of new staff must make sure that the checklist is fully completed. The home’s Manager must make sure that references are obtained and checked for all staff. This is a repeat requirement. Four staff who do not have a CRB Disclosure must not work unsupervised with service users until a Protection of Vulnerable Adults check has been completed. Once the POVA check has been completed, staff may work under supervision at all times. This is a repeat requirement. The Manager must make sure that the Commission is supplied with copies of reports written following monthly monitoring visits by the Person-in-Control. 30/06/06 30/06/06 30/06/06 30/06/06 30/06/06 30/06/06 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 OP5 Good Practice Recommendations People who are responsible for making placements in the home should make sure that service users are supported to make meaningful choices about the home they move into. Wherever possible, visits to the home should be DS0000066841.V291598.R01.S.doc Version 5.1 Page 25 The Wakefield Centre 2. 3. 4. OP15 OP21 OP33 5. OP35 arranged before a person moves in. The home should consider ways of enabling service users to make snacks and drinks for themselves, outside meal times. Bathrooms should not be used for the storage of hoists, weighing scales, wheelchairs, walking frames etc. The Manager should make sure that the results of service user consultations are published and made available to current and prospective service users and their representatives. The Manager should review the practice of providing a joint account for service users’ personal money. Service users should be enabled to earn interest on their savings. The Wakefield Centre DS0000066841.V291598.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Hammersmith Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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 The Wakefield Centre DS0000066841.V291598.R01.S.doc Version 5.1 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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