Inspection on 26/09/06 for The Wedge

This inspection was carried out on 26th September 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 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

The Wedge 20/09/05

The Wedge 21/06/05

The Wedge 04/01/05

The Wedge 07/07/04

The Wedge 19/02/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE The Wedge 8 Park Road Hayling Island Hampshire PO11 OJU Lead Inspector Gina Pickering Unannounced Inspection 26th September 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Wedge DS0000011783.V312197.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Wedge DS0000011783.V312197.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Wedge Address 8 Park Road Hayling Island Hampshire PO11 OJU 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) 023 9246 5225 Mrs Monica Joy Macey Mr John Henry Macey Miss J Macey Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places The Wedge DS0000011783.V312197.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th September 2005 Brief Description of the Service: The Wedge is a large, detached building set in a quiet residential area of Hayling Island. Accommodation consists of sixteen single bedrooms, fourteen of which have an en-suite facility. Communal rooms include a large lounge area with a conservatory, smaller quiet lounge, dining room and attractive, wellmaintained gardens to the front and rear of the building. The home is in good decorative order throughout and provides service users with a comfortable, friendly environment. The Wedge DS0000011783.V312197.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection process took into account information contained within the pre inspection document completed by the home, information received from relative/visitors comment cards, and a site visit carried out on 26th September. During the visit to the home the inspector spoke with one of the registered providers, the registered manager, care staff, the cook and seven residents as well as looking at documentation and viewing the environment. What the service does well: What has improved since the last inspection? Building work is due to be completed in the near future on an extended dining room that will allow all service users to take their meals together. A new laundry facility has been built along with an extended kitchen area. The Wedge DS0000011783.V312197.R01.S.doc Version 5.2 Page 6 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 Wedge DS0000011783.V312197.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection The Wedge DS0000011783.V312197.R01.S.doc Version 5.2 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 the following standard(s): 3&6 Quality outcome in this area is good. This judgment has been made using available evidence including a visit to the service. The good practice of assessment ensures that when a person moves into the home their needs can be met. The home does not offer intermediate care. EVIDENCE: The manager discussed with the inspector the preadmission process. All prospective residents are encouraged to visit the home for a day prior to the decision being made as to whether they want to move into the home. Discussion with two residents confirmed that this happens. Personal, health and social needs are assessed during this assessment process. The results of this assessment are quickly developed into a initial care plan so that care staff are aware of how meet the persons needs when they are admitted to the home. The assessment covers aspects of the person’s physical, health, social and emotional needs. The Wedge DS0000011783.V312197.R01.S.doc Version 5.2 Page 9 Detailed within the residents documents are the terms and conditions of residency at the home; this includes the fee payable, the room the person is accommodating and what service the fees includes. A statement of purpose is available to all interested persons; the manager said that this would be reviewed shortly to put the information into plainer English. The Wedge DS0000011783.V312197.R01.S.doc Version 5.2 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 the following standard(s): 7, 8, 9,& 10 Quality outcome in this area is good. This judgment has been made using available evidence including a visit to the service. The home ensures that each service user’s care plan is reviewed regularly with the involvement of the service user. The plan is updated to reflect any personal, health or social care changes. The home works to an efficient medications policy and procedures that protect the health and wellbeing of those living at the home. The aims and objectives of the home reinforce the importance of treating service users with respect and dignity. EVIDENCE: The Wedge DS0000011783.V312197.R01.S.doc Version 5.2 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 & 15 Quality outcome in this area is good. This judgment has been made using available evidence including a visit to the service. The home considers the views and interest of service users when planning the routines and activities at the home. The practices and attitudes of the staff team give service users the opportunity to remain as independent as they can be and make their own choices about daily life. Visitors are welcome at any time; service users can chose to entertain them in their own rooms, lounge areas or garden areas. Meal times are considered as an important social time for those living at the home, meals are balanced and varied with snacks and drinks being available throughout the day. EVIDENCE: Information is obtained during the assessment process, resident meetings and resident surveys about the interests of the service users and activities and outings they would like. A plan of activities is displayed in the entrance hall to the home; staff and service users say that this plan is flexible to allow choice in what they wish to do. Some of the activities enjoyed by service users include exercise to music, sing a long sessions, visiting entertainers and quizzes. Some service users had recently taken part in an art course at the home and their artwork is to be displayed at the local library. Service users spoke of how they The Wedge DS0000011783.V312197.R01.S.doc Version 5.2 Page 12 had enjoyed a recent trip to a shopping centre. Many of the those living at the home have developed friendships within the home; it was observed that service users sit in friendship groups, like to socialise together in the communal areas or in each other’s rooms. Service users are able to receive visitors at any time and can choose where to receive their visitors. Three visitors were at the home during the course of the site visit, it was observed that they are made to feel welcome and part of the ‘family’ of the home. Relatives comment cards indicate that they are always made welcome when visiting at the home and that they can visit their friend or relative in private. Service users maintain contact with the local community through outings, the visiting library and children’s schools choirs and church choirs visiting at Christmas time. A monthly Holy Communion service is held at the home for those that wish to receive communion. It is clear through observation and conversations with service users that they are able to make choices about their daily routines and activities. Some examples of this are that service users had chosen to put smaller tables together in he dining room to make one big table so a large group of them could sit together at meal times. Service users had had to take their meals at two sittings because of the small size of the dining room, this has now been changed and some service users take their meals in a quiet room so that all can have their meals at the same time; this was done because service users stated that they wanted their meals all at the same time. Service users spoken to are happy with the quality, variety and quantity of food provided at the home. On the day of the visit to then home the lunch menu was fish pie with stewed apples and custard for pudding. Despite there being no menu choice displayed, speaking to service users and staff evidence that if the service user did not wish to have the planned menu an alternative meal is offered. The cook discussed that although there is a rough menu plan, she generally plans meals around fresh seasonal produce and on the known likes and dislikes of those living at the home. Fresh fruit is available at all times and snacks are provided if requested by the service users. Service users are aware they can ask for snacks and drinks at any time; staff were observed throughout the day making warm drinks for service users when they asked for one. Lunchtime was observed to be a sociable experience for the service users. Until the extension to the dining room is completed service users take it in turns to take their meals in the quiet room that us being used a small dining room. The Wedge DS0000011783.V312197.R01.S.doc Version 5.2 Page 13 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 & 18 Quality outcome in this area is good. This judgement has been made using available evidence including a visit to the service. Service users at home demonstrate a good understanding of how to make a complaint and are confident that their concerns will be addressed promptly. Service users are protected from the effects of abuse by a work force that has a clear understanding of the issues about the protection of vulnerable adults. EVIDENCE: A robust complaints procedure is in place. Service users spoken with expressed that they have no worries about voicing concerns or complaints, however all those spoken with said that there has never been a need to make any complaints. The home has an ethos of involving service users in the running of the home with the use of service users meetings and surveys; it can be concluded that because any concerns are raised and dealt with promptly in these forums complaints do not arise. Relatives comment cards indicate that they are aware of the home’s complaints procedure but have never had the need to make a complaint to the home. Adult protection policies are in place. Staff have received training about the protection of vulnerable adults. Staff spoken to are clear and confident about the action they should take if they suspect an act of abuse has happened and are able to demonstrate knowledge about different forms of abuse. The home The Wedge DS0000011783.V312197.R01.S.doc Version 5.2 Page 14 has not had to put into practice adult protection procedures, but the manager was able to demonstrate in conversation that the correct procedure will be followed if there were a case of suspected abuse at the home. The Wedge DS0000011783.V312197.R01.S.doc Version 5.2 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 & 26 Quality outcome in this area is good. This judgment has been made using available evidence including a visit to the service. Service users live in a home that has a well-maintained environment, and has a continual plan of improvement for the home. The well being of those living at the home is protected by good hygiene and infection control practices. EVIDENCE: The home is situated in a quiet residential area of Hayling Island. The home consists of 16 single bedrooms of various sizes, of which 14 have en-suite facilities. A large lounge with a conservatory area, quiet room and separate dining room is available. The dining room is in the process of being extended so that all service users can be accommodated in the dining room at meal times; in the meantime service users take it in turns to use the quiet room as The Wedge DS0000011783.V312197.R01.S.doc Version 5.2 Page 16 a small dining room at meal times. Sufficient toilet and assisted bathing facilities are provided. There is a large garden area at the front of the house that has various seating areas that service users like to use as well as a smaller garden area to the rear of the property that also has seating area. A rolling programme of decorations and replacement of carpets is in place; as bedrooms are vacated they are decorated and re carpeted. Décor and furnishings in all areas of the home is of a homely fashion. Many service users have brought personal items such as ornaments, pictures and small items of furniture to personalize their bedrooms. The home was clean and free from offensive odours on the day the inspector visited. Service users said that the home is always kept clean and tidy. A team of cleaners are employed to ensure there is a member of cleaning staff on duty each day. All washing is done in the homes own laundry, which has recently been relocated to a newly built extension on the back of the house. Care staff are responsible for the laundering of clothes, bedding and other all other items. The laundry area was clean and tidy on the day of the visit to the home. Suitable hand washing facilities are provided for staff and the service users. The Wedge DS0000011783.V312197.R01.S.doc Version 5.2 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 & 30 Quality outcome in this area is good. This judgment has been made using available evidence including a visit to the service. Service users have confidence in the staff team that care for them. Rotas show well though out and creative ways of making sure the home is staffed efficiently ensuring that there are enough staff to meet the needs of those living at the home. Robust recruitment procedures are followed ensuring that service user’s wellbeing is protected. The service ensures that all staff members receive training focussed on improving the outcomes for those living at the home, though clearer documenting of training received by staff will enable training to be audited. EVIDENCE: The staff rota evidenced that on a morning shift there are 3 care staff on duty, a cook and a cleaner, in the afternoon there are two care staff and at night one care staff awake and one are staff sleeping in to be called upon of needed. Working hours are flexible, allowing staff to work hours that fit in with their other commitments but also ensure that there is always enough staff on duty to meet the needs of all living at the home. Service users spoken with stated that they believe there are always enough staff at the home to help, support The Wedge DS0000011783.V312197.R01.S.doc Version 5.2 Page 18 and chat with them. Relatives comment cards indicate that they believe there are always enough staff on duty. Some members of staff have two roles for example the cook also does care work. It is clearly indicated on the duty rota what role each staff member is working at that particular time. One of the registered providers is responsible for the maintenance of the home and garden areas. The duty rota is written in pencil, this should be written in pen so that it cannot be tampered with. At present 78 of the workforce have at least NVQ level 2 in care. Staff say that they receive the training they need to be able to fulfil their roles and support the residents. One member of staff said that she can approach the manager to request training and she will do her best to provide it. Despite the manager stating the training staff have received and staff commenting that they receive training; records of such training are not kept in a manner that allows clear audit of the training received by staff members. It recommended that all staff training be recorded in a manner that can allow for such audits. Robust recruitment procedures are in place. Sampling three staff member’s files evidenced that recruitment procedures are followed. This includes ensuring two satisfactory references and a satisfactory CRB clearance are received before a person commences employment at the home. The manager has details of Skills for Care induction standards that she is going to use for all newly employed staff. Documentary evidence is available that all staff receive regular formal supervision as well as annual appraisals. Staff spoken with confirmed that supervisions are taking place. Discussion with residents did not reveal any concerns that staff might not have the skills to care for the residents. The Wedge DS0000011783.V312197.R01.S.doc Version 5.2 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 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 & 38 Quality outcome in this area is good. This judgment has been made using available evidence including a visit to the service. The manager demonstrates competence and skills to manage the service. The service responds to suggestions by service users, their representatives and staff members that they utilise as part of the quality auditing of the service. Clear procedures protect service user’s finances. The home has a good record of meeting relevant health and safety requirements and legislation. EVIDENCE: The manager has been employed at the home for the past three years. She is a registered nurse and has recently completed her registered managers award. The Wedge DS0000011783.V312197.R01.S.doc Version 5.2 Page 20 Staff expressed satisfaction with the management of the home and the support given to them by the manager. Staff said that they are able to put forward ideas about the running of the home that are considered and acted upon if possible. Staff meetings are held. Minutes from these indicate that comments from staff members are acted on. Auditing of the service provided by the home is done with the use of service users/relatives meetings, service user surveys, staff meetings and the use of the providers monthly visits to the home to assess the service provide by the home. Examples of service users influencing the running of the home are the changes in the seating arrangements in the dining room and the stopping of two sittings at meal times. Discussion with service users indicates that they feel comfortable to voice suggestions about the running of the home and these suggestions will be considered. The home does not look after any service users monies. Procedures are in place to handle costs incurred by the service users. Facilities are available in bedrooms to keep money and valuables in a secure place. Polices and procedures are in place about health and safety issues. The fire logbook indicates that all staff receives fire safety training at least twice a year. Fire safety checks are performed at the fire and rescue services recommended intervals. There was no clear fire risk assessment in place but a comprehensive risk assessment of the whole environment included a degree of fire risk assessment. The manager told the inspector that she was going to check that this assessment complied with the fire safety regulations and if is does not will ensure a fire risk assessment is done. During the visits to the home the kitchen was a clean and tidy, foodstuff stored in an appropriate manner. A recent food hygiene inspection had resulted a slight change in the storage methods of food and the purchase of a new microwave oven. A sample of records was seen evidencing that services and equipment are serviced at the manufacturers recommended intervals. The Wedge DS0000011783.V312197.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 The Wedge DS0000011783.V312197.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP9 OP27 OP30 Good Practice Recommendations Medications in bottles and boxes should have the sate of opening recorded on them. Staff rotas should be written in pen. A clear record of staff training should be kept at the home. The Wedge DS0000011783.V312197.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Wedge DS0000011783.V312197.R01.S.doc Version 5.2 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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