Inspection on 22/09/05 for The Willows Intermediate Care Service

This inspection was carried out on 22nd September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Willows Intermediate Care... 25/10/06

The Willows Intermediate Care... 28/12/05

The Willows Intermediate Care... 23/03/05

The Willows Intermediate Care... 13/01/05

The Willows Intermediate Care... 08/03/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Willows, The Resource Centre Ambergate Road Beechdale Estate Nottingham NG8 3GD Lead Inspector Richard Ramsden Unannounced Inspection 22nd September 2005 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 Willows, The Resource Centre DS0000037311.V252345.R01.S.doc Version 5.0 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. Willows, The Resource Centre DS0000037311.V252345.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Willows, The Resource Centre Address Ambergate Road Beechdale Estate Nottingham NG8 3GD 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) 0115 9293861 Nottingham City Council Mr Stephen Upton Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places Willows, The Resource Centre DS0000037311.V252345.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. To accommodate one named service user under the age of 65 whose file will be kept at the home along with this variation 23/03/05 Date of last inspection Brief Description of the Service: The Willows Resource Centre is a multifunctional complex situated in a residential area that has a high proportion of elderly residents. The complex is very close to a range of community facilities including a church, shops and a community centre. The complex offers a range of facilities to people 50 years old and over. The Willows residential unit provides Intermediate Care for up to 16 people. It is owned by Nottingham City Council Social Services and is run in partnership with Nottingham Health Authority. The residential unit is a single storey building with 16 single bedroom none of which meet National minimum standards size requirements. All bedrooms are well decorated and comfortably furnished. None of the bedrooms have ensuite facilities but there are sufficient bathrooms and toilets, conveniently located throughout the building. There is an inner courtyard garden, which has been well maintained and is accessible by all residents. Willows, The Resource Centre DS0000037311.V252345.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One Inspector completed this unannounced inspection over one-day it took approximately 5 1/2 hours. It included the inspection of care and of the records a discussion with three residents, two visitors, the homes manager and three residents. A partial tour of the building was also completed. What the service does well: This home is well managed and there were many aspects of good practice highlighted in the main body of this report. The staff spoken with during the inspection were very enthusiastic about their role in assisting residents to return to their own homes. The residents spoken with during the inspection were very happy with the care and support they receive from staff. They described the staff is helpful and considerate and said that they ensure that their privacy and dignity is respected at all times. Visitors to the home confirmed that they can visits their friends or relatives at any time and that they are always made to feel very welcome. The observed interaction between staff and residents was of a very good standard. The residents said that they enjoyed the food provided at the home and there was evidence that alternative meals will be provided if people do not want food suggested on the menu. The areas of the home view during this inspection had been well maintained. All of residence spoken with said that they are very happy with their bedrooms and that the home is always kept clean and tidy. Willows, The Resource Centre DS0000037311.V252345.R01.S.doc Version 5.0 Page 6 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. Willows, The Resource Centre DS0000037311.V252345.R01.S.doc Version 5.0 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 Willows, The Resource Centre DS0000037311.V252345.R01.S.doc Version 5.0 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. The homes staff ensures that they can meet the needs of prospective residents by obtaining a full written assessment prior to their admission to the home. The Intermediate Care Unit is helping people to maximise their independence and where possible return home. EVIDENCE: Three residents records were checked as part of this inspection, a full assessment had been obtained for each resident prior to his or her admission to the home. The staff team use this information to ensure that they can provide an appropriate placement for the individual residents. The manager stated that no residents would ever be admitted without a preadmission assessment. The Willows residential unit only provides Intermediate Care and there are specialist facilities, equipment and trained staff to provide intensive rehabilitation to enable residents to return to their homes. Willows, The Resource Centre DS0000037311.V252345.R01.S.doc Version 5.0 Page 9 The home has daily access to a Physiotherapist; Occupational Therapists, Nurses, a Social Worker and two Community Care Officers who work as a team with the residents, to set the goals, which will hopefully eventually enable them to return home. (This is good practice). Willows, The Resource Centre DS0000037311.V252345.R01.S.doc Version 5.0 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): 9,10. The homes medication systems are generally well manage but staff must make sure that all residents who administer their own medication store it securely so that other resident’s health and safety is not put at risk. Residents are treated with respect and their right to privacy is upheld. EVIDENCE: Initially when residents move into the Willows staff administers their medication. Nursing staff will then complete an assessment to see if people are safe to manage their medication independently, or if they require some support from staff. Resident’s medication is kept in the lockable facilities in each resident’s bedroom. However it was noticed that the lockable facilities in one bedroom had been left unlocked with medication in situ. When this facility was rechecked the cupboard had been locked but the key had been left on top of Willows, The Resource Centre DS0000037311.V252345.R01.S.doc Version 5.0 Page 11 the cupboard. As the door to the room was unlocked any residents or visitors to the home could have gained access to this prescription medication. The manager was informed that the risk assessment must always ensure that residents who administer their own medication keep it safely at all times so that no other residents health and safety is put at risk. The home has good systems in place for the recording of receipt and disposal of medication. Medication records had been well maintained at the time of this inspection. The home did not have any controlled medication at the time of inspection but appropriate storage and recording facilities were available. The manager was informed that staff must record the temperature on a daily basis in the room in which the medication is stored. The temperature in this room must not exceed 25°C. The temperature must also be recorded in any bedroom where medication is stored, if the medication states it must be stored below 25°C. All of the residents spoken with during this inspection said that the staff are always friendly and respectful and that they ensure that their privacy and dignity is maintained at all times. The observed interaction between staff and residents was of a very good standard. Willows, The Resource Centre DS0000037311.V252345.R01.S.doc Version 5.0 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 the following standard(s): 13,14,15. People are encouraged to maintain contact with family and friends. Residents are encouraged and supported to exercise choice and control over their lives, as this is an important part of the process to enable them to return home. The diet provided for residents is wholesome, well balanced and varied. EVIDENCE: The homes policy on visitors is included in the information provided to all prospective residents. All of the residents spoken with during the inspection confirmed that they could have visitors at any time and that their visitors are always made very welcome. Two visitors spoken with during the inspection said that their relative had only moved into the Willows the day before this inspection and that they were visiting her there for the first time. They stated that the staff had been very friendly and helpful. Willows, The Resource Centre DS0000037311.V252345.R01.S.doc Version 5.0 Page 13 As part of the rehabilitation process people are helped to exercise choice and control over their lives. The literature supplied to prospective residents informs them how to contact external agents and contains a copy of the City Councils Access to Records Policy. (This is good practice). The home has a five weekly rotating menu that had recently been amended in consultation with the resident group and the people who use the day centre. (This is good practice). Two of the residents spoken with were full of praise for the food provided by the home, they stated there was always plenty of food available and that an alternative will be provided if they do not want food suggested on the menu. One person who had only recently moved into the home said that she was a “fussy eater” and that she was concerned that she may be given food she does not like. The resident could not remember being asked if she had any specific dietary requirements. This residents admission records were checked and a comprehensive record of her likes and dislikes had been passed to the cook. (This is good practice). The inspector showed the records to the resident to reassure her that staff are aware of her dietary requirements. Residents are encouraged to prepare their own breakfast in one of the homes rehab kitchens that are equipped with gas and electric cookers as well as microwaves. Willows, The Resource Centre DS0000037311.V252345.R01.S.doc Version 5.0 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): None None of the standards in this section were assessed as part of this inspection. EVIDENCE: Willows, The Resource Centre DS0000037311.V252345.R01.S.doc Version 5.0 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): 19.22. The accommodation at the Willows has been maintained to a very good standard. Staff now have sufficient ‘alarm bleepers’ to ensure that staff can respond to the call system promptly when residents need assistance. EVIDENCE: The accommodation at the Willows has been very well maintained. Although the bedrooms are small, those viewed, were comfortably furnished and well decorated. All areas of the home are accessible to the residents. The residents spoken with said that they like their bedrooms and that the home is always clean and appropriately tidy. At the last inspection staff reported that there were not sufficient’ alarm bleepers’ to be used by staff on each shift. The manager has since purchased three new ‘alarm beepers’ so that all staff can respond to the call system promptly when residents require assistance. Willows, The Resource Centre DS0000037311.V252345.R01.S.doc Version 5.0 Page 16 Willows, The Resource Centre DS0000037311.V252345.R01.S.doc Version 5.0 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): 28. Staff have received appropriate training to ensure that residents are in safe hands at all times. EVIDENCE: The staff training records show that all but three members of staff have completed NVQ training. The manager has an NVQ level 4 in care and has completed the Managers Award. The senior team leader has completed NVQ level 4 in care and the remaining three Team Leaders have NVQ level 3 in care, two have also completed NVQ level 4 in management. (This is good practice). Since the last inspection staff have completed a comprehensive programme of training and development. The member of staff spoken with during the inspection confirmed this. (This is good practice). Willows, The Resource Centre DS0000037311.V252345.R01.S.doc Version 5.0 Page 18 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): 33,35,38. The home is run in the best interests of the residents but the homes Quality Assurance System should include the views of stakeholders in the community e.g. Chiropodists GPs etc as this will help to assess if the home is meeting its stated objectives. Appropriate accounting and financial procedures are in place to safeguard residents. The manager has taken steps to improve the security in the homes car parking areas. Willows, The Resource Centre DS0000037311.V252345.R01.S.doc Version 5.0 Page 19 EVIDENCE: The home has an effective Quality Assurance System based on seeking the views of residents. The results of the resident’s surveys are published and displayed in the home. (This is good practice). The manager users the information gathered from the Quality Assurance system to produce business plan each year. The Quality Assurance System should also seek the views of stakeholders in the community e.g. GPs and chiropodists to help assess how the home is achieving goals for the residents. The records of residents’ finances were checked at random and were well maintained. Both of the residents who were asked said that they are satisfied with the way in which their finances are managed. Appropriate records and receipts are kept of possessions handed over for safekeeping. At the last inspection a requirement was made that the security in the car park areas must be reviewed as to staff cars had been vandalised. Security lighting has now been provided in the car park areas and night staff are able to part their cars in a separate secure area. Willows, The Resource Centre DS0000037311.V252345.R01.S.doc Version 5.0 Page 20 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 4 HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X 3 X X X X STAFFING Standard No Score 27 X 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X 3 Willows, The Resource Centre DS0000037311.V252345.R01.S.doc Version 5.0 Page 21 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 OP9 Regulation 13 Requirement It is required that residents who administer their own medication must store the medication securely. It is required that staff record the temperature in the room in which medication is stored each day. The temperature must not exceed 25C. The temperature must also be recorded in every bedroom where medication is stored, if the guidance states that the medication must be stored below 25C Timescale for action 22/09/05 2 OP9 13 22/09/05 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 OP33 Good Practice Recommendations It is recommended that the views of stakeholders in the community e.g. GPs Chiropodist etc are sought on how the home is achieving goals for residents. Willows, The Resource Centre DS0000037311.V252345.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Willows, The Resource Centre DS0000037311.V252345.R01.S.doc Version 5.0 Page 23 - 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. 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