CARE HOMES FOR OLDER PEOPLE
The Willows Nursing & Residential Home 105-107 Coventry Road Market Harborough Leicestershire LE16 9BX Lead Inspector
Kim Cowley Unannounced Inspection 9th November 2006 2.45pm 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 Willows Nursing & Residential Home DS0000001934.V318349.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 Willows Nursing & Residential Home DS0000001934.V318349.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service The Willows Nursing & Residential Home Address 105-107 Coventry Road Market Harborough Leicestershire LE16 9BX 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) 01858 463177 01858 434772 Mr James Frederick Cooper Mrs Mary Violet Cooper, Mrs Jacqueline Marie Riddett, Mr John Frederick Cooper Mrs Jacqueline Marie Riddett Mrs Mary Violet Cooper Care Home 57 Category(ies) of Dementia (9), Dementia - over 65 years of age registration, with number (9), Mental disorder, excluding learning of places disability or dementia (9), Mental Disorder, excluding learning disability or dementia - over 65 years of age (9), Old age, not falling within any other category (57), Physical disability (36), Physical disability over 65 years of age (57), Sensory impairment (36), Sensory Impairment over 65 years of age (36), Terminally ill (36), Terminally ill over 65 years of age (36) The Willows Nursing & Residential Home DS0000001934.V318349.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. No person falling in categories TI(E) & TI to be admitted to the Home when 36 persons of that category/combined categories are already accommodated Service user numbers No person falling within categories MD, MD(E), DE, DE(E) may be admitted to the Home when 9 persons in total in these categories/combined categories are already accommodated within the Home No person falling in categories PD(E) & PD to be admitted to the Home when 57 persons of that category/combined categories are already accommodated in the home No person falling in categories PD may be admitted into the Home where there are 36 persons of category PD already accommodated within the home No person falling in categories SI(E) and SI to be admitted to the home when 36 persons of that category/combined categories are already accommodated No one under the age of 55 falling within categories MD or DE may be admitted to the Home Named person To be able to admit a named person under 55 years of age and falling within category LD named in variation application No. 58114 dated 13/11/03 7.12.06 3. 4. 5. 6. 7. Date of last inspection Brief Description of the Service: The Willows Nursing and Residential Home is situated close to the centre of Market Harborough. It provides care for up to 57 older people with a range of needs including physical disabilities, dementia, and sensory impairment. Registered nurses are on duty in the home at all times. The accommodation consists of two older buildings linked by a new wing. Bedrooms are on two floors accessed by both passenger and stair lifts. There are four sitting rooms and one dining room. The home stands within secluded gardens and there is car parking at one side. The fees range from £319 to £700 per week depending on care needs. The Willows Nursing & Residential Home DS0000001934.V318349.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was a thematic inspection that was carried out as part of a national pilot scheme. It consisted of asking a number of standard questions to a sample of residents and their relatives. The registered person was informed and the agreement of residents and relatives sought at the beginning of the inspection. Prior to the visit, the inspector spent half a day reviewing the last inspection report, and information relating to the home received since that inspection. During the course of the inspection, which lasted four hours, the inspector focussed on the National Minimum Standards relating to ‘Choice of Home’ and ‘Complaints’. This was achieved through a method called case tracking. Case tracking means the inspector looked at the care provided to five residents living at the home by meeting them; talking with the staff who support their care; and checking these residents’ records in relation to the Standards being inspected. The inspector also met with three relatives, one of the Owners, the senior nurse on duty, and one of the carers. What the service does well:
All residents and relatives interviewed said their introduction to the home had been positive. Records showed they had received information about the home in advance, and had had the opportunity to visit. One relative said ‘I used a care home directory to find homes in this area. This was the third one I looked at and I liked it straight away.’ Another commented, ‘We went to look at several homes for my relative. They we came here and we liked it so we went on the waiting list. We finally got a place and I’ve been grateful ever since.’ Residents comments about moving into the home included, ‘When I came here I was very ill but the staff nursed me back to health’, ‘My GP suggested this home’, and ‘I can’t remember how I got here, but I’m just glad that I did.’ The Manager (a qualified nurse) or one of the senior nurses assesses all potential residents in their own homes or in hospital prior to admission. They also talk to relatives and health professionals to get their views on resident’s needs. These steps help to ensure the home is suitable each resident and that staff can care for them properly. One relative said, ‘When he came here everything was ready for him and all the equipment he needed was in his room.’ The Willows Nursing & Residential Home DS0000001934.V318349.R01.S.doc Version 5.2 Page 6 The complaints procedure was also examined and all the residents/relatives interviewed said they would have no difficulty in speaking out if they had a complaint. Their comments included, ‘I’d tell the sister in charge if I wasn’t happy about something’, and ‘If I had a complaint I would contact the sister. If she wasn’t available I would speak to the Owners.’ In addition, all those interviewed were confident that action would be taken if they did complain. Residents and relatives also made many positive general comments about the including: ‘The staff deserve medals.’ ‘The staff are wonderful to me when I visit.’ ‘The staff have time for my relative.’ ‘My relative didn’t like eating when he came in and was underweight. Now he enjoys it and is looking much better.’ ‘The home is very clean.’ ‘I have no concerns at all about this home.’ ‘My relative has always got clean clothes on.’ ‘This home is very good and seems to meet all my relative’s needs.’ All areas of the premises viewed during the inspection were clean, warm and tidy. Residents appeared well cared, comfortable and relaxed. Staff were friendly and welcoming. The pre-inspection questionnaire sent to CSCI indicated that the home is appropriately staffed and maintained in line with the National Minimum Standards and the Care Homes Regulations. What has improved since the last inspection? What they could do better:
Some sections of the admission documents were not dated and it was advised that, in future, they all are. This will make it easier to identify when changes in residents’ care needs occur. The Willows Nursing & Residential Home DS0000001934.V318349.R01.S.doc Version 5.2 Page 7 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 summary of this inspection report can be made available in other formats on request. The Willows Nursing & Residential Home DS0000001934.V318349.R01.S.doc Version 5.2 Page 8 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 Willows Nursing & Residential Home DS0000001934.V318349.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are assessed prior to admission to ensure the home is suitable for them. (Standards 1, 2, and 3 were inspected.) EVIDENCE: All potential residents (or their representatives) are given a copy of the ‘Resident’s Guide to the Home’ prior to admission. This includes the home’s Statement of Purpose/Service Users’ Guide. Terms and Conditions are drawn up and when a resident is admitted copies of these are kept on file in the home. They state that four weeks notice will be given if fees are altered. The Manager or a senior nurse assesses those residents interested in coming to the home. They visit them in their own homes or in hospital in order to do this. They also talk to relatives and health professionals to get their views on resident’s needs. These steps help to ensure the home is suitable each resident and that staff can care for them properly. Once admitted each resident has a trial period of at least four weeks.
The Willows Nursing & Residential Home DS0000001934.V318349.R01.S.doc Version 5.2 Page 10 Care records were sampled and showed that residents were properly assessed prior to admission. Some sections of the admission documents were not dated and it was advised that, in future, they all are. This will make it easier to identify when changes in residents’ care needs occur. Residents were interviewed about coming into the home and made the following comments: ‘A relative found this home for me.’ ‘I can’t remember whether I had anything written about the home when I came in. I was ill – I can’t remember anything about coming here.’ ‘When I came here I was very ill but the staff nursed me back to health.’ ‘My GP suggested this home.’ ‘I can’t remember how I got here, but I’m just glad that I did.’ Relatives’ comments on the same subject included: ‘I used a care home directory to find homes in this area. This was the third one I looked at and I liked it straight away.’ ‘I can remember my relative being assessed by staff from here while he was in hospital.’ ‘We went to look at several homes for my relative. They we came here and we liked it so we went on the waiting list. We finally got a place and I’ve been grateful ever since.’ ‘I can’t remember if we had any information about the home when my relative moved it.’ ‘When he came here everything was ready for him and all the equipment he needed was in his room.’ These comments showed that most of those interviewed couldn’t remember assessments being carried out or documentation being received, although care files showed that these things did happen. However the comments also show that relatives made informed choices when the home was selected. Also that those residents and relatives interviewed were pleased with the Willows and that their experience of coming into the home was a positive one. The Willows Nursing & Residential Home DS0000001934.V318349.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is (excellent, good, adequate or poor). This judgement has been made using available evidence including a visit to this service. EVIDENCE: These Standards were not inspected. The Willows Nursing & Residential Home DS0000001934.V318349.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is (excellent, good, adequate or poor). This judgement has been made using available evidence including a visit to this service. EVIDENCE: These Standards were not inspected. The Willows Nursing & Residential Home DS0000001934.V318349.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents feel able to talk to staff about any concerns they might have. (Standard 16 was inspected.) EVIDENCE: The home has a written complaints procedure, which is given to all residents (or their representatives) prior to admission. A copy of the complaints procedure is also displayed in the home. All the residents/relatives interviewed said they would have no difficulty in speaking out if they had a complaint. Their comments included: ‘I’d tell the sister in charge if I wasn’t happy about something.’ ‘If there was anything wrong I would tell the staff.’ ‘If I had a complaint I would contact the sister. If she wasn’t available I would speak to the Owners.’ ‘If I wasn’t happy I would tell the staff straight away.’ And all said they were confident that action would be taken if they did complain. One complaint is currently in the process of being investigated. The Willows Nursing & Residential Home DS0000001934.V318349.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is (excellent, good, adequate or poor). This judgement has been made using available evidence including a visit to this service. EVIDENCE: These Standards were not inspected. The Willows Nursing & Residential Home DS0000001934.V318349.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is (excellent, good, adequate or poor). This judgement has been made using available evidence including a visit to this service. EVIDENCE: These Standards were not inspected. The Willows Nursing & Residential Home DS0000001934.V318349.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is (excellent, good, adequate or poor). This judgement has been made using available evidence including a visit to this service. EVIDENCE: These Standards were not inspected. The Willows Nursing & Residential Home DS0000001934.V318349.R01.S.doc Version 5.2 Page 17 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 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X X The Willows Nursing & Residential Home DS0000001934.V318349.R01.S.doc Version 5.2 Page 18 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. Refer to Standard Good Practice Recommendations The Willows Nursing & Residential Home DS0000001934.V318349.R01.S.doc Version 5.2 Page 19 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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