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Inspection on 09/05/06 for The Willows Residential Home For The Elderly

Also see our care home review for The Willows Residential Home For The Elderly for more information

This inspection was carried out on 9th 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The Inspector was informed by staff that Service Users receive the care they want and the home records information well and has good staff training and support from the Provider who made regular unannounced visits to the home. The home provides adequate opportunity for Service Users to participate in activities with 2 of the Service Users attending different day care groups on a weekly basis. Service Users are encouraged to go out into the community but become anxious and want to remain in the house and prefer to sit in the garden when it`s warm and sunny. The home is clean, tidy and hygienic.

What has improved since the last inspection?

The home has continued to provide good care to the Service Users and have improved and updated their care plans and daily recording.

What the care home could do better:

The Provider needs to appoint a Manager as soon as possible as the home has not had a Registered Manager since December 2004, although this has not had had a adverse effect on the care provider it is in breach of the Care Home Regulations 2001.

CARE HOMES FOR OLDER PEOPLE The Willows Residential Home For The Elderly The Willows The Broadway Minster Sheerness Kent ME12 2DE Lead Inspector Graham Cummings Unannounced Inspection 9th May 2006 09:45 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 Residential Home For The Elderly DS0000024023.V291675.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 Willows Residential Home For The Elderly DS0000024023.V291675.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Willows Residential Home For The Elderly Address The Willows The Broadway Minster Sheerness Kent ME12 2DE 01795 874975 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) Mrs Tracey Melanie Gobbi Care Home 10 Category(ies) of Old age, not falling within any other category registration, with number (10) of places The Willows Residential Home For The Elderly DS0000024023.V291675.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd November 2005 Brief Description of the Service: The home is situated near the coastal road at Minster and offers accommodation for 10 older people. The ten single bedrooms are located on both the ground and the first floor. There is no shaft lift access between floors and the stairs are narrow and incorporate a bend, so the home may not be suitable for anyone with very limited mobility. However, there is a sitting room on both floors, with the one on the first floor having access to a large balcony, with views over the sea.The home is on a bus route, so provides easy access to all the local amenities in the town of Sheerness, which is roughly two miles away. There is limited parking to the front of the property, but unrestricted on-road parking at the side. Service Users mostly come from the local community and retain their own GPs when moving in. The Willows Residential Home For The Elderly DS0000024023.V291675.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced site visit was carried out on the 9th May 2006. The Key Inspection report consists of information gathered from the site visit, previous inspection report, 5 relative comment cards and the completed Pre Inspection Questionnaire. The Inspectors judgement is that the outcome for Service Users is good. The main area that needs to be addressed is the employment of a Registered Manager. The home has not had a Registered Manager since December 2004 and the proposed Manager left in April 2006 for personal reasons, the provider is looking to have the issue addressed by the end of September 2006. The Provider was concerned by the changes in the inspection procedures and was of the opinion that even if you were an excellent home there should be more inspections. Inspection Reports are a validation of how a home runs and if these are between 18 months and 3 years old it may not accurately reflect the care being provided due to changes of Manager, staff and Service Users. From the evidence gathered both before and during the Key Inspection the overall quality of this service is good. What the service does well: What has improved since the last inspection? What they could do better: The Provider needs to appoint a Manager as soon as possible as the home has not had a Registered Manager since December 2004, although this has not had had a adverse effect on the care provider it is in breach of the Care Home Regulations 2001. The Willows Residential Home For The Elderly DS0000024023.V291675.R01.S.doc Version 5.1 Page 6 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 Willows Residential Home For The Elderly DS0000024023.V291675.R01.S.doc Version 5.1 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 Willows Residential Home For The Elderly DS0000024023.V291675.R01.S.doc Version 5.1 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): 1,2,3,5,6 The service provided is good. Prospective Service Users, Care Managers and Family members had information available to make an informed choice about moving into the home. The home does not cater for intermediate care. EVIDENCE: The Provider confirmed that no changes had taken place since the last Inspection and that the Statement of Purpose and Service User Guide remained the same. Evidence seen showed that contracts were on file along with pre placement assessments. The Pre Inspection Questionnaire and comment cards had not been returned prior to the Site Visit these are to be sent to the Inspection as soon as possible. The home does not cater for Intermediate care. The Willows Residential Home For The Elderly DS0000024023.V291675.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): 7,8,9,10,11 The service provided is good. All Service Users have individual care plans and their health care needs are fully met. Service Users do not self administer medication. Service Users feel they are treated with respect and their wishes will be respected at the time of death. EVIDENCE: The Inspector looked at 2 Service User care plans and found both of them to contain clear and concise information relating to the needs of the Service User. The care plans seen contained details of the individuals wishes following their death. The Inspector noted that each care plan had been evaluated monthly and the needs reassessed, all documentation had been signed and dated by the staff member completing the evaluation and where possible the Service User had also signed. Each Service User had a transfer sheet in their file that was filled in with all personal details of the individual in case of an admission to hospital, the reasons for the admision would be completed at the time. The Service User spoken to indicated that they had participated in their care plan with their son, they also confirmed that they were well cared for and happy to live there. All service users are registered with a local GP, optician and dentist. The Willows Residential Home For The Elderly DS0000024023.V291675.R01.S.doc Version 5.1 Page 10 Daily reports were seen and they contained details of the care given, any comments made by the Service User and observations noticed by staff relating to emotional and physical care of the individual. The Inspector observed a positive interaction between Service Users and staff. The Willows Residential Home For The Elderly DS0000024023.V291675.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): 12,13,14,15 The service provided is good. Service Users are able to have a lifestyle that matches their social and recreational needs including regular contact from family and friends. Service Users are able to exercise choice in their daily lives and receive a wholesome and appealing diet. EVIDENCE: There are no written planned activities but the Inspector was informed that there were daily options and if an individual participates in the activity this is recorded in their daily notes, a service user spoken to said that she was happy to watch. Activities include singing, bingo, drawing and colouring. The Provider said that they did not go out much last summer and they are looking to ensure that this happens more often this year. The Inspector saw the lunch provided on the day which was beef casserole and vegetables followed by fruit flan and cream. The Service User spoken to said that the food was good and there was plenty to eat, staff spoken to agreed that the quality of food provided was healthy and varied with Service Users able to have alternative options if they wished. Most of the Service Users have family members visit and some take the Service User out for a short time, however both staff spoken to and the Provider stated that most of the Service Users were anxious about leaving the home and were happy to sit in the garden. The Service User spoken to told the The Willows Residential Home For The Elderly DS0000024023.V291675.R01.S.doc Version 5.1 Page 12 Inspector that she was happy sitting in the lounge. All of the Service Users participated in the recent local Elections through postal votes. The Willows Residential Home For The Elderly DS0000024023.V291675.R01.S.doc Version 5.1 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 The service provided is good. Service Users are complaints and concerns are listened to. Service Users are protected from abuse EVIDENCE: The Inspector had received no complaints, or Regulation 37 Notifications, the Provider confirmed that no incidents, allegations or complaints had been received by the home. Staff have attended Adult Protection training and were aware of the action to take should an incident occur. The Willows Residential Home For The Elderly DS0000024023.V291675.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,23,24,25,26 The service provided is good. Service Users live in a well maintained, clean, pleasant and hygienic environment with access to safe indoor and outdoor facilities. Service Users own rooms suit their needs and have personal possessions around them. EVIDENCE: The home was clean and tidy with a homely atmosphere, it was well furnished and decorated. The home employs a domestic who is rightly proud of the high standard of cleanliness she maintains, care staff spoken to and the Provider were very complimentary about her efforts. The home has 2 lounges and a seating area in the garden, all rooms are well decorated and furnished with Service Users personal belongings. The laundry area is also used as an office and although not ideal it is adequate and storage of information is secure. The Willows Residential Home For The Elderly DS0000024023.V291675.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 The service provided is good. Service Users needs are met by a trained and competent staff team and they are protected by the homes recruitment policy and procedures. EVIDENCE: The Inspector spoke to 2 staff and the Provider, the Acting manager left 2 weeks ago for personal reasons and this means that the home still has no Registered Manager, there are 4 senior staff and the daily responsibilities are equally shared. There are 2 staff on duty from early morning to late evening with a sleepin staff. The Provider and both staff spoken to confirmed that the training offered was excellent and provided them with a greater understanding and knowledge to carry out their job to a high standard. The home does not have a training matrix and the provider could find completing one beneficial and enable them to see when courses need to be updated and any shortfalls highlighted. Both staff when spoken to about the lack of a Manager at the home felt that they were very well supported by the Provider and that they were available at all times if they required help, advice or support. The Inspector saw the file of the newest member of staff and although not in a file yet all of the paperwork was available. The Willows Residential Home For The Elderly DS0000024023.V291675.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 The service provided is Adequate. The home does not have a Registered Manager. The home is run in the best interests of the Service Users. Service Users finances are protected and their health, safety and welfare are promoted and protected. EVIDENCE: The Inspector was informed that the Acting Manager had left the home 2 weeks ago for personal reasons, following a very lengthy discussion with the Provider, it was agreed that the Inspector would clarify the situation with their Line Manager and inform the Provider of the outcome. The Inspector contacted the Provider the following day to confirm that a Manager needed to be appointed as soon as possible and a time limit of 4 months, September 2006 was agreed. The Provider has daily contact with the home and visits at least 3 times a week. Staff are appropriately supervised by the Provider and Senior staff are looking to take on part of this role in the near future when training The Willows Residential Home For The Elderly DS0000024023.V291675.R01.S.doc Version 5.1 Page 17 has been completed. The home is run in the best interests of the Service Users who are fully involved in any decisions about their individual care and the communal activities, the home also have regular contact with family, friends and care managers to ensure that the appropriate and correct care is provided. The home holds limited personal monies but where they do there is an accounting system that register all monies in and out with dates, signatures of staff and wherever possible the Service User. The Inspector had no reason to doubt that Service Users health, safety and welfare were not being promoted and protected. The Willows Residential Home For The Elderly DS0000024023.V291675.R01.S.doc Version 5.1 Page 18 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 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 3 X X 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 3 X 3 X X 3 The Willows Residential Home For The Elderly DS0000024023.V291675.R01.S.doc Version 5.1 Page 19 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 OP32 Regulation 8(1)(a) Requirement The Registered Provider shall appoint an individual to manage the care home where - (a) there is no registered manager in respect of the care home. Timescale for action 30/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Willows Residential Home For The Elderly DS0000024023.V291675.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Willows Residential Home For The Elderly DS0000024023.V291675.R01.S.doc Version 5.1 Page 21 - 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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