CARE HOMES FOR OLDER PEOPLE
Walldene Court Threap Gardens Off Simonside Avenue Howdon, Wallsend NE28 7HT Lead Inspector
Kathryn Reid Announced 13 June 2005 09:30 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 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. Walldene Court B53-B03 S28822 WalldeneCourt V221981 130605 Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Walldene Court Address Threap Gardens Off Simonside Avenue Howdon Wallsend NE28 7HT 0191 263 3791 0191 234 3313 tracey.clayton@anchor.org.uk Anchor Trust Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Miss Tracey Armstrong Clayton CRH 42 Category(ies) of OP - Old Age (41) registration, with number PD - Physical Disability (1) of places Walldene Court B53-B03 S28822 WalldeneCourt V221981 130605 Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: The home currently also provides nursing care to one resident who has physical disability and who is below pension age. The manager knows to notify the Commission should there be any change to this arrangement. Date of last inspection 25th February and 1st March 2005 Brief Description of the Service: Walldene Court is a purpose built home in Howden. The homes operational policy is based upon group living and consists of four small units arranged over two floors. There are forty-two single rooms, known as flatlets, all with en-suite facilities. Some local amenities are within walking distance and access in and out of the home is good. There are plenty of communal and dining areas on each floor and sufficient assisted bathing and toilet facilities around the home. There is a good sized passenger lift in the centre of the building. Walldene Court B53-B03 S28822 WalldeneCourt V221981 130605 Stage4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This announced inspection took place over eight hours and included a tour of resident areas, inspection of records and discussions with the manager and her deputy. Six staff of different designations, for example a nurse, a carer and a domestic were interviewed and the inspector met with four relatives and nine residents. Twenty-nine residents and eleven relatives had completed CSCI comment cards. What the service does well: What has improved since the last inspection?
Areas in need of urgent repair or redecoration at the last inspection have been dealt with and plans for full redecoration and refurbishment next year are in place. The activities organiser is back at work and a full program of activities and entertainment is available. Staff have received training in relevant topics such as palliative care and adult protection. There is continued progress with carers obtaining NVQ qualifications. The new manager has continued to establish herself and has maintained high standards of care and organisation. Walldene Court B53-B03 S28822 WalldeneCourt V221981 130605 Stage4.doc Version 1.30 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. Walldene Court B53-B03 S28822 WalldeneCourt V221981 130605 Stage4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Walldene Court B53-B03 S28822 WalldeneCourt V221981 130605 Stage4.doc Version 1.30 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 standard(s) 3 and 4 The home has an efficient and comprehensive admission procedure. The staff understand and know about the residents care needs and residents feel their individual needs are met. EVIDENCE: Pre and post admission information was seen and covered all relevant areas in the case files that were seen. The senior staff are experienced in and capable of assessing needs and making decisions about admission and the criteria for admission has been adhered to. Nurses and carers can describe individual care needs of residents such as bathing preferences and promotion of independence. Also how they meet these needs and deliver care that is based on good training and best practice. This information corresponded with the understanding and experiences of the residents. Walldene Court B53-B03 S28822 WalldeneCourt V221981 130605 Stage4.doc Version 1.30 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 standard(s) 7 and 8 There is a satisfactory care planning system in place but staff were failing to keep records fully up to date. The health needs of residents are well met and efficient multi disciplinary teamwork takes place. EVIDENCE: Case records were examined for two residents where shortfalls in monthly care plan reviews and health care assessments, such as pressure sore risk, were identified and discussed with senior staff. Suitable nutritional assessment is now in place. Dependency levels were high and twelve residents had many complex needs. The number of residents with pressure sores was low at two and there was no current problem with infection. Three residents were having mental health problems and they had received medical and specialist nurse input and advice to help the staff to manage their care needs. Walldene Court B53-B03 S28822 WalldeneCourt V221981 130605 Stage4.doc Version 1.30 Page 10 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 standard(s) 12 and 13 The provision of social care has returned to a high standard and equal priority is given to group and individual activities. Links with families and friends are well established and support the resident’s good quality of life. EVIDENCE: Staff have been using ‘social diaries’ to record daily activities and the provision of entertainment. The activities coordinator is back from long-term leave and works twenty hours per week. She met with the inspector to tell her about her work and plans for the future. She feels she was at her best when working on a one to one basis with people who are unable or who prefer not to join group activities. Residents reported that activities such as gardening and dominoes were enjoyable and a visit from an entertainer last week had been very successful. Colourful, illustrated weekly activities programs were impressive and informative. Residents and relatives described flexibility and encouragement to visit the home. One relative reported that ‘ a warm and friendly welcome awaits whatever time you visit’. Walldene Court B53-B03 S28822 WalldeneCourt V221981 130605 Stage4.doc Version 1.30 Page 11 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 standard(s) 16 and 18 The home has a satisfactory complaints system and residents and relatives find staff approachable and feel that their views are listened to and acted upon. Staff know how to protect vulnerable residents and how to raise any concerns. EVIDENCE: Staff training in adult protection through North Tyneside Council and in house training has been ongoing. Residents and relatives had confirmed in written questionnaires that they had no cause for complaint. Three relatives and seven residents reported high levels of satisfaction in discussion with the inspector and said that they would feel comfortable in raising any concerns with staff. Walldene Court B53-B03 S28822 WalldeneCourt V221981 130605 Stage4.doc Version 1.30 Page 12 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 standard(s) 19, 20,21,24,25 and 26 The standard of the environment remains good and provides residents with a homely and spacious place to live. Communal lounge, dining and bathing facilities are plentiful and accommodate residents’ needs. The comfort of resident areas, such as bedrooms, will be reduced until upgrading and redecoration is carried out. High standards of hygiene are maintained. EVIDENCE: Several bedrooms, dining rooms, communal bathroom, toilets and sluice rooms were visited on each floor. The home was exceptionally clean and fresh smelling in the areas that were seen. One resident reported that ‘ the home is always nice and clean’. The manager had provided useful detail of the bedroom redecoration program and rooms are redecorated when they become empty. Budgetary plans for some large upgrading works were seen and the manager has become more involved in financial planning for the premises. Walldene Court B53-B03 S28822 WalldeneCourt V221981 130605 Stage4.doc Version 1.30 Page 13 The home is due for redecoration next year that should rectify areas of wear and tear and damage in resident areas. Urgent remedial upgrade and repair had been carried out after the last inspection. An assisted bath had recently been replaced and attention was needed to a broken and loose bath panel on the ground floor that could pose a risk of injury. The gardens and grounds were very overgrown and full of weeds. Raised beds and outdoor planters in the small seating area were colourful and tidy. Walldene Court B53-B03 S28822 WalldeneCourt V221981 130605 Stage4.doc Version 1.30 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 and 30 Staff turnover is minimal and staffing levels are maintained to meet the needs of the residents. The staff benefit from a varied and generous training provision and are competent to carry out their work. Thorough recruitment procedures protect and support the residents. EVIDENCE: 68 of the carers have achieved NVQ qualifications and all of the nurses are NVQ assessors. The staff-training program covers mandatory and clinical topics relevant to the care of older people such as Parkinson’s disease and ‘eating with dignity’. Impressive new individual training portfolios had just been introduced. The nurses have undertaken training in verification of death. The carers had enjoyed in-house sessions on palliative care and training in dementia care was planned for. One of the nurses has left recently to return to hospital work and hers and another part time nurse vacancy are being advertised. Otherwise the home is fully staffed and the handyman is shared with other homes in the area. Six staff made reference to their training and the stability amongst the staff team during interview. Correct recruitment procedures had been followed during a recent staff appointment. The prompt use of the NMC caller code to check nurses’ registration details and the need to explain any gaps in an employment history were discussed. Walldene Court B53-B03 S28822 WalldeneCourt V221981 130605 Stage4.doc Version 1.30 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,35,36,37 and 38 The manager has continued to settle into and develop her role. She is well supported by her staff and the home has remained well organised and running smoothly with emphasis on the residents’ best interests. There has been insufficient formal staff supervision in the past year. Individual financial interests are safeguarded and record keeping is managed efficiently. Staff practise promotes their own safety and that of the residents. EVIDENCE: The manager has completed the first module of the Registered Manager’s Award and also undertaken training in adult protection. She has developed strong relations with other Anchor managers and described good support from her deputy and line manager. Staff spoke of the approachability and support of senior staff and how the new manager was maintaining high standards at the home. Internal audit is well organised and visits by the area manager cover relevant aspects of the running of the home and are well recorded.
Walldene Court B53-B03 S28822 WalldeneCourt V221981 130605 Stage4.doc Version 1.30 Page 16 Staff supervision sessions were overdue by several months and these must now be arranged and maintained. Fire training and service and maintenance records were up to date with supporting evidence in good order and quickly available. Notes of recent staff meetings were seen. A joint bank account has been set up with the agreement of three residents. The manager is not yet aware of how any accrued interest will be handled. Walldene Court B53-B03 S28822 WalldeneCourt V221981 130605 Stage4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 x 15 x
COMPLAINTS AND PROTECTION 2 3 2 x x 3 3 4 STAFFING Standard No Score 27 3 28 4 29 2 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 4 x 3 3 3 3 x 2 1 4 3 Walldene Court B53-B03 S28822 WalldeneCourt V221981 130605 Stage4.doc Version 1.30 Page 18 No 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. 2. Standard 7 and 8 19 and 21 Regulation 15 23(2) Requirement Care plans and health care assessments must be regularly reviewed and kept up to date. Tidy and improve the appearance of the gardens and grounds. Repair or replace the broken bath panel in the downstairs assisted bathroom. Provide all care staff with formal supervision at least six times a year. Timescale for action 31.July 2005 31 July 2005 3. 36 18(2) 31 August 2005 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. Refer to Standard 29 35 Good Practice Recommendations Checks of The nurses registration with the NMC should be carried out promptly. Any gaps in employment histories should be explored and recorded. Establish how any interest accrued on the residents joint bank account will be managed. Walldene Court B53-B03 S28822 WalldeneCourt V221981 130605 Stage4.doc Version 1.30 Page 19 Commission for Social Care Inspection Northumbria House Manor Walks, Cramlington Northumberland NE23 6UR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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