Inspection on 24/08/06 for Walmer House

This inspection was carried out on 24th August 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Walmer House 09/07/07

Walmer House 17/03/06

Walmer House 30/08/05

Walmer House 09/11/04

Walmer House 24/08/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Walmer House 6 Ash Hill Road Torquay Devon TQ1 3HZ Lead Inspector James Rose Unannounced Inspection 09:00 24 August 2006 th 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 Walmer House DS0000018447.V308145.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. Walmer House DS0000018447.V308145.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Walmer House Address 6 Ash Hill Road Torquay Devon TQ1 3HZ 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) 01803 292734 01803 292734 keychangewalmer@aol.com Keychange Charity Mrs Ena Beatrice Pauline Bell Care Home 17 Category(ies) of Dementia - over 65 years of age (17), Old age, registration, with number not falling within any other category (17) of places Walmer House DS0000018447.V308145.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th May 2006 Brief Description of the Service: Walmer House is a large detached Victorian house which stands in its own grounds. The home provides 24-hour care for up to 17 persons who require care by reason of old age or dementia. Accommodation is provided in single rooms throughout, 14 bedrooms have on suite facilities available. A large comfortably furnished communal lounge is situated on the ground floor. Meals are taken in a dedicated dining room at small tables seating up to four persons. A vertical lift is provided and appropriate aids for persons with mobility issues. At the front of the home there is a large off road parking area, to the side and rear of the building there is a well-tended garden with extensive views of the surrounding area. Walmer House is run as a Christian charity by Keychange. The home is situated approximately half a mile from the town centre of Torquay. Walmer House DS0000018447.V308145.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was undertaken over 8.5 hours during August 2006. Samples of the care records were examined and four residents were asked for their views of the service provided at the home, this was undertaken individually in private. Visitors to the home were consulted and healthcare professionals that provided service to the home. Evidence was also obtained from questionnaires that were returned to the Commission and carer staff were also interviewed. The inspection was undertaken with the assistance throughout of the registered manager. What the service does well: What has improved since the last inspection? A requirement was raised at the time of the last inspection concerning the personnel records that had some deficits in the documentation this has now been rectified which will ensure that the legislation is satisfied and residents are safe. There were some deficits in the training undertaken by some members of the care team this training has now been undertaken or arrangements have been put in place to ensure that this is completed in the near future. Walmer House DS0000018447.V308145.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Walmer House DS0000018447.V308145.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Walmer House DS0000018447.V308145.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is adequate. Some of the assessments undertaken of residents’ needs continue to have some deficits in the area of social needs. EVIDENCE: Five assessments were examined of the needs of residents in the home. Health and personal needs were, in general, well covered but some deficits were apparent in the area of social need. The deficits were discussed with the registered manager who agreed a new timescale for completion and advised that she understood what was required. From discussions undertaken with residents and staff in the home it appears likely that social needs are in fact catered for but the lack of recording is the issue. Standard 6 refers to a service not provided at Walmer House. Walmer House DS0000018447.V308145.R01.S.doc Version 5.2 Page 9 Walmer House DS0000018447.V308145.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. Some deficits were apparent in the social needs area of the care planning undertaken. Health needs of residents were appropriately covered. Residents are able to self medicate subject to a risk assessed approach to ensure they have the capacity. Some deficits were apparent in the administration of mediation undertaken by the home. Residents felt that they were always treated with respect and their privacy was maintained. EVIDENCE: An individual care plan was available for each resident in the home; five of these were examined in detail. Health and personal needs were appropriately covered but deficits were apparent in the recording of social needs. This was an issue in previous inspections and requirements have been raised to ensure this was rectified. A requirement has been repeated in this report to ensure that the social needs of residents form part of the care planning processes undertaken by the home. A timescale has been agreed with the registered manager for completion who has advised that what needs to be undertaken is understood. Should the home be unable to meet the timescale agreed the Walmer House DS0000018447.V308145.R01.S.doc Version 5.2 Page 11 registered manager should contact the Commission to renegotiate a date for completion. Residents who wish to self medicate are able to do so subject to a risk assessed approach to ensure they have the capacity to undertake this task safely. The recordings undertaken by the home of the administration of medication were examined. In general the records were well maintained, medication was checked and booked in when received, recorded when issues and a detailed log was maintained of the return of unused medication to the pharmacist. There were, however, some deficits in the administration of three prescriptions apparent. This medication had been checked and booked in by the home but no record was available of this medication being issued. This was discussed with the registered manager at the time of the inspection who understood that a requirement was going to be raised and a timescale was agreed. Four residents were consulted individually and in private during the inspection process, they all stated that they were very happy in the home and felt they received a good service. They also advised that they were treated with respect at all times and that care was taken by the staff to ensure that their privacy was maintained. This was also confirmed from observations made during the inspection. Walmer House DS0000018447.V308145.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. Residents advised that they enjoyed the lifestyle in the home; all their needs were met including their recreational interest. Residents were able to have visitors at anytime and were able to come and go as they wished. Care was taken to ensure that residents made their own choices and that they had control over their own lives. Wholesome, balanced meals were provided that were to the liking of residents and these were served in a dedicated wellappointed dining room. EVIDENCE: Four residents were consulted individually in private during the inspection process, they advised that they enjoyed the life at Walmer House and felt that all their needs were met by the service provided. They advised that they had enough recreational activities available and could not suggest any additions they would like to be provided. One resident stated, “ The new manager has made a great difference to the activities programme there is always something on”. Relatives and friends were able to visit the home at anytime and residents could come and go as they wished. Walmer House DS0000018447.V308145.R01.S.doc Version 5.2 Page 13 It was clear from observations made during the inspection that the staff team went out of their way to give residents time to make their own decisions about what they wanted and did not rush residents when they were assisted during mobilising. Residents advised in the discussions undertaken with them that they felt in charge of their own lives within the home. One resident remarked, “I don’t feel rushed here, I decide what I want” and another said “ I couldn’t do better than this and the food suits me fine”. Residents confirmed that they liked the food provided at the home and stated that the dining room was light and airy and that they had plenty of room to get to their table. Residents were consulted on a regular basis about what food they would like to consume and extra care was taken with residents who were poorly. Walmer House DS0000018447.V308145.R01.S.doc Version 5.2 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): 16 and 18 Quality in this outcome area is good. Residents were confident that if they raised an issue with the management it would be taken seriously and resolved for them and they were appropriately protected from all forms of abuse. EVIDENCE: All the residents consulted were confident that if they raised an issue with the registered manager it would be taken seriously and quickly resolved for them to their satisfaction. The complaints procedure is readily available in the home and a copy is provided in the individual packs of information that is given to each resident. The home has a clear policy and procedure that covers all types of abuse and what action a carer should take if this was discovered and the care team have been trained in its use. Two carers were interviewed in private during the inspection process and both were clear in the protection policy and procedure. Walmer House DS0000018447.V308145.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. Walmer House provides a safe well-maintained environment for the people who live there; the building is clean and pleasant with high standards of hygiene evident throughout. EVIDENCE: A complete tour of the building was undertaken as part of the inspection all rooms were seen. The home was well maintained throughout. The home has a redecoration and maintenance programme running and no shortfalls were found. At the time of the inspection the exterior of the home was being redecorated. The home was clean throughout, no malodour was present and high standards of hygiene were evident. Walmer House DS0000018447.V308145.R01.S.doc Version 5.2 Page 16 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 and 30 Quality in this outcome area is good. There are always adequate numbers of staff on duty to ensure that residents’ needs are met. Residents are safe and protected by the home’s recruitment policies and procedures. The care team is competent to do their jobs; some outstanding training is about to be completed. EVIDENCE: The care team at the home is now up to strength so the need for agency personnel is minimal. All outstanding training has either been completed or the courses are booked and staff will attend in the near future. Residents confirmed in conversations that they were well cared for by the staff team and that their emergency bell system was answered in a timely fashion when used. Personnel files of the care team were available and four were examined in detail, all the necessary documentation was in place and the appropriate checks had been undertaken, this will ensure that residents are safe. Two carers were interviewed as part of the inspection process; this was undertaken individually in private. They advised that they liked working at the home and had a good relationship with the residents and the registered manager of the home. These carers had been trained in the adult protection policy and procedure and were able to demonstrate appropriate knowledge about actions to be undertaken in these circumstances. Walmer House DS0000018447.V308145.R01.S.doc Version 5.2 Page 17 Walmer House DS0000018447.V308145.R01.S.doc Version 5.2 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): 31, 33, 35 and 38 Quality in this outcome area is good. Walmer House is managed appropriately by an experienced person who is fit to be in charge and of good character. The home is run in the best interest of the residents. The financial interest of the residents is safeguarded and the welfare and health and safety of staff and residents are given appropriate priority. EVIDENCE: Since the last inspection the proposed manager has successfully completed the management interview with the Commission and is now registered. She is an experienced person of many years and of good character, some outstanding training is being undertaken which will bring her qualifications up to date. The residents consulted during the inspection process advised that the service in the home had improved with her appointment. Walmer House DS0000018447.V308145.R01.S.doc Version 5.2 Page 19 The manager undertakes to consult residents individually and at residents meetings about the serviced provided in the home. An anonymous questionnaire process is also undertaken to ensure all views are expressed. Four residents are assisted with their pocket monies and clear records are maintained of all transactions undertaken. Receipts are retained of all purchases made by the home on behalf of residents. This system ensures that residents’ personal pocket monies are appropriately safeguarded. Health and safety and welfare issues are seen as most important by the management of the home and these are given priority. In general these issues are well managed the main deficit being medication. A record was examined of the fire precautions undertaken by the home; these were clear and up to date. The regulations concerning the safe use and storage of harmful chemicals were in place and appropriate reports were undertaken of incidents that were experienced in the home. Electrical appliances and the installations were checked and maintained appropriately and all equipment was regularly serviced to ensure it was working and safe. The water system in the home was also checked to ensure it was clear of unwanted bacteria. Walmer House DS0000018447.V308145.R01.S.doc Version 5.2 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 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Walmer House DS0000018447.V308145.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 OP3 Regulation 14 Requirement Timescale for action 30/09/06 2 OP7 15 3 OP9 13 4 OP33 13 The registered manager must ensure that an assessment is undertaken of all the need of a resident. (Previous timescales of 16/03/06 and 16/04/06 not met) The registered manager must 30/09/06 ensure that the residents’ health, personal and social care needs are set out in an individual plan of care. (Previous timescale of 30/03/06 and 30/04/06 not met) The registered manager must 04/09/06 ensure that all staff adheres to the homes policy and procedure for the correct administration of medication. The registered manager must 30/09/06 ensure that quality assurance systems are in place to check that carers are following the policies and procedure sin the home. (Previous timescales of 02/03/06 and 02/04/06 not met) Walmer House DS0000018447.V308145.R01.S.doc Version 5.2 Page 22 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 Walmer House DS0000018447.V308145.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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. 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