Inspection on 01/11/05 for Walnut Close

This inspection was carried out on 1st November 2005.

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

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

Other inspections for this house

Walnut Close 03/08/06

Walnut Close 24/05/05

Walnut Close 07/12/04

Walnut Close 20/07/04

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Newbeech House

Winton House

Treloar College

Rush Court

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

CARE HOMES FOR OLDER PEOPLE Walnut Close Brownsfield Road Thatcham Newbury Berks RG18 3GF Lead Inspector Mrs Rhian Williams-Flew Unannounced Inspection 1st November 2005 10:35 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 Walnut Close DS0000031337.V250566.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Walnut Close DS0000031337.V250566.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Walnut Close Address Brownsfield Road Thatcham Newbury Berks RG18 3GF 01635 587810 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) West Berkshire Council Mrs Petula Bollon Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25), Physical disability (4) of places Walnut Close DS0000031337.V250566.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th May 2005 Brief Description of the Service: Walnut Close is owned by West Berkshire Council. It provides a range of services within one building. The registered services are: Walnut Close Care Home, providing 12 permanent residential places for men and women over the age of 65 and Walnut Assessment and Rehabilitation Centre (WARC), providing 12 rehabilitation/intermediate care places and one respite care place. Within the total of 12 beds up to 4 can be used for men and women aged 50 and over. Walnut close is built on two floors and presently comprises of four separate units, two on each floor. Each unit has its own kitchenette and lounge/dining room. Residents have their own room. The WARC service has its own manager and is directly managed by the Service Manager for Promoting Independence. However, there is only one Acting Manager for the registered services provided in the home, this person also manages the Care Home. The home is located in close proximity to the centre of Thatcham where there are a number of local amenities. The home is adjacent to the GP surgery and the local library. Bus and train services are in close proximity to the home. This information has been taken from the Homes Statement of Purpose. Walnut Close DS0000031337.V250566.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection occurring between 10:35 and 16:00 hours. The Acting Manager was not present. The care home and the Walnut Assessment and Rehabilitation Centre (WARC) were both inspected. 3 residents were spoken with in the care home and 2 service users in the WARC. The emphasis of the inspection was to review the key standards that had not been examined on the last inspection. All previous requirements and recommendations were also reviewed. This report should be read in conjunction with the previous inspection report of May 2005. What the service does well: What has improved since the last inspection? What they could do better: Unusually, the environment of the care home was not free from odour. This must be addressed promptly and a resolution found. Following the inspection a discussion has been held with the Acting Manager and the Responsible Individual and they have given their commitment to resolve the problem. Walnut Close DS0000031337.V250566.R01.S.doc Version 5.0 Page 6 This is the only requirement that has been made following this inspection. Four recommendations have been made for consideration in order to make further improvements to some of the services offered to the residents and service users. 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. Walnut Close DS0000031337.V250566.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Walnut Close DS0000031337.V250566.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Full assessments are completed before people are admitted to the care home and to the WARC. These assessments form part of the persons care plan. The people who use the WARC are in receipt of a good service. The service promotes the persons independence and ensures that the person receives the right equipment and sufficient rehabilitation to enable the person to return home. EVIDENCE: Service users are not admitted to the care home unless they have received a full assessment of their needs. Evidence was seen of full care management assessments. The care plans for residents are devised following reference to the original preadmission assessments. The service users who are resident in the WARC had very detailed assessments of their needs completed prior to referral. These assessments include specialist health care reports and care management assessments. Walnut Close DS0000031337.V250566.R01.S.doc Version 5.0 Page 9 The WARC is sited on the first floor of the care home. The service is dedicated to providing rehabilitation and enablement of the people who use the service. Physiotherapists and Occupational Therapists from the community-based teams provide specific professional support to the unit. The support also includes the provision of appropriate equipment. In conversation with service users of this service it was clear that they felt the unit had offered them an excellent service. They commented on their restored confidence and all the useful help and advice they had been given to enable them to look forward to returning to their homes. Walnut Close DS0000031337.V250566.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 The care plans for the residents in the care home and the service users in the WARC reflect the current needs and aspirations of the people. The storage and administration of medication is conducted safely, including the service users who self medicate. The members of staff respect the privacy and dignity of the people who live in the care home. EVIDENCE: The care plans for a random sample of residents in the care home and in the WARC were inspected. A previous requirement has been met as the care plans in the WARC have been improved considerably. The goal plans for individual residents are current and up-to-date. The individual residents are clearly involved in the care planning and their review. Of the residents spoken with in the WARC they were clear as to the goals they had to achieve and how they could achieve these goals. It was clear that the professional therapy staff, are trying to ensure that the language used in the care plans is accessible to the residents. There was still some evidence of shorthand medical jargon but the Walnut Close DS0000031337.V250566.R01.S.doc Version 5.0 Page 11 manager of the unit assured that when she sees this she asks the therapists to revise it on their next visit. It was recommended that the manager ensures that, goals about a residents self-confidence and emotional well-being are included in their plans, as this is an important part of their rehabilitation. Importantly, these were the particular aspects of care that the residents, highlighted in conversation, as being the help they greatly valued. It was noted that for a resident of the WARC they had not been weighed since admission. The explanation given was that the person was unable to weight bear on the weighing scales in the unit. However, the care home has a “sitting” weighing machine, which the WARC could access. The manager of the WARC was recommended to access the machine for her service users. The care plans for the residents in the care home have maintained a good standard from the previous inspection. This demonstrates that they are reviewed regularly and reflect the current needs of the residents. It is understood that in the near future West Berkshire Council will introduce a new care plan format, which both the care home and the WARC will use. The provision of medication in the care home and the WARC were reviewed. Medication is being stored appropriately and from the records seen there are good procedures for the receipt, recording, handling and administration of medication. The majority of people who use the WARC have been assessed to administer their own medication. Full risk assessments are in place. Only one person keeps their own medication within their own room. This was stored safely in a lockable space. All of the residents in the care home have their medication administered to them. Two particular residents prefer to take their medication in a specific way. This was fully discussed with the Acting Manager and it is recommended, for these particular residents, that their specific needs regarding their medication is risk assessed and recorded in their care plans. This issue was also discussed with the Responsible Individual following the inspection. They acknowledged the recommendation and agreed to work with the Acting Manager to devise a local protocol for these particular residents needs. Of all the residents spoken with all of them were very complimentary about the privacy and dignity they are afforded by the staff. One resident commented that the members of staff are discreet and always seemed to know “when you wanted company or preferred to be alone”. Walnut Close DS0000031337.V250566.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected on this occasion. EVIDENCE: These standards were not inspected on this occasion. However, several of the residents commented that they were rather weary as they had been entertained at a Halloween party the previous evening, which they had thoroughly enjoyed. Walnut Close DS0000031337.V250566.R01.S.doc Version 5.0 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): These standards were not inspected on this occasion. EVIDENCE: These standards were not inspected on this occasion. Walnut Close DS0000031337.V250566.R01.S.doc Version 5.0 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, 22 & 26 The home provides good accommodation to meet the stated needs of the service users. A resolution to an odour that is present in the care home will need to be found. EVIDENCE: The refurbishment of the self-contained rehabilitation flat within the WARC is progressing and near completion. Once complete this will allow for the service to provide rehabilitation to people with a physical disability aged between 50 and 64. In the care home and the WARC aids and adaptations have been provided to assist the residents. Of the staff spoken with all commented that they had sufficient equipment to meet the needs of the residents. Unusually, certain areas within the care home were not free of odour. The staff assured that the carpets and flooring are regularly shampooed particularly, if people have been incontinent of urine. This matter was Walnut Close DS0000031337.V250566.R01.S.doc Version 5.0 Page 15 discussed with the Acting Manager and the Responsible Individual following the inspection and both accepted that a resolution would to be found. This could involve replacement flooring or more thorough deep cleaning of the carpeting. The home has clear policies and procedures for the control of infection and the safe handling of clinical waste. Any foul laundry is washed at appropriate temperatures to control the risk of infection. Walnut Close DS0000031337.V250566.R01.S.doc Version 5.0 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): These standards were not inspected on this occasion. EVIDENCE: These standards were not inspected on this occasion. Walnut Close DS0000031337.V250566.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 & 38 The development of the new quality assurance review will be an important tool to ensure that the quality of care delivered is consistently good. The home is run to ensure the health, safety and well being of the residents and staff. EVIDENCE: West Berkshire Council is devising an annual review of the quality of care in all its care homes. The Responsible Individual Ms Butland is leading this. The proposal documents has been seen and if implemented it will ensure that effective quality assurance and quality monitoring systems are in place. At present, the home does canvass the opinions of the residents and their relatives with regard to their satisfaction and whether they consider any improvements could be made. Walnut Close DS0000031337.V250566.R01.S.doc Version 5.0 Page 18 From observations of the way staff conducted themselves it was evident that the Acting Manager has ensured that the health, safety and well-being of the residents and staff are promoted. The Responsible Individual also regularly monitors this issue during her regular unannounced visits to the home. This is good practice. Walnut Close DS0000031337.V250566.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 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 X 17 X 18 x 3 X X 3 X X X 2 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 3 X X X X 3 Walnut Close DS0000031337.V250566.R01.S.doc Version 5.0 Page 20 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. 1 Standard OP26 Regulation 16 (2) (k) Requirement All areas of the home must be free from offensive odour. Thorough deep cleaning or the replacement of flooring/carpeting must take place to eliminate the present odours. An assessment as to whether furnishings and mattresses need to be replaced because of the retention of stale odours should also take place. If it is highlighted that these items need replacement, this should occur. This action is for the Acting Manager and Responsible Individual to resolve. Timescale for action 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations It is recommended that the inclusion of the emotional well-being and self-confidence of the people who use the WARC should be included in the goals of their care plans. DS0000031337.V250566.R01.S.doc Version 5.0 Page 21 Walnut Close 2 3 OP8 OP9 4 OP33 It is recommended that the manager of the WARC use the sitting weighing scales (which is in the care home) to weigh people who access the service. It is recommended that the Acting Manager ensures that there is a local protocol in place with regard to the specific medication needs of some of the residents of the care home. In addition, risk assessments and care plans need to be devised to accommodate the specific wishes of two residents with regard to their medication. The implementation of the proposed quality assurance review will be an important tool to ensure that the quality of care delivered in the home is consistent. The Responsible Individual is asked to inform the CSCI office of the implementation date. Walnut Close DS0000031337.V250566.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA 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 Walnut Close DS0000031337.V250566.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!