Inspection on 24/05/05 for Walnut Close

This inspection was carried out on 24th May 2005.

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.

Other inspections for this house

Walnut Close 03/08/06

Walnut Close 01/11/05

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 Berks RG18 3GF Lead Inspector Rhian Williams-Flew Unannounced 24 May 2005, 10.00 am 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. WALNUT CLOSE H52-H01-S31337-Walnut Close-V222346-240505Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Walnut Close Address Brownsfield Road, Thatcham, Berks, RG18 3GF 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) 01635 587810 01635 865454 West Berkshire Council Mrs Petula Bollon Care Home (CRH) 25 Category(ies) of Old age, not falling within any other category registration, with number (OP), Physical disability (PD) aged between 50 of places 64 years WALNUT CLOSE H52-H01-S31337-Walnut Close-V222346-240505Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 7 December 2004 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. Each resident has their own room. The WARC service has its own manager and is directly managed by the Service Manager for Promoting Independence. However, the is one Registered 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 H52-H01-S31337-Walnut Close-V222346-240505Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place between 10.00 –17.00 hours on a weekday. The Acting Manager was present for part of the inspection and the Responsible Individual was also spoken with during her routine visit to the home. Eight residents were spoken with throughout the day. A partial tour of the premises took place and eight sets of care records were reviewed along with a number of other records concerned with the running of the home, this included some staff records. Three care staff were spoken to along with the Cook. What the service does well: What has improved since the last inspection? The Acting Manager has implemented clear systems to ensure that members of staff are recruited appropriately and receive the necessary training and supervision so that they can carry out their roles safely and appropriately. The care plans in the Care Home have been reviewed in their entirety and are up to date reflecting the current needs of the residents. The Acting Manager has also started a random review of them to ensure they are up to date. The Care Home has appointed an Activities Coordinator for 10 hours a week. This is proving to be a very welcome service for the residents. Not only are WALNUT CLOSE H52-H01-S31337-Walnut Close-V222346-240505Stage 4.doc Version 1.30 Page 6 they taking part in activities in the home but are also visiting services in the local community. Following the last inspection the Pharmacist Inspector from the Commission for Social Care Inspection has offered advice and guidance with regard to the homes medication policy and procedures. She was satisfied with the homes response to this advice. Some refurbishment and recarpeting has occurred. This has had a significant impact in the entrance lobby to the home. 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. WALNUT CLOSE H52-H01-S31337-Walnut Close-V222346-240505Stage 4.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 WALNUT CLOSE H52-H01-S31337-Walnut Close-V222346-240505Stage 4.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) 1,3,4,5 & 6 The home provides comprehensive and detailed information regarding the services it provides; all residents are admitted following a full assessment of their needs and the home is able to meet these needs. EVIDENCE: The home has met a previous requirement by publishing a full and detailed Statement of Purpose/Service User Guide. It provides clear information in an accessible written format. A selection of needs assessments were reviewed for the most recently admitted residents to the Care Home and the Walnut Assessment and Rehabilitation Centre (WARC). All had detailed care management assessments. In addition, the people being admitted to the WARC service had received a letter, from the member of staff who had conducted an additional visit to the person, offering them a place within the service and identifying for them the identified goals they could hope to achieve during their stay. WALNUT CLOSE H52-H01-S31337-Walnut Close-V222346-240505Stage 4.doc Version 1.30 Page 9 Both services are able to meet the assessed needs of the individuals admitted to the home. All of the residents who were spoken with felt their needs were more than adequately met. The WARC service has changed since the previous inspection. This intermediate care service is in the process of expanding and will provide up to 12 places and one respite care place. At the time of the inspection only five places were occupied. The service now occupies the whole of the first floor of the building. The move of accommodation had occurred in the previous weeks. The service cannot expand to its full capacity until there is a full complement of staff. The physiotherapists and occupational therapists who provide input to the service are also members of the community-based services. It is these professional staff that are required in additional numbers, to expand the service fully. All of the residents in this service were spoken with and expressed a high satisfaction rating with the service they were being provided with. All felt they were being enabled to reach the maximum of their abilities in the hope that they would be able to return to live in their own homes. All spoke of their increasing confidence and how supportive the members of staff are towards them. A newly admitted resident to the Care Home was also spoken with and she was very complimentary about how welcome she had been made to feel and how caring the staff were towards her. She said that she had been very apprehensive about coming to the home but within 24 hours she had felt reassured and much happier. She remarked at how impressed she had been that the Cook had come to speak with her to discuss her likes and dislikes with regard to food. WALNUT CLOSE H52-H01-S31337-Walnut Close-V222346-240505Stage 4.doc Version 1.30 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 standard(s) 7,8 & 10 The care plans for the residents in the Care Home are thorough and up-todate. The care plans for the residents in the WARC service do not adequately reflect the care provided. EVIDENCE: A number of care plans were reviewed in the Care Home and the WARC service. At the previous inspection requirements were made because of shortfalls in the care plans of the residents who lived in the Care Home. Of the care plans seen on this occasion in this service it was clear that a full review of the care planning arrangements had taken place. The care plans reflected the up-to-date needs of the residents and clearly identified, and risk assessed, any particular health needs the individuals had. The plans were being reviewed at least once a month, or sooner if required. The manager had also implemented a percentage audit of the care plans. From conversations with the residents it was clear that their care needs were being addressed in their care plans. The changes implemented since the last inspection, have WALNUT CLOSE H52-H01-S31337-Walnut Close-V222346-240505Stage 4.doc Version 1.30 Page 11 been very positive and it is now clear what each individuals care needs are and how they are to be addressed. Conversely, the care plans seen for the individuals in the WARC service were incomplete. The goal plans for some individuals were not up to date and in one case only identified one specific goal for an individual whereas the admission information on this person had identified several goals. Indeed, in conversation with the Inspector the person themselves identified several goals they wished to achieve and these corresponded with the persons needs assessment completed prior to admission. It was also not evident how included individuals were in devising and reviewing their care plans. For example, some of the people told the Inspector that they would like to know the timescale in which they would return home, as they had not been told nor was it recorded in their care plans. These deficits were discussed with the Manager of the service and she has given her undertaking that the care plans will be reviewed in their entirety and all staff will be reminded of their responsibilities. All the residents for both services were very complimentary about the privacy and dignity they are afforded by staff. It was also evidenced by the Inspector that staff were respectful in their approach to residents. A visiting nurse attended to one resident and the examination was conducted in the persons on room. WALNUT CLOSE H52-H01-S31337-Walnut Close-V222346-240505Stage 4.doc Version 1.30 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 standard(s) 12,13 & 15 The home positively promotes continuing contact with the local community. Residents are also provided with flexible and varied routines of daily living, activities and meal times. EVIDENCE: Since the previous inspection an Activities Coordinator has been appointed for 10 hours per week for the residents in the Care Home. This has been a very positive initiative for these residents. Not only have they been enabled to take part in activities in the home, they have been to art exhibitions, shopping trips and visits to the local community. The residents in the WARC service take part in the full rehabilitation programme, which is tailor-made to their individual needs. A number of these residents were continuing to pursue hobbies they had enjoyed in their own homes. All of the residents spoken with commented on how flexible the staff were in enabling them to pursue their lifestyles at their pace. All said the staff gave them time and they felt unhurried. Many of the residents had visitors throughout the day and all were made to feel welcome. Some of the resident’s spoke of visits they had made to their own families in recent days. WALNUT CLOSE H52-H01-S31337-Walnut Close-V222346-240505Stage 4.doc Version 1.30 Page 13 During a visit to the WARC service the midday meal was served to a group of residents. All the residents sat together on a large round table; this facilitated social conversation. All had selected the choice of their main meal the previous day and these choices were reconfirmed by the carer before serving the meal. The Acting Manager confirmed that the Cook now visits residents each day to discuss with them the choice of their meals for the following day. This has been a positive initiative for both the residents and Cook. The Cook was spoken with and her kitchen visited. Random selections of the kitchen records were looked at and were found to be up-to-date. The Cook commented that she felt much more included in meeting the residents needs with regard to their dietary requirements. It also means that she gets direct feedback as to whether they have particularly enjoyed a meal. WALNUT CLOSE H52-H01-S31337-Walnut Close-V222346-240505Stage 4.doc Version 1.30 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 standard(s) 16 & 18 The home has clear policies with regard to complaints and the protection of vulnerable adults. The home ensures that members of staff routinely receive training with regard to these issues. EVIDENCE: The home has a clear complaints policy in line with West Berkshire Councils procedures. The policy is well publicised in the home. There have been no complaints recorded since the previous inspection. All staff have received training with regard to the complaints policy and how to implement it. The home does have procedures for the Protection of Vulnerable Adults and all staff receive training with regard to protecting vulnerable adults. WALNUT CLOSE H52-H01-S31337-Walnut Close-V222346-240505Stage 4.doc Version 1.30 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 standard(s) 19,20,23 & 24. This home is clean, comfortable and homely. EVIDENCE: Since the previous inspection the services provided in the home have resulted in the use of the accommodation being changed. The ground floor of the premises now accommodates the Care Home and the first floor accommodates the WARC service. There are two discrete units on each floor; this facilitates small-group living. The accommodation provided in each unit appeared to be suitable for its stated purpose. Ongoing decoration and refurbishment is planned. A previous recommendation has been met as the entrance lobby carpet has been replaced. In addition, this carpet was also used to refurbish the stairway and the first floor corridors. The individual residents rooms are decorated to their personal choice and they are encouraged to use their own personal possessions if they wish to furnish their rooms. The resident’s rooms are equipped to assure comfort and privacy. The home is clean and free from odour. WALNUT CLOSE H52-H01-S31337-Walnut Close-V222346-240505Stage 4.doc Version 1.30 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 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) 27,29 & 30 The Acting Manager has established robust systems to ensure that staff are recruited and trained appropriately. She also ensures that there are sufficient numbers of staff on duty at all times. EVIDENCE: With the changes in the services provided at the home a full review of the staffing requirements has been held and a new staffing establishment has been agreed. Presently, there are three vacancies for care staff however, interviews have been held and appointments are pending. When it is necessary to use additional staff the home usually uses West Berkshire Councils own bank staff or, they use one particular agency. Protocols are in place to ensure that any members of staff employed by the agency have been recruited to ensure that all relevant checks have taken place. The recruitment records of the most recently appointed member of staff were reviewed and found to contain all the information required by regulation. There was also evidence that this member of staff was undertaking her induction programme. Evidence was also seen of members of staff progressing through their foundation training within the first six months of their employment. The Acting Manager is also more implemented a robust system for ensuring that all staff receive regular mandatory training within the required timescales and that their individual records record this. This is a very proactive and positive initiative being taken by the Acting Manager. WALNUT CLOSE H52-H01-S31337-Walnut Close-V222346-240505Stage 4.doc Version 1.30 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 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) 31,32,35,36,37 & 38 (partially) This is a well managed home. The Acting Manager is enthusiastic and respected by both the residents who live in the home and the staff who work there. EVIDENCE: The Registered Manager is on long-term sick leave however, the Acting Manager has been running the home for over six months and is proving more than able to discharge her responsibilities for running the home properly. She is suitably qualified and says that she is valuing the experience of running the home. Of the residents and staff spoken with all commented that she is very approachable and inclusive of them. The safekeeping of resident’s money was reviewed and was found to be safeguarded appropriately, in line with the homes policy. All of the homes WALNUT CLOSE H52-H01-S31337-Walnut Close-V222346-240505Stage 4.doc Version 1.30 Page 18 records regarding residents and the running of the home are safeguarded appropriately. The Acting Manager has implemented a new system to ensure that supervision of staff occurs regularly. The supervision records of two members of staff were reviewed and were found to be up-to-date and covering all aspects of care delivery, career development and staffing matters. The Acting Manager is ensuring that all staff attend mandatory training when required. The accident records for some residents were reviewed and deficits were identified in the completion of the information. These deficits were discussed with the Acting Manager, which she accepted and said she would address at the next staff meeting, and with the individual staff members concerned. WALNUT CLOSE H52-H01-S31337-Walnut Close-V222346-240505Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 x x 3 3 x x STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 x x 3 3 3 2 WALNUT CLOSE H52-H01-S31337-Walnut Close-V222346-240505Stage 4.doc Version 1.30 Page 20 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. Standard OP7 Regulation 15 Requirement The Care Plans for the residents in the WRAC service must reflect the current care needs of the indivduals concerned and be reviewed regularly. Timescale for action 31.7.05 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 38 Good Practice Recommendations Accidents records should contain specific information about the injury and the actions taken. WALNUT CLOSE H52-H01-S31337-Walnut Close-V222346-240505Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 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 H52-H01-S31337-Walnut Close-V222346-240505Stage 4.doc Version 1.30 Page 22 - 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. 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