Inspection on 03/08/06 for Walnut Close

This inspection was carried out on 3rd 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 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 01/11/05

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 Sandra Grainge Unannounced Inspection 10:00 3 August 2006 rd 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.V298155.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. Walnut Close DS0000031337.V298155.R01.S.doc Version 5.2 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 Karen Lynda Norris Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24), Physical disability (4) of places Walnut Close DS0000031337.V298155.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st November 2005 Brief Description of the Service: West Berkshire Council owns Walnut Close Care Centre. A range of services is provided 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 on the ground floor and Walnut Assessment and Rehabilitation Centre (WARC) on the first floor, providing 12 rehabilitation/intermediate care places and one respite care flat. Within the total of 12 beds up to 4 can be used for men and women aged 50 and over. Walnut Close has two floors and two separate units on each floor. Each unit has its own kitchenette and lounge/dining room. Residents have their own bedroom. A day centre occupies the remainder of the ground floor; this service is not included in the registration. The Registered Manager for Walnut Close is also the care manager for the permanent residential beds on the ground floor; in addition, the rehabilitation service has its own Manager who is directly managed by the Berkshire Service Manager for Promoting Independence. The home is situated off the main road through Thatcham; the local library, GP surgery and shops are next door. There are ample parking facilities close to the home. Bus and train services are nearby. Scale of charges as at 08.06.06: - £ 64.65 (day)--- £ 630.00 per week. Walnut Close DS0000031337.V298155.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key report contains information collected during an unannounced site visit to the service made during a weekday by a locum inspector. Information held in the Service file pre informed the inspection together with data provided by the Registered Manager. In addition, prior to the visit, Service User views had been sought in a survey “Have your say”. Six forms were returned to CSCI; the comments were favourable and are included in the appropriate sections of this report. During the visit care practice was observed; Service Users were pleased to praise the service and the staff. All the relatives who spoke to the inspector echoed these views. Records were inspected and the Inspector spoke to the Registered Manager, the rehabilitation Service Manager, the chef, and as many of the on duty care and cleaning staff as possible. The inspector met one of the local GPs, a district nurse as well as occupational therapy and physiotherapy staff who are based in the building. Four visiting relatives spoke to the inspector. What the service does well: Service Users are very pleased with the care that they receive. On the first floor relatively younger adults receive rehabilitation care for a limited time to enable them to gain strength, confidence and the ability to return to their own homes. The individual’s goals are planned after multidisciplinary assessment; are monitored and progress is evaluated. The service has been developed and now provides an impressive range of equipment to assist Service Users to learn new skills and adapt to their disability. Service Users residing on the ground floor are less able to communicate but are clearly well cared for and their comments were epitomised for the Inspector by the very frail bed bound lady who woke from a bad dream and informed the Inspector “that’s one of the best things- they make you comfortable” In order to achieve this level of good care and Service User satisfaction the Home has very well trained and qualified staff in post. They are enthusiastic about their work and appreciate the employment and training opportunities given to them by West Berkshire Council. Walnut Close DS0000031337.V298155.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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 DS0000031337.V298155.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 Walnut Close DS0000031337.V298155.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): 1, 2, 3, 4, 5, and 6 Quality in this outcome area is excellent. Service Users had information about the service prior to admission; it had assisted them to make a choice about the home. This judgement has been made using available evidence including a visit to this service EVIDENCE: Service Users and their families informed the inspector that they felt that they had been given clear information about the home before that were admitted; this view was repeated in comment forms completed and returned by Service Users to CSCI. Each individual had terms and conditions of occupancy of the service. Service User needs are identified; the multi disciplinary assessment procedures are clear and recorded. Servile Users had been offered the opportunity to visit the home prior to admission; as a consequence, they were confident that the service was able to meet their need Walnut Close offers a unit that has been designed to offer Service Users rehabilitation following a period of illness or incapacity. A multi disciplinary team plans and offers care to offer each individual the opportunity to recover and develop new skills, with the use of equipment, to enable them to live in their own homes in the community in partnership with a home care service. Walnut Close DS0000031337.V298155.R01.S.doc Version 5.2 Page 9 Relatives reported that they were very pleased with this service and level of care. Walnut Close DS0000031337.V298155.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 excellent. Service Users were very pleased with the care given in the service by friendly staff. The service has adopted recommendations made in the last inspection report concerning the use of medication. This judgement has been made using available evidence including a visit to this service EVIDENCE: Each Service User had a care plan that contained detail of action to be taken to meet the identified need. The Inspector was able to see that staff gave the planned care. Service Users occupying the ground floor have plans to meet their long-term needs. During the visit a very frail bed bound Service User, who looked comfortable, was heard crying in her sleep; when she woke she informed the Inspector that she was all right and “that’s one of the best things – they make you comfortable” The comprehensive plans for those receiving rehabilitation on the first floor are specific to encourage improvement of ability and promotion of independent living that are to be achieved in a set time frame. There were several relatives visiting in this area and they were very pleased with the care and attention that were being given to enable people to get better and return home. Walnut Close DS0000031337.V298155.R01.S.doc Version 5.2 Page 11 One of the local GPs was visiting Service Users in the home; she was very willing to praise the care that staff were giving. In addition a community nurse from the same practice was giving nursing care during the morning. Good care practice was observed; staff treated Service users with kindness and respect. Following the last inspection arrangements had been made to let everyone know that all Service Users are able to have their weight measured and monitored as necessary;” sitting” weighing scales available for use. Service Users are enabled to self medicate when appropriate. Policies and procedures are in place for this. The supplying pharmacist monitors the medication system and a review was held in January in response to a problem. Medication practice was seen to be satisfactory during the visit and the records were in order. Walnut Close DS0000031337.V298155.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. Service Users mainly come from the local area and effort is made to help them maintain their local contacts. This judgement has been made using available evidence including a visit to this service EVIDENCE: The Building is also home to the local day care service. Links are established between the services and many of the residential Service Users attended the day centre before admission. The activities in the day centre are also offered to those in the residential areas. Recent opportunities included computer training and a “silver surfers” club. The Inspector was invited to attend a planned Service User meeting that was held during the morning; the main topic of interest for the Service Users was the choice of the next outings. Not all were able to contribute to the discussion but they were included in the group and were clearly pleased to be there. There were frequent visitors to the home during the visit. The Inspector met a Service User and her husband as they made their daily trip out to visit their home and garden. Meals are usually served in each unit of the home. On the day of this visit there were several vacancies on the ground floor so Service users were invited to gather together for a meal in one unit. Service Users informed the Inspector that they liked the food. Although the chef was from an agency they knew her and she checked on their likes and dislikes. One of the Survey forms Walnut Close DS0000031337.V298155.R01.S.doc Version 5.2 Page 13 commented that “they always go out of their way to find something that I like as I’m a faddy eater”” Walnut Close DS0000031337.V298155.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. Service Users and their relatives know how to make a complaint if they need to and were confident that the staff would listen and resolve any concerns. This judgement has been made using available evidence including a visit to this service EVIDENCE: No complaints had been received by CSCI concerning this home and none had been made to the Service. There had been no issues raised under the policy for the protection of vulnerable adults. Staff were trained to be aware of abuse and how to respond appropriately to any allegation. Walnut Close DS0000031337.V298155.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, 20, 21, 22, 24, 25 and 26 Quality in this outcome area is good. The requirement of the previous inspection had been met; new flooring has bee supplied and Service Users live in a home that is clean, tidy and odour free throughout. This judgement has been made using available evidence including a visit to this service EVIDENCE: Although sixteen Service User bedrooms do not meet the national minimum size this did not have a detrimental impact on the care or wellbeing of the current residents. All rooms were attractive, odour free and tidy. Many have been personalised to reflect the Service User’s interests and family life. All floor areas in the home have been reviewed and some carpets have been replaced; in other areas more appropriate washable composite flooring has been provided. Walnut Close DS0000031337.V298155.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 excellent. Service Users are given care by a team of well-qualified and trained staff. This judgement has been made using available evidence including a visit to this service EVIDENCE: Service Users informed the inspector that the staff “know what they are doing” and are available to give them help when it is needed. Most staff have worked in the home for many years. They have all received basic training that is regularly updated; many have taken the opportunities given to them and have continued to develop their skills and abilities. Sample staff recruitment files were inspected; safety checks for protection of vulnerable adults had been carried out and were recorded. Walnut Close is the base for the day centre and the occupational therapy and physiotherapy Rehabilitation services; there are opportunities for sharing of skills, facilities and equipment. Walnut Close DS0000031337.V298155.R01.S.doc Version 5.2 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): 31,32, 33, 36, 37 and 38 Quality in this outcome area is good. Service Users live in a home that is well managed and where they are safe and their rights are respected. This judgement has been made using available evidence including a visit to this service EVIDENCE: The management structure of the service has been clearly defined. Both the Registered Manager and the rehabilitation service Manager have achieved the Manager’s award. Roles and responsibilities are clearly understood and the Service Users benefit from living in a well run home where the staff work together as a team. Since the last inspection provider management reports have been sent to CSCI regularly and there was evidence that a quality control programme is in operation in the service. Staff receive regular supervision that is recorded and they are given opportunities to develop their skills. Safety regulations are observed for Service Users and staff. Staff were unable to tell the Inspector the time or length of breaks taken when they work a long Walnut Close DS0000031337.V298155.R01.S.doc Version 5.2 Page 18 shift. This has an effect on the times when they are available to give care to Service Users. This was the only unclear issue concerning the management of the home. The Registered Manager is aware of this issue and it is being discussed. Recently the electrical power supply for the area had been shut down for twelve hours. The registered Manager had made arrangements for emergency care of the Service Users and had used the incident as an opportunity to review the emergency plans for the home. Walnut Close DS0000031337.V298155.R01.S.doc Version 5.2 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 3 3 4 4 3 4 HEALTH AND PERSONAL CARE HEALTH AND PERSONAL CARE Standard No 7 8 9 10 11 Score 3 3 3 3 X 3 3 3 4 4 3 3 X DAILY LIFE AND SOCIAL ACTIVITIES STAFFING Standard No Score 27 3 28 3 29 3 30 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No 12 13 14 15 Score 3 3 3 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 Score 3 3 3 Walnut Close DS0000031337.V298155.R01.S.doc Version 5.2 Page 20 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 34 35 36 37 38 X 3 X 3 3 Walnut Close DS0000031337.V298155.R01.S.doc Version 5.2 Page 21 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 OP36 Regulation 18 (1) Requirement The Registered Manager to send a plan to demonstrate that staff are able to have statutory meal breaks. Timescale for action 25/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP16 OP38 Good Practice Recommendations The Registered Manager should revise the Service’s complaint documents to make sure that they make reference to the CSCI not NCSC. The Registered Manager should review shift patterns to ensure that staff have statutory meal breaks. Walnut Close DS0000031337.V298155.R01.S.doc Version 5.2 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.V298155.R01.S.doc Version 5.2 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. 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