Inspection on 04/03/09 for Walstead Place

This inspection was carried out on 4th March 2009.

CSCI found this care home to be providing an Good service.

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

Walstead Place 07/03/07

Walstead Place 04/10/05

Walstead Place 27/05/05

Walstead Place 16/11/04

Walstead Place 26/05/04

Walstead Place 27/06/02

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Walstead Place Walstead Place Lewes Road Walstead Lindfield West Sussex RH16 2QG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: David Bannier     Date: 0 4 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 32 Information about the care home Name of care home: Address: Walstead Place Lewes Road Walstead Place Walstead Lindfield West Sussex RH16 2QG 01444483885 01444482254 walstead@caringhomes.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Walstead Place Residential Home Ltd care home 54 Number of places (if applicable): Under 65 Over 65 54 old age, not falling within any other category Additional conditions: 0 The maximum number of service users who can be accommodated is: 54 The registered person may provide the following category of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category - OP Date of last inspection Brief description of the care home Walstead Place is registered as a care home to accommodate up to 54 users in the category of old age, not falling into any other category. The premises are a converted and extended building in Lindfield, near Haywards Heath. Accommodation is provided on three floors, and there is a vertical lift. All rooms are for single occupancy. The current fee levels range between GBP450 and GBP 770 per week. This does not include personal items such as toiletries, hairdressing and chiropody. Care Homes for Older People Page 4 of 32 Brief description of the care home The registered providers are Caring Homes Limited for whom the responsible individual is Ms S. Turner. The registered manager in charge of the day to day running of the establishment is Miss J. Large. Care Homes for Older People Page 5 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The inspection has followed the Inspecting for Better Lives methodology and is called a key inspection as it assesses those standards determined by the Commission as key standards. This inspection will also determine the frequency of inspections hereafter. The registered provider returned an Annual Quality Assurance Assessment prior to the inspection. Some residents and staff were sent surveys by the Commission entitled Have Your Say. These are designed to enable residents and staff to give their opinions about how the care home is being run. The information received from these documents Care Homes for Older People Page 6 of 32 will be referred to in the report. A visit to the care home was made on Wednesday 4th March 2009. As this was an unannounced inspection we gave the manager and provider no notification of our intention to visit. We spoke to some residents and observed care practices. This helped us to form an opinion of what it is like to live in this care home. We also spoke to some staff on duty in order to gain a sense of how it is like to work at the care home. We also viewed some of the accommodation and examined some records. We were accompanied by an expert by experience during the first part of our visit. An expert by experience is a person who, because of their shared experience of using services, visits a service with an inspector to help them get a picture of what it is like to live in or use the service. The visit lasted approximately seven and a half hours. Whilst the manager was not available the deputy manager and the area manager were present. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 32 Care Homes for Older People Page 9 of 32 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 32 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care needs of prospective residents have been assessed before they moved into Walstead Place. Walstead Place does not provide intermediate care. Evidence: During our last visit we formed a judgement that prospective residents have detailed pre admission assessments carried out prior to moving into the care home. This ensures the home is able to confirm it can meet the needs of the residents that have been assessed. We identified the names of three residents for case tracking purposes. Documents and records seen confirmed that the needs of the identified residents continue to be appropriately assessed before they have been admitted. Documentation examined Care Homes for Older People Page 11 of 32 Evidence: included information about the reason for the admission, the residents medical history, social and psychological history, their current medication, and details of their current physical care needs. Four surveys returned by residents confirmed they had received enough information about Walstead Place before moving in so they could decide if it was the right place for them. One survey included the following comment, I came in for respite care after a fall and as a room was available long term, I decided I would stay as I couldnt cope at home any longer. Two surveys confirmed they had not had sufficient information. One resident commented, I collapsed at home and all the thinking was done for me. Another resident told us they received information, Only when I visited. The expert by experience reported, Of the five residents I spoke to, two had made their own choice in coming to the home. One said, I came here for a short time after my operation and as soon as I came through the door I knew I wanted to live here. Its the the best home in the country. Ive not regretted it and Ive lived here for four and a half years. The other said, I came here because of the couple running it. But after I moved in I found out they had left and this place is run by a company and its not as good as it used to be. The other three had been placed in the home by their children because they could no longer manage on their own. One said, Its alright, but its not like being in your own home. Residents we spoke to confirmed they felt well cared for. Staff on duty were able to clearly demonstrate they know about the needs of newly admitted residents. Information included in the AQAA confirmed that what this care home does well is conducting, Pre admission assessments giving an insight into prospective residents history, care needs and interests. We encourage as many visits to the home as is required whilst choice is being made and invite enquirers to lunch and social events. The AQAA also confirmed We are unable to cater for intermediate care. Care Homes for Older People Page 12 of 32 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans have been drawn up for each resident. They set out the needs of each resident and the action staff should take to ensure they have been met. Residents health care needs have also been met. Residents have been protected by the homes policies and procedures for dealing with medicines. Residents have been treated with respect and their right to privacy has been upheld. Evidence: Residents care records include care plans which have been drawn up from the information gathered at the pre admission assessment. Care plans include details of residents identified needs together with clear information for staff to follow so they Care Homes for Older People Page 13 of 32 Evidence: know the action they are expected to take to ensure they have been met. There was evidence that confirmed care plans have also been routinely reviewed. This means that information about residents care needs is kept up to date. We were informed that residents do contribute to the review but there was no record of this. We recommended that residents are asked to sign their care plan to confirm they have been consulted. If the resident does not wish to sign, we recommended that the person conducting the review includes a note confirming the resident has been consulted. Care records also include details of appointments with residents doctors or district nurses including details of any treatment prescribed and provided. Three surveys returned by residents confirmed that they always get the care and support they need. Three surveys confirmed this is usually the case. Four surveys returned by residents confirmed they always get the medical support they need, whilst two confirmed this is usually the case. Two surveys completed by staff confirmed they are always given up to date information about the needs of residents in care plans. One member of staff commented, We are always informed about the needs of people we support before starting our care. Information provided in the AQAA confirmed that, Pre admission assessments form the basis of individual care plans, which are implemented within 48 hours of admission. Care is allocated on a daily basis to care staff. It also confirmed that, Access to the home is available and encouraged to other professionals - GPs, chiropodist, physiotherapist, district nurse, opticians dentist, audiologist. During our last visit we found evidence that residents are treated with dignity and their right to privacy is respected. On this occasion we observed care practices and found that staff are respectful when speaking to residents and ensure residents are treated with dignity when personal care is being provided. Staff were seen to address residents using the name and title they prefer. Staff were seen to knock on the doors to residents private accommodation and wait for a response before entering. We spoke to several residents during our visit. They informed us they felt well treated by the staff. Information provided in the AQAA confirmed that, Staff are instructed to to treat service users with respect and dignity. They are to knock and wait for an answer before entering a service users room. Care Homes for Older People Page 14 of 32 Evidence: We looked at care records and medication records. We also noted that a secure facility had been provided to store all medication. We were satisfied that medication records had been well maintained and were up to date. We noted that staff who handle medication had been provided with appropriate training. We discussed the homes practices of storing and administering medication with the deputy manager. We expressed some concern that there may not be sufficient storage space. Following discussion, it was agreed with the area manager and the deputy manager that they would look into the provision of additional storage where this is necessary. The AQAA confirmed that, Staff administering medication have undergone appropriate training. records are kept of all medication received, administered and returned to the pharmacy. The AQAA also confirmed the care home has policies and procedures in place regarding the control, storage, disposal, recording and administration of medicines. Care Homes for Older People Page 15 of 32 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Routines in the home are flexible, allowing residents to have control over their lives where possible and encourages residents to make choices about what they wish to do. Activities are offered by the home which take into account the hobbies and interests of residents. The home continues to support residents in maintaining contact with family and friends. Home cooked food continues to be provided to a good standard. Alternative meals are provided as required. Evidence: We noted that care records include details of each residents interests and hobbies. We were informed that an activities coordinator has been appointed who is responsible for organising activities for residents to enjoy. We were also informed that there is programme of activities which are arranged on a daily basis. We were shown a copy of previous weeks activities and noted they included bingo, exercises, board games, Care Homes for Older People Page 16 of 32 Evidence: knitting groups, quizzes. There have also been visiting musicians who have regularly provided concerts and entertainments. Outings have also been organised for those residents who are interested. Residents we spoke to confirmed there is a programme of activities for them to enjoy. One resident told us an activity sheet is issued each week. We were also told, I like to go to everything. Today there will be board games. I find the activities enjoyable. There is an activity coordinator who organises everything for us. I also like to read. My daughter goes to the library for me. She knows what books I like to read. Another resident told us, I dont like to take part in in the organised activities. I am more likely to curl up with a good book. I do know the other residents think the activities are quite good. There are various games and exercises which are organised each week. We dont have a visiting library. Surveys returned by three residents confirmed there are always activities arranged by the home that they can take part in. One resident commented, There are a good range of activities. One survey confirmed this is usually the case, whilst two surveys this is only sometimes the case. The expert by experience reported, In the two residents rooms I visited I saw the weekly list of activities. There was something scheduled for each day. On the day I visited morning exercise was scheduled in the main lounge for 11.30am. I joined in the exercise activity and of all the homes I have visited it was the best exercise class I have seen for variety, materials used and suitability of the exercises. There were ten residents all of differing abilities and the coordinator was encouraging, engaging and extremely competent. The expert by experience went on to report, One of the carers told me that the home shares a bus with one of their sister homes in Worthing and uses it once a fortnight to organise outings. Theres not enough room for everyone so outings are arranged according to interests. The bus will go to Brighton, garden centres, shows etc and they will usually have tea out. Otherwise taxis are ordered for residents when requested. Of the five residents I spoke to only one used taxis on a regular basis and they used the same driver. They told me Im going to buy an extra light wheelchair and then my driver can take me out of the care to go shopping and out and about. There is a church in the village of Lindfield, which is the nearest village to the home. One of the carers told me that some of the church community come and collect some of the residents for church services, but one of the residents told me, I love the church. I used to go quite often but we havent been for quite a while now. I dont know why. Two of the residents particularly mentioned the church activities which take place once a week in the home, with group discussions and all denominations are welcome. Care Homes for Older People Page 17 of 32 Evidence: The expert by experience further reported, One of the residents I spoke with has just completed their autobiography which took nine months to write and had given them enormous pleasure. The resident was encouraged by the manager who has helped organise a book launch to take place at Walstead Place and also to draw up a guest list. In addition the resident collects and records music and has the latest sound technology in their room. As they have very poor vision the resident also has a very large flat screen television and a specialised reading viewer which magnifies up to foolscap sheet of paper. Another of the residents I spoke to likes reading but has no access to a library. I later spoke to the activities coordinator who will re-look at a visiting library facility. Information within the AQAA confirmed that, Service users are able to have choice with regard to leisure, social and cultural interests. Service users have access to regular visiting clergy and church services. Activities which have been arranged are guided by residents choice. Celebrations are made of birthdays and wedding anniversaries. During our last visit we formed the judgement that residents have been supported in maintaining contact with their family and friends. Visitors are made welcome in the home at any reasonable time. During this visit we noted that care records include details of residents families and next of kin, including telephone numbers, so that they may be contacted. The expert by experience reported, Of the five residents I spoke to all had visitors who came at different times. They took the opportunity to go out with their visitor as, due to its position, transport is needed to go outside the home. When the home has a Christmas party or summer fete visitors come and join in. Information in the AQAA confirmed, Families are invited to join service users for lunch and social events. We noted that residents were not expected to get up for breakfast. Some had chosen to have breakfast in their own room and then get up at a pace which suited them. We concluded that the routines of the care home supported residents in making their own decisions about how they wished to spend their day. All the surveys returned by residents confirmed that staff listen to them and act on what they say. Care Homes for Older People Page 18 of 32 Evidence: The expert by experience reported, One of the carers I spoke to confirmed that residents assisted with washing and dressing when they are ready. They are helped either by the day or night staff depending on when the resident wishes to retire to bed. Whilst walking around the home about 10.30 to 10.45 I saw two people in the main lounge, one reading, and the other just sitting. The resident reading didnt want to be disturbed and the other resident was waiting for the exercise class to start. Another resident was sitting the smaller lounge in the sun and appeared happy. Information provided in the AQAA confirmed that, Service users are able to exercise choice and control over their lives. We spoke to the cook during our visit who told us about the main meal of the day that was being prepared. This consisted of a choice of roast pork, roast potatoes, cabbage, carrots, sage and onion stuffing and gravy or mushroom omelettes followed by a choice of chocolate sherry trifle, rice pudding and peaches or fresh fruit salad and ice cream. The chef also informed us of the special diets that were currently being catered for. This included diabetic and lactose free diets. We were given copies of recent menus to look through. They demonstrated that a varied, wholesome and appealing diet has been provided. We observed the main meal of the day being served. We noted that tables in the dining room had been attractively presented with linen tablecloths and napkins, fresh flowers, condiments, a choice of cold drinks and individual place settings. The meal was served out from a heated cabinet and was attractively presented to encourage residents appetite. Residents we spoke to confirmed the meal was tasty and nicely cooked. We spoke to several residents who confirmed they were satisfied with the food provided. One resident told us, The food is good. We had a food tasting session a little while back. We now have scrambled egg on the menu. I feel we dont have enough onion. For example onion soup or onion in different varieties would be nice. Another resident said, The food is excellent. The food is much better since the new people have taken over. I tried out the different dishes during the food tasting to see what they were like. I think we get enough food and we can eat in our own room if we wish. Three surveys returned by residents confirmed they always like the meals at the home. One resident commented, Except on Friday, when fish is served the alternatives are poor. Proper coffee would be nice occasionally. One survey confirmed this is usually the case. Two surveys confirmed the residents sometimes likes the food provided. The expert by experience reported, All residents take breakfast in their rooms. Of the Care Homes for Older People Page 19 of 32 Evidence: five residents I spoke to all were happy with the variety and quality of the breakfasts and the times suited all. All had cereal and toast, none had a cooked breakfast. when I asked one of the residents, they replied, I dont believe that sort of thing is available in the mornings. If it is, I havent been told. Lunch and supper are served in the dining room and residents are encouraged to eat there to socialise. Morning coffee and afternoon tea with homemade cakes are served to the residents from trolleys where they happen to be. The expert by experience also reported, Two of the residents I spoke to said the lunch was often disappointing. One said, The meat is tough. It doesnt matter whether its pork, beef or lamb and the vegetables are always the same and there isnt enough fruit. I have complained but nothing seems to happen. The chef told me that he prepares the menu on a four weekly basis and receives feedback through the complaints book which residents are encouraged to use. It was later confirmed that the home has now changed its meat supplier. Another of the residents told me, After lunch and supper I always go around and talk to everyone, especially some of the older ladies. I think they enjoy having a chat and laugh with me. The staff are wonderful here. Jane (the manager, who is now retiring) is always organising something special. We had a wonderful Christmas dinner with all the trimmings and wine. And we had a lovely meal on Valentines Day. Of course we always have a little something when it is someones birthday. One of the care staff told me, We try to arrange the seating for meals so that people who get on with each other sit together and shy people with people who like to chat. Some of our men like to sit together so they can talk about the war. Others come up to us and ask to sit on certain tables. We are really flexible because we think its important for our residents to socialise. Information provided in the AQAA confirmed that, Service users are able to have nourishing, home cooked meal choices and be able to eat in surroundings at times suitable to them. Care Homes for Older People Page 20 of 32 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes complaint procedure enables residents and their relatives to have the confidence that any complaints they make will be taken seriously and acted upon. The registered provider has made the necessary arrangements to ensure residents are protected from possible harm or abuse. Evidence: During our last visit to Walstead Place we formed a judgement that the home has a clear complaints procedure in place that is displayed in the home. Complaints are dealt with promptly and efficiently and residents felt able to speak with the manager should they have any complaints or concerns. On this occasion we noted that the homes complaint procedure was on display in the front hallway of the property, near to the main office. Residents we spoke to during our visit confirmed they knew who to speak to if they wished to make a complaint. They also confirmed they were confident their concerns would be listened to and taken seriously. One resident commented, If I needed to make a complaint I would speak to the manager. She is quite approachable. All the surveys returned by residents confirmed they knew how to make a complaint should it be necessary. Care Homes for Older People Page 21 of 32 Evidence: Information in the AQAA confirmed that, The complaints procedure is displayed within the home and is also evidenced in the service user guide and brochure pack. Complaints are logged and action taken within correct timescales. The AQAA also confirmed three complaints have been received over the past 12 months. They have all been resolved to the satisfaction of the person making the complaint within agreed timescales. During our last visit we formed a judgement that staff training on abuse ensures staff are aware of the need to report any incidents of abuse within the home in order to protect the residents from harm. We spoke to some staff who were on duty. They confirmed they have received training with regard to identifying different types of abuse. Following discussion the staff were able to demonstrate they knew the different categories of abuse that they might encounter. They were also able to explain who they should notify if they witnessed an incident where a resident had been abused. We also examined records of staff training which confirmed they had received training in this area. Residents we spoke to confirmed they were satisfied with the quality of care provided. They also confirmed they felt they were in safe hands. The AQAA also confirmed, Staff training on safeguarding adults ensure staff are aware of the need to report any issues of concern. Care Homes for Older People Page 22 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has been maintained to a good standard of cleanliness and decoration. Residents are provided with a comfortable and homely environment in which to live. The home has been well maintained, ensuring it is safe for residents and staff. Evidence: We looked at the private accommodation of several residents along with the communal areas, including the dining room and the lounges. These areas were clean, decorated and furnished in a comfortable manner that met the needs of the residents accommodated. Residents have been encouraged to bring personal effects and small items of furniture in order to make bedrooms as individual as possible. Residents we spoke to told us they were satisfied with their accommodation. One resident commented, Overall the home is quite clean. The gardens are very nice. Another resident told us, The accommodation is comfortable. I have been able to bring some of my own possessions including some furniture and my bed. Four surveys returned by residents confirmed the home is always fresh and clean, whilst two confirmed this is usually the case. One resident commented, I have nothing to complain about except for a leaky tap in my bathroom. The tap is worn and needs replacing. It is a job for a proper plumber. This is already on the list of repairs waiting. Care Homes for Older People Page 23 of 32 Evidence: I have been waiting over three years. The expert by experience reported, One of the residents told me Ive complained that the radiator in the main lounge hasnt been working but nobody had done anything about it and its cold in here with only one fire in this big room. Ive also complained about these chairs. They are hard to sit down in and get up out of and for some of our activity they are not suitable. The activities coordinator confirmed they had raised the subject of chairs to the management and they were hoping they they would be updated or new chairs purchased. The expert by experience also reported, The two rooms I visited were very pleasant and shared with another room a very large balcony which gave broad views across the countryside. The rooms had personal possessions and were comfortable. We discussed the concerns about the leaking tap and the radiator not being fixed with the area manager. We were shown how minor maintenance work is reported to the maintenance team for repair. The paperwork demonstrated that the repair to the tap did indeed need a specialist plumber and it was expected to be repaired in the near future. It also demonstrated the fault had been reported in January 2009. The area manager expressed some surprise about the faulty radiator as they had no knowledge of it; there was no record of it having been reported to the maintenance team. However, despite this the area manager agreed to ensure the radiator is repaired. We also spoke to the area manager about the armchairs which were not suitable. We were informed that the registered provider had identified Walstead Place as needing major refurbishment in the next year. It is proposed this will include updating carpets and curtains, furniture and improvements to bathrooms. We also visited the kitchen area, the laundry, and several bathrooms. We noted that these areas have been maintained to a high state of cleanliness. Information within the AQAA confirmed, The home is tastefully decorated with several communal areas including a reception hall, two lounges, a conservatory and dining room with access to gardens overlooked by the countryside. Residents are invited to personalise their rooms with the option offered to families to do this prior to admission to help with the transgression form home to care environment. The home is clean, tidy and fresh with an on site maintenance operative and gardener. There is an ongoing programme of routine maintenance and renewal. Care Homes for Older People Page 24 of 32 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The needs of residents living at Walstead Court are met by a competent staff team. Staffing levels are also sufficient to meet residents current needs. Residents are protected by the homes recruitment procedures and practices. Staff have been trained so that they are competent to do the work expected of them. Evidence: During our last visit we formed a judgement that residents needs had been met by sufficient numbers of competent and trained staff. Four surveys returned by residents confirmed staff are always available when they are needed, whilst two surveys confirmed this is usually the case. Residents we spoke to during our visit confirmed they are very satisfied with the care provided. One resident told us, The staff are good. I am fairly independent, they will help me if I need it. Another resident commented, I am well cared for. Information supplied in the AQAA informed us, Residents needs are competent and trained staff. Care Homes for Older People Page 25 of 32 Evidence: We looked at staff training records. They demonstrated that newly appointed staff undertake structured induction training. This includes providing an understanding of the principles of good care practices and covers the promoting of residents rights, independence, choice and dignity. Training records also provided evidence that confirmed staff have been provided with mandatory training such as fire safety, health and safety, manual handling and food hygiene. Staff surveys returned us confirmed induction training covered everything they needed to know to do the job very well when they started. One member of staff commented, Induction is done on the computer and was very helpful. They also confirmed they had been given training which is relevant to their role, helps them understand and meet the needs of residents and keeps them up to date with new ways of working. We spoke a group of staff who were on duty. Following discussion, they told us about their role in the care home, the training they have undertaken, their understanding of the needs of identified residents and the action they are expected to take to ensure residents needs have been met. The AQAA confirmed, All staff have an individual training plan to include induction (Skills for Care for new staff). The AQAA also confirmed that, of the 18 permanent care workers employed, 12 have obtained the National Vocational Qualification (NVQ) in Care or Health and Social care at Level 2 or above. We looked through the recruitment records of two staff who have been appointed since our last visit. These records demonstrated that the registered providers have obtained appropriate checks for staff, including criminal records checks, written references and proof of each persons identity. All surveys returned by staff confirmed their employer had carried out the necessary checks in them before they started work at Walstead Place. The AQAA also confirmed, All staff have POVA and CRB checks. Care Homes for Older People Page 26 of 32 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Walstead Place has been well managed and has been run in the best interests of residents. Steps have been taken to ensure residents financial interests have been safeguarded. The health, safety and welfare of residents of residents and staff have been promoted and protected. Evidence: During our last visit we judged that residents at Walstead Place lived in a home that is well run and managed by a competent and experienced manager . Miss Jane Large is the registered manager. Whilst Miss Large was not available, the area manager and the deputy manager were present throughout our visit. Care Homes for Older People Page 27 of 32 Evidence: We were shown copies of minutes of residents meetings. They demonstrated they take place regularly and residents relatives are able to attend if they wish. Meetings include discussions about activities and planned outings or seasonal events such as a pantomime and a party to celebrate Christmas. There is also an opportunity for residents to raise issues regarding the day to day running of the home. During the last meeting, which took place in February 2009, Miss Large informed residents of her intention to retire. The expert by experience reported, A residents meeting is held once a month and the Activities Coordinator posts copies of the minutes to each residents room. Residents we spoke to confirmed a residents meeting takes place monthly. One resident told us, We are told about anything that is happening or is due to happen. For example we are told about any staff changes, any new residents who are arriving or the death of any resident. We were also shown minutes of staff meetings. They also demonstrated they are held regularly and that the manager uses them as a means of communicating with the staff of the care home. We were also shown records which demonstrated that all staff have attended individual supervision sessions on a regular basis. This ensures they receive the support the require and there is a means of identifying training needs for each member of staff. Surveys returned by staff confirmed they often meet with the manager for support and to discuss how they are working. Staff on duty who we spoke to confirmed they receive supervision every two months and attend staff meetings every three months. They also confirmed they felt well supported by the management. Information provided in the AQAA confirmed that, Residents live in a home that is well run and managed by an experienced manager who is an RGN with her Registered Managers Award, supported by an excellent manager. The home is run with the best interests of the service users in mind. The registered provider has set up a quality assurance system to be used throughout their care homes. We saw evidence that this was in use at Walstead Place. This includes satisfaction questionnaires that residents and their relatives are asked to complete on a regular basis. Representatives of the registered provider also visit the home on a monthly basis to monitor and evaluate how well the home is being managed. We were advised the information that is gathered is evaluated and drawn up into a report. This included details of any shortfalls identified and an action plan setting out what would be done to rectify them with agreed timescales. We were informed Care Homes for Older People Page 28 of 32 Evidence: that the provider uses visits to the home made by their representatives to monitor how the action plan is implemented. We examined copies of the reports of visits made by representatives of the registered provider. They confirmed that they had been undertaken regularly and had been used to monitor the service provided. Residents we spoke to confirmed that either they or their relatives deal with their own financial affairs. However, the care home does also have a facility to keep safe small amounts of cash for residents who need it. We looked at a selection of records of money deposited by residents for safekeeping and found they were up to date and accurate. Information in the AQAA confirmed that, Clear and concise records are kept of all financial transactions. Information supplied in the AQAA confirmed the registered provider has taken appropriate steps to ensure the premises and equipment within the care home is safe for use. For example, gas and electrical appliances have been checked and maintained regularly. We found evidence that a programme of training provided to all staff includes health and safety issues, fire prevention, manual handling and first aid. Information provided in the AQAA also confirmed, Health and safety and welfare of service users are promoted and protected at all times, through regular meetings, one to one meetings, supervision, training and regular audits. Care Homes for Older People Page 29 of 32 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 30 of 32 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 31 of 32 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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