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Inspection on 11/01/06 for Waltham Hall Nursing & Residential Home

Also see our care home review for Waltham Hall Nursing & Residential Home for more information

This inspection was carried out on 11th January 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Waltham Hall Nursing and Residential Home is well managed and records necessary for the health and welfare of the residents are maintained. A relaxed and friendly atmosphere is evident throughout the home and staff go about their daily work in an unhurried and professional manner. Privacy and dignity is maintained at all times and it was evident throughout the inspection that residents were well cared for and their care and support needs were met. The registered manager is both supportive and approachable and families and friends are encouraged to be involved in the life of the home. The home is well maintained both internally and externally and the decoration and furnishings are presented in a comfortable and homely way.

What has improved since the last inspection?

Care plans are up to date and reviewed on a regular basis. A new daily routine sheet has been developed which covers the resident`s preferred daily routines, social needs and preferences. This document is included in the care plan documentation. The majority of the care plans now contain a photograph of the individual resident confirming their identity. Abuse awareness training has been developed and the Registered manager is in the process of delivering this training to all staff working at the home. Recruitment practices are sound with all required checks being made.

CARE HOMES FOR OLDER PEOPLE Waltham Hall Nursing & Residential Home Melton Road Waltham On The Wolds Melton Mowbray Leicestershire LE14 4AJ Lead Inspector Diane Butler Unannounced Inspection 11th January 2006 09.50 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 Waltham Hall Nursing & Residential Home DS0000001931.V275717.R01.S.doc Version 5.1 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. Waltham Hall Nursing & Residential Home DS0000001931.V275717.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Waltham Hall Nursing & Residential Home Address Melton Road Waltham On The Wolds Melton Mowbray Leicestershire LE14 4AJ 01664 464865 01664 464881 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) Claregrange Limited Patricia Jane Groom Care Home 61 Category(ies) of Old age, not falling within any other category registration, with number (61), Physical disability over 65 years of age of places (61), Terminally ill over 65 years of age (2) Waltham Hall Nursing & Residential Home DS0000001931.V275717.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Named Person To be able to admit a named person of category PD named in variation application No. V9608 dated 5 July 2004 for periods of respite care. To be able to admit the named person of category PD named in variation application no: V11698 dated 25 August 2004 for periods of respite care. No one falling within category TI(E) may be admitted into the home where there are 2 persons of category TI(E) already accommodated within the home. To admit named person falling within category PD aged 61 years of age named in variation application No. V24411 dated 6 September 2005 24th May 2005 Date of last inspection Brief Description of the Service: Waltham Hall Nursing and Residential Home is situated in the Leicestershire village of Waltham on the Wolds and is registered to provide personal and nursing care to sixty one persons over the age of sixty five. Accommodation, which can be found on two floors, is accessible by two shaft lifts. Communal areas including dining rooms and lounges can be found on both floors. There are thirty-one single bedrooms with ensuite facilities and twenty-six single bedrooms without ensuite facilities within the home and two double bedrooms with ensuite facilities are also available. There is a large garden to the front, side and rear of the building which is well maintained and accessible to all residents, relatives and visitors. A large carpark is available for visitor parking. The home enjoys delightful views over the surrounding countryside. Waltham Hall Nursing & Residential Home DS0000001931.V275717.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over six hours and commenced at 9.50 am on the 11h January 2006. The main method of inspection used was ‘case tracking’ which involved selecting four residents and tracking the care they receive through the checking of their records, discussion with them, the care staff and observation of care practices. The inspector also had the opportunity to speak to other residents and relatives visiting the home on the day of the inspection. What the service does well: What has improved since the last inspection? Care plans are up to date and reviewed on a regular basis. A new daily routine sheet has been developed which covers the resident’s preferred daily routines, social needs and preferences. This document is included in the care plan documentation. The majority of the care plans now contain a photograph of the individual resident confirming their identity. Abuse awareness training has been developed and the Registered manager is in the process of delivering this training to all staff working at the home. Recruitment practices are sound with all required checks being made. Waltham Hall Nursing & Residential Home DS0000001931.V275717.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Waltham Hall Nursing & Residential Home DS0000001931.V275717.R01.S.doc Version 5.1 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 Waltham Hall Nursing & Residential Home DS0000001931.V275717.R01.S.doc Version 5.1 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): 1,2,3,5 The admission process is well managed with all prospective residents having their needs assessed before entering the home. EVIDENCE: • A Statement of Purpose/ Service User Guide is available. This document includes information about the facilities in the home and the services that can be provided. A copy of the homes Terms and Conditions document, a list of current charges and the complaints procedure are also included. A new needs assessment document has been developed and the registered manager stated that whenever possible, new residents are assessed before they move into the home. On checking the paperwork belonging to a resident due to take up residence, it was evident that an initial assessment had been completed. • Waltham Hall Nursing & Residential Home DS0000001931.V275717.R01.S.doc Version 5.1 Page 9 • Prospective residents and/or their relatives are invited to look around the home before moving in. This enables them to see the facilities that are offered and reassure them that their individual needs could be met. Residents and relatives spoken with confirmed that they had had the opportunity to look around the home before making a decision to take up residence. • Waltham Hall Nursing & Residential Home DS0000001931.V275717.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Residents are looked after well in respect of their health and personal care needs and personal support is offered in such a way as to protect the resident’s privacy, dignity and independence. EVIDENCE: • Care plans belonging to four residents were checked during the inspection. All four were up to date and had been reviewed on a regular basis. All included the identified care needs of the individual residents and the actions to be taken by the staff to meet those needs. A record sheet that shows the resident’s preferred daily routines and social needs and preferences is also included. Relevant assessments were included in the care plans checked; these included mobility assessments and waterlow risk assessments. A risk assessment for the use of bed rails was included in the care plan for a resident who required this piece of equipment. On checking the daily record sheets it was noted that staff are writing the daily events in the care plan document and referencing this on the daily DS0000001931.V275717.R01.S.doc Version 5.1 Page 11 • • Waltham Hall Nursing & Residential Home record sheet. The Manager explained that this had been brought in so that the care plans would be looked at on daily basis and therefore reviewed regularly [this had been required at the last inspection]. • A number of the care plans included photographs of the residents as required at the last inspection. The registered manager explained that the remaining photographs would be obtained in the near future. Evidence was seen to confirm that residents have full access to health care services. These include local GP’s, community nurses and Speech and language Therapists. The procedures for the administration of medication were checked during the inspection. All records checked on this occasion were in order with the exception of one signature omission. Discussion with residents and staff and observations during the inspection showed that the staff had a good awareness of the residents individual care needs and how to ensure that a resident’s privacy and dignity are maintained at all times. All residents spoken with stated that care needs were currently being met and relatives spoken with agreed with this statement. Comments received during the inspection included: “The staff are wonderful” “You can’t fault the staff, I can’t speak too highly of them”. “They’re a good bunch” “It’s a most wonderful place”. “Since she’s been in bed the staff have been brilliant” • • • • • Waltham Hall Nursing & Residential Home DS0000001931.V275717.R01.S.doc Version 5.1 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): 13,14,15 Visiting is encouraged to enable residents to maintain contact with family, friends and the local community. EVIDENCE: • Residents are offered choices on a daily basis. Choices include when to get up or go to bed, what to wear, where to eat meals and whether to join in activities. One resident explained, “You have a choice, they will offer to take you to the dining room for your meal, but if you prefer, you can have it in your room”. A second resident stated, “I can get up when I want to”, if I want a lay in I can”. An activities organiser visits the home at least twice a week and a list of activities is displayed in the home. • • • Waltham Hall Nursing & Residential Home DS0000001931.V275717.R01.S.doc Version 5.1 Page 13 • Family and friends are encouraged to visit and an open door policy is very much in place. One relative spoken with stated, “They always make me feel welcome”. A second visitor explained, “I am very happy with the home, I can come at any time”. All residents spoken with shared how much they enjoyed the food served at the home. A choice is offered at each mealtime and the food is served to suit the resident’s individual needs, whether this is in soft form, pureed form, or as a normal meal. Comments received from residents regarding the food served included: “You get two choices at dinner time and you can have a cooked breakfast as well, I had poached egg today”. “The foods not bad at all”. “They bring good meals, always tasty and always a choice”. • • Waltham Hall Nursing & Residential Home DS0000001931.V275717.R01.S.doc Version 5.1 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): 16,18 Arrangements for the receiving and responding to complaints are sound resulting in satisfactory protection of resident’s rights. EVIDENCE: • A complaints procedure is in place and all residents spoken with were aware of who to go to should they have a concern of any kind. One resident explained, “I would speak with matron, matron is very good and always acts if there is a concern”. A copy of the complaints procedure can be found in the homes Statement of Purpose document and a copy is displayed in the homes reception area. The registered manager stated that one complaint had been received since the last inspection in May last year. This statement was supported on inspection of the complaints file. It was noted that the one complaint received had been dealt with appropriately. Staff spoken with during the inspection were aware of what to do should they suspect any act of abuse and the Registered Manager is aware of her responsibilities with regard to adult protection. Training on Abuse awareness has been developed as required at the last inspection and the registered manager stated that she was in the process of going through this training with all staff. DS0000001931.V275717.R01.S.doc Version 5.1 Page 15 • • • • Waltham Hall Nursing & Residential Home Waltham Hall Nursing & Residential Home DS0000001931.V275717.R01.S.doc Version 5.1 Page 16 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): 19,20,24,25,26 The standard of the accommodation within this home is good providing residents with a safe, clean and comfortable place to live. EVIDENCE: • • The home is well maintained both internally and externally and the decoration and furnishings are presented in a comfortable and homely way. The rooms belonging to the residents who were case tracked were seen. These were clean, (though it was noted that in two of the four bedrooms the bed tables were sticky and in need of cleaning), appropriately furnished and included the residents personal belongings. The laundry facilities were seen and were found to be in order. It was noted that one of the washing machines was out of order. The laundry assistant on duty at the time of the inspection explained that they were waiting for this to be repaired and although she currently only had one machine to work with she was able to clear the washing daily. DS0000001931.V275717.R01.S.doc Version 5.1 Page 17 • Waltham Hall Nursing & Residential Home • All areas of the home seen on this occasion were clean and fresh. Waltham Hall Nursing & Residential Home DS0000001931.V275717.R01.S.doc Version 5.1 Page 18 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): 27,28,29,30 Recruitment practices within the home ensure appropriate protection for residents. EVIDENCE: • An appropriate recruitment procedure is in place. Application forms are completed, references are collected and the registered manager carries out a face-to-face interview with all applicants. Three staff files were checked. All included two references, proof of identity and evidence of a POVA 1st (Protection of Vulnerable Adults) check and a CRB (Criminal Records Bureau) check. • Waltham Hall Nursing & Residential Home DS0000001931.V275717.R01.S.doc Version 5.1 Page 19 • A new induction programme, which encompasses the standards set out by Training Organisation for Personal Social Services Training (TOPSS) has been obtained and is being used for all new care workers. The files belonging to two new care workers who are currently working through this induction were seen. The Registered manager explained that after completion of this induction programme the care workers will be enrolled to commence their NVQ (National Vocational Qualification) level two training. The Registered manager is also in the process of introducing in house training sessions in relevant areas of care. These include ‘recognising dementia’, ‘nutrition in the elderly’ and ‘pressure area care and manual handling’. During the inspection the inspector asked residents, visitors and staff whether they felt that there were adequate staff on duty to meet the needs of the residents currently living in the home. Comments received included: “I’m not sure that there is always enough staff on”. “In the past there hasn’t always been enough on to take her to the toilet straight the way”. “There’s normally enough on, but if some one phones in sick there’s not much they can do about it”. “They sometimes seem a bit overworked” “Sometimes they go short, but they tell you” “I feel there is the right number of staff on” “I use the buzzer if I need someone and someone always comes” On the day of the inspection a relaxed atmosphere was evident with staff going about their work in an unhurried and professional manner. • • Waltham Hall Nursing & Residential Home DS0000001931.V275717.R01.S.doc Version 5.1 Page 20 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): 31,32,35,36,38 The home is managed efficiently and appropriate policies and procedures are in place to ensure the safety of the residents. EVIDENCE: • The Registered Manager has worked at Waltham Hall for many years and has completed her National Vocational Qualification level four and Registered Managers Award. All staff, residents and relatives spoken with stated that she was approachable and supportive. It was evident during the inspection that the residents benefited from the ethos, leadership and management that the registered manager provides and positive relationships between staff and residents were evident throughout the inspection. • Waltham Hall Nursing & Residential Home DS0000001931.V275717.R01.S.doc Version 5.1 Page 21 • • All staff spoken with confirmed that supervision sessions take place. Records for some of these sessions were seen. Money kept by the home on the resident’s behalf was checked. It was noted that current practice is to keep it all in one resident account. It is strongly recommended that residents money is not pooled but kept individually and the appropriate records and receipts be kept. Monthly quality audit checks are carried out and resident and relatives meetings have been held in order to gather their views on the service that is provided. Environmental risk assessments covering all areas of the home are in place. A risk assessment was completed on the front door following safety concerns highlighted at the last inspection. The registered manager stated that from this assessment it was decided that a key code lock would be fitted. The inspector was informed that the Responsible Individual was in the process of having the lock fitted. This will be checked at the next inspection. Staff spoken with confirmed that moving and handling training, health and safety training, fire safety training and infection control training had been provided. Whilst walking around the home the inspector witnessed a member of staff transferring soiled clothing from a bedroom to a sluice room without using a bin or bag. The Registered manager stated that she would look into this straight the way. Records seen on this occasion were found to be up to date and accurate. • • • • • • Waltham Hall Nursing & Residential Home DS0000001931.V275717.R01.S.doc Version 5.1 Page 22 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 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X 2 3 X 3 Waltham Hall Nursing & Residential Home DS0000001931.V275717.R01.S.doc Version 5.1 Page 23 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. x Standard x Regulation x None Requirement Timescale for action 11/01/06 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 Refer to Standard OP35 Good Practice Recommendations It is strongly recommended that resident’s money kept for safekeeping be kept individually and not pooled in one residents account. Waltham Hall Nursing & Residential Home DS0000001931.V275717.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX 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 Waltham Hall Nursing & Residential Home DS0000001931.V275717.R01.S.doc Version 5.1 Page 25 - 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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