Inspection on 07/11/07 for Waltham House

This inspection was carried out on 7th November 2007.

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

Waltham House 27/10/06

Waltham House 09/01/06

Waltham House 16/06/05

Waltham House 15/11/04

Waltham House 30/07/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Waltham House Waltham House Louth Road New Waltham Grimsby North East Lincolnsh DN36 4RY Lead Inspector Theresa Bryson Key Unannounced Inspection 7th November 2007 09:00 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 House DS0000057503.V354518.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. Waltham House DS0000057503.V354518.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Waltham House Address Waltham House Louth Road New Waltham Grimsby North East Lincolnsh DN36 4RY 01472 827725 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) Infinite Care Lincs Ltd Jane Elizabeth Robinson Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Waltham House DS0000057503.V354518.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th October 2006 Brief Description of the Service: Waltham House is a large old property on the outskirts of New Waltham close to the town of Grimsby. It is set in mature gardens with car parking space to the front and side. The home is registered to provide care and support for eighteen older people over the age of sixty-five. The home has two storeys serviced by a stair lift, on the upper floor there are two sections that have further steps and therefore these areas of the home are only suitable for ambulant people. There are four bedrooms in the middle section where there are no steps to negotiate. There is one large sitting room, a dining room and a further sitting room. There are adequate bathroom, shower and toilet areas. The home accepts service users who are privately funded and funded by surrounding local authorities starting at £329. These are reviewed annually. Details about the home in the form of a service users guide and statement of purpose is always on display in the main reception area and is sent or given to each prospective service user. Waltham House DS0000057503.V354518.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit took place over one day in November 2007. Prior to this surveys were sent out to relatives, staff and health professionals assisting the home. There was a good return result of these. The event history kept by CSCI was also checked. A number of records and documentation was checked on the day of the site visit. The home submitted a completed AQAA prior to the visit and supplied copies of other documents during the site visit. There were only a limited number of people using the service who could make informed decision to speak to us on the day of the site visit, but a number of staff were spoken to. The Registered manager was away at the time, but the Deputy manager, for the whole of the day, assisted us. What the service does well: Staff are always very welcoming and helpful and appeared to have a good knowledge base about the people they look after and how the home is required to run. They were observed assisting people in a variety of tasks and this they did with respect and dignity to each person, taking care to address individual needs and using a calm and patient approach. Documentation is kept on each individual and this is up dated on a regular basis to ensure current needs are being met. Events and visits to and away from the home are documented and all appeared to be legible written and accurate. Safe practises are in place for the safe administration of medication. Documentation is also available to ensure prospective service users can make informed decisions about entering the home as they detail what services are on offer and other information about living in the home. Prior to admission a full assessment takes place, which enables staff to prepare fro a person’s admission. All meals are prepared in a safe and clean environment and choices offered on a daily basis. This ensures they have a balanced diet. Safety checks are made Waltham House DS0000057503.V354518.R01.S.doc Version 5.2 Page 6 on all supplies to the home and staff have been adequately trained to do their job. People are confident to approach staff and the management team if they have any concerns and these are documented in an appropriate manner. Robust systems are in place to ensure staff are safe to work with people living in the home and prevent them from being harmed. Staff are supervised regularly to ensure they are capable of doing their jobs and training is offered regularly to meet individual needs and mandatory training. This ensures they are aware of the latest methods of looking after people and can give good care and advice. Records are kept to ensure that the building is safe to live in and well maintained. Areas have been updated to suit individual needs and tastes. People living in the home are asked their opinions as well as those visiting to ensure the Company is running the home for the benefit of those living there. What has improved since the last inspection? What they could do better: There appeared to be limited choices available to ensure the social needs and expectations of people could be met to cover their diverse needs. This must be in place to ensure people are occupied, as they would wish to be. Events should respect the age of people and by related to their specific needs and desires covering a broad range of religious, cultural and social tastes and expectations. Although the home was clean and tidy the domestic staff employed are only part time and this puts a strain on the care staff to complete domestic and laundry work. Care must be taken not to use care staff hours which have been Waltham House DS0000057503.V354518.R01.S.doc Version 5.2 Page 7 calculated to meet individuals care needs to domestic type work which may put people at risk from needs being unmet. 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. The summary of this inspection report can be made available in other formats on request. Waltham House DS0000057503.V354518.R01.S.doc Version 5.2 Page 8 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 House DS0000057503.V354518.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. People who use the service experience good quality outcomes in this area. Comprehensive information is supplied to ensure prospective service users can make informed decision. EVIDENCE: During the course of this visit Standards 1,3 and 6 were checked. As the Responsible individual had changed since the last inspection the Statement of Purpose and Service Users Guide was checked. This now contains updated information to ensure that prospective service users can make informed decision as to whether to stay in the home. The home uses a comprehensive pre-assessment tool to determine whether a prospective service user’s needs can be met by the home. This is then used to plan a package of care for that person. Waltham House DS0000057503.V354518.R01.S.doc Version 5.2 Page 10 The manager or deputy will always try to assess each person prior to admission to help staff to prepare, but the home will accept short stay and emergency admissions as well. The home does not accept intermediate care and Standard 6 is not applicable. Waltham House DS0000057503.V354518.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. People who use the service experience good quality outcomes in this area. Care plans are kept up to date to ensure current needs are being met. EVIDENCE: During the course of this visit Standards 7,8,9 and 10 were checked. Prior to the site visit a number of surveys were sent to relatives and health care professionals who support the home. The majority of these were returned and positive comments were made about the delivery of care. During the course of the site visit 4 care plans were tracked in depth. These showed what peoples current needs were, what care had been delivered and how often these had been updated. There was good follow through on the documentation provided for example when a person had an accident and showed that the management team were also checking that correct levels of care had been provided by staff. Waltham House DS0000057503.V354518.R01.S.doc Version 5.2 Page 12 There were only a limited number of service users who could make informed decision to speak to us during the site visit, but those who did made very positive comments about the care they were receiving. For example “the girls are looking after me” and “they clean my glasses” and “happy in this room”. The manager and deputy audit the care plans. Although the evaluations were at least monthly and appeared to give a good précis of the care delivered and events which had taken place for each individual this now needs a little more expansion to include more detail about the plan of care. The files also needed to be tidied up in that older documentation, although needing to be kept, could be transferred to another file, so as not to confuse staff of what to look for in the working daily file. The drug administration records were checked over in the presence of the deputy manager. A new trolley has been purchased and a new secure area found to store it. On tracking some drug administration sheets and having feed back from staff there appears to be a safe system in place to ensure people are free from harm when medication is dispensed and stored. Staff were observed throughout the day assisting people in a variety of tasks. These included personal care, meals and activities. Each task was completed calmly and with dignity to each person. Staff showed respect to each individual and when questioned had a good knowledge base about the people they were looking after. Waltham House DS0000057503.V354518.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. People who use the service experience good quality outcomes in this area. A variety of activities are on offer to ensure the social expectations of people are being met and they are provided with meals prepared in a safe environment. EVIDENCE: During the course of the visit Standards 12,13,14 and 15 were checked. Each person resident in the home had had social needs assessment completed to ascertain what their expectations were in their daily lives. There was written evidence to show that these are elevated on a regular basis. There was documented evidence of what types of activities had taken place but the recording was very basic and did not give justice to the in depth planning and participation in events of people. There was also pictorial evidence around the home of planned events on offer and details of what had taken place. Many people living in the home like to be quiet and are offered more one to one activities. One person stated, “I like my books and just to talk”. Waltham House DS0000057503.V354518.R01.S.doc Version 5.2 Page 14 There were permission letters in the care plan for people’s photos to be displayed. Some of these were checked against the photos on display on the family tree. Some reality orientation material was on display in the main entrance, but the home needs to ensure that this is not too child like and find alternative methods of ensuring daily orientation takes place. It was recommended that the manager checks that any staff member using their care to transport people to events outside the home has the correct level of insurance for their car. The people appeared to have participated in some local events this year including trips to the garden centre, local amateur railway museum and shopping trips. Good links have also been forged with the local community with visits made to local events and some people coming into the home like the local church. On touring the home and from auditing the surveys sent and speaking to people living there and staff, care is taken to ensure that individual needs are being meet daily. For example there was ample evidence in the rooms of how people had been allowed to adapt their environment to suit their tastes and needs. Relatives spoke highly of how staff take care to ensure needs are addressed for example how a person likes to dress and how welcoming staff are to visitors. On touring the kitchen this was a very clean and tidy environment and written evidence was seen on how safety checks are completed to ensure food is prepared safely and in a clean environment. The last environmental health officer’s visit had been in April 2007 and the minor requirements had now been addressed. A copy was seen by us when on site. There was ample evidence that fresh produce is supplied and home baking takes place. Those spoken to and on the surveys commented on the choices given at meal times and there were ample portions. The menus seen showed a balanced and varied diet was on offer to ensure that people remained healthy and this was adapted for those who were too ill to take a normal diet. Staff were observed assisting people who required help at a mealtime. This they did with dignity to each person, going at the service users pace, but ensuring they were encouraging at all times. This will ensure each person is monitored closely and seen to partake of an adequate diet to help them stay healthy. Waltham House DS0000057503.V354518.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. People who use the service experience good quality outcomes in this area. A robust system is in place to protect service users from harm and ensure they can raise concerns in confidence. EVIDENCE: During the course of this visit Standards 16 and 18 were checked. No concerns had been raised directly to CSCI but the home had stated one was dealt with in house since the last inspection. The log of this was seen on the site visit and all evidence appeared to be correct and dealt with appropriately. People spoken to who live in the home and returned survey reports stated that they had every confidence in the management team to deal with any concerns in a confidential manner. The policy was displayed and had all the correct information to ensure that people would know how and who to complain to. Staff had received updated safe guarding adults training since the last inspection and stated they felt confident in how to recognise a harmful situation and would know who to refer issues to. No referrals had been made to safe guarding adults’ teams. Waltham House DS0000057503.V354518.R01.S.doc Version 5.2 Page 16 This will ensure that staff are aware of what constitutes a harmful situation and what to do to protect people living in the home. Waltham House DS0000057503.V354518.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. People who use the service experience good quality outcomes in this area. People are living in a safe and comfortable environment at the moment. EVIDENCE: During the course of this visit Standards 19 and 26 were checked. The deputy manager accompanied us on a tour of the building and grounds. Some redecoration work was continuing in the main part of the building to ensure that people were still living in a comfortable environment adapted to their needs. Some new items have been included since the last inspection. This has included names on doors, but no evidence was produced to show that the Waltham House DS0000057503.V354518.R01.S.doc Version 5.2 Page 18 methods being used had been agreed by all service users, or whether they thought this a childish way of communicating. Also the home no longer uses real coal fires but they have been replaced with electrical ones with a coal effect, which has made staff’s work a lot easier and less dust in the lounges. The conservatory has been pulled down to allow some new building work to take place. The gardens were looking tidy and clean, but part of the car park has been lost as extensive building work is under way in the grounds. Appropriate signage was on display. A discussion took place between the deputy manager, the site manager for the building firm and us as to the progress of the current work. Further advice is being sought by the CSCI as to the timing of the work and the safety and comfort of the people living at the home. Several people living in the home and relatives on survey forms retuned stated they felt there was a lot of noise at times. This should be monitored by the manager to ensure peoples’ lives are not too disrupted by the work. There was ample evidence that people had been allowed to change the rooms according to their needs and tastes, which relatives stated had helped their loved ones to settle in to the home. Although the home was clean and tidy staff stated there is only a part time cleaner and completing domestic tasks is sometimes difficult when they also have to care for the people living there. There was no evidence to support that people were being neglected and needs left unmet, but should be addressed by the management team as hours allocated only are for caring duties, not domestic, on the matrix used. Waltham House DS0000057503.V354518.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. People who use the service experience good quality outcomes in this area. There is a robust system in place to ensure staff are safe to work with people in the home and are then trained to do their jobs. EVIDENCE: During the course of this visit Standards 27,28,29 and 30 were checked. A new rota had been put in place form August 2007 and the home had used the Residential Forum Matrix to determine how many staff were needed to ensure the current needs of people living in the home could be met. There appeared to be adequate staff available to ensure needs were being met and those people spoken to and surveyed stated this was so and many positive comments were made about the care given by the staff. Each staff member had received a training update in 2007. This was recorded on their individual records, which were currently being amended to ensure all dates had been included on training completed. The records showed that all mandatory training had taken place as well as specialist course on topics such as aggression management, bereavement and Dementia. Waltham House DS0000057503.V354518.R01.S.doc Version 5.2 Page 20 Staff spoken to stated how much choices they have for topics for training and are able to choice ones they feel suits their needs. All also stated how useful the topics had been for the current group of people living in the home. This will ensure that staff have the correct skills and knowledge base to ensure people are looked after correctly and to the best of their ability. 3 staff personal files were tracked in depth and showed that all safety checks had been made prior to commencement of employment to ensure they were safe to work with people in the home. Waltham House DS0000057503.V354518.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. People who use the service experience good quality outcomes in this area. People live in an environment, which is adequately maintained and are asked their opinions about the running of the home. EVIDENCE: During the course of this visit Standards 31,33,35,36 and 38 were checked. Records were seen to show that adequate checks are made on a regular basis to ensure the building is safe, all equipment is in working order and the staff are adhering to the fire and health and safety policy. A copy of the quality report for 2007 was shown to us, which showed how the home had consulted with people living there and others and meetings held. Waltham House DS0000057503.V354518.R01.S.doc Version 5.2 Page 22 The Company had set out a business plan showing its strengths, weaknesses, opportunities and threats and how it was going to address issues in the forthcoming year for the benefit of the people who live in the home. People spoken to stated how approachable the management team are and how kind staff are to them and they do feel they are part of a family. Records were also seen to show that adequate accounting systems are in place to ensure the personal allowance money held by the home is accounted for. The records appeared accurate and 3 were tracked in depth. This ensures people’s money is kept in safe keeping for them. And used only for their personal benefit. Staff are also monitored closely and the supervision records of staff seen and 3 tracked in depth. These set out how a person is coping in their job roles and what may be needed to enhance the care they are giving and where they fit into the staff group collectively looking after the people who live there. All of these combined methods of checking the building, the staff and the finances help towards each individual resident in the home having their needs met and being able to live in a safe and comfortable environment. Waltham House DS0000057503.V354518.R01.S.doc Version 5.2 Page 23 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 X 3 X X N/A 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 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 X 3 X 3 3 X 3 Waltham House DS0000057503.V354518.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP12 Regulation 16.2.m. Requirement The home must ensure that there is more accurate recording of activities and these meet the diverse needs of the people. Sufficient staff should be employed to ensure the home can be maintained to a reasonable standard of cleanliness without this impinging on the care staff duties. Timescale for action 30/03/08 2. OP19 23.2.d. 30/03/08 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. 3. Refer to Standard OP7 OP12 OP12 Good Practice Recommendations Care plan records should be kept in such a way as not to confuse those accessing them, but all documentation kept for the required period of time. The manager should ensure that any transport used for carrying people living in the home is insured correctly and fit for purpose. The manager should ensure that all events which take DS0000057503.V354518.R01.S.doc Version 5.2 Page 25 Waltham House place in the home are age related and not child like as this falls outside the boundaries of the categories of registration. Waltham House DS0000057503.V354518.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 House DS0000057503.V354518.R01.S.doc Version 5.2 Page 27 - 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. 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