Inspection on 14/12/05 for Walton House Nursing Home

This inspection was carried out on 14th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Walton House Nursing Home 19/07/07

Walton House Nursing Home 22/08/06

Walton House Nursing Home 17/06/05

Walton House Nursing Home 22/11/04

Walton House Nursing Home 28/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Walton House Nursing Home Walton House 188 Chorley Road Walton-le-dale Preston Lancashire PR5 4PD Lead Inspector Phil McConnell Unannounced Inspection 14th December 2005 10:00 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 Walton House Nursing Home DS0000025584.V264271.R01.S.doc Version 5.0 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. Walton House Nursing Home DS0000025584.V264271.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Walton House Nursing Home Address Walton House 188 Chorley Road Walton-le-dale Preston Lancashire PR5 4PD 01772 628514 01772 697200 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) St Andrew`s Health Care Limited Mrs Jane Lyth Care Home 44 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (44), of places Terminally ill (3) Walton House Nursing Home DS0000025584.V264271.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. This home is registered for a maximum of 44 service users to include: Up to 44 service users in the category of OP (Old Age, not falling in any other category) Up to 3 service users in the category of TI (Terminally Ill). The service should at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidelines which may be issued through the Commission for Social Care Inspection regarding staffing levels in care homes. 17th June 2005 5. Date of last inspection Brief Description of the Service: Walton House is a care home providing 24-hour personal and nursing care. The home is registered for 44 service users. Walton House is privately owned and operated by St Andrews Health Care Ltd. Responsibility for the day-to-day running of the home is that of the registered manager, Mrs J Lyth. The home is located in Walton-le-Dale, near to shops, pubs, post-office and other town amenities. It has a car park at the main front entrance and a garden area with flowerbeds and a patio with seating at the rear. The home is a two storey purpose-built building. Bedroom accommodation is on the ground and first floors. The majority of bedrooms are single, however a number of companion rooms are available for those who wish to share. There are no en-suite bedrooms. There is a passenger lift. Accessible toilets and bathrooms are located on both floors near to bedroom and living rooms. There is a lounge area on each floor. Dining facilities are situated on the ground floor Corridors are wide and fitted with grab rails. Other appropriate aids are provided in bathrooms to assist service users with mobility problems. Walton House Nursing Home DS0000025584.V264271.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out by two inspectors and was unannounced, which meant that the provider was unaware that the inspection was to take place on that particular day. A providers pre-questionnaire, comment cards for service users, relatives and carers, other professionals and general practitioners, were sent out prior to the inspection. The feedback from the comment cards that were returned was generally positive. Some of the comments received from relatives included “My mother in law is treated with dignity, respect, and most of all loving care” “Very pleased with the care my mother receives” “Very happy with all aspects of my Fathers care” The inspectors spoke with the Registered manager, service users and members of staff. Service users records and staff records were examined, and a full tour of the premises was undertaken. As part of the inspection process the inspectors used “case tracking” as a means of assessing some of the National Minimum Standards. This process allowed the inspectors to focus on individual people living at the home. What the service does well: Service users said that the care staff were very good and were always very helpful. Staff members said the management team supports them giving them confidence and motivation to do their job. Adequate, organised and structured training is provided to staff. The food menu offers a choice at each mealtime, with fresh fruit and vegetables always available. The meals are well cooked and the staff are aware of the importance of providing a healthy and wholesome variety of food. The home employs an activities organiser and there is a daily programme of activities in place, offering variety and choice for the service users. The home has good relationships with other professional agencies, which was reflected in some of the comment cards received, from social services “Social workers, placing people at Walton House, have found staff to be courteous, Walton House Nursing Home DS0000025584.V264271.R01.S.doc Version 5.0 Page 6 caring and knowledgeable” and from a General Practitioner “Walton House provide good quality care” and “Good quality patient care and appropriate requests for reviews”. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Walton House Nursing Home DS0000025584.V264271.R01.S.doc Version 5.0 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 Walton House Nursing Home DS0000025584.V264271.R01.S.doc Version 5.0 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): 3 The pre-admission process was not consistent. As such some service users and their representatives are not involved in a pre-admission assessments. EVIDENCE: There was a filing system in place to hold and maintain the service users care documentation. This included a long-term need assessment document and a care plan document, containing an appropriate and relevant list of potential needs for service users. This demonstrated that there is adequate documentation in place, to enable staff to know the assessed needs of the people living at Walton House. However, the inspectors examined the files of some of the service users one of whom has only recently moved to the home. One of them did not contain a social services assessment or any evidence of a pre-admission assessment (previous requirement), another file had an uncompleted social activity plan and there was no photograph on the file and again no pre-admission assessment. The files that were inspected showed little evidence of service user involvement and a lack of relevant assessments, which is essential to ensure that service users needs are being appropriately met. Walton House Nursing Home DS0000025584.V264271.R01.S.doc Version 5.0 Page 9 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): 10. The rights of service users to be treated with dignity and respect were upheld by the practices and procedures within the home. EVIDENCE: Standards 7,8 and 9 were not fully inspected on this occasion (inspected on last inspection) although the inspectors noted that one service users file did not contain sufficient health assessment information, or a risk assessment for bed rails. This was a requirement made at the last inspection and therefore remains outstanding. The standard for medication was not fully assessed on this occasion as it was assessed on the last inspection. However, it was noted that appropriate records are kept and that drugs are disposed of in the correct manner, helping to ensure that service users are safeguarded and protected. The feedback from the comment cards confirmed that service users are treated with respect and dignity. Staff were observed during the inspection interacting with service users and people were being treated respectfully, with their rights and choices being acknowledged. Walton House Nursing Home DS0000025584.V264271.R01.S.doc Version 5.0 Page 10 It was stated by staff that service users are addressed by the name they prefer and the inspectors observed staff speaking to service users respectfully and by their preferred names. Staff induction records were examined and it was noted that they were signed and dated by the staff member, when the task had been completed. One of the induction training sessions covered privacy, dignity and respect, helping to ensure that people are treated respectfully. The home has a mobile phone and service users are supported, when necessary to use the phone, helping to maintain contact with family and friends. Walton House Nursing Home DS0000025584.V264271.R01.S.doc Version 5.0 Page 11 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): 14 Service users are given the opportunity to exercise choice in their lives and support is available from staff if needed to promote independence and choice. EVIDENCE: There was a policy and procedures in place, which are accessible to staff, covering a service users right to exercise personal autonomy and choice in relation to their lifestyle and management of finances. The induction and foundation training records show that promoting choice is one of the subjects covered and in discussion with some service users, staff members and visitors to the home, the inspectors were informed that people are given choices in all aspects of their lives. Enabling service users to maintain independence and personal autonomy. The statement of purpose has details for accessing an advocacy agency, with information for staff and service users to contact an advocate, should the need arise. The staff and service users who were spoken to, were aware of how and when to consult an advocacy service. This helps to ensure that service users have the opportunity for someone outside of the organisation to mediate on their behalf if the necessity arises. Walton House Nursing Home DS0000025584.V264271.R01.S.doc Version 5.0 Page 12 Although standard 15 was not fully inspected on this occasion, the inspectors were able to observe and speak to some of the service users during the lunchtime. The food was well cooked and wholesome and presented in an appealing way. Service users said, “the food is very nice” and “there is always enough” Some service users were observed being supported to have their lunch by staff and this was done in a sensitive and caring manner, helping to ensure inclusion and promote dignity. Walton House Nursing Home DS0000025584.V264271.R01.S.doc Version 5.0 Page 13 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): These standards were not assessed on this inspection. EVIDENCE: Walton House Nursing Home DS0000025584.V264271.R01.S.doc Version 5.0 Page 14 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 A regularly monitored system needs to be maintained. To ensure that repairs are dealt with in a timely manner. EVIDENCE: An inspection of the home was carried out and the service users bedrooms were found to be generally well decorated and personalised, with peoples own belongings, photographs and ornaments. During the tour of the home, the inspectors spoke to some of the service users and to some visitors. Some of the comments made included, “I have settled in very well” “It feels like home” and “I like being here” A visitor said, “I am always made welcome and the home is lovely and comfortable” During the tour of the home a number of things were identified that will need attention and recommendations were made to the manager, including, Walton House Nursing Home DS0000025584.V264271.R01.S.doc Version 5.0 Page 15 The dishwasher in the kitchen is leaking around the base and it now needs to be replaced, because of the risk of infection. Pipe work in some bathrooms is not covered and needs to be covered for health and safety reasons. One or two carpet grips were not correctly fastened down, this could cause someone to trip and have an accident. Some areas of the home have an unpleasant odour. This needs to be addressed to help ensure a pleasant environment for the people who live and work at the home. The grounds appeared to be safe and accessible to the service users, thereby giving people the opportunity to venture outside and benefit from the grounds. The department of environmental health carried out an inspection (February 2005) and some recommendations were made. The manager assured the inspectors that the recommendations had been addressed. This indicated that the provider complies with requirements and recommendations, which are made by regulatory bodies, in order to promote service users wellbeing and health and safety. Walton House Nursing Home DS0000025584.V264271.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 30. Training for staff is well managed, structured and professionally delivered, ensuring that staff are competent and confident to perform their roles. EVIDENCE: A training matrix was examined, which had been developed for different grades of staff, RGN’S (Qualified staff) senior care assistants, care assistants and ancillary staff. And this covered the period 2005 to 2006 and showed that staff are adequately trained to meet the needs of the service users who live at Walton house. Induction records for staff were examined and everything was up to date and in place. There is a structured approach to training and development. The manager advised the inspectors that staff receive a minimum of three days training per annum. Staff members said that they received adequate and appropriate training and felt that they delivered a good quality service. Walton House Nursing Home DS0000025584.V264271.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 35 and 38. Residents lived in a home that was managed by a responsible person whose training and experience helped make sure she discharged her responsibilities fully. The arrangements for handling money on behalf of residents were thorough enough to ensure their financial interests were safeguarded. Attention to health and safety matters was not thorough enough to ensure that the health, safety and welfare of residents and staff was consistently protected. EVIDENCE: Records showed that the registered manager is a first level registered nurse who has extensive experience of running and managing a care home for this Walton House Nursing Home DS0000025584.V264271.R01.S.doc Version 5.0 Page 18 client group. The registered manager had also completed a relevant management qualification and continued to meet the professional registration requirements of the Nursing and Midwifery Council so that she keeps up to date with current good practice. Discussion with staff showed that the manager provided leadership and direction so that every one knew what their role was and what was expected of them. Residents spoken to say they saw the manager regularly and that she would be the point of contact if they were unhappy with the service they received, that she would listen and try to help. Residents were happy with the service they received and felt that the home was meeting their needs Records of all financial transactions that take place relating to service users are kept and maintained in order to ensure that everything is correct and accounted for. The home handled some personal allowances for residents and written records of all financial transactions were kept. Any personal spending money brought in by relatives for residents was stored in a safe that only two members of staff had access to. This meant that residents’ money was appropriately safe guarded. Records were kept of any money handled by the home on behalf of residents and receipts kept for any purchases made for them so a clear audit trail of income and expenditure was available if needed. When asked about access to their money residents said, “my family look after my money” and “I ask the staff if I want anything and they sort it out”. The management of health and safety matters could be improved by ensuring that all certificates to confirm that equipment and systems used by the home are up to date. At the time of inspection records showed that the gas safety certificate was out of date and a risk assessment to show how the home manages the risk of legionella was not in place. In addition, although fire safety training had been provided fire drills were infrequent and did not include the night staff. Mandatory training for staff was provided and a number of staff had completed training in moving and handling, fire safety and food hygiene. Some further training courses had been arranged to make sure all staff received the training they need to help them carry out their duties safely. Walton House Nursing Home DS0000025584.V264271.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 2 X X X X X X X STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X X 2 Walton House Nursing Home DS0000025584.V264271.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? YES 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 OP3 Regulation 14(1)(C) Requirement The registered person shall not provide accommodation to a service user at the care home unless, so far as it shall have been practicable to do so until there has been appropriate consultation regarding the assessment with the service user or a representative of the service user. (Previous timescale of 31st August 2005 not met) The registered person shall make arrangements that unnecessary risks to the health or safety of service users are identified and so far as possible eliminated, including those at risk of falling and the safe use of bed rails. (Previous timescale of 31st of August 2005 not met) The registered person shall having regard to the number and needs of service users ensure that – (b) the premises to be used as the care home are of sound construction and kept in a good state of repair externally and internally. (c) Equipment provided at the home for use by service users or persons who work at the care home is DS0000025584.V264271.R01.S.doc Version 5.0 Timescale for action 31/03/06 2. OP8 13(4)(C) 31/03/06 3. OP19 23(2)(B) (C) 31/03/06 Walton House Nursing Home Page 21 maintained in good working order; 4 OP38 23(4)(e) The registered person shall after consultation with the fire authority – (e) ensure, by means of fire drills and practices at suitable intervals, that the persons working at the care home and, so far as practicable, service users, are aware of the procedure to be followed in case of fire, including the procedure for saving life. 28/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Walton House Nursing Home DS0000025584.V264271.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Chorley Local Office Levens House Ackhurst Business Park Foxhole Road Chorley PR7 1NW 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 Walton House Nursing Home DS0000025584.V264271.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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