Inspection on 12/12/05 for Walton Manor

This inspection was carried out on 12th 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 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

Walton Manor 04/11/08

Walton Manor 09/04/08

Walton Manor 25/06/07

Walton Manor 09/03/07

Walton Manor 09/09/05

Walton Manor 07/10/04

Walton Manor 14/06/04

Walton Manor 17/03/04

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 Manor 23 Luton Grove Walton Road Liverpool Merseyside L4 4LG Lead Inspector John McCabe Unannounced Inspection 12th December 2005 09:30 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 Manor DS0000059447.V272289.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 Manor DS0000059447.V272289.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Walton Manor Address 23 Luton Grove Walton Road Liverpool Merseyside L4 4LG 0151 298 1605 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) European Wellcare Homes Ltd Mrs Phillipa Hoxha Care Home 49 Category(ies) of Old age, not falling within any other category registration, with number (49) of places Walton Manor DS0000059447.V272289.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. 7. 8. 49 Nursing beds and 49 Personal Care beds in the overall number of 49 11 of the 49 beds are for Intermediate Care of which one bed may accommodate a person under the age of 65 years old To accommodate one named male person under 65 years of age within the overall total of 49 (PC) This service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection To accommodate one named female person under 65 years of age within the overall total of 49(N) To accommodate one named male person under 65 years of age for respite care from 5 November 2004 to 11 November 2004. To accommodate one named person under 65 years of age for respite on a regular planned basis only within the overall total of 49 residents To accommodate one named person under 65 years of age for respite nursing care 9th September 2005 Date of last inspection Brief Description of the Service: Walton Manor Care Home is a registered service with the CSCI providing care services for older people with personal care and nursing needs. The home also provides 11 Intermediate Care beds promoting short-term rehabilitation services for service users encouraging their return to home. The home provides 49 beds on two floors and as a purpose built home it is part of a larger care home group named European Wellcare Nursing Homes Ltd. The intermediate care unit is staffed separately and is well equipped with rehabilitation aids, a domestic kitchen and communal sitting areas. The ground floor is spacious with a large lounge and conservatory. There are designated smoking areas within the home. Each floor has its own dining area. The home is situated in a residential area of Walton in Liverpool, close to local amenities and shops. The area is well served by public transport (mainly buses); the city centre is approximately a fifteen-minute drive away. The building is centrally heated, has an enclosed private garden, which is not overlooked and contains fruit trees, there is a car park provision. Walton Manor DS0000059447.V272289.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on the 12/12/05 and commenced at 0930 hours and took 4 hours. The acting manager of the home was present throughout the inspection period. Personal files of both residents and staff were inspected, and a full tour of the building took place, which included the kitchen, laundry, and resident’s bedrooms. Staff and residents were spoken with as regards their view about the care home. The care home was clean tidy, and had adequate staffing levels to care for the residents. What the service does well: What has improved since the last inspection? What they could do better: The home’s environment, especially the large ground floor lounge, needs new floor covering and redecoration, to make the room brighter and more homely in appearance. The communal toilet on the ground floor is out of order and needs repairing. Furniture in the conservatory needs replacing as it compromises the homes infection control policy. Walton Manor DS0000059447.V272289.R01.S.doc Version 5.0 Page 6 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 Manor DS0000059447.V272289.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 Manor DS0000059447.V272289.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): 1,2,3,4,5,6 The Home’s Statement of Purpose is up to date and ensures that the home stays within the category of resident agreed with the commission, and prospective residents have some knowledge of the home before they decide to move in on a permanent basis. The residents’ pre-admission nursing/personal care assessment documentation is relevant and comprehensive; this ensures that the skill mix of the workforce in the home can meet the resident’s identified care needs. EVIDENCE: All residents in the home are provided with a statement of terms and conditions, plus a contract when they move in to the home on a permanent basis. Residents are able to visit the home or have an overnight stay before they move in on a permanent basis. The home’s senior nurses undertake a nursing pre admission assessment on residents before they are admitted to the home, to ensure care needs are Walton Manor DS0000059447.V272289.R01.S.doc Version 5.0 Page 9 Identified. Other health care professionals known to the resident are also involved in the assessment Care staff in the home undertakes mandatory and specialist care training, which is ongoing. Specialist care training includes dementia, stroke, diabetes, and challenging behaviours. This training is to help ensure that the assessed and changing care needs of the residents are met. The home has a designated intermediate care unit for eleven residents. The Unit contains equipment and facilities to help deliver intensive rehabilitation to clients to enable them to return home. Any resident admitted to the unit, that are subsequently assessed as needing long-term care, will be treated as a new admission with assessment and care planning arrangements made before admission to long-term care. This client group is encouraged to maintain independence with the intention that the short-term rehabilitative support given enables the service user to return to their own home. This care involves a multi-disciplinary approach including Occupational Therapy, Physiotherapy and designated care staff with the appropriate skills and competencies to achieve this aim. A full time first level nurse manages the unit. Walton Manor DS0000059447.V272289.R01.S.doc Version 5.0 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): 7,8,9,10,11. Residents’ individual health, personal and social care needs are clearly recorded, and provides care staff the information they need to meet the residents care needs. Personal support in the home is offered in such a way as to promote and protect the resident’s privacy, dignity and independence. EVIDENCE: All residents in the home have an individual care plan, which is formulated on admission to the home, reviewed by the senior nurses on a monthly basis. Daily health records are documented for each resident, this includes any critical incidences plus any visits from GPs, specialist nurses etc. Most of the care staff have undertaken training on tissue viability. The Primary Care Trust (PCT) tissue viability nurse will visit the home at any time if needs arise. Photographic and skin mapping evidence for pressure sores is recorded in the resident’s personal file, so as the healing process of the sore can be checked. Walton Manor DS0000059447.V272289.R01.S.doc Version 5.0 Page 11 All residents in the home can access their NHS entitlements; which includes, dentists, opticians, and chiropodist. Care staff will accompany residents for hospital or clinic appointments. GPs visit residents when needs arise. No resident in the home self medicates, all medications for residents are administered by the nurses in the home. The protocols for the receipt, storage, disposal, and documentation of medications in the home are in accordance with the National Minimum Standards (NMS). However, the acting manager should discourage nursing staff from re writing medications scripts and using Latin abbreviations for daily medication doses. Residents “Unwanted medications” are recorded by two first level nurses and then taken from the care home by the supplying pharmacy. On the day of the unannounced inspection, residents told the inspector that staff in the home were always courteous, respectful, and maintained their privacy and dignity when doing personal care. Some residents have asked for same gender carers to undertake personal care with them; staffs always fulfil this request. Walton Manor DS0000059447.V272289.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Residents are encouraged to exercise choice and to have flexibility how they spend their day in the home. They also pursue leisure activities according to their choice and preferences. This allows independence and individuality for each resident. Residents receive a varied nutritious diet that is in accordance with their preferences. EVIDENCE: Residents in the home are asked on admission, about their lifestyle, choice of foods, and choices and preferences of the social activities they would like to participate in. On admission to the home the resident with help from a family member completes “Getting to know you” questionnaire, which is a “Work life History” of the resident, and includes schooling, work, hobbies, food likes and dislikes etc. This information is used to facilitate organised activities for the resident. When residents participate in organised activities, it is recorded in the resident’s personal file. Walton Manor DS0000059447.V272289.R01.S.doc Version 5.0 Page 13 The home employs an activities coordinator for 24 hours per week who on the day of the inspection was taking residents out to the Bootle Cricket Club for Xmas lunch and entertainment. The home had organised “Raffles” to pay for the resident’s lunch. The activities coordinator also engages the residents on the Intermediate Care unit, especially for cooking skills, passive physical exercises, and other relevant occupations before their discharge home. Other care staff also participates in the activities for the residents. The residents had helped care staff to decorate the home for the Christmas celebrations. The home activities coordinator would benefit from contacting the National Association of Patient Activities (NAPA), for information, and literature of how to organise and document residents organised social activities. Visitors are allowed in the home at any reasonable time of day, and residents may entertain their visitors, in the communal lounges, or in their own bedroom. The residents informed the inspector that they enjoyed the variety of food in the home, and were looking forward to Lamb Casserole or Poached Haddock for their lunch. Walton Manor DS0000059447.V272289.R01.S.doc Version 5.0 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): 16,17,18. The home has a satisfactory complaints system, with evidence that residents feel their views are being listened to and acted upon. The homes policy and training programmes for POVA, and Whistle blowing, ensure that the homes residents are protected from any abuse. EVIDENCE: There have been no internal complaints, and no complaints were reported to the commission since the last inspection. Many of the residents are encouraged to use their postal votes in the local or General Elections. The care home has up to date information on the Protection of Vulnerable adults, this information is communicated to new employees on their induction course. On the day of the inspection there was evidence that many of the staffs in the home had undertaken training on POVA protocols, and the Whistle Blowing Policy. Walton Manor DS0000059447.V272289.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26. More effort is needed to improve the interior of the home, especially the ground floor lounge, to ensure a comfortable and pleasant environment for the residents. EVIDENCE: The home is clean and tidy and efforts are being made by the homes handyperson to improve the fabric and decor of the home. However, the ground floor lounge is dull and needs redecoration and the carpet is worn and is in need of replacement. This was legal requirement in the last inspection report; the requirement does not have to be complied with till the 31/12/05. A resident’s communal toilet is out of order (immediately opposite the main lounge). This is causing inconvenience to residents and staff. The furniture in the conservatory is so damaged that it will compromise the homes infection control policies. The furniture should be repaired or renewed. Walton Manor DS0000059447.V272289.R01.S.doc Version 5.0 Page 16 The homes laundry has a backlog of resident’s clothes and bedding waiting to be washed, one of the two washing machines is broken, and one of the two dryers is also broken. The machines have been out of order for at least one month whilst spare parts are bought. Staff in the laundry are frustrated, as the backlog of soiled laundry piles up and begins to smell. Corporate management of the home should give priority to repairing the machines in the laundry, so as to avoid inconvenience to residents and staff. A discarded bed mattress has been placed in the garden area of the home, no reason could be offered to the inspector why this soiled bedding was among the trees and flower beds. Though unsightly, the mattress could be a potential home for vermin or cats and therefore should be removed, to the appropriate rubbish tip. All of the bedrooms in the home are single occupancy, and most of the residents have personalised their bedrooms with pictures and memorabilia. All communal bathrooms and toilets in the home provide privacy, and meet individual needs. The homes infection control policy includes the prevention and spread of Methicillin Resistant Staphylococcus Aureus (MRSA) and Hepatitis B. Walton Manor DS0000059447.V272289.R01.S.doc Version 5.0 Page 17 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. The standard of vetting and recruitment practices is robust with the appropriate checks being carried out on all new staff. This helps ensures that the residents are not put at risk. EVIDENCE: There is always a first level nurse on duty, who is assisted by care staff and ancillary staff. The home recruitment policy is robust and in accordance with the National Minimum Standards (NMS). All staff in the home has an up to date CRB/POVA enhanced certificate, so ensuring the safety of the residents. The inspector evidenced the Personal Identification Numbers (PINS) of all the registered nurses in the home, which was documented on Nursing Midwifery Council (NMC) stationary. All PINS were in date and valid. Mandatory and specialist training for all staff is ongoing in the home; i.e. diabetes, dementia, cognitive impairment. This was evidenced in the personal files of the staff. Walton Manor DS0000059447.V272289.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,37,38. Staff morale is high in the care home, resulting in an enthusiastic workforce that works positively with residents to improve their whole quality of life, plus the turnover of care staff is low. The home regularly reviews aspects of its performances through a good programme of self-review and consultations, which include seeking the views of residents, staff and relatives. EVIDENCE: An experienced first level nurse with many years of care home management manages the home; previously she was the deputy manager of the home. The acting manager has enrolled (2006) on a NVQ Level 4 care programme. Walton Manor DS0000059447.V272289.R01.S.doc Version 5.0 Page 19 Staff and residents told the inspector that, the home was run in an open, positive transparent way, both staff and residents have regular meetings with the manager; the meetings are minuted and actioned upon. All staff in the home have documented supervision six times per year, this ensures that all staffs have the opportunity to discuss with the manager, and other senior nurses. Any issues, which can effect or improve the care for the residents. Documented supervision of all staff gives the staff and managers opportunities to discuss their own /or identified training needs. Currently, there is a full time vacancy for a carer on night duty. Where possible, residents look after their own financial affairs. Families of residents are consulted as regards bank accounts of their relatives. The resident, family member, and Wellcare agree on a written contract on how the interest on small bank accounts of residents are utilised. The home’s certificates of insurance and worthiness for machinery, gas, electricity, fire equipments, lifts were in date and valid, including the home certificate of Employer’s Liability Insurance Certificate. The home has qualified First Aid staff on duty 24 hours per day. All staff and residents records are kept secure in accordance with the Data Protection Act 1998. Thus protecting confidentiality. Walton Manor DS0000059447.V272289.R01.S.doc Version 5.0 Page 20 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 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 2 2 3 3 3 3 2 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 3 3 3 3 3 3 Walton Manor DS0000059447.V272289.R01.S.doc Version 5.0 Page 21 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. Timescale for action No. Standard Regulation Requirement The registered person must ensure that the soiled bed mattress is removed form the garden area. The registered person must ensure that the fabric furniture in the Conservatory is replaced or repaired so it does not comprise the Infection Control policies of the home. The registered person must ensure that the resident’s communal toilet on the ground floor is repaired, so as not to cause inconvenience of residents or staff. 1 OP19 23 31/01/06 2 OP20 23 31/01/06 3 OP21 23 31/01/06 4 OP26 23 The registered person must ensure that the washing machine and dryer are repaired so as not 31/01/06 to comprise the Infection Control policies of the home. Walton Manor DS0000059447.V272289.R01.S.doc Version 5.0 Page 22 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 OP19 Good Practice Recommendations It is recommended that a lock be fitted to the hairdressers room in the care home. Walton Manor DS0000059447.V272289.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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. 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