Inspection on 25/06/07 for Walton Manor

This inspection was carried out on 25th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 09/03/07

Walton Manor 12/12/05

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 Mrs Julie Garrity Key Unannounced Inspection 25th June 2007 9.30 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.V345734.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. Walton Manor DS0000059447.V345734.R01.S.doc Version 5.2 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) waltonmanor@europeanwellcare.com European Wellcare Homes Ltd Jane Scarisbrick Care Home 49 Category(ies) of Old age, not falling within any other category registration, with number (49) of places Walton Manor DS0000059447.V345734.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. 7. 49 Nursing beds or 49 Personal Care beds in the overall number of 49. 11 of the 49 beds are for Intermediate Care of which three beds 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 Personal Care (PC). 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 March 2007 Date of last inspection Brief Description of the Service: Walton Manor Care Home provides care services for older people with personal care and nursing needs. The home also provides 11 Intermediate Care places. Intermediate care is a specialised care provision that is for people to gain independence before they return to their own homes. The intermediate care unit is staffed separately and is well equipped with rehabilitation aids, a domestic kitchen and communal sitting areas The home is a modern building and was built with the purpose of providing a care home. There are 45 bedrooms in total as although the home is registered for 49 residents, four bedrooms were converted to be used as additional facilities on the intermediate care unit, such as a kitchen. The bedrooms are on two floors and are accessible by a passenger lift. 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 the city centre is approximately a fifteen minute drive away. Walton Manor DS0000059447.V345734.R01.S.doc Version 5.2 Page 5 The building is centrally heated, has an enclosed private garden, which is not overlooked there is a car park provision. There is scaffolding around the front of the building. This is due to a fault located in the wall. A building expert has stated that this is not a risk to the residents living in the home. The care Home is owned by European Wellcare Homes Ltd, they own a number of homes that provide a wide variety of care provision. The manager has been in post for several years and is registered with CSCI to be the manager. The home charges accommodation and care fees in line with Local Authority fees,. Fees for private residents are dependent on their assessed needs. Walton Manor DS0000059447.V345734.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out over one day. The site visit started at 9.30 and left at 18.10. A pharmacy inspector Maggy Howells was also included in the site visit. The inspector spoke with 11 residents, 8 staff, 4 relatives, 1 visitor and the manager. The inspector reviewed the records available in the home and CSCI offices. These included care plans, accident records, medication records, staff rota, staff files, maintenance records, menus, activities programme, audits in the home, staff training and information given to residents. Information sent to CSCI by Walton Manor, Social Services and a pre-inspection questionnaire completed by the home were also part of the inspection. Additionally a tour of the premises and the grounds was done. Observations of staff interactions with the residents took place over the day. The inspector followed an inspection plan written before the start of the inspection to ensure that all areas identified in need of review were covered. All of the Key standards were covered in this inspection, these are detailed in the report. Feedback was given to the manager during and at the end of the inspection. The arrangements for equality and diversity were discussed during the visit and are detailed throughout this report. Particular emphasis was placed on the methods that the home used to determine individual needs, promote independence and support to make informed decisions in line with individual choices. What the service does well: Residents are able to make their bedrooms their own space and they are encouraged to bring in items that make it feel like home. Residents spoken with were positive about their own bedrooms and had a number items such as kettles, fridges and microwaves to maintain their independence. Relatives spoken with felt that the staff were approachable and that they were always welcomed to visit their relatives in the home. There is a conservatory, a smaller lounge or the resident’s own bedrooms, which supports the relatives to visit in private. The intermediate care unit, has a service that is specific to helping individual residents return to their own homes. The home has made adaptations in the building to make sure that this can be achieved such as a kitchen with washing facilities and the unit has its own separate staff team. Walton Manor DS0000059447.V345734.R01.S.doc Version 5.2 Page 7 All residents are supported to visit the home before they are admitted and trained staff assess their individual needs in order to determine if those needs can be meet before they move into the home. 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. The summary of this inspection report can be made available in other formats on request. Walton Manor DS0000059447.V345734.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 Walton Manor DS0000059447.V345734.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): Standards reviewed 1, 3, 5 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have the opportunity to visit the home before they move in. Most of the residents who move into the home have their needs assessed in order for the residents to be happy that the home can meet their needs. EVIDENCE: A relative said, “I came to have a look around the home, my mum was in hospital at the time so she couldn’t come and look around. I liked the look of the place and the staff seemed to be really nice. They had a brochure that I looked at and it seemed okay. Since mum moved in she has settled very well and seems to be happy here”. Information was available in the home that explained the services that they gave to the residents and their relatives, this was available in only one print and there was no alternatives for people who may find reading the information Walton Manor DS0000059447.V345734.R01.S.doc Version 5.2 Page 10 in the current format difficult. The manager said that alternatives can be arranged if requested. The home has a unit that supports residents who are only staying for a short time, this is for individuals who may not be ready to return home but hospital care is not needed. This is called intermediate care and has medical professionals involved such as physiotherapists. One resident on this unit said, “The hospital sent me here from home, only staying here for a little bit then I’m going home. I didn’t have a choice as to come here or not, it’s where the hospital sent me. I didn’t have any information given to me until I came here”. Not all the records for the residents staying on the intermediate care unit were available. Staff said they are assessed by the home when they moved in. All potential residents who do not stay on the intermediate care unit have assessments done to make sure that the resident’ needs can be known and the staff can find out if Walton Manor can meet the individual’s needs. Copies of the homes own assessments and those from Social Services were seen on the residents files looked out. One resident said “I talked to the manager after I came here, she told me what it was like. I’m happy”. Walton Manor DS0000059447.V345734.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): Standards reviewed 7, 8, 9 and 10 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. There have been significant improvements in the management of medications, however a number of areas that will further reduce errors and protect the residents remain in need of improvement. Written instructions to staff are not always clear and in some cases not available this will prevent staff from being aware of and able to meet all residents individual needs at all times. EVIDENCE: The manager explained that they had tried very hard to improve the management of medications. This included training to staff, regularly checking by the manager (an audit) to make sure that they had been recorded and given properly. Although the management of medications has significantly improved a review of the medications showed errors had been made which resulted in two residents being given the wrong strength of medication this occurred when staff had in correctly transferred information from one record to another. There were four examples were there were Records were inaccurate Walton Manor DS0000059447.V345734.R01.S.doc Version 5.2 Page 12 for “when required” medications such as painkillers. As such it was not possible for the manager to be sure that the residents had received this as they should. There was also a lack of information noticed in the residents care plans that did not inform the staff as to when these medications were to be used. Medication was not always stored securely. The trolley was left unattended with tablets on top of it during a medication round. Medication must be kept secure at all times in order to protect residents. Where medication had been prescribed on a ‘when required’ basis, nurses did not always have enough written information to make a clinical decision as to whether the medication was needed or not. All residents in the home have an individual care plan, which is meant to detail what their needs are and how to meet those needs. Of the six care plans viewed, all had been reviewed. The plans are in different styles as the home is currently changing the way it records and manages resident’s care needs. This is very confusing, with information in the care plans being difficult to find and has resulted in very large amounts of documentation that staff do not read and residents and their families cannot access easily. Of the six plans viewed, none had been signed by the resident or discussed with the residents. Two residents spoken with had not seen a care plan and one said, “I have no idea what is written down about my needs, I have exercises to do that staff help me with every day, I don’t know if they are written down staff just tell me what it is each day”. Although all six plans had been reviewed, they did not accurately detail all the residents needs or how to meet those needs. Walton Manor DS0000059447.V345734.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): Standards reviewed 12, 13, 14 and 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The needs and choices of residents are not always found out and put into place. The promotion of independence for residents on the intermediate care unit is not always in line with their needs. Staff do not have the skills to fully support and promote independence skills for residents less able to express an opinion. However those residents that are more independent are supported to maintain their independence. EVIDENCE: Residents in the home are asked on admission, about their lifestyle, choice of foods, and preferences of the social activities they would like to participate in. With help from a family member or a staff member, the resident completes a questionnaire, which is used to provide staff with a history of the resident. This information could not be found in any of the care records looked at. Although some staff spoken with have a good understanding of residents personal choices. Other staff were observed to not be aware of good ways to communicate with some residents or to support their individual choices. Walton Manor DS0000059447.V345734.R01.S.doc Version 5.2 Page 14 On the intermediate care unit choices and expectations of the residents are meant to be looked at and the residents are supported in the service to regain and develop independent skills, such as cooking, cleaning etc. These are to be written in either the resident’s plan or the occupational and physiotherapy records. However daily activities were not reflected in the plans seen. One resident on the unit said, “No I don’t make my own drinks or do any cooking, house work, staff take good care of me”. A notice board is available that is completed on a daily basis that details what activities are available that day. When residents participate in organised activities, it is recorded in the activities records available in the lounge. This records what activities residents have done. It does not look at the activities that the residents would like to do or how to provide individual activities for residents that don’t wish to do group activities. Several residents were spoken with said, “I have my crocheting, I enjoy that a lot”, “I don’t like big activities”, “there’s not a lot to do beyond watching the television” and “I have lots of my stuff here, can get a cup of tea when I want. Visitors are encouraged in the home and residents can entertain their visitors, in the communal lounges, or in their own bedroom. Several visitors were spoken with during the site visit all said that they felt that their loved one was well cared for, happy and safe in the home. One relative said “staff are very welcoming, its nice to get to the home and have them greet me, they take such good care of her”. The menus in the home show that a good choice of different foods is provided. Residents spoken with confirmed this comments such as “I usually have what’s offered but if I don’t like it I do get to have something else. A copy of the menu is available on each of the dining tables and is also written on a chalkboard in the dining room. However both these are in the dining room so residents who do not sit here are not reminded of what is available that day. Presentation of food in the home was viewed and the opportunity to make sure that the meals look nice is taken. This includes liquidized meals were the chef makes sure each item is dealt with separately so that the residents can enjoy their food. Walton Manor DS0000059447.V345734.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): Standards reviewed 16 and 18. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The residents feel their views are being listened to and acted upon. The home has a policy and training programmes for protecting adults that is designed to protect the residents from potential abuse. However staff do not always understand this process or fully act on concerns identified. EVIDENCE: The manager keeps a record of all concerns raised with her and investigates these correctly this is then used to make sure that the issue is fixed and stopped from happening again. Records in the home showed that all the complaints formally received had been investigated. Staff do not always pass onto the manager information that is needed for her to review and make sure that concerns can be addressed. Regular residents meetings also support residents to raise their concerns, although they have been given training in recognising and reporting complaints this does not always happen and will prevent the manager from dealing with concerns properly. A copy of how to raise concerns is available in the homes main entrance. Staff spoken with know how to raise concerns but not all are aware of who is responsible for dealing with more serious concerns or how the home would deal with it. Walton Manor DS0000059447.V345734.R01.S.doc Version 5.2 Page 16 All staff had received training in protecting vulnerable adults and in recognising signs and symptoms of potential abuse. This was seen in the training records and the staff also discussed the training they had recently had. Walton Manor DS0000059447.V345734.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): Standards reviewed 19, 20, 22, 23, 24, 25 and 26. Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The standards of decoration and furnishing in the main areas of the home have continued to deteriorate. There is little evidence of improvement through maintenance or future planning. Many of the residents own bedrooms have been made personal to them, with familiar items and furniture. The main public areas of the home do not present as an attractive and homely place to live. EVIDENCE: A review of the home showed that the main areas such as dining area, lounge, bathrooms and corridors are in need of redecoration and refurbishment. This includes carpeting that is beginning to stain, furniture that is worn and damage to radiators and bathing facilities that has not been addressed. The manager does do regular audits on the environment in order to make sure that the Walton Manor DS0000059447.V345734.R01.S.doc Version 5.2 Page 18 internal decoration can be identified. However this has not prompted any redecoration or refurbishment of the home. Externally the home has a significant amount of scaffolding around the front of the building. Over a year ago a fault with this wall was identified. The home has discussed the issue with the local council and structural survey has been done that details there is no risk to the residents. However this issue has progressed very slowly and there is still no date as to when the repairs will be done. There is no formal maintenance plan that would detail when or how the home will be redecorated or the needed repairs will be done. All of the bedrooms in the home are single occupancy, and most of the residents have personalised their bedrooms with pictures and memorabilia. Residents spoken with said, “I don’t like to leave my room. I have everything that I need in the room. My family like this room as well, they brought all my things in from home”. The kitchen area was clean and tidy. A regular cleaning scheduled is in place to make sure that the kitchen staff can stay on top of all the cleaning and make sure that it gets done. Fridge and freezer temperatures are recorded and food stores are managed to make sure that food does not go out of date. There is equipment in the home that is not maintained appropriately this includes bedrails, wheelchairs, call system and assisted baths in one of the bathrooms. Not maintaining equipment appropriately does not meet the individual residents needs. Walton Manor DS0000059447.V345734.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): Standards reviewed 27, 28, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff recruitment has improved staff now have an up to date file and any missing items such as police checks have been located and put into place. Staffing levels are in place that meet residents needs, however these are not always maintained. Staff do not always demonstrate the skills that they need to support the residents as individuals. EVIDENCE: Staff were observed during the day not to rush residents and to approach their work in a relaxed manner. The residents, relatives and staff said that there is enough staff available in the home. Staffing levels are monitored and staff put into place to meet the needs of the residents. This has recently resulted in more staff being available and is very good practice. However this is not always maintained and on occasion there can be less staff in the home than the amount being identified to meet residents needs. Each member of staff has a file in place that identifies the training that they are to receive or have received recently. These are very well organised and show how staff are being given the training that they need in order to do their Walton Manor DS0000059447.V345734.R01.S.doc Version 5.2 Page 20 job. Supervision is also in place. However observations showed that the staff’s ability to communicate with residents did not always meet their individual needs. Staffing recruitment files were reviewed had been significantly updated to make sure that all staff are recruited properly before they can work in the home. Walton Manor DS0000059447.V345734.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): Standards reviewed 31, 32, 33, 35, 36 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager has a good understanding of the areas of the home that are in need of improvement and progress has been made from the last site visit to increase quality. There remain areas within the home that need to be increased in quality, as yet the home does not have a plan as to how they will achieve this. There are arrangements in place to promote residents, interests, safety and welfare. However these are not sufficient to meet their individual needs and promote their interests. Walton Manor DS0000059447.V345734.R01.S.doc Version 5.2 Page 22 EVIDENCE: One relative said, “This is a nice home, it’s near to where we live so we can visit easily. The staff are always welcoming and the manager is very approachable”. Mum is happy here, she likes her room, has friends and is settled”. The manager has worked in the home for several years a new deputy manager has been recruited and is assisting in a number of management duties such as quality audits and staff supervision. Staff expressed confidence in the manager and deputy. One member of staff said, “The manager and deputy are very good.” Regular residents, relatives and staff meetings are held and the minutes of these meetings are available for those who are interested or need this information. One resident said, “I like living here, there are things I would like to do, like get out and about more. But that’s not always possible. I don’t want to go to a meeting. I’ve not seen anything about a meeting. These are nice girls who try very hard”. The organisation that owns the home has a number of quality assurance systems in place designed to identify strengths and areas of improvement. These included audits, such as medications, care, plans and environment. However environmental and care plan audits of the home are not sufficient to make positive changes and increase the quality in these areas and the home does not have a plan that would promote quality. Where possible, residents look after their own financial affairs. Families of residents are consulted as regards bank accounts of their relatives. Records for the funds held by the home were viewed. There is now a float available for residents to access small amounts of money at any time if they needed it and larger amounts must be ordered from the head office. The home’s certificates of insurance and maintenance of machinery, gas, electricity, fire equipments, lifts were in date and valid, including the home certificate of Employer’s Liability Insurance Certificate. The maintenance man regularly looks at the emergency lighting in the home on a monthly basis, the call system on a monthly basis and the fire alarms. However two bedrooms did not have a call system that had the leads attached to the wall that make its possible for residents to summon the staff, when they can not physically get up and reach the button on the wall. There was no explanation for this and prevents the residents using those bedrooms from summoning help if they needed it. Risk assessment in the home for individual residents are not always accurately completed by the staff. In two cases staff had placed spare mattresses on the residents bedroom floors without explanation. The manager said this was to prevent injury if they feel out of bed. Risk assessments regarding the use of bedrails do not follow best practice to prevent injury to residents. Walton Manor DS0000059447.V345734.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 2 x 3 x 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 2 2 2 2 2 2 3 3 2 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 2 x 3 3 x 2 Walton Manor DS0000059447.V345734.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 OP7 Regulation 15 (1) (2) (a) (b) (c) (d) Requirement Residents care plans need to be reviewed to clearly identify the residents needs and how to meet those needs. Consultation with residents and/or their relatives needs to occur in order that all individuals can be kept informed of how the residents needs will be meet and checked that the resident agrees to this action. Medication can only be given in accordance with the prescriber’s instructions. The procedure for transferring medication from one month to the next must be reviewed in order to minimise the risk of medication errors. Resident’s daily routines, personal preferences and choices need to be determined. This information needs to be readily available to influence the personal support of the residents and promote the routine of the home. This is of particular relevance with resident’s menu choices and the activities available. DS0000059447.V345734.R01.S.doc Timescale for action 25/10/07 2. OP9 13(2) 25/07/07 3. OP12 16 (2) (i) (m) (n) 25/10/07 Walton Manor Version 5.2 Page 25 4. OP16 22 (1) (2) (3) 5. OP19 23 (2) (b) (d) 6. OP27 18 (1) (c) (i) 7. OP38 13 (4) (b) (c) The current arrangements for reporting complaints and serious incidence to the manager needs to be looked at. The management team needs to be made aware of all complaints in order that they can be dealt with. Staffs awareness of how to raise concerns and how different concerns will be dealt with needs to be increased in order to fully safeguard the residents. The Environment needs to be reviewed to determine the maintenance, redecoration and refurbishment requirements. A plan that details how and when the quality of the environment will be improved needs to be developed in order that the residents can be aware of the redecoration and refurbishment. A homely, warm, welcoming environment is essential to a positive sense of well being for residents. Staff training and skills needs to reviewed. A plan needs to be developed as to how the staff are to be developed in order that they have the skills to meet the assessed needs of residents. Risk assessments that provide staff with the means to identify the potential risk to residents and actions that they need to take need to be in place and kept up to date as well as reviewed. Where actions are taken from an identified risk these need to be included in the risk assessments. 25/07/07 25/08/07 25/08/07 25/07/07 Walton Manor DS0000059447.V345734.R01.S.doc Version 5.2 Page 26 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 OP3 Good Practice Recommendations The assessments used by the home need be reviewed to make sure that residents full needs can be identified before admission and used to form accurate individual care plans. All care staff need to be involved in the care plans in the home and to regularly access and read them. Criteria for the administration of when required and variable dose medication should be clearly defined and recorded for all residents Verbal dose changes and new medication should be accurately entered onto Medication Administration Record charts with staff signature, date and authority where appropriate. Verbal dose changes should be confirmed in writing by the prescriber and clearly documented. Medicines need to be maintained securely at all times. Staffing levels should be monitored on a monthly basis to determine that the correct amount of staff are available. The staffing levels required need to be met at all times in order to support the residents appropriately. The registered person should review the current audits and policies and procedures in the home to make sure that they increase the quality of the service provided. These should also indicate what actions are to be taken from the findings of the audits. This will allow for quality areas to be identified and action taken to resolve any issues. An improvement plan that identifies how to increase the quality of the service needs to be developed. 2. 3. OP7 OP9 4. OP27 5. OP33 Walton Manor DS0000059447.V345734.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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 Walton Manor DS0000059447.V345734.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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