CARE HOMES FOR OLDER PEOPLE
Walton Manor 187 Shay Lane Walton Wakefield WF2 6NW Lead Inspector
Susan Vardaxi Unannounced Inspection 28th February 2006 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 Manor DS0000062365.V284646.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Walton Manor DS0000062365.V284646.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Walton Manor Address 187 Shay Lane Walton Wakefield WF2 6NW 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) 01924 249777 01924 249777 Walton Manor Ltd Ms Linda Armitage Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (36) of places Walton Manor DS0000062365.V284646.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Can provide care and accommodation for three named service users with physical disabilities, category PD (E) 26th September 2005 Date of last inspection Brief Description of the Service: Walton Manor is a privately owned care home for older people situated in Walton village on the outskirts of Wakefield. The home is set back from the road in large well-maintained grounds, having gardens to the front and the rear. There is sufficient car parking space available. The home offers accommodation for 36 people in single and double bedrooms over two floors most of which have en-suite facilities. There are communal areas of different sizes that are comfortably furnished for the service users. Service users are registered with several local GP practices and district nurses support the care team at Walton Manor in the care of the people who live there. Walton Manor DS0000062365.V284646.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place on 28th February 2006 over a period of 5 hours. The registered manager was on holiday, the assistant manager arrived at the home shortly after the inspection commenced and assisted with the inspection process. The process included discussions with some service users, a visiting district nurse, some staff, a walk round some areas of the building and grounds and checking some of the records held at the home. Thanks are extended to the service users, staff, assistant manager and all concerned for their hospitality and cooperation throughout the day. What the service does well: What has improved since the last inspection? What they could do better:
The standard of care is generally good. To ensure that the interests of service users are fully protected, the staff must receive appropriate medication and adult protection training. The assistant manager was unable to provide written confirmation that a POVA first check had been completed for a member of staff. Some service users appeared to have declined in health, becoming frailer. Dementia care training is needed to ensure the needs of service users are fully met. A recommendation relating to the provision of seated weighing
Walton Manor DS0000062365.V284646.R01.S.doc Version 5.1 Page 6 scales was made at the last inspection. This type of equipment has not been provided. A room giving privacy to hairdressing would be beneficial to ensure service users’ privacy and dignity is promoted. This was discussed with one of the providers who said they would look into how this could be achieved. 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 DS0000062365.V284646.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Walton Manor DS0000062365.V284646.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The pre admission assessment and admission arrangements are satisfactory. EVIDENCE: Service users’ records show that pre admission assessments are completed and a letter is sent to the service users confirming that the home can meet their needs. Walton Manor DS0000062365.V284646.R01.S.doc Version 5.1 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): 7,8,9,10,11 Staff develop with people, a personal plan that details their needs and preferences, which sets out how they will be met, in a way that the individual finds acceptable. Despite some improvements in the way medication is administered, appropriate staff training on medication is required to ensure that the best interests of service users are fully protected. EVIDENCE: The service user plans that were seen were found to be appropriate and detailed their needs. These plans included information about choices and preferences. Risk assessments, nutritional assessments and records of weight checks had been kept, however the provider said that the type of weighing scales recommended at the last inspection had still not been purchased. The records seen showed that GPs, district nurses, chiropodists, continence advisers and other health professionals visit when required. A visiting district nurse said they did not have any problems regarding the care at the home. Some medication records were seen and an improvement in the recording since the last inspection was noted. Medication training had not been provided however the assistant manager said this had been arranged and was due to
Walton Manor DS0000062365.V284646.R01.S.doc Version 5.1 Page 10 commence in March 2006. The medication storage arrangements were not checked on this occasion. A visiting hairdresser was seen to dry the hair of service users while they sat in the hallway. The assistant manager said that she and the manager have had Palliative Care training and arrangements have been made for staff to have training in April 2006. The records relating to this were not inspected on this occasion. Walton Manor DS0000062365.V284646.R01.S.doc Version 5.1 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): 15 The menus show that service users receive a wholesome appealing diet in pleasing surroundings at times convenient to them. EVIDENCE: The lunch menus offer choices of fish, or meat, three types of vegetables and potatoes. The evening meals consist of soup, a hot meal or salad or three varieties of sandwiches. Nutritional assessments had been completed on the records seen. There are small pleasant dining areas for service users to dine in or meals can be served in service users’ bedrooms if required. Walton Manor DS0000062365.V284646.R01.S.doc Version 5.1 Page 12 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): 17,18 The evidence shows that service users have their legal rights protected and are enabled to exercise their legal rights directly and participate in the civic process if they wish. To ensure that all the staff are fully aware of issues relating to abuse, appropriate training in adult protection must be provided for all staff. EVIDENCE: The assistant manager said all service users are registered on the electoral register, their preferred method of voting is always respected and they are always given information leaflets left at the home by election candidates. The ancillary staff who were spoken with said they had not had adult protection training. Walton Manor DS0000062365.V284646.R01.S.doc Version 5.1 Page 13 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): 20,23,25 The building provides a very high standard of homely accommodation for service users to live in. EVIDENCE: The communal areas seen are decorated, furnished and cleaned to a very high standard and provide a very pleasant, comfortable environment. The service users’ bedrooms seen were clean, very well decorated and furnished with many of their own possessions. The kitchen was seen to be clean and tidy. The environmental health officer was completing a food hygiene inspection at the time of this visit. Walton Manor DS0000062365.V284646.R01.S.doc Version 5.1 Page 14 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): 29,30 Service users could be put at risk if staff commence employment without the appropriate recruitment checks. Manual handling, dementia care and adult protection training would ensure service users’ health needs are fully met. EVIDENCE: A newly recruited member of staff’s file showed that an application form had been completed, two satisfactory references had been received however records showed their induction commenced four days before the CRB check had been received. The assistant manager said the POVA first check had been completed prior to the induction however she was unable to confirm this with the appropriate documentation, as the record was not available. Another staff file seen showed that all checks had been completed prior to them starting work. Staff training records seen and showed ten staff have NVQ 2 & 3 qualifications, some mandatory training had been provided and Palliative care training is planned for April 2006. The assistant manager said a member of staff was planning to attend infection control training and will cascade the training throughout the staff team. It was observed throughout the visit that some service users have dementia type conditions. Staff have not had training in dementia care. Some of the staff, as mentioned before, have not received adult protection training. Records were seen showing some manual handling training updates had been completed, one member of staff said they had not had manual handling training.
Walton Manor DS0000062365.V284646.R01.S.doc Version 5.1 Page 15 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, 38 To ensure the financial interests of all service users are protected, two signatures should be obtained for all financial transactions made on behalf of the service user. The fire officer’s advice regarding the storage arrangements for oxygen should be followed to ensure service users’ safety. EVIDENCE: Some service users’ records for money held by the home, which is used to pay for hairdressing, chiropody etc were seen, and no discrepancies noted. Receipts had been obtained, however two signatures had not always been obtained when transactions had been made. An oxygen cylinder was seen in close proximity to electrical equipment. Since the inspection the assistant manager has verbally confirmed that the fire officer’s advice has been requested as recommended at the inspection. Four ancillary staff spoken with said that fire drills are held and training provided. The environmental health officer was completing a food hygiene inspection at the time of this visit.
Walton Manor DS0000062365.V284646.R01.S.doc Version 5.1 Page 16 Training records showed that arrangements have been made for six staff to attend food hygiene and infection control training. A member of staff is planning to attend meetings in respect of health protection and there are plans for her to cascade the training throughout the staff team. Records were seen showing some manual handling training updates had been completed, one member of staff said they had not had manual handling training. The areas of broken floor covering in the kitchen observed at the last inspection had been repaired as recommended. Walton Manor DS0000062365.V284646.R01.S.doc Version 5.1 Page 17 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 3 18 1 X 3 X X 3 X 3 X STAFFING Standard No Score 27 X 28 X 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 2 X X 2 Walton Manor DS0000062365.V284646.R01.S.doc Version 5.1 Page 18 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 OP8 Regulation 14(1) Requirement The registered person must ensure that weighing equipment be provided that is suitable for their abilities and will enable all service users to be weighed on a regular basis. The registered person must ensure that all staff receive training appropriate to the work that they perform. This is to include appropriate medication training for all staff who administer medication. The registered person must ensure that appropriate recruitment checks are completed (CRB and POVA first checks) prior to staff commencing employment. Records of these checks must be available for inspection purposes. The registered person must make arrangements, by training staff or by other measures, to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse.
DS0000062365.V284646.R01.S.doc Timescale for action 30/04/06 2 OP9 13(2) 18 (1)(c) (i) 30/04/06 3 OP29OP18 17(1)(a) Schedule 3 01/04/06 4 OP18 13(6) 30/05/06 Walton Manor Version 5.1 Page 19 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP30 OP35 OP38 Good Practice Recommendations Dementia care and manual handling training should be provided for all staff (as appropriate to their role) to ensure service users’ needs are appropriately met. Two signatures should be obtained on the records for all financial transactions made by the home on service users’ behalf. The pharmacist advice regarding the arrangements for ensuring the safe storage of medications should be followed. Walton Manor DS0000062365.V284646.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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