Inspection on 09/09/05 for Walton Manor

This inspection was carried out on 9th September 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 12/12/05

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 L4 4LG Lead Inspector John McCabe Unannounced 9 September 2005 09:30 th 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 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 F52_F02_s59447_WaltonManor_v248951_090905_Stage_4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Walton Manor Address 23 Luton Grove Walton Road Liverpool L4 4LG 0151 298 1605 Telephone number Fax number Email 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 CRH 49 Category(ies) of OP - 49 registration, with number of places Walton Manor F52_F02_s59447_WaltonManor_v248951_090905_Stage_4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1) 49 Nursing beds and 49 Personal Care beds in the overall number of 49. 2) 11 of the 49 beds are for Intermediate Care of which one bed may accommodate a person under the age of 65 years old. 3) To accommodate one named male person under 65 years of age within the overall total of 49 (PC). 4) This service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 5) To accommodate one named female person under 65 years of age within the overall total of 49(N). 6) To accommodate one named male person under 65 years of age for respite care from 5 November 2004 to 11 November 2004. 7) 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. Date of last inspection 7 October 2004 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 and there is a car park provision. Walton Manor F52_F02_s59447_WaltonManor_v248951_090905_Stage_4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection commenced at 0930 hours and took 5 hours. The registered 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. 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 cooler machine in the homes kitchen needs to be replaced, to ensure safety of foodstuffs. Chemicals in the home should be locked away and secure so to prevent any potential accidents of residents, especially those with cognitive impairment. Walton Manor F52_F02_s59447_WaltonManor_v248951_090905_Stage_4.doc Version 1.40 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 F52_F02_s59447_WaltonManor_v248951_090905_Stage_4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Walton Manor F52_F02_s59447_WaltonManor_v248951_090905_Stage_4.doc Version 1.40 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 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 Identified. Other health care professionals known to the resident are also involved in the assessment. Walton Manor F52_F02_s59447_WaltonManor_v248951_090905_Stage_4.doc Version 1.40 Page 9 Care staff in the home undertake mandatory and special care training, which is ongoing, to 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 F52_F02_s59447_WaltonManor_v248951_090905_Stage_4.doc Version 1.40 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 standard(s) 7,8,9,10,11. Resident’s 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 F52_F02_s59447_WaltonManor_v248951_090905_Stage_4.doc Version 1.40 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). Residents “Unwanted medications” are recorded by two first level nurses and then taken from the care home by the 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; staff always fulfills this request. Walton Manor F52_F02_s59447_WaltonManor_v248951_090905_Stage_4.doc Version 1.40 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 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. The home has employed an activities coordinator for 24 hours per week; some residents were off on a barge trip on the day of the inspection. 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. Walton Manor F52_F02_s59447_WaltonManor_v248951_090905_Stage_4.doc Version 1.40 Page 13 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 fish and chips for their lunch. Walton Manor F52_F02_s59447_WaltonManor_v248951_090905_Stage_4.doc Version 1.40 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 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 F52_F02_s59447_WaltonManor_v248951_090905_Stage_4.doc Version 1.40 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 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 the carpet is worn and needs redecoration of and renewed floor covering. During the tour of the home, the hairdresser’s room was open (no lock fitted to the door). The room contained various paint products, and a large container of sealant. These products are potentially dangerous especially if ingested. Some of the residents have varying degrees of cognitive impairment, and are mobile, and could gain access to these products. Walton Manor F52_F02_s59447_WaltonManor_v248951_090905_Stage_4.doc Version 1.40 Page 16 All chemicals in the home should be locked away, and for other safety reasons the hairdresser’s room should be lockable The kitchen was clean and tidy, however the cooler machine was not worker in the “cool room”. The chef told the inspector it had been reported to the maintenance man. The machine was not working during the last inspection, (October 2004) obviously it now needs replacing to ensure foodstuffs for residents is not compromised. All of the bedrooms in the home are single occupancy, and most of the residents have personalised their bedrooms with pictures and memorabilia. All bathrooms and toilets in the home provide privacy, and meet individual needs. The homes updated infection control policy includes the prevention and spread of Methicillin Resistant Staphylococcus Aureus (MRSA) and Hepatitis B. Walton Manor F52_F02_s59447_WaltonManor_v248951_090905_Stage_4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30. The standard of vetting and recruitment practices has improved 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 have 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 trainings for all staffs is ongoing in the home; i.e. diabetes, dementia, cognitive impairment. This was evidenced in the personal files of the staff. Walton Manor F52_F02_s59447_WaltonManor_v248951_090905_Stage_4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,45,36,37,38. 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 eleven years of care home management manages the home; the registered manger has successfully completed a NVQ Level 4 care programme. Walton Manor F52_F02_s59447_WaltonManor_v248951_090905_Stage_4.doc Version 1.40 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. Where possible residents look after their own financial affairs, the home doesn’t hold any bank accounts for individual residents. 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. All staff and residents records are kept secure in accordance with the Data Protection Act 1998. Thus protecting confidentiality Walton Manor F52_F02_s59447_WaltonManor_v248951_090905_Stage_4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 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 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 3 3 3 3 3 3 Walton Manor F52_F02_s59447_WaltonManor_v248951_090905_Stage_4.doc Version 1.40 Page 21 NO 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. No. 1. Standard 19 Regulation 23 Requirement The registered person must ensure that, the ground floor lounge in the care home is redecorated and new floor covering laid. The registered person must ensure that, the cooler machine in the main kitchen is replaced The registered person must ensure that, any potential dangerous chemicals, or substances are locked and secure and not accessible to residents. Timescale for action 31st December 2005. 31st December 2005. 31st December 2005. 2. 3. 19 19 23 12 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 19 Good Practice Recommendations It is recommended that a lock be fitted to the hairdressers room in the care home. Walton Manor F52_F02_s59447_WaltonManor_v248951_090905_Stage_4.doc Version 1.40 Page 22 Commission for Social Care Inspection Liverpool Area Office 3Rd Floor 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. Extracts may not be used or reproduced without the express permission of CSCI Walton Manor F52_F02_s59447_WaltonManor_v248951_090905_Stage_4.doc Version 1.40 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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