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Inspection on 04/12/05 for Wansbeck Care Home

Also see our care home review for Wansbeck Care Home for more information

This inspection was carried out on 4th December 2005.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The senior on duty and staff were professional, competent and demonstrated their knowledge of the service users. The staffing levels were appropriate to meet the needs of the service users. Service users were smartly dressed, looked well and said they liked the home and the staff. Staff were attentive and respectful to service users. Visitors were very complimentary about the home, - `Excellent here, always warm, clean and good food.` - `Always made welcome.` - `X (staff name) keeps us informed of any changes by telephone.` The new development of the home is providing good opportunities to consult with service users and their families. The manager and his team want to provide a good service and look at ways of improving their practice and the person centred experience of the service users.

What has improved since the last inspection?

Changes to the environment such as painted bedroom doors with doorknockers and letterboxes chosen by service users is good for orientation and creates a homely atmosphere. The proposed changes in the philosophy of care to be a community within a community. Care plans look at a range of needs and guidance to meet them is good.

What the care home could do better:

Three areas require improvement regarding care plans, personal preferences must be recorded in care plans about bathing, dressing and hygiene. An assessment of the arrangements to manage service users monies i.e. can manage independently or requires assistance must be made. Nutritional monitoring where indicated must occur. Some health and safety matters require attention such as potential trip hazards and the presence of `steradent` in some service users bedrooms who are vulnerable. The wear and tear of bathrooms and toilets decoration.

CARE HOMES FOR OLDER PEOPLE Wansbeck Care Home Church Avenue West Sleekburn Choppington Northumberland NE62 5XE Lead Inspector Deborah Haugh Unannounced Inspection 4th December 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Wansbeck Care Home DS0000000531.V269530.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. Wansbeck Care Home DS0000000531.V269530.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Wansbeck Care Home Address Church Avenue West Sleekburn Choppington Northumberland NE62 5XE 01670 817173 01670 855269 wansbeck@highfield-care.com 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) Southern Cross Care Homes Limited Mr Stephen Spencer Smith Care Home 40 Category(ies) of Dementia - over 65 years of age (30), Old age, registration, with number not falling within any other category (10) of places Wansbeck Care Home DS0000000531.V269530.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 2 residents suffering from dementia may also have a physical disability 5 residents in the DE(E) category are under the age of 65. Date of last inspection 8th August 2005 Brief Description of the Service: Wansbeck Care Home comprises of a purpose built residential unit for older people adjoined to an older building, which was originally a vicarage. The older part of the Home contains the ancillary services such as the laundry, kitchen, staff rooms and office facilities. The home is situated close to local shops and facilities in West Sleekburn. There is level access to the front entrance of the home, which is located beside the car parking area. Wansbeck Residential Care Home caters for 40 service users, 30 of whom may have a dementia, 5 of whom may have dementia but are aged under 65 years of age and 10 older people not falling into any other category of need. Wansbeck Care Home DS0000000531.V269530.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 4/12/05 at 10.00 at the weekend. The Registered Manager, Stephen Smith was not on duty during the visit but spoke to the inspector by telephone. Edwin Deleon, senior care was the person in charge. Time was spent looking at the kitchen, communal lounges to check the cleanliness, maintenance and decoration. Service users and visitors shared their views about the home. Time was also spent observing the contact between service users and staff. Three Care Plans for service users care were examined. Arrangements for care staff training; recruitment, service users finances and quality assurance could not be fully checked in the absence of the manager, deputy and administrator. What the service does well: The senior on duty and staff were professional, competent and demonstrated their knowledge of the service users. The staffing levels were appropriate to meet the needs of the service users. Service users were smartly dressed, looked well and said they liked the home and the staff. Staff were attentive and respectful to service users. Visitors were very complimentary about the home, - ‘Excellent here, always warm, clean and good food.’ - ‘Always made welcome.’ - ‘X (staff name) keeps us informed of any changes by telephone.’ The new development of the home is providing good opportunities to consult with service users and their families. The manager and his team want to provide a good service and look at ways of improving their practice and the person centred experience of the service users. Wansbeck Care Home DS0000000531.V269530.R01.S.doc Version 5.0 Page 6 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. Wansbeck Care Home DS0000000531.V269530.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 Wansbeck Care Home DS0000000531.V269530.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): NMS 3 was checked and met at the last inspection. EVIDENCE: Wansbeck Care Home DS0000000531.V269530.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7&8 Care plans are in place and staff have the information to meet service users needs but some areas require improvement. The health needs of service users are met and multi disciplinary working is taking place. EVIDENCE: Three care plans were examined and residents and staff spoke about their needs. The documentation regarding the care of residents is positive and the staff know the residents well. Personal preferences in two care plans are not recorded for tasks such as personal care. Assessments are not undertaken regarding the service users arrangements for managing their finances. Some people are not able to deal with their finances and so a care plan must be in place as a need. Social care plans continue to be developed. Care plans are evaluated monthly and reviewed. There is evidence of other professionals being involved. Wansbeck Care Home DS0000000531.V269530.R01.S.doc Version 5.0 Page 10 The health care needs of service users are identified and good guidance is put in place. However one nutritional care plan requires daily intake to be recorded, this was not in place. Care plans are shared with service users and/or their representative and 6 monthly reviews take place. Wansbeck Care Home DS0000000531.V269530.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): All of the above standards were checked and met at the last inspection. EVIDENCE: Wansbeck Care Home DS0000000531.V269530.R01.S.doc Version 5.0 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): 16 & 18 The home has a satisfactory complaints system in place. Systems are in place to protect service users from abuse. EVIDENCE: Senior care staff on duty are aware of the homes procedure should a service user or relative make a complaint. Staff recognise the importance of listening to people and being given the opportunity to put things right if needed. Senior staff demonstrated their responsibility to protect service users from abuse. Staff are aware of their obligation to report bad practice through the Whistle blowing procedure. Wansbeck Care Home DS0000000531.V269530.R01.S.doc Version 5.0 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): 19, 22 & 26 The standard of the environment within this home is good providing service users with a safe, clean and homely place to live. However several areas must improve. EVIDENCE: A tour of the home was completed. Communal lounges were clean and homely. New lounge and dining areas are available upstairs, which provides service users with smaller living areas. The activity room will become a small kitchen/activity area for service users with staff support. One of the bathrooms upstairs is having new tracking installed for moving and handling. This method of transferring older people may not be appropriate for everyone. The home has alternative hoists, which must always be available. Wansbeck Care Home DS0000000531.V269530.R01.S.doc Version 5.0 Page 14 Adequate numbers of bathrooms and toilets are provided for the service users living in the home. However areas of maintenance are required in one of the toilets and a bathroom. Extractor fans were dusty in some toilets. (See requirements) Two potential trip areas require attention. (See requirements) Bedrooms are homely and personalised by the service users, relatives or staff. One bedroom was mentioned to the senior regarding a strong odour. Bedroom doors are now painted and service users were asked what colour they would prefer. Doorknockers and letterboxes have been fitted which adds to a homely personalised atmosphere. Health and safety concerns were again raised regarding Steradent tablets which must must be secured from service user bedrooms who are at risk. A fatal tragic incident occurred in another setting where a service user ate an effervescent tablet and it frothed and cut off the air supply to the person. Wansbeck Care Home DS0000000531.V269530.R01.S.doc Version 5.0 Page 15 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 Staffing numbers are in keeping with agreed levels so that they are appropriate to the assessed needs of the service users, size, layout and purpose of the home. The Registered Provider ensures that staff that are trained cares for service users. Robust staff vetting must protect Service users. EVIDENCE: At the time of the inspection staffing levels reflected the current occupancy. Three members of staff are on duty upstairs and three downstairs throughout the waking day. Four waking night staff are in place. Future proposals regarding the home to have two units upstairs and two downstairs will have implications for staffing. Agreements are in place to have 4 members of staff upstairs (2 staff on each unit) and 3 members of staff on the ground floor (1 person in the proposed single sex unit and 2 staff during the waking day on the ‘residential’ unit.) Night staffing will remain at 4. According to the Registered Manager staff have received mandatory training. NVQ training is being provided and 30 of staff have been awarded Level 2. Wansbeck Care Home DS0000000531.V269530.R01.S.doc Version 5.0 Page 16 The Registered Manager said that by 2006 the home will exceed National Minimum Standards for NVQ Level 2 training at 50 . Records were not available to the senior carer regarding staff training so the standard could not be fully assessed. Confidential recruitment records were not available at this inspection, as the senior carer does not have access. Therefore a check could not be made. However recruitment arrangements were inspected during 19/01/05 inspection with the Registered Manager and a sample of 2 new staff records were examined. Suitable arrangements were in place for ensuring the protection of service users. These included Criminal Records Bureau and POVA checks, 2 references and proof of identification. Staff received the General Social Care Councils Code of Conduct. Wansbeck Care Home DS0000000531.V269530.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 The Manager is suitably qualified and experienced and provides clear leadership. EVIDENCE: The Registered Manager is a Registered Mental Nurse and has just completed the Registered Managers Qualification and is waiting verifying. The Manager agreed to forward the certificate once received. The Manager continues to make significant improvements to the home since his start in April 2004. Wansbeck Care Home DS0000000531.V269530.R01.S.doc Version 5.0 Page 18 Southern Cross Care Homes Ltd acquired Highfield Care Homes and are developing quality assurance arrangements. The current quality assurance system is ISO9001/ Health Mark Certification. A fuller examination of arrangements could not be made on this occasion with the senior carer in charge. However the home has an annual development plan that is monitored by senior managers within the company. The plan sets objectives, how these are to be actioned, who is to facilitate, target dates and outcomes. Service users money, which is looked after by the home, is securely stored. Only the Registered Manager, Deputy and Administrator have access. This standard could not be assessed fully. Arrangements are in place so that monies are available if required. Health and safety concerns were immediately raised regarding Steradent tablets which were again found in service user bedrooms who are at risk. Two potential trip areas continue to require attention. (See requirements) Wansbeck Care Home DS0000000531.V269530.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 1 X X 2 X X X 2 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 2 X X 1 Wansbeck Care Home DS0000000531.V269530.R01.S.doc Version 5.0 Page 20 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 OP8OP7 Regulation 15 Requirement Care plans regarding personal hygiene must reflect the person’s preferences e.g. bathing. Where indicated in care plans daily nutritional intake must be recorded. The arrangements for service users finances must be assessed i.e. personal monies, ability, risks, and representative’s support. Care plans must be put in place where appropriate. The identified bedroom odour must be managed (Immediate requirement) The identified areas must be dealt with - 1. Replace/repair Riverbank toilet wooden boxed area where paint is bubbling. 2. Repair/paint Seaview bathroom boxed area by bath. 3. Clean extractor fans in toilets. Health and safety hazards must be managed 1. Secure Steradent tablets from at risk DS0000000531.V269530.R01.S.doc Timescale for action 30/01/05 2 OP26 16(2) 05/12/05 3 OP19 23(2) 31/12/05 4 OP38OP19 13(4) 04/12/05 Wansbeck Care Home Version 5.0 Page 21 5 OP38OP19 23(2) service user bedrooms. OUTSTANDING 12/8/05 Immediate Requirement. Potential trip hazards must be made safe or carpet replaced 1.office staircase carpet is threadbare 2. carpet area near the laundry, hairdressers. 31/12/05 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 OP26 Good Practice Recommendations Contact Infection Control Nurse Newcastle General Hospital for training for nominated staff member to be the homes link. Consider providing plastic covered pull cords to be used in bathrooms and toilets for ease of cleaning. Consider double bagging clinical waste. The Registered Manager should have the Registered Manager’s Qualification in management by end of 2005. A minimum ratio of 50 trained members of staff (NVQ 2 or equivalent) should be achieved by 2005, excluding the Registered Manager. 2 3 OP31 OP28 Wansbeck Care Home DS0000000531.V269530.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Wansbeck Care Home DS0000000531.V269530.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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