Inspection on 20/04/07 for Wantsum Lodge

This inspection was carried out on 20th April 2007.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Wantsum Lodge 30/04/08

Wantsum Lodge 07/11/06

Wantsum Lodge 28/02/06

Wantsum Lodge 26/10/05

Wantsum Lodge 04/11/04

Wantsum Lodge 18/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Wantsum Lodge Wantsum Lodge 32 St Mildreds Road Ramsgate Kent CT11 0EF Lead Inspector Brenda Pears Key Unannounced Inspection 20th April 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Wantsum Lodge DS0000023619.V336293.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. Wantsum Lodge DS0000023619.V336293.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wantsum Lodge Address Wantsum Lodge 32 St Mildreds Road Ramsgate Kent CT11 0EF 01843 582666 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) Choicecare 2000 Limited Post Vacant Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places Wantsum Lodge DS0000023619.V336293.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users under the age of 65 years are restricted to one (1 ) whose DOB is 02/04/1943. 7th November 2006 Date of last inspection Brief Description of the Service: Wantsum Lodge provides residential care for up to 32 older people, the Home is attached to a large building providing accommodation for the elderly and accesses Wantsum Lodge for catering and laundry services. The Home is situated in a residential area in the coastal town of Ramsgate, within easy walking distance of shops, post office and churches, and within a short drive of the town centre with community facilities such as health centres, library, railway station and a shopping centre. There is no off street parking but ample parking is available on the streets to the front of the building. The fees for support from the home are set during the assessment period and are very individual to the needs of the service user, depending on the level of support required and the staffing numbers provided. The average fee levels, as a guide at this time, are between £303.00 and £520.00 per week. Wantsum Lodge DS0000023619.V336293.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second unannounced inspection to be undertaken at Wantsum Lodge in this inspection year and the process consisted of speaking with the acting manager, staff members, service users and also included a review of records, documents and undertaking a tour of the premises. The focus of this inspection was on the previous requirements and also on the core minimum standards. Observations, previous findings and information all inform the outcomes in this report. What the service does well: What has improved since the last inspection? Wantsum Lodge continues to be improved through refurbishment, redecoration and internal improvement. This is ongoing until all areas meet the required standards. The building is attached to a property that is owned by the home but has been rented out for some time. This part of the building is currently in the process of being reclaimed and it is proposed that this will become an extended part of Wantsum Lodge in the future. The medical area has been improved, records were clear and up to date and the previous odour in this area has been eradicated. All areas of the kitchen and food storage have also been improved and a cleaning schedule is now in place to ensure these areas remain clean. Wantsum Lodge DS0000023619.V336293.R01.S.doc Version 5.2 Page 6 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. Wantsum Lodge DS0000023619.V336293.R01.S.doc Version 5.2 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 Wantsum Lodge DS0000023619.V336293.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are pre admission assessments on record that support the needs of new service users entering the home. This ensures the full well being of service users moving into the home. EVIDENCE: The acting manager stated that the service user guide and the statement of purpose have been updated. Service user guides are available in each individual room to give additional information and support to those moving into the home. One new service user said that there was enough information provided to help a decision to be made about moving into the home. Wantsum Lodge DS0000023619.V336293.R01.S.doc Version 5.2 Page 9 All new admissions are undertaken following a pre admission assessment to ensure the placement is appropriate. Files seen at this time did contain pre admission assessments that are undertaken by the acting manager or deputy manager. Intermediate care and rehabilitation is undertaken using appropriate equipment plus assessed support from care staff and healthcare professionals. Care is undertaken to enable a full recovery and to ensure independence is achieved and maintained. Healthcare appointments are fully recorded and show that GPs and district nurse provide support in the home and all outcomes are also recorded. Wantsum Lodge DS0000023619.V336293.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Appropriate healthcare information is recorded on care plans and continued development will ensure these are regularly reviewed. A spot check of medication is now undertaken on a monthly basis. These practices support appropriate care and ensure the well being of service users. EVIDENCE: Files seen at this time were tidy and orderly, with an index and information easily found. Recordings have improved a little, but still need additional attention to be paid to provide fuller and more informative records. The acting manager explained that staff are being supported and encouraged to record more information. There is currently still a lot of observation stated as ‘appeared fine’ or ‘had a good day’. The acting manager explained that goals and personal development plans are to be reviewed by staff. The aim is to complete a full history of achievements Wantsum Lodge DS0000023619.V336293.R01.S.doc Version 5.2 Page 11 to date and future achievements that are being worked towards. Full details of how staff are to support this development is to be recorded on care plans along with risk assessments. Discussions were undertaken regarding additional training for staff to support Service users with a visual loss, this will enable the person to be as independent as possible. Talking books are available in the home and ordered regularly, but a more individual approach is required. Care plans have, in the main, been reviewed regularly, although some areas are still not fully up to date. There are new systems being developed to ensure reviews are regularly carried out. This will also provide full information on files to show reviews have been carried out. The medication storage area has been cleared of clutter and the odour that was previously found has been eradicated. A new medication fridge and thermometer has been purchased and a new sink is to be installed in this room. A suitable sink is needed to deal with all aspects of medication appropriately and to ensure the control of infection. It was noted that this room remains very small for the purpose of handling medication, however, staff are working hard to meet requirements in this area. The acting manager explained that all food eaten is recorded and the percentage is then worked out and also recorded. This is monitored to ensure any drop in the intake of food is followed up and checked by a GP. A new procedure for the handling and dispensing of medication has been developed and this is on display in the medication area and on the medication administration record (MAR) folder. The MAR sheets were seen to be up to date and much clearer and more orderly than at the previous inspection. A new supplier now deals with medication and the home undertakes a monthly audit of records and medication storage. All medication is now renewed, replaced or returned on a monthly basis with the new stock rotation routine that is in place. Observations at this time, discussions with staff and discussions with service users at this time and at the previous inspection, confirm that services users are respected and their privacy is considered and maintained. Wantsum Lodge DS0000023619.V336293.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Choice and autonomy are supported and visitors are encouraged, ensuring individuals have control over their own routines and life. EVIDENCE: Previous discussions with service users confirmed they are well cared for and are comfortable in the home. It was felt that staff are always available to help when needed and are caring. Staff and service users were seen to be enjoying a good relationship and one new service user explained that staff had been ‘very helpful’. It was explained that the move had been made easy and staff and the food were ‘very good’. There is a choice of food and service users spoken to at this time stated meals are not rushed and that food is good and choices are offered. Those wishing to eat in their rooms are supported to do so and service users have previously confirmed this. Wantsum Lodge DS0000023619.V336293.R01.S.doc Version 5.2 Page 13 Notices are posted in the home to inform visitors and family members of service user meetings. The manager also explained that she speaks to service users individually on a regularly basis. The entrance hall has up to date information and notices of forth coming events. Some activities offered to service users include the chance to undertake weekly exercise, music is provided regularly and quizzes, beauty sessions, outings with Age Concern and concerts are also offered. Special events such as anniversaries or birthdays are celebrating and previous family occasions have been enjoyed in the home. A special buffet and celebration cakes are made by the cook, who knows individual preferences and tastes. Wantsum Lodge DS0000023619.V336293.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is a complaints policy in place, ensuring everyone knows how to make a complaint and abuse procedures and training continue to be developed. EVIDENCE: A complaints policy is in place to support anyone who may have any problems. Previous discussions with service users confirmed they can talk to the manager or staff and feel that they will be listened to. The manager explained that a good working relationship is enjoyed between the home, visitors and family members. This does enable discussions to be undertaken when any matters arise and this supports a quick and appropriate outcome for all concerned. Special events are fully supported in the home and fund raising has been undertaken by family/visitors in the past to help the home with special purchases. The manager deals with all finances and holds the only key for accountability and safety and money is securely stored in the home. Wantsum Lodge DS0000023619.V336293.R01.S.doc Version 5.2 Page 15 Procedures continue to be developed to support staff in the home. These local procedures reflect the actions that will be taken by staff in any situations. The inspector did not view these at this visit, but the acting manager explained that all managers in the group are working together to develop all relevant ‘in house’ procedures. The first procedures being dealt with include abuse, medication and the care of terminally ill clients. Wantsum Lodge DS0000023619.V336293.R01.S.doc Version 5.2 Page 16 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): 19,25,26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. While redecoration and some refurbishment has enhanced areas of the home, other areas remain in need of total refurbishment before the home reaches an acceptable standard throughout. EVIDENCE: The home was found to be clean, fresh and odour free at the time of this inspection. Rooms seen at this time were clean, beds were made and bedding was clean, there was no odour in any room. Wantsum Lodge continues to be improved through refurbishment, redecoration and internal improvement. This is ongoing until all areas meet the required standards. Wantsum Lodge DS0000023619.V336293.R01.S.doc Version 5.2 Page 17 Wantsum Lodge continues to be improved through refurbishment, redecoration and internal improvement. The building is attached to a property that is owned by the home but has been rented out for some time. This part of the building is currently in the process of being reclaimed and it is proposed that this will become an extended part of Wantsum Lodge in the future. The serving area that supports the kitchen is becoming very damaged and marked. The surface top is dented in several places and is to be replaced. Flooring was found to be very stained at the time of this inspection. Bathroom and toilet areas now have fixed dispensers for the dispensing of gloves and coloured plastic bags. This creates a more orderly and pleasant environment for service users. Flooring in some toilet areas remains heavily stained and requires replacing. Some minor repairs have been undertaken around the home and decoration is being started on the top floor of the home. There is a room allocated for staff if they wish to use it, but this area remains in need of redecoration and refurbishing to make this more suitable for staff to enjoy their breaks. The kitchen, freezer area and dry storeroom have been improved since the last inspection. All these areas were found to be clean and free of clutter in all parts. Surfaces in the kitchen have been cleared and this now provides a suitable environment to undertake food preparation. The flooring in the kitchen and adjoining areas has been painted and now presents a clean and easy to maintain area. A cleaning schedule is now in place and staff are working hard to maintain this standard of cleanliness. The laundry areas are still in urgent need of new flooring to ensure the control of infection and provide easy to clean floors. The manager explained that quotes were currently being obtained prior to starting work in this area. All radiators have low temperature surface throughout the home, there is a telephone booth for service users to use that is in a quiet area to ensure privacy. Wantsum Lodge DS0000023619.V336293.R01.S.doc Version 5.2 Page 18 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): 27,28,29,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Training is now monitored to ensure staff have appropriate skills to support service users. However, staff files must continue to be reviewed until these contain all required paperwork, ensuring the safety and well being of service users. EVIDENCE: Care staff at the time of this inspection consisted of the acting manager, the deputy manager, one senior carer and three care assistants. Night staff consists of two waking carers and on the day of this inspection, three night staff were on duty as one person was being inducted. The induction process includes shadowing on night shift to give a complete picture of routines in the home. Night carers undertake two hourly checks and these are recorded with comments on how the service user was found, e.g. ‘sleeping’ or ‘asked for a cup of tea’. If a service user is ill, then half hourly checks are undertaken and this information is specified at the change over of shifts. Wantsum Lodge DS0000023619.V336293.R01.S.doc Version 5.2 Page 19 Service users confirmed in conversations that staff are always ready to assist and do provide support with consideration for dignity. This was also confirmed during discussions with visitors and service users during the previous inspection. The acting manager has NVQ level 3 and is undertaking her RMA. She has also gained certification to undertake training regarding adult protection. All homes in the group are carrying out this training and refresher training will be delivered at least six monthly. Through this training, whistle blowing is being encouraged and thoroughly discussed. The deputy manager is qualified to undertake moving and handling training in the home. Additional staff training includes the handling of medication that is booked for this month, infection control is also booked for all care staff and refresher training is updated as needed. All homes in this group work together to keep abreast of training needs to ensure staff skills remain current. Staff files sampled showed that most required paperwork is on records. Files continue to be reviewed to ensure all picture identification is retained. Some long term staff have been reminded to bring in this identification and the acting manager explained that this would continue until all files are completed. Some references need to be followed up as on one file sampled, only a part of the references have been returned. CRB checks are undertaken prior to any new staff starting work and copies are kept in an independent file. Wantsum Lodge DS0000023619.V336293.R01.S.doc Version 5.2 Page 20 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): 31,33,37,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The current acting manager is a suitable person and the best interests of service users are considered. The manager and staff group do consider the health and welfare of service users. EVIDENCE: The current acting manager has worked in care for the past ten years, progressing to senior carer and has now been in the post of acting manager in the home for four months. She is currently applying to become the registered manager and is extending her qualifications and skills through continued training. Wantsum Lodge DS0000023619.V336293.R01.S.doc Version 5.2 Page 21 The fire record book was up to date and regular fire safety checks are undertaken. All incident reports are reviewed on a monthly basis and are also checked by the area manager. She also recognises the areas in the home that still need attention. The staff team are working together, under her direction, to improve all areas in the home. Some good auditing and monitoring procedures are currently in place to ensure acceptable standards are maintained. Quality assurance procedures are currently being put into place to regularly gain comments from service users, visitors, family members, care managers, stakeholders and healthcare professionals. It is intended to gain these opinions on a six monthly basis. There is a comments book available for visitors to use in the main entrance hall. Staff supervision is being undertaken and records were seen on a sampling of staff files undertaken at this time. There are clear signs for emergency and fire exits, fire extinguishers are appropriately placed, clearly signed and serviced. There were no COSHH items in evidence, and cupboards with materials posing a risk were appropriately locked at this time. Servicing certificates were up to date and current with the PAT and full electrical certificate due for renewed before the end of April. Wantsum Lodge DS0000023619.V336293.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X X X X X 2 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X 2 3 Wantsum Lodge DS0000023619.V336293.R01.S.doc Version 5.2 Page 23 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 OP7 Regulation 14 Requirement That all parts of care plans are regularly reviewed to ensure appropriate care is provided at all times. (Partially completed) 2. OP19 OP25 OP 23 The redecoration and refurbishment programme continues until a suitable environment is achieved throughout the home. (Partially completed) 3. OP26 16, 23 The flooring in the laundry area to be impermeable to ensure the control of infection. 31/07/07 30/09/07 Timescale for action 30/06/07 4. OP37 15 Daily records to be fully completed at all times to ensure the safety and well being of service users. (Some improvement achieved) 31/05/07 5. OP37 7,9,19 That staff files contain all DS0000023619.V336293.R01.S.doc 30/06/07 Version 5.2 Page 24 Wantsum Lodge required documentation in line with schedule 2 of the National Minimum Standards. (Partially completed) 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 OP4 OP30 Good Practice Recommendations To access appropriate information, environmental assessment and training regarding supporting service users with sight loss. Wantsum Lodge DS0000023619.V336293.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Wantsum Lodge DS0000023619.V336293.R01.S.doc Version 5.2 Page 26 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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