Inspection on 26/10/05 for Wantsum Lodge

This inspection was carried out on 26th October 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 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 20/04/07

Wantsum Lodge 07/11/06

Wantsum Lodge 28/02/06

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 32 St Mildreds Road Ramsgate Kent CT11 0EF Lead Inspector Brenda Pears Announced 26 October 2005 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. Wantsum Lodge H56-H05 S23619 Wantsum Lodge V226452 261005 AN Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Wantsum Lodge Address 32 St Mildreds Road Ramsgate Kent CT11 0EF 01843 582666 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) Choicecare 2000 Limited CRH 32 Category(ies) of Care Home for Older People over 65 registration, with number of places Wantsum Lodge H56-H05 S23619 Wantsum Lodge V226452 261005 AN Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Wantsum Lodge provides residential care to 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 availbale on the streets to the front of the building. Wantsum Lodge H56-H05 S23619 Wantsum Lodge V226452 261005 AN Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection and the inspection consisted of speaking with the manager who is to apply for registration, staff members and service users. The methods of inspecting the home included checking records, tracking service user care plans, examining staff files, discussions with service users, observations and a tour of the building. The inspection focussed on the requirements from the last inspection, key standards and particularly the quality of life experienced by service users. The manager is currently overseeing a home in Dover for part of the week, leaving the deputy manager and a senior member of staff in charge at Wantsum Lodge along with 2 senior carers. The manager spends every Friday at Wantsum Lodge and is also on call. When a new manager is fully inducted at the home in Dover, the manager will then spend only 2 days a week away from Wantsum Lodge. Service users stated they have missed having the manager full time in the home and will be pleased to have her back with them. As part of the pre-inspection process, residents and relatives were consulted for their views of the home. The service users and families returned their comment cards, providing valuable feedback about the home, which helped in the planning of this inspection. The home was found to be clean and service users were cheery, friendly and waiting to speak to the inspector. Service users were fully included in this inspection and were relaxed and laughing with staff and visitors at this time. The home has an ongoing redecoration programme in place and the manager is aware of the areas needing upgrading. Rooms are individualised with personal items and, in the main, are comfortable but in need of continued redecoration. Service users stated they are well cared for and staff are always there when support is needed, questionnaires received and discussions at this time also confirm this. What the service does well: The home has previously supported and cared for one service user who became unwell and then became terminally ill. Letters have been received prior to this inspection where family members state that the ‘love and care’ was the best anyone could expect. Staff have obviously provided much needed support at this time and ensured all needs have been fully met. Wantsum Lodge H56-H05 S23619 Wantsum Lodge V226452 261005 AN Stage 4.doc Version 1.30 Page 6 Service users stated that staff are always available to assist when needed and that the home provides ‘a good standard of care’. Visitors stated they are always welcomed into the home and are enabled to support the person living in the home wherever possible. 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. Wantsum Lodge H56-H05 S23619 Wantsum Lodge V226452 261005 AN Stage 4.doc Version 1.30 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 Wantsum Lodge H56-H05 S23619 Wantsum Lodge V226452 261005 AN Stage 4.doc Version 1.30 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 &3 Information is provided to service users that support the decision process both before and on admission into the home. Pre admission assessments are undertaken prior to any admission into the home to ensure all needs can be met and placement is appropriate. EVIDENCE: Wantsum Lodge H56-H05 S23619 Wantsum Lodge V226452 261005 AN Stage 4.doc Version 1.30 Page 9 The Statement of Purpose and the Service User Guide documents have both been reissued and now contain fuller information but some minor adjustments are to be undertaken before these documents are fully completed. A copy of the Service User Guide is in place in each room in the home. Files contain pre-admission assessments that have been undertaken to assess individual needs and to ensure Wantsum Lodge is the best home to meet those needs. Assessments include physical and social needs and may be carried out in conjunction with health or social service professionals. Individual care plans are prepared on admission based on these assessments. Wantsum Lodge H56-H05 S23619 Wantsum Lodge V226452 261005 AN Stage 4.doc Version 1.30 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 Care plans are in place and reviewed regularly and while all areas of care are clearly in place, a completed care plan was easily accessed to support staff and ensure appropriate care is given at all times. Service users are treated with respect and the right to privacy is upheld. Not all incidents have been fully recorded to support the appropriate care of service users. There was also no evidence of incidents being passed to the next shift in the handover book. Accident records were found to be incomplete and some did not contain details of what checks were made on the service user following an incident. This poor recording does not ensure appropriate care is given and does not support the safety of service users. While medication is stored appropriately, there were no records showing why medication had not been given when the reason was not purely a refusal. The fridge temperatures were also shown as too high for the safe storage of medication. There are no service users currently self medicating but risk assessments would be undertaken for any person wishing to deal with their own medication. Wantsum Lodge H56-H05 S23619 Wantsum Lodge V226452 261005 AN Stage 4.doc Version 1.30 Page 11 EVIDENCE: Visits by healthcare professionals are recorded on each care plan and contain full information of care given. Specialist organisations are contacted to support service users and appropriate support and aids are obtained. Service users and visitors spoken to at this time confirmed all needs are being met by the home and staff are always available when assistance is needed. Care plans contain clear and updated information. Incident reports are poorly completed, particularly on night records, and do not contain information that evidenced checks were made on a person following a fall. One fall was recorded on the daily report record for that person but the night checks at this time stated ‘all fine’ on the hourly checks. Handover books did not contain information about falls or incidents and this does not ensure the appropriate care or support is given following an incident in the home. Staff must be made aware of the importance and implications of full recording at all times and that records are official documents supporting the care given in the home. Discussions at this time and questionnaires received prior to this inspection confirm that service users right to privacy and respect is observed at all times. Visitors also stated that family and service users are treated with respect and are supported appropriately. The medication administration records (MAR) have ‘F’ for some entries, indicating a reason other than refusal for medication not being administered, but no reason for this is written in the appropriate area of the MAR sheet. This is not using appropriate procedures or supporting full and appropriate care for service users. Any complications with health or medication cannot be fully tracked and staff who administer on the next shift will be unaware why medication was not previously administered. This is not complying with the safe handling of medication as set out by the Royal Pharmaceutical Society. A procedure for the administration of medicines has been developed and this was reviewed by relevant professionals and is now in place in the home. The storage area for medication is very small and therefore needs to be tidy and orderly to support good practice. While this area was in order, this storage does need some review to identify alternative storage for dressings that do take up a great deal of this space. Wantsum Lodge H56-H05 S23619 Wantsum Lodge V226452 261005 AN Stage 4.doc Version 1.30 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 All aspects of service user needs are met by the home and family, friends or advocates are encouraged to maintain contact. Choice and autonomy are supported and encouraged. A variety of meals are offered at all times and special choices, needs or diets are catered for. EVIDENCE: Friends and family are encouraged to visit and are also invited to various events undertaken in the home. Service user needs are met and staff were observed to be undertaking tasks in an appropriate way and with due consideration for choice and dignity at this time. This was evidenced when a tour of the building was undertaken and those wishing to remain in their rooms were supported to do so. This was also confirmed in questionnaires received and through discussions undertaken at this time with service users and visitors. Service users stated that staff are always available to assist when needed and that the home provides ‘a good standard of care’. Wantsum Lodge H56-H05 S23619 Wantsum Lodge V226452 261005 AN Stage 4.doc Version 1.30 Page 13 There is a key worker system in place and some discussions were undertaken regarding this system being strengthened. Service user meetings have not been carried out as this has been service user choice, but if the key worker system included specific days for service users to meet in small groups or have shopping days, then individual needs and preferences would be made known to staff and more individual activities arranged. One couple had recently enjoyed a celebration for their 70th wedding anniversary and the local mayor and reporters attended, a copy of the newspaper article was on display in he main entrance hall. Both service users stated they had a wonderful time and enjoyed their special day. The servery area has been retiled and there is also new flooring in the dining room, however, the walls in the dining area are in need of redecoration as this currently looks very shabby. There now is a hot trolley available to support meal times and service users stated they enjoy their meals, there is always plenty of food and choices are given at all times. This was confirmed in questionnaires received and also through discussions with service users. Wantsum Lodge H56-H05 S23619 Wantsum Lodge V226452 261005 AN Stage 4.doc Version 1.30 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 & 18 Service users know their complaints will be listened to and acted on and service users are protected from abuse at all times. Service users stated they feel safe in the home and questionnaires received also confirm this. EVIDENCE: The home’s complaint procedure was seen on display and every service user is provided with a copy of this document in their Service User Guide. A record of complaints is maintained and the home enjoys a close working relationship with family members that supports all areas of service user safety and well being. The complaints procedure is copied in the Service User Guide and in the Statement of Purpose, but some additional information is required to fully support service users to access alternative organisations should the need arise. Service users are protected from abuse in the home and training is to be booked to ensure awareness of protection is fully supported. The home has an abuse policy and also a policy for whistle blowing, however, there is no procedure to give direct guidance to staff should any form of abuse be suspected. This does not support the staff team in all situations or give full guidance regarding abuse or underpin the full protection of service users. Wantsum Lodge H56-H05 S23619 Wantsum Lodge V226452 261005 AN Stage 4.doc Version 1.30 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, 25 & 26 The home was found to be clean, hygienic and much improved in some areas of the home. The ongoing redecoration and refurbishment programme is gradually addressing areas that need to be improved in the home. EVIDENCE: Wantsum Lodge H56-H05 S23619 Wantsum Lodge V226452 261005 AN Stage 4.doc Version 1.30 Page 16 The Home is much improved through the new carpeting that is in place in the large lounge area adjoining the dining room and new carpeting throughout the corridor areas on the ground floor. The room used for hairdressing was in the process of being redecorated, the dining room is in need of redecorating to provide a comfortable and acceptable environment. Individual rooms are redecorated as they become empty and full refurbishment and matching soft furnishings are then installed. Safety and well being is supported in the home, pump soap and paper towels are in use and COSHH items were appropriately stored. All radiators are covered and wardrobes are secured to walls. Doors are alarmed, fire points are clearly signed as are all fires escapes. Wantsum Lodge H56-H05 S23619 Wantsum Lodge V226452 261005 AN Stage 4.doc Version 1.30 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 recruitment and induction processes do safeguard service users. There is a training matrix in place to ensure refresher and core training is up to date at all times. Staff are therefore provided with appropriate skills to support service users and meet individual needs. EVIDENCE: Staff files show that the appropriate selection and recruitment processes are in place to ensure the full safety of service users. While a full induction programme is in place, records are signed at the completion of this programme. Good practice would dictate that signatures and dates be recorded at the completion of each section to evidence the timescales undertaken in the induction process. Staffing at this time consisted of the manager, deputy manager, 2 senior carers, 3 care staff, one domestic, one laundry person, a cook and kitchen assistant. Discussions with visitors, service users and questionnaires received confirmed that service user needs are met appropriately and staff are readily available at all times. Training undertaken by staff includes fire safety, moving and handling, NVQ, the safe handling of medication and an adult protection awareness course is Wantsum Lodge H56-H05 S23619 Wantsum Lodge V226452 261005 AN Stage 4.doc Version 1.30 Page 18 also to be undertaken. The manager has completed the RMA management award and is also booked to undertake assessor training. Wantsum Lodge H56-H05 S23619 Wantsum Lodge V226452 261005 AN Stage 4.doc Version 1.30 Page 19 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) 33,37 & 38 The manager is supported by the senior staff in providing clear leadership throughout the home with staff demonstrating a good awareness of their roles and responsibilities. Service users benefit from a safe and well run home and staffing structures enable service users to feel supported at all times. The best interests of service users is at the centre of care delivered in the home. Accidents must be fully recorded in all appropriate areas to ensure the full safety of service users through continuity of care and information. EVIDENCE: Wantsum Lodge H56-H05 S23619 Wantsum Lodge V226452 261005 AN Stage 4.doc Version 1.30 Page 20 The manager is currently overseeing another home in the group and is absent from Wantsum Lodge for 4 days in each week. While the deputy manager and senior staff have been taking charge of Wantsum Lodge, service users and visitors stated they have missed having the manager in the home and all will be pleased to see her back on a permanent basis. The staff group, visitors and service users were observed to be relaxed and confident when dealing with management at this inspection. In the main, the safety of service users and staff are promoted in the home but recording needs to be completed more fully. While accidents are recoded and monitored, information was not completely recorded in all areas. This does not ensure the full tracking of incidents and does not support the sharing of information to provide full safety and appropriate care at all times. The home has policies in place but still has no procedures to support staff or ensure the correct actions are carried out at all times to fully support service users. Discussions and comments received all confirm that family/visitors/advocates are welcomed and are included in the daily routines of the home. This supports service users to feel the home is their own, to have control over their lives and to feel that their views are heard and regarded as being important. Wantsum Lodge H56-H05 S23619 Wantsum Lodge V226452 261005 AN Stage 4.doc Version 1.30 Page 21 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 2 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 x 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x 2 STAFFING Standard No Score 27 3 28 x 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 x 2 x x x 3 x x 2 3 Wantsum Lodge H56-H05 S23619 Wantsum Lodge V226452 261005 AN Stage 4.doc Version 1.30 Page 22 yes 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 1 Regulation 4&5 Requirement Timescale for action 31/12/05 2. 8 & 37 3. 10 4. 18 5. 18 & 37 That the Service User Guide contains full information regarding choices of where complaints can be made and appropriate addresses and telephone numbers to support this 12,13 & All incidents/accidents to be fully 17 recorded in all appropriate areas, to provide full information and ensure the continuity of care. Medication records are to be fully completed in all areas and fridges containing medication must be at the appropriate temperatures for safe storage. 12, 13, 17 The abuse policy must contain & 20 up to date, clear and full information that supports staff and protects service users. 12 & 17 Local procedures are to be developed to support staff in their duties, to support the induction process and to protect/support service users. 30/11/05 30/11/05 31/12/05 Plan of action to be with CSCI by 30/11/05 Wantsum Lodge H56-H05 S23619 Wantsum Lodge V226452 261005 AN Stage 4.doc Version 1.30 Page 23 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 Good Practice Recommendations Wantsum Lodge H56-H05 S23619 Wantsum Lodge V226452 261005 AN Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford Kent TN23 1HU 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 Wantsum Lodge H56-H05 S23619 Wantsum Lodge V226452 261005 AN Stage 4.doc Version 1.30 Page 25 - 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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