CARE HOMES FOR OLDER PEOPLE
Wantsum Lodge Wantsum Lodge 32 St Mildreds Road Ramsgate Kent CT11 0EF Lead Inspector
Brenda Pears Unannounced Inspection 28th February 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Wantsum Lodge DS0000023619.V277780.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Wantsum Lodge DS0000023619.V277780.R01.S.doc Version 5.1 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 Vacant Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places Wantsum Lodge DS0000023619.V277780.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 26th October 2005 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 DS0000023619.V277780.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken with a focus on the well being, safety and quality of life of service users living in the home. The methods of inspecting the home included speaking to the manager and service users, undertaking a sampling of records and observations of the building. This report reflects the findings at this and at the previously announced inspection. The Environmental Health Officer was also in the home at the time of this inspection. What the service does well: What has improved since the last inspection?
The ongoing redecoration and refurbishment programme continues to improve areas in the home. The hairdressing room is almost complete and is now a light and relaxing environment for service users to enjoy. This is creating a brighter, more suitable environment for service users and this programme needs to continue until all areas in need of upgrading have been addressed.
Wantsum Lodge DS0000023619.V277780.R01.S.doc Version 5.1 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. Wantsum Lodge DS0000023619.V277780.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Wantsum Lodge DS0000023619.V277780.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3 Pre admission assessments are undertaken prior to any admission into the home and information is provided to service users that support the decision process and ensure all individual needs can be met. EVIDENCE: The Statement of Purpose and the Service User Guide documents are both in place and copies of the Service User Guide is in place in each service user room. Files contain pre-admission assessments that have been undertaken to assess individual needs and to ensure Wantsum Lodge is able to meet those needs. Wantsum Lodge DS0000023619.V277780.R01.S.doc Version 5.1 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 8,9 Health care needs are being met and while medication is stored appropriately, this area is in need of attention to provide an appropriate area for the dispensing of medication. 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. At the time of this inspection there were some service users who were not well and remained in bed. The manager was ensuring regular checks were being made on these people to ensure they had fresh drinks and everything they needed. Medication records were sampled and were up to date and clearly identified any allergies. While medication storage is appropriate and fridge temperatures are regularly checked, attention needs to be paid to details. Temperatures in the room as well as the temperature of the medication fridge are recorded but
Wantsum Lodge DS0000023619.V277780.R01.S.doc Version 5.1 Page 10 the fridge temperature must be clearly identified and immediate action taken if this is no at an acceptable level. The medication storage area also needs to be totally cleared to provide a tidy and orderly area. There has been some work undertaken to tidy this area but more work and cleaning is needed before this is an acceptable medication storage area. Wantsum Lodge DS0000023619.V277780.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 The food is wholesome and choices are available to meet service user needs. EVIDENCE: At the time of this inspection, staff were preparing fresh vegetables for lunch and there was a choice for main course with pudding and custard or ice cream to follow. There is a hot trolley available to support meal times and service users stated they enjoy their meals and there is always plenty of food. Staff ask service users just before lunch time, what they would like to eat, ensuring that the choice is made at the right time and reflects how the person is feeling. Wantsum Lodge DS0000023619.V277780.R01.S.doc Version 5.1 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 There is a complaints procedure in place and displayed in the home with copies of the Service User Guide being placed in all rooms to support and inform service users. EVIDENCE: No complaints have been received since the last inspection. A complaints 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. Wantsum Lodge DS0000023619.V277780.R01.S.doc Version 5.1 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 25, 26 The home was found to be clean and odour free with improvements continuing through the home through the ongoing redecoration and refurbishment programme. EVIDENCE: The improvements are continuing throughout the home to provide a brighter and more acceptable environment in all areas. The hairdressing room is almost complete, providing a light and relaxing environment for service users to enjoy. This programme needs to continue until all areas in need of upgrading have been addressed. Wantsum Lodge DS0000023619.V277780.R01.S.doc Version 5.1 Page 14 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 There is a training matrix in place to ensure refresher and core training is regularly up dated, supporting the well being and safety of service users and to support staff development. EVIDENCE: Staffing at this time consisted of the manager, 4 carers, 3 care staff, one domestic, one laundry person, a cook and kitchen assistant plus 2 maintenance men. The manager has been overseeing other homes in the group but she will be permanently at Wantsum Lodge from the end of March. The manager is always on call for Wantsum Lodge and is readily available for staff and families. Wantsum Lodge DS0000023619.V277780.R01.S.doc Version 5.1 Page 15 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 The home continues to have policies in place but still has no procedures developed to support staff or ensure the correct actions are carried out at all times for the safety of service users. EVIDENCE: There is a need for local procedures to be developed that would fully reflect routines currently undertaken in the home, to support staff and ensure the well being of service users at all times. These would then support staff in all areas and fully inform new staff through the induction period. This is specifically required for use when dealing with any case of abuse. Clear and specific guidelines are required to ensure correct actions are taken by staff at all times. Wantsum Lodge DS0000023619.V277780.R01.S.doc Version 5.1 Page 16 Wantsum Lodge DS0000023619.V277780.R01.S.doc Version 5.1 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 x X X X X X X 2 3 STAFFING Standard No Score 27 3 28 X 29 X 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X 2 x Wantsum Lodge DS0000023619.V277780.R01.S.doc Version 5.1 Page 18 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 OP9 Regulation OP 13 Requirement Timescale for action That the medication storage area is orderly, clean and free of 08/04/06 clutter to support appropriate practices for the dispensing of medication. The redecoration and refurbishment programme continues until the environment is at a level that provides a suitable environment throughout the home. (Plan of action to CSCI by the stated date) Local procedures are to be developed to support staff in their duties, to support the induction process and to protect/support service users. (Plan of action to CSCI by the stated date) 2 OP25 OP 16, 23 15/04/06 3 OP37 OP 12, 17 15/04/06 Wantsum Lodge DS0000023619.V277780.R01.S.doc Version 5.1 Page 19 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Wantsum Lodge DS0000023619.V277780.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Kent and Medway Area Office 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 DS0000023619.V277780.R01.S.doc Version 5.1 Page 21 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
