CARE HOMES FOR OLDER PEOPLE
Warde Aldam Christian Nursing Home Westfield Lane South Elmsall Pontefract West Yorks WF9 2JX Lead Inspector
Tony Railton Unannounced Inspection 10:35 28 February 2006
th 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 Warde Aldam Christian Nursing Home DS0000006223.V284365.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. Warde Aldam Christian Nursing Home DS0000006223.V284365.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Warde Aldam Christian Nursing Home Address Westfield Lane South Elmsall Pontefract West Yorks WF9 2JX 01977 643697 01977 643452 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) Trinity Care Ltd Mrs Maureen McKechnie Care Home 60 Category(ies) of Dementia (40), Mental Disorder, excluding registration, with number learning disability or dementia - over 65 years of of places age (60), Old age, not falling within any other category (60), Physical disability over 65 years of age (60) Warde Aldam Christian Nursing Home DS0000006223.V284365.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Can accommodate one named service user under 65 years of age Date of last inspection 18th May 2005 Brief Description of the Service: Warde Aldam Christian Nursing Home is situated on the outskirts of South Elmsall. Set back in its own grounds this single storey home has a large drive with parking to the front. There are extensive gardens to the front and smaller gardens to the sides and rear. Set on the top of a hill some of the views from some bedrooms, dining rooms and lounges of the surrounding countryside are spectacular. Warde Aldam consists of three separate units providing a home for up to sixty older people some of who may also have a physical disability or have a mental health problem. All residents are offered a room of their own, some of which may have en-suite facilities. There are various lounges available including quiet rooms and television rooms. There are three large dining rooms. There is also a smoker’s lounge for those who wish to smoke. Some of the toilet and bathrooms are shared and there is assisted bathing for those who require it. There is an activities room which is well equipped and activities are arranged on a regular basis for those who wish to participate. The home is support by other healthcare professionals including Community Mental Health Team, General Practitioners and Specialist Nurses. All areas of the home are decorated and maintained to a good standard. There is a homely and relaxed atmosphere created in the home and residents and their relatives are invited to comment on the quality of care and support provided. Warde Aldam Christian Nursing Home DS0000006223.V284365.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was a very pleasing and enjoyable unannounced inspection when the inspector took the opportunity to speak to nearly all residents, four relatives, the registered manager, administrator, unit managers, nurses, carers, housekeeper and domestic staff. There was also the opportunity to see a sample of residents case files including, assessments, risk assessments, care plans, reviews, medical and daily records. Some staff files were also seen including personal, training and supervision records. On the day of the inspection it was noted that the home met all statutory requirements and nearly all good practice recommendations. A number of improvements were also noted. This was a particularly enjoyable inspection and the inspector would like to take the opportunity to thank the residents, their relatives, the manager and her staff team for their hospitality, patience and co-operation throughout the inspection. What the service does well:
The inspector was particularly impressed with the positive attitude of unit heads, nurses and carers towards residents. Throughout the inspection there was evidence of positive relationships fostered between residents and staff. This is to be commended. There was a relaxed and homely atmosphere created and the home also appeared to be open and inclusive. The inspector was particularly impressed with the atmosphere in the activities room which was most enjoyable with residents laughing and explaining that they had just been ‘tossing pancakes’. Throughout the inspection residents said that they enjoyed living in the home and relatives spoken to commented and said that that they were pleased with the home and the care provided. On the day of the inspection there was evidence of residents receiving alternative therapy such as Reflexology and some residents were enjoying a visit from the hairdresser. Although there was a relaxed atmosphere the home was a hive of activity and staff were going about their duties in a relaxed and unhurried manner. The assessment and care planning systems in the home are good and these are reviewed on a regular basis. On the day of the inspection there was a visit from a local GP and residents healthcare needs appear to be met. The manager said that part of the homes success is due to the fact that the home recruits local people to look after and care for local people. The inspector was impressed by the good standards of cleanliness throughout the home and in particular residents’ bedrooms which are personalised and comfortable. Warde Aldam Christian Nursing Home DS0000006223.V284365.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better:
This was a very positive inspection when there was no failure to meet statutory requirements noted and very few good practice recommendations. As far as the physical environment is concerned the home is decorated and maintained to a very high standard and the housekeeper and her domestic team are to be commended for their efforts in maintaining such a good standard of cleanliness throughout the home. However, the only thing to let the home down and although clean and free of any unpleasant odour, the foyer carpet on the dementia unit is very stained and unsightly and probably needs to be replaced. Although the homes documentation has improved since the last inspection the daily records would benefit from the use of descriptive words to reflect and show residents choices and preferences, likes and dislikes. Discussion with the registered manager and unit head confirmed the need to show that residents are in control and are driving what happens to them. This will become particularly important come the introduction of the Person Centred Planning documentation this year.
Warde Aldam Christian Nursing Home DS0000006223.V284365.R01.S.doc Version 5.1 Page 7 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. Warde Aldam Christian Nursing Home DS0000006223.V284365.R01.S.doc Version 5.1 Page 8 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 Warde Aldam Christian Nursing Home DS0000006223.V284365.R01.S.doc Version 5.1 Page 9 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): 3 and 6 Residents’ personal and healthcare needs are assessed before they are admitted to the home. The home does not provide specialist rehabilitation or intermediate care facilities. EVIDENCE: Examination of residents’ records and through discussion with the registered manager show that residents’ are only admitted when it is agreed that the home can meet their personal care needs. Some records seen show that some residents are provided with an Integrated Care Management Programme Assessment completed by the local authority before they are admitted. Warde Aldam Christian Nursing Home DS0000006223.V284365.R01.S.doc Version 5.1 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 the following standard(s): 7, 8 and 10 Residents’ personal, social and healthcare needs are set out in their individual plan and met by the home. Residents said that they are treated well and their relatives say that their loved ones are treated with respect and dignity at all times. EVIDENCE: Discussion with nearly all residents, some of their relatives and through observation it was noted that there are positive relationships fostered between residents and staff and their relatives. One relative said that all the staff are “very good” and very “caring”. Another said that her mother has “everything she needs and is well cared for”. Residents’ records show that they are supported by local community based healthcare professionals including general practitioners, district nurses, continence advisors, alternative therapists and specialist palliative nurses and their healthcare needs are met. Warde Aldam Christian Nursing Home DS0000006223.V284365.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): 12,13, 14 and 15 Residents’ and their relatives are happy with the quality of care provided by the home which meets their expectations and suits their lifestyles. Positive relationships with residents’ relatives and their friends are openly encouraged. Residents are supported and encouraged to make decisions about their lives. Residents an their relatives said that the meals are good and that there is a choice of menu EVIDENCE: Through discussion with residents and some of their relatives and examination of the menu, notice boards, it was established that residents are happy with the meals provided. One resident said that “its not like home cooking but its alright” another said that he “enjoys” his meals. One relative said that the food always “looks good” and “smells nice”. Throughout the inspection residents were observed been offered choices and been asked what they would like to do. There was a wonderful atmosphere in the activities room where residents were enjoying making and ‘tossing’ pancakes. The activities co-ordinator and his assistant are to be commended for their efforts in maintaining such good standards within the home. A record is kept of the activities which are arranged and organised on a regular basis for those residents who wish to participate. On the day of the inspection residents had a visit from an alternative therapist who had come to administer Reflexology to those who required it. Some residents’ were having a visit from
Warde Aldam Christian Nursing Home DS0000006223.V284365.R01.S.doc Version 5.1 Page 12 the hairdresser and others relaxing with their relatives and friends in the lounges. After discussion with the managers of the units and the registered manager the inspector acknowledges that residents are encouraged and supported to make decisions about the way they live their day to day lives. However, the daily records would benefit from the use of descriptive words to reflect and show residents choices, preferences, likes and dislikes. The inspector was impressed by what he saw on the day of the inspection and the use of descriptive words in the daily records should help capture and demonstrate to others the good work achieved by the home Warde Aldam Christian Nursing Home DS0000006223.V284365.R01.S.doc Version 5.1 Page 13 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 and 18 Residents and their relatives know that if they have any complaints that they will be listened to, taken seriously and acted upon. Residents are protected and safeguarded by the policies and practices regarding Adult Abuse and Protection. EVIDENCE: Examination of some staff records show that appropriate checks including CRB and POVA (Protection of Vulnerable Adults List) and references are taken up before someone is employed. Discussion with the registered manager and examination of the record of complaints, show that complaints received by the home since the last inspection have been appropriately dealt with. Staff training records show that some staff have received Adult Abuse and Protection Training arranged and organised by Wakefield Social Services and Health. There are plans for other staff to attend this training later in the year. This good practice is to be commended. It was noted that the home has a copy of Wakefield Social Services and Health Multidisciplinary Adult Abuse and Protection Policy and Procedure and that adult abuse forms part of the induction training for new staff. Warde Aldam Christian Nursing Home DS0000006223.V284365.R01.S.doc Version 5.1 Page 14 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): 19,20,24 and 26 Residents live in well decorated and well maintained home surrounded by their own possessions. Residents enjoy living in a home which is clean, pleasant and hygienic. EVIDENCE: The inspector was impressed with the high standard of decoration and maintenance throughout the home. On the day of the unannounced inspection all parts of the home were very clean. The housekeeper and her team of domestics are to be commended for their efforts in maintaining such a good standard of cleanliness throughout the home. Through inspecting a number of residents’ bedrooms it was found that they are surrounded by their own possessions and their bedrooms are comfortable, clean and homely. The inspector was impressed with the good standard maintained in residents bedrooms and in particular those who have mental health problems or dementia. The unit managers and their staff teams are to be commended for their efforts in maintaining such a good standard of bedrooms throughout the home.
Warde Aldam Christian Nursing Home DS0000006223.V284365.R01.S.doc Version 5.1 Page 15 One resident said that she “enjoyed” living in the home, “liked” her bedroom and that she has “everything she needs”. One relative said that her mums bedroom is “great” and that it’s like “home from home”. Unfortunately on the day of the inspection and despite been clean and free from any unpleasant odours, it was noted that the foyer carpet between the two adjoining units is heavily stained and looks unsightly. For the benefit of residents and visitors to the home the inspector suggests that this carpet be replaced. Warde Aldam Christian Nursing Home DS0000006223.V284365.R01.S.doc Version 5.1 Page 16 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 and 30 Residents’ care and support needs are met by competent, qualified and experienced staff team. Residents are also safeguarded and protected by the staff selection and recruitment processes. EVIDENCE: The inspector was pleased to note that four care staff have a National Vocational Qualification Level 3 and fourteen have NVQ Level 2 this brings the percentage of NVQ trained care staff to over 50 . This good practice is to be commended. Through discussion with the registered manager and examination of staff training records and training ‘Matrix’ it was established that staff have attended training and update training on First Aid, Moving and Handling, Food Hygiene and infection control. It was noted that the home has a Palliative Care Link Nurse who attends the Specialist Palliative Nurse meetings arranged by the Macmillan Nurses. Staff selection and recruitment records show that appropriate checks and references are taken up before new staff are employed. On the day of the inspection there appeared to be enough staff available in sufficient numbers to carry out their duties in a relaxed and unhurried manner. After speaking to almost all staff the inspector was impressed with the positive attitude towards residents and the work that they do. On the day of the inspection there was a real sense of teamwork and pulling together for the benefit of residents. The registered manager, unit managers, nurses, care staff, housekeeper and domestic staff are to be commended for their efforts in maintaining such a good , positive environment for residents.
Warde Aldam Christian Nursing Home DS0000006223.V284365.R01.S.doc Version 5.1 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): 31,32,33, 36 and 38 Residents enjoy living I a well managed home which is run in their best interests, where they are safe and cared for by supervised staff. EVIDENCE: The manager of the home is a qualified nurse and said that she is currently doing the Registered Managers Award NVQ Level 4. On the day of the inspection there was a relaxed, open and inclusive atmosphere created within the home and it was clear that residents benefited from the management style and leadership approach of the manager. After speaking to most staff it was established that they enjoy working in the home and feel supported in the work that they do. The manager said that part of the homes success is down to fact that local people are recruited to care for local residents. This seems to work particularly well and positive relationships are fostered between residents and staff. The registered manager said that regular staff meetings and residents meetings take place and that there is a monthly management audit carried out by the organisation which also considers health and safety issues.
Warde Aldam Christian Nursing Home DS0000006223.V284365.R01.S.doc Version 5.1 Page 18 Staff supervision notes and the supervision matrix show that care staff are appropriately supervised and a record is kept for inspection. The manager said that there is a quality assurance monitoring system which includes seeking the views of residents and their relatives. The manager went on to say that residents’ questionnaires have been sent to head office to be collated and a report provided. Examination of the notice boards show that there is an open Dementia forum advertised and it is hoped that people will attend to discuss issues relating to the home and caring for those with Dementia. This good practice is to be commended. Warde Aldam Christian Nursing Home DS0000006223.V284365.R01.S.doc Version 5.1 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 2 X X X 4 X 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 4 3 X X 3 X 3 Warde Aldam Christian Nursing Home DS0000006223.V284365.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? N/A 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. Standard Regulation Requirement On the day of the inspection there was no failure to meet statutory requirements noted. Timescale for action 28/02/06 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 OP12 Good Practice Recommendations The daily records would benefit from the use of descriptive words to reflect and indicate residents’ choices, preferences likes and dislikes. This should provide evidence and hopefully reflect that indeed residents are driving what happens to them and that they can and do have a say in how they live their daily lives. The home should consider replacing the heavily stained carpet in the foyer between the two dementia units. The registered manager should inform the CSCI upon completion of the Registered Managers Award. 2 3 OP20 OP31 Warde Aldam Christian Nursing Home DS0000006223.V284365.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB 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 Warde Aldam Christian Nursing Home DS0000006223.V284365.R01.S.doc Version 5.1 Page 22 - 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!
