CARE HOMES FOR OLDER PEOPLE
Wardington House Wardington House Banbury Oxon OX17 1SD Lead Inspector
Philippa MacMahon Unannounced 04/05/2005 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. Wardington House H57_H08 S27188 Wardington Hse V224115 040505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Wardington House Nursing Home Address Wardington Banbury Oxon OX17 1SD 01295 750622 01295 750036 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) Wardington House Partnership George Tuthill Care Home (CRH) 60 Category(ies) of Dementia - over 65 years of age (DE(E)) 60 registration, with number Mental Disorder, excluding learning disability or of places dementia - over 65 years of age (MD(E)) 60 old age ,not falling within any other category (OP) 60 Learning disability over 65 years of age(LD(E)) 5 Physical disability over 65 years 0f age PD(E))10 Past or present drug dependence over 65 years of age (D(E)) 5 Past or present alcohol dependence over 65 years of age (A(E)) 5 Wardington House H57_H08 S27188 Wardington Hse V224115 040505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: On admission residents should be aged 60 years and over. Up to 5 named residents under the age of 60. Date of last inspection 18/10/2004 Brief Description of the Service: Wardington House lies on the edge of Wardington village close to the town of BanburyThe home has been providing care for the mentally infirm, and particularly those suffering fromAlzheimers disease since 1965. No routine tranquilizing or sedative drugs are used. Instead a relaxed, stress-free environment is offered so that residents can retain their freedom of choice and individuality. The accommodation is provided on three floors and is accessed by a passenger lift. There are 19 single rooms, 20 double rooms, 2 with 3 sharing, and a top floor special unit with 6 sharing. Within the complex there is also a unit for residents who want more independence. The 3 large communal lounge/dining rooms offer choice, and space to wander in safety. Large picture windows provide a lovely open aspect to the extensive attractive grounds that are accessible to the residents and allow a safe environment for them to enjoy. There are plans to build more single rooms, with en-suite facilities, so that the residents can have more choice of accommodation. The total number of residents for which the home is registered is not expected to change. Wardington House H57_H08 S27188 Wardington Hse V224115 040505 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection focused on talking to the residents, relatives, and staff, and generally observing what life is like for the residents. It was a busy morning in the home with residents going about their daily activities. The nurse in charge was the Deputy Matron, and the Registered Provider/Manager was also present. Two inspectors were present at the inspection that lasted for approximately 2 hours. What the service does well:
The home provides a lovely comfortable, safe, environment, both within the home and in the extensive grounds. The proprietor works hard developing the home’s environment, so that the residents are able to receive a more personalised service. The care provision is excellent, individual, and based on current best practice for people with dementia or Alzheimer’s disease. The activities programme is very well thought through and provides a lot of scope to enrich the lives of the residents. Involvement of the family, and friends in the life of the home is seen by the registered manager and matron to be of great importance to the overall care provision, and is much appreciated by those who visit the home. Meals and mealtimes are well planned and every effort is made to ensure that the residents receive a wholesome and nutritious diet, in comfortable and pleasurable surroundings. The proprietor is proactive in improving the services provided. Wardington House H57_H08 S27188 Wardington Hse V224115 040505 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Wardington House H57_H08 S27188 Wardington Hse V224115 040505 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 Wardington House H57_H08 S27188 Wardington Hse V224115 040505 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) None of these standards were assessed on this occasion. EVIDENCE: Wardington House H57_H08 S27188 Wardington Hse V224115 040505 Stage 4.doc Version 1.30 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 standard(s) 10, It was apparent to the inspector that the staff respected the issues of privacy and dignity of the residents. EVIDENCE: As part of this visit the inspector sat for some time in the lounge observing the interactions between staff and the residents. On all occasions the residents were addressed in a kindly, appropriate and respectful manner. It was particularly noticeable when a resident became noisy and anxious, and the member of staff interacted appropriately and quietly escorted the person to a different area of the room, and the tension in the room was immediately released. All of the residents were dressed in their own clothes and great attention is paid to their appearance. One resident spoken to has a private telephone in her room and always receives her mail unopened. Wardington House H57_H08 S27188 Wardington Hse V224115 040505 Stage 4.doc Version 1.30 Page 10 The residents who were spoken to held the staff in very high regard and affection. Wardington House H57_H08 S27188 Wardington Hse V224115 040505 Stage 4.doc Version 1.30 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 standard(s) 12,13,14,15. The residents’ very individual needs, and preferences are always taken into account and the provision of care is tailored to meet these. The home places great importance on the involvement of families and friends. It is commendable that the home goes to such lengths to maintain individual residents’ autonomy and choice. The provision of meals and mealtimes is of a high standard. EVIDENCE: There are very few routines in the home and these are centred on meal times. The majority of the residents have little awareness of time, space, or orientation, and the aim of the care provision is to allow freedom and choice wherever possible and within safe boundaries. The residents were observed to be able to wander and talk freely to other residents and staff in an open and non-confrontational way. Suitable activities are provided from a well-structured activities plan that is led by an activities co-ordinator, who unfortunately was not well at the time of this
Wardington House H57_H08 S27188 Wardington Hse V224115 040505 Stage 4.doc Version 1.30 Page 12 inspection. A copy of the programme was made available to the inspector and is communicated to the resident’ relatives and staff. A recently acquired mini bus with disabled access will give further opportunity for more residents to be able to take part in outings both locally and further afield. There was very appropriate calming background music playing in one of the lounges, and the residents were sitting quietly enjoying it. The Roman Catholic priest attended the home during the inspection and was made very welcome by all. He explained to the inspector his role in the home and that he regularly visited his “flock”. The local Anglican church provide a monthly Holy Communion service in the home and any resident wishing to attend the church will be assisted to do so. Relatives and friends are considered to be part of the family at Wardington House and are always made to feel very welcome. There were two visitors at the time of this inspection. All residents are encouraged to bring personal possessions with them on admission. One of the residents had brought her piano and as her private room is of a good size is able to have it with her. The piano has been a big part of her life and she has always played it every day, and can continue to do so. The resident played a song for the inspector with great skill and delight. Meals and meal times are considered to be a very important part of the residents’ daily activities, and are taken in the attractive dining areas of the home. One of the small dining rooms is a designated luncheon club for those residents who wish to have a more peaceful meal, and are able to engage in conversations. The menus show that a wholesome nutritious diet is always offered, and suit individual needs. Menus are changed seasonally and include fresh fruit and vegetables. Homemade cakes are always very well received at tea time and much looked forward to by the residents spoken to. One of the residents is on a complex alternative therapy diet and the home’s staff and cooks are able to meet the resident’s needs. Wardington House H57_H08 S27188 Wardington Hse V224115 040505 Stage 4.doc Version 1.30 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 standard(s) 17 Residents’ legal rights are protected. EVIDENCE: The majority of residents are not able to participate in the civic process, but those wishing to are assisted to do so. Wardington House H57_H08 S27188 Wardington Hse V224115 040505 Stage 4.doc Version 1.30 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 standard(s) z19,20,21 The registered manager works hard at continually improving the home’s environment, so that the residents are able to receive a more personalized, comfortable and safe service. The communal bathrooms need to be updated. EVIDENCE: The home is situated in an attractive village and has extensive well-maintained attractive grounds. A named member of staff is responsible for safety, and organizes fire training for staff. Each shift has an identified person responsible for fire safety. The registered manager places great importance in fire prevention and a sprinkler system is to be installed throughout the home in the next few weeks. The ventilation in the kitchen is very poor and the registered manager is actively looking at ways of improving this. The home uses close circuit television (CCTV) in the entrance areas, and has an individually designed door safety system well suited to the client group.
Wardington House H57_H08 S27188 Wardington Hse V224115 040505 Stage 4.doc Version 1.30 Page 15 The grounds are extensive and the residents are able to go outside as and when they want to, apart from when it is raining, or getting dark, when the outside doors will be closed. Routine maintenance and updating of the fabric of the home is continuous. The communal space is extensive and provides a number of rooms for the residents to enjoy. These rooms are beautifully appointed with quality furnishings and fittings in keeping with the old style of the house, and providing a comfortable and homely atmosphere for the residents to enjoy. Most of the individual rooms have a toilet and washbasin, and there are toilets close to the communal rooms. The communal bathrooms have needed to be upgraded for some time and do not match the very high quality of the rest of the home. Whilst this work is in the development plan for the home, there is as yet no time frame for the work being carried out. A “model bathroom” has been completed in one of the private rooms, and the registered provider is looking at improving on this design before progressing to upgrade the communal bathrooms. Wardington House H57_H08 S27188 Wardington Hse V224115 040505 Stage 4.doc Version 1.30 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 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) None of these standards were assessed on this occasion. EVIDENCE: Wardington House H57_H08 S27188 Wardington Hse V224115 040505 Stage 4.doc Version 1.30 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 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) None of these standards were assessed on this occasion. EVIDENCE: Wardington House H57_H08 S27188 Wardington Hse V224115 040505 Stage 4.doc Version 1.30 Page 18 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 x x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 4
COMPLAINTS AND PROTECTION 3 3 3 x x x x x STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x 3 x x x x x x x x x Wardington House H57_H08 S27188 Wardington Hse V224115 040505 Stage 4.doc Version 1.30 Page 19 no 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. 2. Standard Regulation Requirement Timescale for action 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 21 Good Practice Recommendations It is a good practice recommendation that the development plan for improving the bathing facilities has time scales included for completion of this work. Wardington House H57_H08 S27188 Wardington Hse V224115 040505 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Burgner House 4630 Kingsgate Oxford Business Park (South) Cowley, Oxford, OX4 2SU 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 Wardington House H57_H08 S27188 Wardington Hse V224115 040505 Stage 4.doc Version 1.30 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!
