Inspection on 22/05/06 for Waterside Care Centre

This inspection was carried out on 22nd May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Waterside Care Centre 31/12/09

Waterside Care Centre 20/07/09

Waterside Care Centre 14/07/08

Waterside Care Centre 18/04/07

Waterside Care Centre 18/01/06

Waterside Care Centre 01/06/05

Waterside Care Centre 09/11/04

Waterside Care Centre 06/07/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Waterside Care Centre 60 Dudley Road Tipton West Midlands DY4 8EE Lead Inspector Richard Eaves Unannounced Inspection 22nd May 2006 10:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Waterside Care Centre DS0000004824.V287508.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. Waterside Care Centre DS0000004824.V287508.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Waterside Care Centre Address 60 Dudley Road Tipton West Midlands DY4 8EE 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) 0121 520 2428 0121 520 2448 dalwoods@bupa.com BUPA Care Homes (AKW) Ltd Mrs Frances Taylor Care Home 60 Category(ies) of Old age, not falling within any other category registration, with number (60) of places Waterside Care Centre DS0000004824.V287508.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th January 2006 Brief Description of the Service: Waterside Care Centre is a purpose built Home, opened in 1997, which provides 60 beds for frail older people who require nursing care. The Home is located on the main road between Dudley and Tipton, with public transport and local amenities easily accessible. There are pleasant views of the Black Country canal at the rear of the Home and the Black Country Museum is approximately 300 metres away. There is car parking to the front of the Home and gardens and patio areas to the rear. Accommodation is provided on two floors, all bedrooms are single and have en-suite facilities. There are large lounge/dining rooms on both floors and a number of small quiet sitting areas. The Home offers intermediate / rehabilitation care in up to 10 of its beds, with a team of professionals visiting each week to assess and assist this care. The current scale of charges are £430 - £700 per week. Waterside Care Centre DS0000004824.V287508.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection visit was undertaken by an Inspector from the Commission for Social Care Inspection using the following information: the action plan submitted by the home to the unannounced inspection in undertaken during January 2006, reports from the organisation relating to the conduct of the home, the pre-inspection questionnaire, comment card responses from service users and relatives and records held at the home. The inspection involved a full tour of the bedrooms, communal rooms and service areas and provided an opportunity to speak with most of the service users. What the service does well: What has improved since the last inspection? The home is now better able to demonstrate good practice in the administration of medication with all staff undertaking up dates to ensure they all follow the same procedures in accordance with the homes policies. The process of formal supervision has improved and staff feel better involved and fully benefiting from this process. Staff morale has been substantially improved among care staff. The home has increased its numbers of nursing beds and received a new hoist. Waterside Care Centre DS0000004824.V287508.R01.S.doc Version 5.1 Page 6 All staff have undertaken adult protection training both using the company internal course and the local social services training. 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. Waterside Care Centre DS0000004824.V287508.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 Waterside Care Centre DS0000004824.V287508.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&6 The home provides good sources of information about the home and invites prospective service users to visit and spend time at the home prior to admission to enable them to make an informed decision about entering the home. The staff group are stable well established and collectively have the knowledge and skills to assess needs and to meet these assessed needs of the current service users. Confirmation is given to the service users prior to admission that their needs can be met by the home Designated staff provide skilled intermediate care maximising the opportunities for rehabilitation. EVIDENCE: The statement of purpose and service users guide have recently been the subject of review and include details of the manager, these documents have recently been reviewed and are an excellent source of information for current and prospective service users. Waterside Care Centre DS0000004824.V287508.R01.S.doc Version 5.1 Page 9 In addition to receiving confirmation that the home can fulfil the agreed needs prior to admission a contract of terms and conditions is provided and a copy retained on file. The pre and post admission assessment processes are thorough, including all activities of daily living and an extensive range of risk assessments, all subject to regular review. The file documents information of the service user or representatives involvement in the assessment process. A sample of 6 case files were randomly selected for case tracking and show that the assessment process is thorough, including all activities of daily living and an extensive range of risk assessments, assessments are subject to monthly review with the Minimum Data Set assessment is reviewed 3 monthly. Risk assessment outcomes show representative involvement and consents when required. Service users admitted under the intermediate care arrangements have their own facilities and dedicated staff team. The team are supported and given training in rehabilitation from the Primary Care Trust rehabilitation staff that include, physiotherapists and occupational therapists. Waterside Care Centre DS0000004824.V287508.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 – 10 Care plans are derived from a comprehensive range of assessments and provide the basis for the delivery of care and detail the actions required of staff to meet the identified needs. Health care needs of service users are fully met. Medications are well managed all facilitating the promotion of service users health. Service users are treated with respect and their privacy upheld. EVIDENCE: Care plans were randomly inspected in the three areas of ground, first floor and those admitted under the intermediate care arrangements. Overall the care plans were derived from extensive assessments of needs and individually assessed risks were well completed and provided good direction for the delivery of care. Care plans are subject to daily assessment and fully reviewed as the assessments fill the page. Records of the delivery of care are of a good standard, the key workers completing a diary of personal care such as hygiene, bath shower hair and nails on at least daily basis, attendance in rooms where service users are bedfast or just elect to occupy their rooms are maintained consistently of each attendance. The evaluation sheets observed had no clear Waterside Care Centre DS0000004824.V287508.R01.S.doc Version 5.1 Page 11 identifier of which care plan they referred and were liable to cause confusion if they become separated from the plan. One example was found of a care plan for pressure relief not identifying the equipment used although appropriate items of equipment were in place(AL). The home uses monitored dosage cassette system (Nomad) for the delivery of most tablet medicines. The allegation of poor administration practices have not been substantiated although arising from this all staff involved in medication administration have received update training. An inspection of medication records show that all aspects of medication management are of a good standard. Daily temperature monitoring of the medicines room shows that previous problems of being too hot has been resolved by improved ventilation. Staff were observed to interact well with service users showing respect and using the preferred terms of address, they were seen to be sensitive to protecting the service users dignity in dress, toileting and cleanliness. In conversation with service users many who were able to converse clearly spoke of “nice staff”, “a most delightful home”, “you couldn’t find a better home” and “staff and nurses are all lovely”. A service user without family who rarely receives visits (GB) says, “very satisfied and is well cared for”. Waterside Care Centre DS0000004824.V287508.R01.S.doc Version 5.1 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 the following standard(s): 12 – 15 The systems for service user consultation about activities is good with evidence that their views are sought and even minority views are acted upon. The home has an open visiting policy to maintain service user contact with family and friends. Many aspects of care evidences that service users exercise choice and control over their lives, but staff must guard against routines detracting from service users choices. The meals in this home are good offering both choice and variety and catering for special dietary needs EVIDENCE: Activities at the home are co-ordinated by two part time staff who between them provide a range of social events for both floors separately each day, they are supported in this by a number of care staff who have undertaken a package of training in providing activities. Activities regularly undertaken include, Bingo, sing-a-longs, exercises, hand massage and nail care, games, quizzes, gardening, art sessions. Trips are Waterside Care Centre DS0000004824.V287508.R01.S.doc Version 5.1 Page 13 arranged on a monthly basis. Those spoken with said there was always plenty of things happening and they felt free to participate or not as they chose. Entertainers visit on a monthly basis. Visiting clergy provide regular communion for a number of service users. Individual records are kept of individual participation in activities. Events planned for across the summer include visits to the theatre, the Black Country Museum and a summer fete. Many service users are assisted to go on regular shopping trips. The home has an open visiting policy and there are quiet rooms available for service users to receive visitors in private should they wish. Relatives meetings are arranged bimonthly and individual formally documented contact is made each month. The case files include a section that identifies personal likes and wishes such as rising and settling time and their ability to make their own choices of clothes to wear. In conversation with service users they were content that these wishes are fully taken into account by care staff in the assistance they provide and routines are applied flexibly to accommodate personal wishes of the moment. Meals are provided from menus that include choice and cooked option at the three main meals. The 3-week rotating menu is also changed for each season and provides good quality well balanced and nutritious diet. Progress has been made in improving the level of satisfaction with meals and those service users responding in discussion said the meals were good with those intermediate care residents particularly pleased with the meals especially the cooked breakfasts. During the day of inspection information was received that the home had been awarded the gold award for healthy eating and safe catering. Waterside Care Centre DS0000004824.V287508.R01.S.doc Version 5.1 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 the following standard(s): 16 & 18 The home has a satisfactory complaints system with some evidence that complainants’ views are acted upon. The training of staff achieving good levels of knowledge and understanding safeguards arrangements for the protection of service users from abuse. EVIDENCE: The home has an appropriate complaints procedure that is displayed in the reception area of the home. An inspection of the home’s complaint log found that complaints are appropriately investigated and responded to the satisfaction of the complainants. An allegation investigated under adult protection procedures was deemed to be unfounded. The homes adult protection policy and procedure make reference to both Dudley and Sandwell Local Authority policies. Staff training in adult protection is mandatory and included within the foundation period following employment. In addition to internal training staff attend the local social services training in prevention of abuse. Waterside Care Centre DS0000004824.V287508.R01.S.doc Version 5.1 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 the following standard(s): 19 & 26 The home provides a good standard of décor, furnishings and managed services providing a safe, disabled accessible environment and an attractive, and homely place to live. The bedrooms have bathrooms in close proximity for the convenience of service users. The home is clean, free from odours and hygienic. EVIDENCE: Waterside Care Centre DS0000004824.V287508.R01.S.doc Version 5.1 Page 16 A tour of the building found the home to be clean, hygienic and free from offensive odours. Decoration is in good order with some having been undertaken recently and a programme of refurbishment is planned for this year for the ground floor, corridor carpets on the first floor are badly marked, the manager says this has been identified for replacement this year. Since the previous inspection a number of rooms have been re-carpeted with further orders made to continue the replacements. The bedrooms and communal areas are comfortably furnished to provide a homely environment, profiling beds are available for service users nursed in bed and a further 4 are due to be received. Previously identified bathing facilities utilised as storage space for equipment continues and planned adaptation has not been undertaken. If the facility is surplus to the standard requirement and to be used for storage this must be undertaken with all appropriate adjustments necessary for storage rooms. Records are kept which detail routine maintenance and redecoration, the records of monitoring services such as fire, emergency lighting and water temperatures were up to date and show actions taken if adjustments have been required. The laundry is well equipped with washers that meet the requirements for sluicing and disinfection of linen. Sluice disinfectors are provided for cleansing of toileting items such as bedpans and urinals. Staff hand wash facilities have controlled hot water that promotes good hand washing practice. Waterside Care Centre DS0000004824.V287508.R01.S.doc Version 5.1 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 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 – 30 The home has a good mix of staff in sufficient numbers to provide consistency of care that meets service users needs. The home continues to make progress in developing a skilled staff group, although staff turnover has reduced the number of qualified staff and could affect the consistency of care to service users. Recruitment and selection processes are to a good standard protecting vulnerable people. EVIDENCE: The rotas confirm that numbers across the 24hour period and skill mix of qualified and unqualified staff are appropriate to the needs of service users. The ancillary services provide a full 7-day service. Staff met and spoken with were enthusiastic and those who were recently employed received formal induction that meets TOPPS standard. The standard of 50 of care staff being trained to NVQ level 2 standard while previously achieved has fallen below this due to leavers, although 10 carers are due to complete and a further 10 carers have enrolled. A random selection of staff files were inspected with the addition of the new starters and recruitment and selection procedures were seen to be completed to a very good standard including all required checks including references, CRB and POVA declaration. The company procedures are based on good practice and equal opportunities. Waterside Care Centre DS0000004824.V287508.R01.S.doc Version 5.1 Page 18 An inspection of training records shows that mandatory training is up to date and all staff have over the last months been revisiting the TOPPS standard induction and foundation programmes and are now undertaking individual programmes of development. These programmes include infection control, intermediate care, fire safety trainers, drug update for nurses, palliative care, HACCP for catering staff, and human resource topics for senior staff including, managing poor performance, managing investigations, sickness absence, equal opportunities, employment law, appraisals and recruitment. Waterside Care Centre DS0000004824.V287508.R01.S.doc Version 5.1 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 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, 33 & 35 – 38 Leadership of this home is good and staff demonstrate an awareness of their roles and responsibilities, resistance by some staff to good management practice potentially could undermine care delivery to service users. The sound financial management of the home and arrangements for safekeeping of their money safeguards service users interests personal and financial. Staff receive supervision and direction to ensure that the service users receive consistent quality care, the documentary evidence of supervision is weak and distracts from the certainty of the delivery of care. The best interests of service users are safeguarded by the homes record keeping, policies and procedures. Environment management and staff training in respect of health and safety ensures service users safety and welfare are protected. Waterside Care Centre DS0000004824.V287508.R01.S.doc Version 5.1 Page 20 EVIDENCE: The home is led by an experienced and well qualified nurse manager and is supported in this by a stable committed staff group at all levels. On the day of the inspection it was apparent that there was a very good atmosphere amongst the staff. Staff in each area of the home were engaged in conversation and said they were happy with their work, supervisions and training opportunities. The manager holds frequent staff meetings and maintains a record and actions taken in response to staff inputs. A survey of service users views undertaken during December has been analysed and report of findings and an action plan has been implemented. The manager also undertakes regular topic satisfaction surveys and feeds back the findings and actions resulting to the service users meetings. The area manager undertakes monthly regulation 26 visits providing a report for the Commission. The manager agrees a budget for each year to meet the agreed business plan, which reflects the findings of the auditing undertaken. The home does not act as appointee for service users, arrangements with full accounting practice is in place for personal allowances held for safekeeping. Staff supervision is now well established and staff confirm that they get benefit from the process. An inspection of records required by regulation and listed in the schedules show these to be maintained, up to date, accurate, kept secure and used in accordance with the Data Protection Act. The home is subject to a health and safety audit by the company advisor, which covers all areas of the home with good standards found. Inspection of the health and safety monitoring records show these to be up to date and that very good standards are being maintained consistently. Certification of services and equipment are all in date. Staff training in health and safety, fire safety training is satisfactory. Waterside Care Centre DS0000004824.V287508.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 3 3 Waterside Care Centre DS0000004824.V287508.R01.S.doc Version 5.1 Page 22 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 OP7 Regulation 15(1) Requirement The registered person must ensure that any equipment used in the care of service users is clearly identified in the care plan. The care plan evaluation record must be clearly identified to which care plan it refers. The registered person must ensure that surplus bathrooms are appropriately adapted prior to use for storage. Timescale 31/3/06 not met The registered person must ensure that all staff hand wash outlets have a supply of safe, running hot water. Extractor fans must be maintained clean and in working order. The first floor corridor carpet must have the marks removed or carpet replaced. The planned refurbishment of the ground floor to be undertaken and bedrooms redecorated as they are free.. Waterside Care Centre DS0000004824.V287508.R01.S.doc Version 5.1 Page 23 Timescale for action 30/06/06 2. OP21 23(2)(l) 30/06/06 3. OP19 13(3) & 23(2)(c,d) 30/09/06 4. OP28 18(1)(a) The registered person must ensure that sufficient staff are qualified to NVQ level 2 in care to ensure a minimum of 50 of carers can be achieved at all times. 30/09/06 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 OP7 Good Practice Recommendations The record of monthly relative contact should be completed including when contact has not been achieved. 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