Inspection on 17/02/09 for Waverley House

This inspection was carried out on 17th February 2009.

CSCI found this care home to be providing an Good service.

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

Waverley House 09/12/09

Waverley House 05/03/08

Waverley House 15/08/06

Waverley House 03/03/06

Waverley House 18/11/05

Waverley House 24/03/05

Waverley House 16/11/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Waverley House Etnam Street Leominster Herefordshire HR6 8AQ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Michael Moloney     Date: 1 7 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Waverley House Etnam Street Leominster Herefordshire HR6 8AQ 01568612126 01568620445 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Shaw Healthcare Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 27 Number of places (if applicable): Under 65 Over 65 0 47 dementia old age, not falling within any other category Additional conditions: 47 0 The maximum number of service users to be accommodated is 47. The registered person may provide the following category of service only: Care Home with Nursing (Code N) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category (OP) 47 Dementia over 65 years of age (DE) 47 Date of last inspection Brief description of the care home Waverley House (Phase 1) is registered with the Commission for Social Care Inspection (CSCI) to provide accommodation and personal care for a maximum of 47 people over the age of 65 to include 10 places for people with dementia. This building has been recently rebuilt to conform with the National Minimum Standards for Care Homes for Older People. The home is located in Leominster within walking distance of the town centre. Care Homes for Older People Page 4 of 24 Brief description of the care home Accommodation is provided over three floors providing specialist nursing care and long-stay care for older frail people and includes people with dementia. The registered provider is Shaw Healthcare Ltd. The post of registered manager is currently vacant therefore the home has an acting manager in place. People who use the service and their representatives are able to gain information about this service from the Statement of Purpose and Service User Guide. Inspection reports produced by CSCI can be obtained direct from the provider or are available on our website at www.csci.org.uk The fees charged were £767.64. Care Homes for Older People Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: A range of evidence was used to make judgements about this service. This includes: information from the provider which included a self assessment document that they are required by law to complete, records kept in the home, medication records, discussions with the staff team, tour of the premises, previous inspection reports and talking with as well as observing the care experienced by people using the service Care Homes for Older People Page 6 of 24 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 24 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People looking to live in the home and their representatives have the information needed to choose a home which will meet their needs They have their needs assessed and a contract which clearly tells them about the service they will receive. Evidence: Should anybody wish to live in this home information was seen that outlines the service that they would receive, what they could expect of the staff and other information such as how to make a complaint and how much living there would cost them. This information was seen to be available on a DVD as well. The records of someone who had recently started to live in the home were also looked at. These showed that the home staff had assessed her needs before they had decided whether or not they could look after her. She had then been offered a place in the Care Homes for Older People Page 9 of 24 Evidence: home. Care Homes for Older People Page 10 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that a person living in this home receives is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: The records of four people who live in this home were looked at. All were seen to have care plans that were drawn up after their needs had been assessed. Records were also seen that showed that these care plans were reviewed by the staff each month so that any comments made by people such as doctors and district nurses could be noted and acted upon. A variety of risk assessments were seen to be in place. Not only were the more general issues assessed but so were such things as falls, manual handling and nutrition. Talking to staff and watching how they assisted the people concerned showed that they were aware of what these documents said. Care Homes for Older People Page 11 of 24 Evidence: Risk assessments were seen to have been carried out around raising the safety rails on the sides of the beds. The medication rooms were looked at and these were found to contain medication trolleys, a fridge and controlled drugs cabinet which had been secured to the wall. The general medication records as well as those for the controlled drugs were looked at and seen to have been fully completed. Looking at the staff training records and talking to the manager and her staff confirmed that only those who had received appropriate training were allowed to administer medication. Care Homes for Older People Page 12 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in this home are able to choose their life style, social activity and keep in contact with family and friends. Social, cultural and recreational activities meet their expectations. They receive a healthy, varied diet according to their assessed requirement and choice. Evidence: The records of a number of the people who now live in this home were looked at in relation to this section. Each persons files contained a list of their likes and dislikes. To check that these records were accurate one person was visited in her room. However, she was asleep and a member of staff who was just leaving her room said that she had just gone in to turn the music off. She mentioned the type of music which had been identified in the file as the like being checked out as part of the inspection. A list of the daily activities that were available to people were seen on each landing and looking through the daily notes in their files showed that it was recorded whether or not that person took part and whether this was by choice or because they had Care Homes for Older People Page 13 of 24 Evidence: another commitment such as a hospital appointment or family visitors. The manager and the staff explained that these notes showed whether or not the activities that had been organised were of interest or benefit to the people to whom they were being offered. During the inspection a number of the relatives of the people who live in the home were spoken to and all were very positive about the care that they had observed. During one of these conversations one visitor said, The care is 100 perfect- Lovely and her mother, who lived in the home, agreed. Throughout the inspection staff were seen to be treating people in friendly and dignified manner and were regularly approached by the people that they were caring for. Each time the staff were seen to give a full response to any request or a clear explanation as to why they could not stop at that moment. Talking with the staff confirmed that the issues around privacy and dignity had been discussed within all elements of their training. Talking with the people who live in this home, their relatives and the staff as well as looking at the menus showed that meals were to everybodys liking were nutritious as well as varied. On the day of the inspection there was a choice of either a chicken or a lamb dish. Both looked appetising. Talking to the cook and looking at peoples records showed that a number of special diets were being catered for such as those containing low salt or for diabetics. Care Homes for Older People Page 14 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live in this home have access to a robust and effective complaints procedure, are protected from abuse and have their legal rights protected. Evidence: The home was seen to have a complaints procedure that contained all of the information that someone would be needed should someone wish to raise and issue. Looking at the complaints log showed that three issues had been raised and these had been investigated and resolved by the homes management. Talking with the manager and her staff showed that staff had an understanding of what was required of them within the local policies and procedures for the protection of vulnerable adults. The manager confirmed that two issues had been referred into those procedures. Staff also confirmed that training in this area was included within their induction programmes. Talking with a number of the people who live in this home and their relatives showed that they understood who should be contacted if they had any concerns. Care Homes for Older People Page 15 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the home gives anyone living there a safe, wellmaintained and comfortable environment which encourages independence. Evidence: This home is in the centre of the Herefordshire town of Leominster. Since the last inspection it has been completely rebuilt and re-equipped with the older buildings that stood on the site being completely demolished. It is on three floors with the ground floor being taken up with a residential unit as well as the service block. This contains the kitchen which provides meals for all of the people living in the home as well as a fully equipped laundry to keep the clothing and the bedding of those people clean. On the first floor the home provides nursing care and support for another residential care area and on the third floor there is another residential area that can provide rehabilitation support for those who live in it. All bedrooms are for single use and have en-suite facilities. Each area has its own dining area as well as two lounge areas. There is also a large Care Homes for Older People Page 16 of 24 Evidence: lounge on the ground floor that can be used by people from anywhere in the home. The home also has a large, secure rear garden. This is divided into two with the ground floor residential area having exclusive use of one half and the rest of the home having the use of the other half. There is also a small car parking area to the rear of the home as well as public parking nearby. Care Homes for Older People Page 17 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to fill the aims of the home and meet the changing needs of people who live in this home. Evidence: The employment records of three of the staff were looked at and these showed that appropriate references had been obtained before people had access to service users as part of the procedure that ensures that they are fit do so. Looking at the staff rota as well as talking with the residents, the manager and staff showed that there high ratio of staff, in relation to the numbers of people being cared for, on duty to make sure that the needs of the those living in the home are met. During the inspection a lot of conversations between residents and staff were seen and heard. The staff were always professional, clear and polite when they spoke. Talking with a number of the staff confirmed that they have received or were about to go on the training that would ensure that they are able to meet the needs of the people living at the home. This was confirmed by talking with the manager and looking at the training records. Care Homes for Older People Page 18 of 24 Evidence: Talking to staff, the manager and looking at records also confirmed that a significant number of staff had achieved National Vocational Qualification level 2 or above in care and that others were making progress towards obtaining it. Care Homes for Older People Page 19 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager. Evidence: At the time of this inspection the manager was in the process of completing an application to be registered with the Commission for Social Care Inspection. This process is designed to assess the suitability of the applicant to manage a service such as this. Records were seen that showed that a member of the proprietors senior management team visits the home at least once a month. Equality and diversity for the service users were seen to be promoted throughout the home within the assessments, care plans and policies. Care Homes for Older People Page 20 of 24 Evidence: The home does store cash for some of the people living there. The system for recording this was seen to be transparent and accurate. Various records were seen to be kept that monitored systems and the environment in order to make sure the people living in the home safe. These were found to be kept up to date. Hazardous materials such as some cleaning fluids were seen to be kept securely and instructions about how they should be used safely were also available. Care Homes for Older People Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 23 of 24 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 24 of 24 - 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!