Inspection on 20/11/08 for Waverley Lodge Nursing Home

This inspection was carried out on 20th November 2008.

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 Lodge Nursing Home 28/11/07

Waverley Lodge Nursing Home 12/02/07

Waverley Lodge Nursing Home 29/11/05

Waverley Lodge Nursing Home 03/08/05

Waverley Lodge Nursing Home 21/12/04

Waverley Lodge Nursing Home 18/08/04

Waverley Lodge Nursing Home 07/05/03

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Newbeech House

Winton House

Treloar College

Rush Court

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Waverley Lodge Nursing Home Dunwood Manor Nursing Centre Sherfield English Romsey Hampshire SO51 6FD     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: Kathryn Emmons     Date: 2 0 1 1 2 0 0 8 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. the things that people have said are important to them: They reflect 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 25 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 25 Information about the care home Name of care home: Address: Waverley Lodge Nursing Home Dunwood Manor Nursing Centre Sherfield English Romsey Hampshire SO51 6FD 01794513033 01794519700 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Belinda Jane McClatchey Type of registration: Number of places registered: Sentinel Health Care Ltd care home 26 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users to be accommodated is 26. The registered person may provide the following category/ies of service only: Care home with nursing - (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) Physical disability (PD). Date of last inspection Brief description of the care home Waverley Lodge Nursing Home is located in Sherfield English with a sister home on the same site. The establishments are both owned by Sentinel Health Care Ltd. The home is registered to accommodate twenty-six service users in the categories of old age and adults from 18 years and older people in the categories of physical disability and terminal illness. Waverley Lodge was purpose built and shares some service facilities Care Homes for Older People Page 4 of 25 Over 65 26 0 0 26 Brief description of the care home with the sister home such as laundry and kitchen. The home has two floors and accommodation for residents is located on both of them, and a passenger lift and stairs provide access to the first floor. All bedrooms are singles and twenty-four have ensuite WCs. There is level access to landscaped gardens and there is a hydrotherapy pool on the site that is used by the home as well as by the three other care homes operated by the company. The home is situated approximately three miles from Romsey. A minibus is available to enables residents to access the amenities in the local community. Care Homes for Older People Page 5 of 25 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: The visit to the service was undertaken by one inspector who spent six and a half hours at the home. The care received by three residents was looked at in detail. This is a method called case tracking. This included looking at their personal records a range of general records and staff details. This forms part of a key inspection and focused on the standards in the key areas that most effect the quality of life for the residents. Information already held such as a service history and the providers self -audit which is called an AQAA (Annual Quality Assessment Audit) were used to plan the visit. During the visit the inspector spoke to the manager, responsible individual and four staff and 12 residents. We also sent comment cards for staff and residents to complete and we also considered the comments these contained when writing the report. Weekly fees for the service start from #seven hundred and twenty five pounds a week. Care Homes for Older People Page 6 of 25 Care Homes for Older People Page 7 of 25 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 8 of 25 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 9 of 25 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. Through pre admission assessments residents can be confident that their needs can be met by the service. Up to date information enables residents to make an informed choice regarding living at the service. Contracts provide residents with confidence that their rights are upheld in respect of purchasing their care and the service they can expect to receive. Evidence: As part of case tracking we looked at the admission details for three residents, including the newest person to be admitted to the service. We could see that information regarding the residents needs had been obtained before the resident had been offered a place at the service. The manager confirmed that where possible they would assess the prospective resident and discuss with the deputy manager. Information is obtained from the resident, their relatives and any other social or health professionals such as the residents social worker, doctor or hospital staff if the resident Care Homes for Older People Page 10 of 25 Evidence: is admitted from hospital.The home has its own assessment forms and we saw these contained a lot of areas for information to be obtained which means that all of the residents needs would be known before admission. There are two documents in place which provide information to prospective residents and their relatives to help them reach a decision about living at the service. These two documents are called the service user guide and the statement of purpose. These documents were up to date and are in the form of a brochure which is regularly updated. This needs to be amended slightly to inform people of which staff work in the service and their experience and qualifications. This means that residents can be confident that trained and skilled staff would be caring for them. We saw contracts in place and these had been signed by the residents and the manager. We did not see any letters on files which should be sent to prospective residents confirming that their assessed needs could be met, but the manager and the responsible individual confirmed these are sent and were located in a central correspondence file along with billing information.. There is a policy in place for emergency admission even though the manager confirmed that where possible this is avoided. Intermediate care is not provided at the service. Care Homes for Older People Page 11 of 25 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. Care plans and risk assessments which are regularly reviewed give residents confidence that their individual needs are known. Medication systems enable residents to be confident that they will receive their medication correctly. Systems in place provide good access to health care professionals. Residents dignity and privacy is respected Evidence: Using case tracking we looked at three residents service user plans . These included the newest person to be admitted to the home.The plans contained admission information, details of medications, care needs ,weight and nutritional needs. We could see the resident had been included in the production of their care plans and reviews were taking place. We could see that daily records were maintained which staff are able to use to monitor the progress and welfare of the residents. A key worker system is in place and staff we spoke with were able to tell us about this. One resident did not know who their key worker was but they did have the information in their room and said that they were able to speak to any staff to request help with their room and any Care Homes for Older People Page 12 of 25 Evidence: shopping they may need. We saw many interactions between staff and residents. All of these interactions were appropriate and valuing of the resident. Staff have an awareness of individuality and one carer said I have enough time to not be rushed so i must give the person time to say what they want and not rush them ,its their home and Im here to help and I speak to the people here like i would any one else and how i expect to be spoken to. We overheard and then saw interactions between one staff member and a resident who had very limited verbal communication and made their needs known through various noises and facial expressions. Even though the resident had not been living at the service very long the staff member was already able to understand what the resident was requesting. Privacy and dignity was upheld and staff were seen to knock on residents doors before entering. Residents confirmed through comment cards that they were satisfied with the arrangements for seeing doctors and other health care professionals. We were told by the manager that a local GP surgery visited the service every week to see those residents who have either requested to be seen or needed to see the Doctor. The home also has a Hydrotherapy pool situated in the ground and the service employs two physiotherapists to support the residents who use this facility. There is a very small charge payable to use the Hydrotherapy pool and residents are aware of this before they book an appointment. One resident told us they had recently visited the dentist and another couple of residents said they had seen the optician. We saw from notes that a chiropodist also visits the service. Medication arrangements were reviewed by us. This included us looking at the services medication policy including arrangments for self medicating. Residents are assessed on admission to see if they are able to self medicate. The manager said that assessment of the ability to self medicate would now be ongoing as residents needs and abilities may change and they may be able to take some control over some aspects of administering their medication. We looked at the medication administration records for all of the residents. These had been completed by trained nurses and were satisfactory. Before each medication sheet there is a current photograph of the resident to assist staff to minimize errors in giving medication to the wrong resident. We saw in staff files evidence of recent medication training. Care Homes for Older People Page 13 of 25 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. Residents are able to lead a lifestyle similar to what they had before living at the service. Appropriate activities are provided and individuality is respected. Dietary choices and preferences are catered for. More social outing opportunities will enable residents to have a more varied lifestyle. Evidence: The residents we spoke with gave examples of what activities took place at the home these included quizzes, games and occasional outside entertainers. An activities coordinator works at the service and a bi monthly news magazine called Waverleys World is produced. This also contained information on staff, activities and other events which have been occurring at the service. We could see that forthcoming trips were being arranged for a boat trip and a theatre trip into Southampton. One of the residents attends the local swimming pool and another resident said they were going on a shopping trip the following month. We spoke with residents who said they would like to go out of the home more . Comment cards from both staff and residents identified this an area for improvement for the service and staff we spoke to also said that the service would be better for residents if more social trips could be arranged. The manager and responsible individual have already identified this as an area for Care Homes for Older People Page 14 of 25 Evidence: development and meetings will be taking place to look at how more social opportunities such as going to the cinema, going to the pub to watch the football can be arranged. Residents meetings take place and minutes are maintained of these including actions that are going to be taken. A recording is taken of the meeting which can then be played to those residents who are not able to attend the meeting for example if they are on bed rest or do not want to attend. By recording the meeting this means that residents who may not be able to understand written minutes are not excluded for the decision making process. This also enables residents to maintain their rights as citizens and uphold their own values and beliefs in relation to taking control over how they spend their lives. Cultural and religious needs of residents are respected and clergy from various denominations visit the service to provide worship services. Residents are also assisted to attend local worship in the local community.We saw from the services newspaper and residents told us that various religious and cultural days are celebrated such as Burns night, Chinese new year, Indian New Year (Saka), St Andrews day and , St Georges day. Residents told us that they could chose when they received visitors . There were areas around the home for residents to meet with visitors if they didnt want to use their rooms. Residents are supported to make their own decisions regarding choosing to see visitors. Residents said they were able to exercise control over all aspects of their lives and that staff always gave them choice when they were supporting residents. One resident said. I only have a problem with my legs not my mind and they (staff) all understand that and another said I do need help and they will give me time to decide what i want to do then help me. Comment cards all indicate that the food was always good. We saw that there is a small kitchen in the home and the main meals are prepared in the kitchen of the other care home located in the grounds at Waverly and then transported over in a hot trolley. Residents told us The food here is great Always lots of choice and you can have what you want, i like everything. We could see that specialized diets such as sugar free and high fibre were provided for residents were involved in discussion regarding changing the menus and adding more options. Care Homes for Older People Page 15 of 25 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. A complaints policy enables residents and visitors to the service to raise any issues. They can be confident that their concerns will be listened to and dealt with. . Staff receive safeguarding adult training and the services policy is up to date. Evidence: There is a complaints policy on display and also contained within the homes brochure. We have not received any concerns or comments or allegation regarding the service. The AQAA informed us that in the past twelve months 2 issues were raised by relatives of two of the residents. Both of these concerns were investigated using the services complaints procedure. Both of the outcomes were recorded and we could see that the complainants were satisfied with the responses they received. The manager said that all comments and concerns are taken seriously and will always be investigated. Residents and staff we spoke with said they were confident any issues they raised would be investigated by the manager promptly. We saw in staff records, and all staff we spoke with confirmed that they had received training in safe guarding adults. We could see from the AQAA that the safeguarding adults policy had recently been reviewed but we did not view it on this visit. Care Homes for Older People Page 16 of 25 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. Residents live in a clean and pleasant service. Decor and furnishings are residents choice and specialized equipment enables then to be as independent as possible. Evidence: We took a tour of the premises and found them to be clean and tidy and fresh throughout. Since the last inspection a wall has been removed in the dining area to enable all residents to take their meals together if this is their choice. The corridors are wide and residents were seen to be able to move around freely in their wheelchairs. There is a lift which residents were seen to be using independently. Domestic staff are employed seven days a week and their duties include cleaning carpets and ensuring infection control measures are in place. We saw that staff were wearing different aprons depending on what activity they were doing and wore gloves when delivering personal care. Records showed that staff had received training in infection control. Residents said they liked their rooms and we could see that they had personalized them. Bedrooms were laid out so that staff were able to move hoisting equipment safely around the room and that those residents who used wheelchairs were able to move around their bedrooms safely. A maintenance person is employed and any repairs are reported and are addressed Care Homes for Older People Page 17 of 25 Evidence: promptly. The AQAA informed us that a lot of decorative work had been carried out in the last twelve months and upgrading of residents bedrooms was ongoing. The home is located in woodlands and landscaped gardens and share the grounds with another care home belonging to the organization and some private flats also managed by the same organization. Residents told us I love living here, such wonderful views to look out to and I moved bedrooms and it was painted before i moved into it with a colour I chose with Jane (manager) Care Homes for Older People Page 18 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. An enthusiastic and trained care team cares for residents. The organisations recruitment procedures are robust and protect residents. Sufficient staffing levels enable residents needs to be met. Evidence: Comment cards we received, which had been completed by residents ,all indicated that residents felt their care needs were always met. All except two comment cards ,which indicated sometimes, indicated staff were always available to meet resident needs. On the day of our visit we spoke with residents who continued to confirm they felt their were enough staff on duty to give support and care in an unhurried way. Staff told us that they felt their were enough staff on duty and that they were allocated four or five residents each morning to provide support to. Staff said they had a good team atmosphere and all worked well together. One staff member whose first language was not English said they had received a lot of support from staff when they started work at the service and that this support continued to be in place. Residents made comments regarding staff such as They are good to get on with, you can have a laugh with them and Its like being helped by a friend ,after a while you forget they are staff. We looked at three staff recruitment files. We could see the necessary checks such as Care Homes for Older People Page 19 of 25 Evidence: written references, application forms and criminal record bureau checks had been completed in their entirety. An induction process is in place and during the visit we saw one new member of staff receiving some induction training on health and safety. We looked at training records and could see that training had been delivered in various areas such as basic food hygiene , infection control ,moving and handling and fire safety. The manager also confirmed that more training in diabetes and Mental Capacity Act were due to take place in the near future. Since the last inspection the manager had attended a train the trainer course in moving and handling so that all staff receive this training before they support residents with moving and handling. Staff were supported to gain their NVQs in Care (National Vocational Qualification) and over 50 of staff now have this qualification. This means that they have an increased skill and knowledge base which may mean they are able to deliver an increased quality of care. Each shift has at least two trained nurses on shift to ensure that all nursing needs are met in a safe way. Care Homes for Older People Page 20 of 25 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. Residents live in a well managed service and are involved in the decision making regarding the running and operating of the service. Quality assurance systems are in place to improve the quality of the service . Regular supervision sessions mean that staff training needs can be identified and met. Health and safety arrangements keep residents, staff and visitors to the service safe. Evidence: Since the last inspection the manager has been registered by the commission . Residents made positive comments regarding the manager such as Jane comes and says hello whenever she is working and matron is very good and will listen to you and help if she can. Staff said I find her very fair and kind and I have a lot of respect for her and she will listen to you and has made some good improvements with how we do things. The manager is supported by the organisations group matron who is also the Care Homes for Older People Page 21 of 25 Evidence: Responsible Individual. We could see the monthly Regulation 26 reports are carried out . These include looking at the conduct of the home and any work that needs to be carried out and looking at the dependency needs of residents to ensure that enough staff are on duty. We could see from the sample of records we viewed that polices and procedure were regularly updated. Health and safety environmental risk assessments are carried out and the AQAA informs us of recent reviews of all polices and procedures. We could see from records and staff told us that regular supervision sessions for staff take place. This means that there is a formalized way of recording staff views and any learning and development needs they may have. There is a quality assurance system in place which comprises of questionnaires sent to residents and their families and internal audits of systems in the service such as medication and catering arrangements and completion of care plans. Where possible the service does not look after residents finances. When bills are to be paid such as hairdressing, newspapers and chiropody the bills are sent directly to the resident or their relative for payment. Any monies used to purchase items for residents are receipted and a clear audit trail is maintained. Care Homes for Older People Page 22 of 25 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 23 of 25 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 24 of 25 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 25 of 25 - 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. 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