Inspection on 03/08/05 for Waverley Lodge Nursing Home

This inspection was carried out on 3rd August 2005.

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

Waverley Lodge Nursing Home 20/11/08

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 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 09/07/2008.

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Waverley Lodge Nursing Home Dunwood Manor Nursing Centre Sherfield English Romsey SO51 6FD Lead Inspector Tim Inkson Unannounced 03.08.05 9:30am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People and Care Homes for Adults 18 – 65*. 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. Waverley Lodge Nursing Home H54 S11423 Waverley Lodge V240676 030805.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Waverley Lodge Nursing Home Address Dunwood Manor Nursing Centre, Sherfield English, Romsey, SO51 6FD Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01794 513033 01794 519700 Sentinel Health Care Limited Mr N Young CRH 26 Category(ies) of PD(E) - 26; OP - 26; PD 26; TI - 26 and TI(E) registration, with number 26 of places Waverley Lodge Nursing Home H54 S11423 Waverley Lodge V240676 030805.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The number of persons for whom accommodation and nursing care is provided at any one time shall not exceeed 26 2. General Nursing Care: Elderly persons 60 years plus, Convalescent care Respite care and Terminal care all 18 years plus 3. Specialist Nursing Care : Physical disability and Pallative care both 18 year plus Date of last inspection 21.12.04 Brief Description of the Service: Waverley Lodge Nursing Home is located in Sherfield English. It is on the same site as it’s sister home Dunwood Manor. The establishments are both owned by Sentinel Health Care Ltd (the company).Waverley Lodge was purpose built and shares some hotel service facilities with Dunwood Manor i.e. laundry and kitchen. The home has 2 floors and accommodation for residents is located on the both of them, and a passnger lift provides access the first floor. All bedrooms are singles and 24 have en-suite WCs. The home is provided with assisted bathing facilities and the communal/shared rooms comprise, a lounge and dining room, a kitchenette, a smoking room and an activities room. 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. Located some 3 miles from the market town of Romsey, the home is situated on a bus route but also benefits form having a minibus that enables residents to access the amenities in the local community.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 cactegories; physical disability and terminal illness. Waverley Lodge Nursing Home H54 S11423 Waverley Lodge V240676 030805.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was the first of two that must be made to the home during the period, April 2005 to March 2006. It was unannounced beginning at 09:00 and finishing at approximately 16:50 hours on 3rd August 2005. During the inspection records and documents were examined, an opportunity was taken to tour the premises, some staff working practice and organised activities were observed. In addition residents (11), visiting relatives (1), a healthcare professional (1), and staff (5) were spoken to. Other information that influenced this report was a questionnaire completed by the registered manager and 3 comment cards received from 1 resident and 2 relatives. At the time of the inspection there were no vacancies with 26 residents being accommodated, of these 8 were female and 18 were male and their ages ranged from 31 to 98 years. The home’s deputy manager was available throughout the day to provide assistance and information as required and the company’s operations director and managing director were also available at one stage to discuss any matters of concern that might have arisen during the inspection visit. What the service does well: What has improved since the last inspection? At the last inspection of the home on 21st December 2004 there had been a slight offensive odour in two bedrooms. The home had subsequently implemented a more thorough cleaning regime and consequently there were no offensive odours throughout the building at the time of this inspection. A visiting relative commented about the cleanliness of the home. Waverley Lodge Nursing Home H54 S11423 Waverley Lodge V240676 030805.doc Version 1.40 Page 6 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. Waverley Lodge Nursing Home H54 S11423 Waverley Lodge V240676 030805.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Standards Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Waverley Lodge Nursing Home H54 S11423 Waverley Lodge V240676 030805.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3 and 5 There were good admission procedures in place that included providing potential residents with information about the home and assessing their care needs before they moved into the home. Potential residents were also able to visit the home and/or have a trial stay before deciding whether to live there permanently EVIDENCE: Copies of the home’s Service users Guide were observed in residents’ bedrooms and the document provided clear details of the facilities and services that the home provided. Residents spoken to said that either before they moved into the home or soon afterwards they were given detailed information about the home, also that they were able to visit the home to view it or have a short stay at the home to enable them to decide whether it was suitable. In Waverley Lodge Nursing Home H54 S11423 Waverley Lodge V240676 030805.doc Version 1.40 Page 9 addition some residents recalled someone from the home seeing them before they moved in, in order to ascertain what help they needed and that subsequently the home wrote to them and confirmed that the home could meet their needs. Evidence of such written communication was seen in a sample of 4 records that were examined. • “I came and looked around with my mother and the registered manager talked to me about what help I needed”. • “I have been her about a week and I have decided that I want to stay” • “I was her for a fortnight and then said that I liked the place and have since then settled in very well”. The records examined also confirmed that assessments of the needs of potential service users were made before they moved into the home and following their admission very detailed assessments of individuals’ need were completed and that these were reviewed regularly. Where individuals had been admitted to the home through care management arrangements copies of the assessments and care plans of the relevant local authority were also available. Waverley Lodge Nursing Home H54 S11423 Waverley Lodge V240676 030805.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards to be inspected at least once during a 12 month period JUDGEMENT – we looked at outcomes for standard(s) 7,8 and 10 There were good systems in place to ensure that the social and health care needs of service users were met and their privacy and dignity was promoted EVIDENCE: The care plans and related records of 4 residents were examined. Plans of care were detailed and set out the action staff had to take and any equipment that was necessary to meet the assessed needs of service users. There was evidence that residents and /or representatives were involved in the development of the care plans and that they were reviewed regularly. One resident said, “I have a copy of my care plan in my room”. Waverley Lodge Nursing Home H54 S11423 Waverley Lodge V240676 030805.doc Version 1.40 Page 11 Residents said that the help and care they from staff was in accordance with their agreed plans and that they believed staff had the skills to look after them properly. Comments about the care and support residents received included the following: • “The staff are very good, I need help with washing and dressing, getting to the toilet and I have to be moved in a hoist. I always feel safe when they help me. • “They seem to know what they are doing when they help me” “They help me in and out of bed and have to use the hoist – they know what they are doing”. • “They do their very best to manage my mother” • “I need help with everything, and I feel totally confident when they help me, they certainly know their business”. Where care plans indicated equipment (e.g. wheelchair, Zimmer frame; hoist; pressure relieving aid) was necessary this was observed to be in place. Permanent staff spoken to were able to describe the contents of care plans and the details of the specific care, help and/or equipment/aides that service users required. Records examined and discussion with residents and staff indicated that the home actively promoted the health care needs of individuals. Residents said that doctors visited them at the home from a local practice in addition that the home arranged visits to specialists, clinics etc, when necessary and that other regular health care checks and treatments were arranged for them. The deputy manager confirmed that two surgeries held “rounds” in the home to see their patients every week as well as visiting residents on request when the home had concerns about an individual’s health. The home had access to remedial therapy assistants employed by Sentinel Healthcare Ltd and they were able to implement prescribed plans of treatment including the use of the hydrotherapy pool located in the grounds that was highly regarded by many service users. • “I have seen the visiting doctor about twice and I saw the chiropodist recently”. • “I love the hydrotherapy, I am looking forward to my next session on Friday”. A range of recognised methods/tools for assessing service users health needs and for identifying the need for interventions that could be required were used by the home e.g. nutrition and pressure sores. Although at the time of the inspection no residents had pressure sores at a previous inspection of the home on 21st December 2005 specific and detailed wound management plans were seen and there was evidence on that occasion that they were monitored and reviewed regularly. The registered manager had also stressed that the home liaised with the local tissue viability nurse for advice and support when necessary. A visiting health care professional said, “the staff are committed, up to date with their practice and their care plans are good”. Waverley Lodge Nursing Home H54 S11423 Waverley Lodge V240676 030805.doc Version 1.40 Page 12 Staff spoken to described some training courses that they had attended including “palliative care” and “continence promotion” that were directly related to and concerned with the specific care and support that the home provided. All residents spoken to said that the staff generally respected their privacy and dignity. They also confirmed that they were able to wear their own clothes and that they were addressed by their preferred terms that were noted in their care plans. • “They always knock on my door - they asked me when I came in what I wanted to be called” • “They don’t always knock - they always ensure my modesty is preserved”. • ” I find that they are polite”. • “They are always polite and ensure I am covered up when I am washed or dressing”. Waverley Lodge Nursing Home H54 S11423 Waverley Lodge V240676 030805.doc Version 1.40 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with asssistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 12 and 15 A good variety of activities and events were organised from which service users could benefit. Good links were maintained with the community and visitors were encouraged and made welcome. The meals in the home were good, providing variety, choice and catering for special dietary needs. EVIDENCE: The home employed an activities organiser for 5 days a week. The home also had access to mini bus that was used to take residents out. There was evidence from photographs and notices around the home that entertainment and activities were a priority in the home. Residents said they enjoyed the trips out and other organised activities. The records of residents that were examined included details about their leisure interests. Waverley Lodge Nursing Home H54 S11423 Waverley Lodge V240676 030805.doc Version 1.40 Page 14 Organised group activities were observed taking place in the home’s lounge during both the morning and afternoon of the inspection. On each occasion a different small group of residents was participating in board games i.e. scrabble and draughts. One resident said, “we cheat a bit sometimes”. Another described the range of activities that were available, “we have lots of activities, quizzes, cards, board games and trips out”. One visitor said that her relative who was confined to bed because of her frailty was seen for a short period of time on a one-to-one basis when someone usually read to her but she would like more time to be spent with her and suggested that hand or foot massage could be both enjoyable and beneficial for her. The company’s operations director said that staff spent time with residents who were unable or did not want to get out of bed for one-to-one individual activity sessions. Residents said that the home’s routines were unobtrusive and that they were able exercise choice about things that were important to them. • “Its very relaxed, if you want to go for a smoke you can, you can go to bed and get up at any time you want”. • “I choose to have my meals in my room”. • “I don’t have to be up by a certain time One resident spoken to who was in bed late in the morning and watching his television said, “I did not want to get up today”. Residents and visitors confirmed that visiting arrangements were flexible and that visitors were made welcome to the home. A visiting relative said that communication with the home was good and that she was notified of any concerns about the health of her relative in the home. • “Visitors can come and go at any time” • “I have plenty of visitors and there are no restrictions” • “The manager always rings me if he says he is going to”(visitor). • “I had visitors every day last week”. Most residents spoken to said the food provided by the home was good and that there was a wide choice and variety. They also said they were advised of the choices available and orders for meals were taken in advance, that they had three meals a day and could have snacks and drinks at other times. The presence of jugs of fruit juice and water and fresh fruit was noted in communal areas and fluids were also observed available and accessible for individuals too frail too leave their rooms or who were bedfast. Comments about the food included the following: • “I have no complaints about the food, there is plenty of it, we have 3 choices at lunchtime and at night we can have whatever sandwiches we want. If you don’t want ham and egg pie or you want extra you just say”. • “The food is very good” • “The food is marvellous, they are fantastic, she gets things specially and exactly what she wants and how she wants it” (visitor). Waverley Lodge Nursing Home H54 S11423 Waverley Lodge V240676 030805.doc Version 1.40 Page 15 “The quality is not bad, and the lunch isn’t too bad, but the evening meal is sandwiches and I am used to a big meal in the evening. I eat it all and there is considerable choice”. The company’s operations manager said that there was a microwave available in the home and if someone wanted to have their main meal in the evening it could be arranged. The home shared kitchen facilities that were located in another home on the site also owned by Sentinel Health Care and at the inspection of that home on 26th April 2005 it was noted that details about the specific dietary needs of some residents (e.g. diabetic; soft or pureed food), were kept in the kitchen and that fresh produce was used in meals. It was noted that homemade “apple cake” was served to residents with tea during the afternoon of this inspection. • Waverley Lodge Nursing Home H54 S11423 Waverley Lodge V240676 030805.doc Version 1.40 Page 16 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Arrangement for protecting service users and responding to their concerns were satisfactory. EVIDENCE: The home’s complaints procedure was appropriate and was readily accessible in the Service Users Guide, a copy of which was available in every bedroom. Residents and visitors said that they were confident about taking up any concerns with the home’s manager. A record of complaints made to the home was kept and there had been two complaints made to the home since the last inspection of the home on 21st December 2004. One was from a relative and one from a member of staff .The records set out; details of the complaint; the name of the person investigating the matter; the agreed action and the outcome. It was apparent that both complaints had been resolved. No complaints had been made to the CSCI about the home in the last 12 months. The home had a number of written detailed policies and procedures concerned with adult protection and related matters. These comprised: • Prevention of abuse • Confidentiality • Whistle-blowing Waverley Lodge Nursing Home H54 S11423 Waverley Lodge V240676 030805.doc Version 1.40 Page 17 • • • • • Residents personal money and valuables Gifts, bequests and wills Relationships Aggression Restraint A copy of the local authority’s adult protection procedures was available. There was documentary evidence that all the home’s staff had undertaken training in abuse. This was confirmed in conversations with staff. It was apparent from these discussions that they knew the appropriate action to be taken if they suspected or knew that abuse was occurring in the home. Where risk assessments indicated that the use of bed rails were necessary to prevent a resident suffering serious injury a singed agreement was in place. This was necessary as bed rails may be regarded as a form of restraint and as such their use or not was agreed with the individual and other interested parties e.g. relative/representative, GP, care manager, and the decision was recorded. Waverley Lodge Nursing Home H54 S11423 Waverley Lodge V240676 030805.doc Version 1.40 Page 18 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20 and 26 The home provided a comfortable, clean and safe standard of accommodation, with suitable facilities to meet service users needs. EVIDENCE: Waverley Lodge is situated in a rural area approximately 3 miles from the market town of Romsey. It is set back from the main road and bus-route to Salisbury, in an estate of some 20 acres and is surrounded by woodland, fields and has landscaped gardens. Waverley Lodge Nursing Home H54 S11423 Waverley Lodge V240676 030805.doc Version 1.40 Page 19 The home was purpose built and has accommodation for service users on two floors. On the same site and linked by a covered walkway is another nursing home also owned and managed by Sentinel Care. Some of the facilities on the site are shared by the two homes i.e. laundry, kitchen, hydrotherapy pool and gardens. The premises were in good repair. There was evidence from observation and discussion with residents that some improvements had been undertaken that included redecoration of the ground floor corridor and the installation of a large area of decking outside the ground floor lounge. At the last inspection of the home on 21st December 2004 the registered manager had stated that some of the public areas of the home were to re-decorated during 2005. • “The decoration is alright, they have just decorated the hallway and corridor and put new handrails up” (resident) Sentinel Healthcare Ltd, employed permanent maintenance staff and at a previous inspection of the home of other homes operated by the company they have been observed working during the inspections. Residents and visitors said that the building was clean and hygienic and that the communal/shared accommodation was comfortable. • “This place is the cleanest, there are no smells, it is always beautifully kept. If there is a accident they deal with it straightaway”(visitor). • “They keep the place nice and clean” (resident). • “Its very comfortable and we can go in the garden which is very nice”. At the last inspection of the home on 21st December 2004 there had been slight offensive odour in 2 bedrooms, but on this occasion there were no offensive odours throughout the building. The company’s operations director said that some bedrooms were thoroughly “deep cleaned” daily, if necessary. The communal areas on the ground floor comprised a large lounge and a small separate dining room, a kitchenette and a smoking room. There was a small activities room that was being used for storage and a hairdressing room on the first floor. The décor and furnishings in the communal areas were domestic in character. Access to the garden and grounds surrounding the home had been improved by the installation of a large raised area of decking that residents could get to easily from two sets of patio doors in the lounge and dining room. The views from the decking were attractive and residents said that they would utilise the decking as soon as some patio furniture that was on order had been set out. In another part of the extensive grounds and garden a temporary canvas gazebo/tent had been erected to provided shade in sunny weather for residents wishing to use the outside areas. There was evidence that the safety of the building was assured by among other things, staff receiving training at appropriate intervals in fire safety matters and fire safety equipment and systems in the home were checked and serviced regularly. Housekeeping staff were observed during the inspection undertaking cleaning tasks and all staff were observed using protective clothing appropriately. Waverley Lodge Nursing Home H54 S11423 Waverley Lodge V240676 030805.doc Version 1.40 Page 20 There were a range of written policies and procedures available concerned with infection control these included: • Clinical waste • Spillage of bodily fluids • Laundry health and safety There were sluice disinfectors located on both floors of the home. There were no offensive odours throughout the building. The home’s laundry facilities that were shared with the other home on the site were appropriately located and equipped and procedures were in place for managing soiled items that prevented the risk of cross infection. Waverley Lodge Nursing Home H54 S11423 Waverley Lodge V240676 030805.doc Version 1.40 Page 21 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 29 and 30 (Older People) and Standards 34 and 35 (Adults 18-65) the key standards to be inspected at leat once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, and 29 The skill mix of the home’s staff was good and they were deployed effectively to meet the needs of service users. Recruitment procedures for new staff were satisfactory. EVIDENCE: All residents spoken to said that staff were able to provide the help and care that they needed and they felt safe when staff assisted them. The majority of residents also said that there were enough staff on duty in the home at all times and that the alarm call system was responded to quickly. Staff were observed reacting to the call system well within 60 seconds of it being activated on several occasions throughout the day. The perceptions of one visitor and some staff was that at times more staff would be beneficial. Staff were able to describe the contents of care plans, the needs of individual service users and the help they required. Comments about the staff included the following: • “The staff are brilliant” (resident) Waverley Lodge Nursing Home H54 S11423 Waverley Lodge V240676 030805.doc Version 1.40 Page 22 • “I have nothing but admiration for them, I am full of praise they are so dedicated” (visitor) The home’s nursing and care staff comprised 6 registered nurses and 10 health care assistants and of the latter 4 had at least National Vocational Qualification (NVQ) Level 2 or equivalent. The minimum staffing level maintained in the home at all times for registered nurses and care assistants was as follows: 08:00 to 14:00 2 4 6 14:00 to 20:00 2/1 2/3 4 20:00 to 08:00 1 2 3 Registered nurses Care Assistants Total In addition the home employed or shared with the other nursing home on the site staff dedicated to, cleaning, catering, organising activities, administrations, remedial physiotherapy, and maintenance. At the time of the inspection the home was having to use agency staff to provide holiday cover but a visitor said that she had noted that the home attempted to use the same staff from the agency to ensure some continuity. She also said that the registered manager attempted to keep a “constant team of staff” and that he had “increased the morning staff numbers”. There were 2 agency staff on duty at the time of the inspection and neither had a formal qualification although they both said that they had undertaken moving and handling and fire safety training. The registered persons should be aware of the expectation in standard 28.2 of the National Minimum Standards for Care Homes for Older People and the corresponding standard 32.5 of the National Minimum Standards for Care Homes for Adults (18 to 65). That any agency staff working in the home be included in the 50 ratio of care staff qualified to at least National Vocational Qualification (NVQ) level 2 in Care. The records of 3 staff employed since the last inspection of the home on 29th November 2004, were examined. All the necessary pre-employment checks and information that must made or obtained, had been undertaken and received prior to them working in the home. Waverley Lodge Nursing Home H54 S11423 Waverley Lodge V240676 030805.doc Version 1.40 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s polies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 33, 35 and 38 (Older People) and Standards 23, 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 34 and 36 The home’s management approach was good, promoting a supportive, inclusive, relaxed, living and working environment. Staff were supervised appropriately and there were good procedures in place ensuring residents interests were safeguarded. Waverley Lodge Nursing Home H54 S11423 Waverley Lodge V240676 030805.doc Version 1.40 Page 24 EVIDENCE: Residents, visitors and staff described Waverley Lodge as homely and friendly and staff were observed exchanging banter with residents. During the afternoon of the inspection there was considerable interaction between groups of residents and a lot of conversation and laughter in the lounge. Residents described the atmosphere as friendly and staff spoke enthusiastically about working in the home. There was evidence that residents and staff participated in regular meetings and were consulted and involved in discussions about life in the home. • “I have no problems with the staff and its like living in a big family” (resident) • “I would say the place was relaxed and quiet” (staff member) • “The staff are wonderful” (visitor) • “I love it because I have all my friends here, I like the staff. I have been to 2 other homes and this is the best place that I have been” (resident). • “The atmosphere is brilliant, the communication in the home is great, we sort out our problems with the manager ,both he and the deputy manager are very helpful and supportive. I am really happy here” (staff member). • “Its really nice here, its far more friendly that the last place I worked and you are left alone to your own devices”(staff member) • “We cannot speak to highly of the matron and most of the staff….” (Comment card form a relative) The mix of genders and ethnic origins of the staff group demonstrated evidence of the home’s commitment to the promotion of equal opportunities. An examination of records and discussion with staff indicated that they received regular and frequent supervision and this included an annual appraisal. The latter summarised the work individuals had undertaken in the preceding 12 months and identified their future training needs and career aspirations. • “We try and provide supervision about every 6 weeks” (registered nurse) • “I have supervision about every month, sometimes from the matron and sometimes from a registered nurse” (health care assistant). The home managed the financial affairs of some residents and also held small amounts of money for some individuals. A sample of the records of some of these monies accorded with the balances held by the home. The managing director of Sentinel Health Care was a corporate appointee for a number of residents in Waverley Lodge and other homes owned by the company. Residents’ finances were held in an account kept separate from the company’s main business account and itemised records that were seen at a previous inspection were kept of deposits and withdrawals in respect of each individual resident. There was some discussion with the managing director on Waverley Lodge Nursing Home H54 S11423 Waverley Lodge V240676 030805.doc Version 1.40 Page 25 this occasion of the need to ensure that residents were able to receive interest on any savings that they might have. Waverley Lodge Nursing Home H54 S11423 Waverley Lodge V240676 030805.doc Version 1.40 Page 26 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 3 2 x 3 3 4 x 5 3 6 N/A HEALTH AND PERSONAL CARE ENVIRONMENT Standard No 19 20 21 22 23 24 25 26 STAFFING Score 3 3 x x x x x 3 Score Standard No 7 8 9 10 11 Score 3 3 x 3 x Standard No 27 28 29 30 3 2 3 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION Standard No 16 17 18 Score 3 x 2 MANAGEMENT AND ADMINISTRATION Standard No Score 31 x 32 3 33 x 34 x 35 3 36 3 37 x 38 x Waverley Lodge Nursing Home H54 S11423 Waverley Lodge V240676 030805.doc Version 1.40 Page 27 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 29 Good Practice Recommendations It is recommended that the registered persons ensure that any agency staff working in the home be included in the 50 ratio of care staff qualified to at least NVQ level 2 in Care Waverley Lodge Nursing Home H54 S11423 Waverley Lodge V240676 030805.doc Version 1.40 Page 28 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI. Waverley Lodge Nursing Home H54 S11423 Waverley Lodge V240676 030805.doc Version 1.40 Page 29 - 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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