Inspection on 02/05/05 for Waymead Short Term Care

This inspection was carried out on 2nd May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Waymead Short Term Care 08/08/07

Waymead Short Term Care 10/10/06

Waymead Short Term Care 02/05/06

Waymead Short Term Care 07/12/05

Waymead Short Term Care 15/12/04

Waymead Short Term Care 27/07/04

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Dalewood Respite Care

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Fairways

Treloar College

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Kestrel House, St Anne`s Opportunity Centre,

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

CARE HOME ADULTS 18-65 WAYMEAD SHORT TERM CARE St Anthonys Close Off Binfield Road Bracknell Berkshire RG42 2EB Lead Inspector Jill Chapman Unannounced 2 May 2005 @ 08:00 nd 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. WAYMEAD SHORT TERM CARE H51-H01 31646 Waymead STC V217322 030505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Waymead Short Term Care Address St Anthonys Close Off Binfield Road Bracknell Berkshire RG42 2EB 01344 424642 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) Bracknell Forest Borough Council Mrs Denise Angela Lacey Care Home 10 Category(ies) of Learning Disability registration, with number of places WAYMEAD SHORT TERM CARE H51-H01 31646 Waymead STC V217322 030505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 15/12/04 Brief Description of the Service: Waymead Short Term Care Unit provides respite care, for adults with a learning disability. The home can accommodate up to 10 service users per night. The home is registered to take service users who are male or female between the ages of 18-65 years.The service is owned and operated by Bracknell Forest Borough Council. WAYMEAD SHORT TERM CARE H51-H01 31646 Waymead STC V217322 030505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on a bank holiday Monday morning for a period of 5 hours. The purpose of the inspection was to follow up progress from the previous inspection and to see the routine on a day when residents are not out at day care. There were eight service users in residence and four were willing to give their views about the home. The inspector spoke to the three staff on duty and observed the breakfast, morning and some of the lunchtime routine. Care records for the eight service users were seen and health and safety records were sampled. A resident showed the inspector the communal areas of the home and one bedroom. A report from the Occupational Therapist was seen. There was a relaxed atmosphere in the home due to the bank holiday and residents spoken to said they are happy with their care. What the service does well: What has improved since the last inspection? The provision of outside activities has been developed to enable more choice; there is improved recording, opportunities and additional staff on some shifts to support these WAYMEAD SHORT TERM CARE H51-H01 31646 Waymead STC V217322 030505 Stage 4.doc Version 1.30 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. WAYMEAD SHORT TERM CARE H51-H01 31646 Waymead STC V217322 030505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection WAYMEAD SHORT TERM CARE H51-H01 31646 Waymead STC V217322 030505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 & 5 Residents benefit from a pre admission assessment to see if the placement is suitable but this has not always been translated into how the home can meet their needs. Residents do not have Service (Guest) Agreements in place to help them know what the home can offer and what is expected of them. EVIDENCE: One file sampled of a new resident showed that she had been assessed via a Waymead referral form. A requirement has been outstanding from 14-10-2003 to provide Service Users Agreements. On this visit a draft Guest Agreement was shown to the inspector and staff confirmed that this has not yet been implemented. This is in pictorial format to help residents understand it. The agreement covers most of the areas in the standard but Guest Agreements should be implemented without further delay. WAYMEAD SHORT TERM CARE H51-H01 31646 Waymead STC V217322 030505 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 & 9 A lack of systematic planning, review and risk assessments means that there is high possibility for needs not to be met and for residents to be potentially at risk. EVIDENCE: Eight working files were sampled for the residents in the home during the inspection. Four files had no care plans or risk assessments. Three other files showed care plans and risk assessments dated 2000/2001 and in one they were dated 2003/4. On one file sampled additional care instructions were on sticky labels on the front cover and should be converted into proper dated care plans. A crisis care plan had been provided by the Care Manager on how to respond to a residents’ Mental Health needs. This was kept in the office and not available with her contact sheets as a working document for staff. A behaviour guideline for a resident was also not available with the working records. A behaviour guideline for another resident was dated 2003 and needs review. In discussion with residents it was clear that they had needs that staff are responding to, which are not recorded as care plans. WAYMEAD SHORT TERM CARE H51-H01 31646 Waymead STC V217322 030505 Stage 4.doc Version 1.30 Page 10 A review system needs to be developed to ensure that current needs are met in a planned and consistent way. WAYMEAD SHORT TERM CARE H51-H01 31646 Waymead STC V217322 030505 Stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 14, and 17. Residents’ benefit from a good selection of in house activities and outside activities are being further developed, to offer more choice. There is choice and support offered at mealtimes. EVIDENCE: A resident showed the inspector around the home and was enthusiastic about the in house activities on offer and the opportunity to meet up with friends. The home is developing the variety of outside activities on offer and these are recorded. Extra staff are made available to support activities, at weekends and Wednesday evenings which is challenge club night. Residents said they enjoyed going to town, the garage shop, car boot sales and a local park. Residents said that they enjoy the meals provided at Waymead. Food stocks are good and it was seen that choice was offered at the breakfast and lunch meal. Staff helped residents with their meal as necessary. WAYMEAD SHORT TERM CARE H51-H01 31646 Waymead STC V217322 030505 Stage 4.doc Version 1.30 Page 12 WAYMEAD SHORT TERM CARE H51-H01 31646 Waymead STC V217322 030505 Stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 20 Residents have their medication kept safely while they are in the home and there is a system to help them take this. Management failure to implement recommendations to improve the system potentially puts residents potentially at risk. EVIDENCE: There is a system for booking in resident’s medication and this is stored securely. A shortfall is, that for one resident, the home is not following the instructions on the pharmacist label but the different instructions given by the parent. For another resident the pharmacists instruction are ‘as directed’, and staff said there is need for further clarification. The Pharmacy Inspectors’ report, dated 19th March 2004, clearly states that medication should only be given in line with the instructions on the pharmacists label. Other recommendations on this report have not been carried out. WAYMEAD SHORT TERM CARE H51-H01 31646 Waymead STC V217322 030505 Stage 4.doc Version 1.30 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 There is a procedure for dealing with residents and carers concerns. Staff are aware of how to respond to concerns about residents safety. EVIDENCE: There is a user-friendly complaints procedure in place and two complaints received had been dealt with appropriately. There is a vulnerable adults procedure and staff spoken to have received training and were familiar with this. WAYMEAD SHORT TERM CARE H51-H01 31646 Waymead STC V217322 030505 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 29 & 30 The home is well situated to give residents access to local facilities. There is good communal space and leisure equipment to make staying in the home comfortable and interesting. Management need to respond to the concerns raised by the Occupational Therapist, which affect residents’ safety and dignity. Residents benefit from a clean environment and well cared for clothing. EVIDENCE: The home is purpose built and in easy walking distance of the amenities of Bracknell town centre. A resident gave the inspector a tour of the communal areas of the building. He said he likes coming to Waymead and spoke of the benefits of the large games room, the lounge/dining room and conservatory. The home has three TVs, pool table, video, electric organ, music centre and computer. He showed the bedroom he was occupying and the CD player, which is provided in the room. The room was well furnished and clean. A report from the Occupational Therapist, dated 20-12-05, was seen on the notice board. This highlights the lack of space, in bathrooms and the lack of space to use the hoist in the bathroom with the Parker bath, the lack of a changing table and the need for overhead tracking for a hoist. The report also highlight a lack of privacy and dignity for residents, because they have to be changed in their rooms and transferred to the bathrooms WAYMEAD SHORT TERM CARE H51-H01 31646 Waymead STC V217322 030505 Stage 4.doc Version 1.30 Page 16 either in their wheelchairs or the hoist covered only in towels. Alterations to the shower room and overhead tracking are highlighted as priority work. The registered persons should notify CSCI of their plans to address these shortfalls and a timescale should be set to carry out this work. There is a large laundry with suitable equipment. An infection control policy on display pre dates the transfer from Berkshire County Council to Unitary Authorities in 1998 and needs review to see if it is up to date practice. Staff wash and iron residents’ clothes before they go home. A resident said she was very pleased with this excellent service. WAYMEAD SHORT TERM CARE H51-H01 31646 Waymead STC V217322 030505 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31. Staff were confident about their role and were seen to respond to residents needs. Residents knew their key workers and how they help them.. EVIDENCE: Staff on duty were clear about their roles and the routine of the day. They were helpful to the inspection process. They reacted positively to the varying needs of the residents. Residents knew who their key worker is and how they help them. Staff confirmed that training updates are ongoing. WAYMEAD SHORT TERM CARE H51-H01 31646 Waymead STC V217322 030505 Stage 4.doc Version 1.30 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 42 & 43 There has been management failure in addressing out of date care systems and outstanding requirements. Some health and safety systems sampled were up to date but other key documentation is out of date and potentially puts residents at risk. EVIDENCE: There is an experienced registered manager in post but due to long-term sickness the home has experienced a long period of instability. Although interim management arrangements have been in place, some key areas, which need development, have not moved on. Delays in responding to outstanding requirements need to be urgently addressed. It is positive that an Assistant Unit manager is in post and that another has just been recruited. Health and safety record sampled were up to date. It was noted that a planned fire drill is due soon. Two residents told the inspector about the fire evacuation procedure and the time and day of fire alarm testing. The insurance policy on display is out of date. WAYMEAD SHORT TERM CARE H51-H01 31646 Waymead STC V217322 030505 Stage 4.doc Version 1.30 Page 19 WAYMEAD SHORT TERM CARE H51-H01 31646 Waymead STC V217322 030505 Stage 4.doc Version 1.30 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 2 x x 1 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 1 x x 1 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x 1 3 Standard No 11 12 13 14 15 16 17 x 3 x 3 x x 3 Standard No 31 32 33 34 35 36 Score 3 x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 WAYMEAD SHORT TERM CARE Score x x 1 x Standard No 37 38 39 40 41 42 43 Score 2 x x x x 2 x H51-H01 31646 Waymead STC V217322 030505 Stage 4.doc Version 1.30 Page 21 yes 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 5c Regulation 5 Requirement Develop a standard form of contract for the provision of services and facilities by the registered provider to service users, which meets the criteria in the standard . This is outstanding from Ensure that medication is given according to the written instructions on the packet. The registered persons should notify CSCI of their plans to address the shortfalls in the the bathrooms which have been identified by the Occupational Therapist, and give a timescale to carry out this work. Care plans should be available and up to date. Risk assessments should be available and up to date. A system needs to be developed to enable ongoing review. Up to date details of the homes insurance policy should be avaiable in the home Recommendations made by the Pharmacy Inspector to improve the medication system should be carried out. Timescale for action 2-08-05 2. 3. 13(2) 29 20 23(n) 2-08-05 2-08-05 4. 5. 6. 7. 8. 6 9 6 25 13(2) 15 13(4)c 15 43 20 2-08-05 2-08-05 2-08-05 2-08-05 2-08-05 WAYMEAD SHORT TERM CARE H51-H01 31646 Waymead STC V217322 030505 Stage 4.doc Version 1.30 Page 22 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. 2. Refer to Standard 30 5 Good Practice Recommendations The Infection Control Policy needs review to see if it is up to date practice. A copy of the service user plan and arrangements for reviewing this could be added to the Guest Agreement. WAYMEAD SHORT TERM CARE H51-H01 31646 Waymead STC V217322 030505 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 2nd Floor 1015 Arlington Business Park Theale, Reading Berkshire RG7 4SA 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 WAYMEAD SHORT TERM CARE H51-H01 31646 Waymead STC V217322 030505 Stage 4.doc Version 1.30 Page 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. 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