Inspection on 29/08/07 for WCS - Mill Green

This inspection was carried out on 29th August 2007.

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

WCS - Mill Green 26/10/09

WCS - Mill Green 22/11/06

WCS - Mill Green 29/11/05

WCS - Mill Green 12/07/05

WCS - Mill Green 27/04/05

WCS - Mill Green 01/12/04

WCS - Mill Green 02/04/04

Similar services:

Aston Court Nursing Home

Breme

Ravenhurst

Westmead

Ashcroft Hollow Nursing Home

Bricklehampton Hall Nursing Home

Briar Hill House

Radbrook Nursing Home

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

CARE HOMES FOR OLDER PEOPLE WCS - Mill Green Newbold Road Rugby Warwickshire CV21 1EL Lead Inspector Amanda Hennessy Key Unannounced Inspection 29th August 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address WCS - Mill Green DS0000004266.V344807.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. WCS - Mill Green DS0000004266.V344807.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service WCS - Mill Green Address Newbold Road Rugby Warwickshire CV21 1EL Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01788 552366 01788 542655 Warwickshire Care Services Limited Ms Victoria Britton Care Home 15 Category(ies) of Learning disability (2), Physical disability (13), registration, with number Physical disability over 65 years of age (2) of places WCS - Mill Green DS0000004266.V344807.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd November 2006 Brief Description of the Service: Mill Green is a registered care home providing personal care and support for 15 people with physical disabilities, 2 of whom can be over 65 years of age. 2 of the places available are for respite service provision. Residents’ accommodation is on the ground floor. The shared space in the home consists of a large lounge with dining area. Each service user has an en-suite toilet to their bedroom with two bedrooms having an en-suite shower facility with WC. There is one bathroom with assisted bath and two shower rooms, both with WC’s. In addition to the main kitchen and laundry of the home there is a domestic kitchenette and laundry room for use by residents. There are two office facilities used by management and staff. There are extensive wellmaintained gardens to the front and sides of the home and an internal garden used for leisure activities by residents. All bedrooms over look garden areas. The home is situated in Newbold on Avon, which is in the suburbs of Rugby in Warwickshire, and close to shops, local services and facilities. Fees per person range from £730 per week, up to £929 per week (any fee information included in this report applied at the time of the inspection), depending on need. Hairdressing, private chiropody, newspapers and toiletries are not included within the fee but are available within the home for an additional cost. WCS - Mill Green DS0000004266.V344807.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an inspection undertaken without any prior notice by one Inspector. The inspection was carried out between 10.00 and 16.00. The inspection included a tour of the building, talking to service users, staff and the Manager, a review of records including information forwarded by the Manager before the inspection and survey comment cards that were completed by service users and their relatives. Care records were reviewed as part of the “case tracking” of two service users, two staff records who have been employed since the previous inspection were also examined. The previous two requirements have been addressed; No new requirements were made as a result of this inspection. What the service does well: Mill Green residential home is clean, friendly, welcoming and well maintained. The home has an experienced manager who provides effective and competent leadership for her staff. There is a stable staff team who provide continuity of care for the homes residents and there is a high percentage qualified and experienced care staff. All prospective residents have a comprehensive assessment of their needs and are able to visit the home and have a meal there prior to their agreement to come to live or stay at the home. Residents have appropriate access to health care and the health care needs of the residents are identified and followed up by staff. The home has appropriate and safe administration and storage of medicines. There are no apparent rigid rules or routines in the home. There are no restrictions on visitors to the home within reasonable hours and visitors say that they are always made welcome. Residents say that the homes staff are very good, comments received included: ‘The staff are lovely’ ‘The staff are very good and have taken time to learn how to communicate with me using the deaf blind manual alphabet.’ WCS - Mill Green DS0000004266.V344807.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. WCS - Mill Green DS0000004266.V344807.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection WCS - Mill Green DS0000004266.V344807.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at the home have an assessment of their needs and all required information about the home, giving assurance that the home will be able to meet their needs. EVIDENCE: People who wish to live in the home have an assessment of their needs prior to coming to live at the home. Further information is taken when the residents come to live at the home that identifies their likes, dislikes and their preferences, for example, preferred rising and retiring times, whether they liked a bath or a shower and how often they prefer a bath or shower, preferred drinks and foods and so on. These assessments then form the basis of their plan of care. Prospective residents are invited to visit the home and can join the existing residents for lunch if they wish to. The manager said she is currently developing the statement and purpose and service user in a pictorial format. WCS - Mill Green DS0000004266.V344807.R01.S.doc Version 5.2 Page 9 All residents are given terms and conditions of residency and service user guide giving them all required information about the home. WCS - Mill Green DS0000004266.V344807.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good systems in place for care planning and minimising the identified risks for the residents to ensure that residents’ needs are met. The health care needs of the residents are being met and the medication system was well managed and safe. EVIDENCE: People who live at the home have a plan of care that identifies their needs and gives staff instructions how to meet their needs. Care plans seen covered all required areas including, personal care, medical needs, dietary requirements and social needs. It was nice to see a record of what residents are able to do for themselves and what assistance they require. Individual likes, dislikes and preferences are also included within their plan of care. It was pleasing to see that the all residents’ plans of care are reviewed monthly and whenever possible the resident is involved in this review. WCS - Mill Green DS0000004266.V344807.R01.S.doc Version 5.2 Page 11 All residents care records seen, included required risk assessments including, nutritional and pressure sore risk, risk of falls assessments and moving and handling needs. All risk assessments are regularly reviewed and updated. Visits from health care professionals are recorded separately and are to easy to track and cross reference to changes in care needs. Residents spoken to confirm they could see the doctor if they wished and that they had visits from the chiropodist, optician, district nurses and so on when necessary. The home has good systems in place to administer and store of medicines. There is a record of all medicines that are received into the home and administered or codes identified when medicines are not administered and the reason why. There is a record of the drugs fridge temperature to ensure that medicines are stored within safe temperatures. A requirement made at the previous inspection to have protocols in place for the administration of PRN (as and when necessary) has been addressed. All residents have door knockers on their doors and staff knock and wait for residents to allow they to enter. Residents spoken to said that staff respect their privacy and confirmed that they knock before coming into their rooms and they are able to spend time in their rooms without being disturbed if they wished. Staff were seen to knock doors before entering. Medical consultations take place in the privacy of residents’ bedrooms. All bedrooms are lockable and residents are able to have their own key if they wish to. WCS - Mill Green DS0000004266.V344807.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are no rigid rules or routines in the home and residents can take part in a range of activities of their choice. There are no restrictions on visitors to the home within reasonable daytime hours. Residents are happy with the catering arrangements at the home. EVIDENCE: Routines in the home are kept to a minimum and residents are able to choose how they spend their time. One resident spoken to said: “ There is a lot of freedom here in everything, there are no restrictions.” The Home Manager said that the home encourage people to live ordinary lives irrespective of their disability or illness. The home encourages and supports people who live at the home to develop themselves by continuing hobbies / activities they had or did before they came to Mill Green and also to try new activities. Family interactions and personal relationships are also encouraged and residents are both encouraged and supported to be a part of the local community. WCS - Mill Green DS0000004266.V344807.R01.S.doc Version 5.2 Page 13 The home now has an Activity Organiser and it was good to hear that more activities and trips out are now organised and that life storybooks are being developed to highlight residents’ interests. Several service users enjoy going out to activities such as Speedway, and shopping. Issues highlighted at the previous inspection in relation to transport are being resolved. The Home Manager said that they can borrow the mini bus of a local home in their care group which has enabled more trips out to take place, although some residents did say they would like to go out more. One resident said that he enjoys wine making but his regular swimming sessions do not always take place due to a requirement that two staff are needed to accompany him and this was sometimes problematic. There are no restrictions on visitors to the home within reasonable daytime hours and visitors were seen to come and go throughout the course of the inspection and have a good relationship with staff. Relatives who returned surveys identified: “ We can come at any time and staff always make us welcome”. Residents stated they are able to go to bed and get up when they chose and spend their time as they chose. Residents are encouraged to personalise their rooms to their choosing and evidence of this was seen during the tour of the home. All the residents spoken with during the inspection were satisfied with the catering arrangements. Residents said: ‘ The meals are very good’ and, “There is always a choice, the meals are very good”. Lunch was observed, with staff giving residents assistance when necessary, the meal was unhurried and appeared to be enjoyed by all the residents. It was also nice to see tables appropriately laid and residents helped to get up to the dining table. WCS - Mill Green DS0000004266.V344807.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has appropriate systems in place to highlight concerns and ensure that residents are listened to and safeguarded. EVIDENCE: Residents spoken to said they would not hesitate to raise any concerns with the Manager. Residents are given a copy of the complaints procedure within their “Service User Guide” when they come to live at the home. The complaints procedure is also displayed in the home. The home has received seven complaints with a record of complaints received and the investigation that had been undertaken; although complaints about smoking at the home have been referred to the homes head office. The home has appropriate policies and procedures to safeguard people who live at the home. Staff spoken to were clear of actions that they would undertake if allegations of abuse were made. Staff receive training in adult protection and procedures that they should undertake. WCS - Mill Green DS0000004266.V344807.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is pleasant place to live and is clean, spacious and well maintained. EVIDENCE: The home is spacious, clean and a pleasant place for residents to live. The home is well maintained and has a programme of maintenance and redecoration. All residents’ accommodation is situated on the ground floor of the home and gives level access throughout. The home has a range of aids and adaptations to assist people with disabilities and include grab rails, hoists, wheel in showers and assisted baths with a staff call system throughout the home. There is a large, enclosed and attractive garden at the back of the home which is accessible to service users, several residents sat in the garden and enjoyed the late summer sun during the inspection. WCS - Mill Green DS0000004266.V344807.R01.S.doc Version 5.2 Page 16 All bedroom doors have a knocker and can be locked if residents wish to, there is also a lockable facility within residents’ rooms for them to keep treasured items if they wish to. The home was clean, uncluttered and free from unpleasant odours. The laundry was well maintained, and the appropriate systems for managing soiled laundry and reducing the risk of cross infection explained by the staff. WCS - Mill Green DS0000004266.V344807.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are sufficient staff to meet residents needs. Recruitment and selection procedures are robust and safeguard the service users. Staff training opportunities are good. EVIDENCE: The home has appropriate and sufficient staff to meet residents needs. Staff numbers have increased and are usually are based on a one aratio of one staff member for one resident. The Manager says that staff are settled and happy in their roles and there is in a minimal staff turnover giving additional assurance of the continuity of care for people who live at the home. The manager also said that staff are enthusiastic and motivated to learn and develop. Staff spoken to said confirmed this saying “ I love my job”. Residents said that are friendly and approachable” another said “ The staff are lovely here”. Staff are actively encouraged to attend training and carry out care and there are are 70 of care staff with a care qualification ( a minimum of National Vocational level 2). WCS - Mill Green DS0000004266.V344807.R01.S.doc Version 5.2 Page 18 Recruitment processes are good and all required checks such as references and criminal records checks are carried out prior to new staff commencing employment. New staff receive induction required induction training and it was reassuring to see that all staff have regular staff supervision sessions. WCS - Mill Green DS0000004266.V344807.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The manager of the home provides effective and excellent leadership to ensure the smooth running of the home. Systems are in place to continuously monitor the service on offer with a view to continuous improvement and ensure that people who live at the home are listened to. Residents’ health, safety and welfare is safeguarded at the home. EVIDENCE: The manager has managed the home since 1996 and has extensive care and management experience and has all required qualifications. Outcomes of the WCS - Mill Green DS0000004266.V344807.R01.S.doc Version 5.2 Page 20 inspection are that the home has strong and effective leadership and that residents needs are met and their views listened to. The manager is keen to ensure that her home continues to improve and has a programme of monitoring the quality of care, meals and housekeeping provided. The manager or a representative of the management team meet with each resident monthly to discuss their views on the service that the home provides and there is a record of this. In addition surveys are also sent out to staff, residents, relatives and visiting professionals, which are analysed, and actions required identified. It was pleasing to see that the Manager had been reviewing Commission for Social Care Inspection quality indicators to enable her to proactively look at ways that the home can develop even further and has developed an action plan to enable her to do this. Areas identified for improvement have been ensuring that the service user guide is available in formats such as large print and reviewing how complaints are recorded. This demonstrates that the home is not complacent with the excellent care and service that it provides but wishes to continually improve. The home does not handle any finances on behalf of the residents. One resident manages his own financial affairs and others managed small amounts of personal cash. Records seen show that staff receive supervision at the required frequency. Health and safety of the staff and residents is well managed. Required checks on the fire system, emergency lighting and hot water are undertaken. All equipment is serviced regularly. Required risk assessments for fire and food were also available. There are required and comprehensive reports of accident and incident and it was positive to see that the manager undertakes ongoing audits of residents accidents to ascertain patterns in the frequency, times and places that residents fall. WCS - Mill Green DS0000004266.V344807.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 x 4 x 3 3 x 3 WCS - Mill Green DS0000004266.V344807.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO 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. 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. Refer to Standard Good Practice Recommendations WCS - Mill Green DS0000004266.V344807.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ National Enquiry Line: 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 © 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 WCS - Mill Green DS0000004266.V344807.R01.S.doc Version 5.2 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. 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