Inspection on 24/06/07 for WCS - Newlands

This inspection was carried out on 24th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

WCS - Newlands 25/07/06

WCS - Newlands 23/11/05

WCS - Newlands 14/06/05

WCS - Newlands 24/01/05

WCS - Newlands 20/05/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Aston Court Nursing Home

Polesworth Group 70 Long Street

Breme

Ravenhurst

Polesworth Group 64 Long Street

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

CARE HOME ADULTS 18-65 WCS - Newlands Whites Row Kenilworth Warwickshire CV8 1HW Lead Inspector Yvette Delaney Key Unannounced Inspection 24st June 2007 09:30 WCS - Newlands DS0000004267.V337940.R01.S.doc Version 5.2 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 - Newlands DS0000004267.V337940.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 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. WCS - Newlands DS0000004267.V337940.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service WCS - Newlands Address Whites Row Kenilworth Warwickshire CV8 1HW 01926 859600 01926 864240 admin@wcsnewlands.f9.co.uk 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) Warwickshire Care Services Limited Ms Wendy Bridge Care Home 26 Category(ies) of Learning disability (4), Physical disability (18), registration, with number Physical disability over 65 years of age (4) of places WCS - Newlands DS0000004267.V337940.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Admissions No further service users with both a physical disability and/or learning disability must be admitted. The registration category of physical disability and learning disability (4) relates to the four named service users only. 25th July 2006 Date of last inspection Brief Description of the Service: The home provides care for 26 adults with a physical disability, aged between 16 and 65 years. The home offers short term and respite care. Newlands was built in 1976 for people with a disability. However, over the years there has been a significant change in the nature of disability of residents, from that originally conceived. As a result, Newlands has been partially redesigned and re-furbished. The residential and nursing home occupies a single storey building with some unusual roof elevations. An attached two-storey section is used for the head office accommodation of the parent company. There are also attached facilities used by the WRVS meals service. There is a large car parking area at the front of the home. The premises are separated into three living units each having a corridor with bedrooms off, a kitchenette, and adjacent dining and lounge area. There is also a large communal dining room, entrance hall with a waiting/meeting area, two enclosed courtyards/gardens and large grassed and planted areas surrounding the building. All areas are wheelchair accessible and there are automatic doors and ramps for access. The current placement fees for the home range from £830 - £960 per week. WCS - Newlands DS0000004267.V337940.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection visit was unannounced and took place on a weekend day, Sunday 24 June 2007. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people who use the service and their views of the service provided. Before the inspection, the manager of the home was asked to complete and return a questionnaire containing further information about the home as part of the inspection process. Some of the information received within this document has been used in assessing compliance with standards and is included within this report where appropriate. Before the inspection, a random selection of people who live in the home and relatives were sent questionnaires to seek their independent views about the home. Six questionnaires were received from residents, all of whom had received external support to complete the questions. Responses from the questionnaires are detailed in this report where appropriate. Three people living at the home were identified for close examination by reading their, care plans, risk assessments, daily records and other relevant information. This is part of a process known as ‘case tracking’ and where evidence of the care provided is matched to outcomes for residents. Records examined during this inspection, in addition to care records, included, social activity records, staff duty rotas and medication records. Staff on duty were supportive on the day of the inspection visit and the inspector was able to tour the home, and spend time speaking with residents and staff. The inspector had the opportunity to meet a number of the residents by visiting them in their rooms and spending time in communal lounges and dining areas and talked to several of them about their experience of the home. The Commission has been advised about concerns received related to the management of wound care in the home. The local Social Services department under the Protection of Vulnerable Adult procedures is investigating this incident formally. WCS - Newlands DS0000004267.V337940.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: There a number of improvements needed to make sure that all the people who use the service have positive outcomes. To ensure that people who live in the home receive appropriate care all care plans must be reviewed to clearly reflect the assessed individual and current needs of all people admitted to the home. Particular attention must be given to wound care. Nurses and care staff must consistently complete daily records to ensure sufficient details are recorded to accurately reflect how someone has spent WCS - Newlands DS0000004267.V337940.R01.S.doc Version 5.2 Page 7 their day, follow up on concerns raised and provide information for monitoring and audit of care provision. Risk assessments must be completed and updated by staff and a consistent approach to applying the criteria maintained. This will ensure that residents are not exposed to risk to their health and wellbeing. The activities programme should be reviewed and further developed so that residents are given more opportunities for stimulation through leisure and recreational activities, which match their cultural preference. Where possible the views of residents should be sought and taken into account when planning activities. Staff must be made aware of any changes to the policy and procedures in the home for the wearing and laundering of uniforms to ensure practice is consistent and that residents and staff are not at risk of cross contamination. The activities programme should be reviewed and further developed so that people are given more opportunities for stimulation through leisure and recreational activities, which match their cultural preference. Where possible the views of people should be sought and taken into account when planning activities. 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 - Newlands DS0000004267.V337940.R01.S.doc Version 5.2 Page 8 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 Outcomes Statutory Requirements Identified During the Inspection WCS - Newlands DS0000004267.V337940.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5 Quality in this outcome area is good. People wishing to move into the home have their individual needs assessed ensuring that the home has the resources to meet their needs before admission. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People considering moving into the accommodation have their care needs assessed before deciding whether to move in for a trial period. Social Services carry out a Care Management Assessment and the Primary Care Trust are involved in assessing whether people moving into the home require nursing care. One of the senior care assistants talked about the assessment process in reference to a resident that they are a key worker for. The senior carer had visited the resident before they were admitted into the home and explained in our conversation that the visit involved talking to the potential resident about their needs. The assessment supported the decision that the home would be able to meet the resident’s needs. This resident was one of the residents’ followed the case tracking process. Speaking with the resident and their family they were able to confirm that an assessment had taken place in the resident’s home. WCS - Newlands DS0000004267.V337940.R01.S.doc Version 5.2 Page 10 The family said that information given to them by staff in the home, which includes the Statement of Purpose and Service User Guide Supported them in making a decision about moving into the home. The resident and family said that they had been given the opportunity to visit to have a look round, make a choice as to which of the available bedrooms the potential resident would like to have before making a decision as to whether to move into the home. Comments received from residents confirmed that they received enough information about the home and for some that the decision to move into the home was made by their relatives. One resident said in their questionnaire that: “The home is right for…as the staff are all friendly.” Three residents’ personal care record files were examined and used in the case tracking process. Two residents had been at the home for some time and one resident had recently moved into the home. Examination of the files showed they had their care needs assessed before moving into the home. Preadmission assessments carried out involved assessing a residents needs in relation to individual health and social care needs. These include medical and health history, mobility, personal support and potential areas of risk. This information is important as it provides a base from which to plan a person’s care and ensures that the home has the ability to meet these needs. WCS - Newlands DS0000004267.V337940.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 and 10 Quality in this outcome group is good. Individuals are involved in decisions being made about their lives and play an active role in planning the care and support they receive. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents care files continue to be in an ongoing state of development, with the intention of improving care plan documentation. Three residents care files were examined through the case tracking process. Individual residents needs were assessed and the level of support required discussed with each resident and their family as appropriate. Care files contained a range of information related to daily living, personal care and support needs, leisure, interests and hobbies. This information supports staff in providing care to people living in the home. Emphasis in the home is on providing person-centred care by ensuring that, residents’ individual capabilities are assessed. One of the good aspects of individual care plans was the information provided on how staff could effectively communicate with residents who are unable to speak. Information WCS - Newlands DS0000004267.V337940.R01.S.doc Version 5.2 Page 12 provided details on individual residents body language, mannerisms, facial expressions and other non-verbal communication that staff should be aware of when providing care and in the persons’ day-to-day life. In the completed questionnaire received the manager states that plans for the development of care delivery in the home is to make sure that there is more focus on the individual needs of people living in the home. The home plans to do this by providing more time for one to one interaction. Some elements of person centered care was observed on the day of inspection. Delivering care in this way will support staff to look at people living in the home as individuals and therefore provide appropriate care. WCS - Newlands DS0000004267.V337940.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17 Quality in this outcome group is adequate. Social, recreational activities and meals provided do not meet the needs or expectations of all people living in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Comments made by the people living at the home indicate that they are supported to gain regular access to the local community for leisure and recreational purposes. A photo board was seen on display in the central dining area containing a photographic record of many of the activities and outings enjoyed by the people at the home. The photographs showed that people who lived in the home had taken part in birthday celebrations, a fishing exhibition and a karate event for the disabled. The views of people who used the service on activities that take place in the home varied. Comments made include: “I would like to see more crosswords.” WCS - Newlands DS0000004267.V337940.R01.S.doc Version 5.2 Page 14 “Activities never take place.” “No activities arranged that I can take part in.” “Don’t always want to take parting organised activities, available if chooses to take part.” “Activities, don’t always attend, that is my choice.” “I like bingo.” On the day of the inspection, one resident was attending church this was made possible with the help of staff and the support of someone from the church and a resident had gone visiting with their family for the weekend. Staff and people living in the home said that they were supported to celebrate their birthdays. This could involve celebrating at the home or going out with friends. Discussions with staff and information in care files confirmed that with the support of suitable risk assessments to ensure the safety of residents restrictions are not placed on people who use the service going out independently into the local community. Two sets of relatives were seen visiting and there are no restrictions placed on visiting times. Comments by the people visiting on the day indicated that the home receives them in a friendly manner. Family members visiting on the day of inspection were observed to make cups of tea in the small kitchenettes. Entries in people’s review notes confirm that their relatives are encouraged to attend and offer support at their care reviews. Where possible and with the support of social services and other professionals individual residents are assessed and helped to move back into the wider community. One of the care staff spoke about a resident who had recently been successfully rehabilitated into the community with the necessary support. A visitor on the day of inspection had been a resident in the home and explained that they had been supported to integrate back into the community and live a meaningful life. Practices and routines observed in the home were unhurried and residents encouraged to fulfil their own preferences to day-to-day life. This includes mealtimes, although encouraged to sit in the lounge and make mealtimes a social occasion residents could choose to have their meal in their bedroom. Residents were observed eating their meal at lunchtime. This time was observed to be a social occasion for some residents. A number of residents required support with eating and this was carried out in a discreet and respectful manner. WCS - Newlands DS0000004267.V337940.R01.S.doc Version 5.2 Page 15 Residents spoken with said that they had enjoyed their meal. One resident said that the choice of food available was very good. Other comments made in the questionnaires returned to the Commission varied. Some residents said that sometimes they liked the meals and others said that they did not like the meals. Residents were observed on the day to eat most of the food provided for them and said that they had enjoyed their Sunday dinner. Residents were seen to sleep late. People’s routines are recorded in their care plans to help staff to assist people sensitively and to carry out their care support in the way they like it provided. Staff also showed respect for each residents’ privacy by knocking on their bedroom doors before entering. WCS - Newlands DS0000004267.V337940.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome group is adequate. Standards are compromised by shortfalls in record keeping resulting in plans for care that are not consistently updated and monitored to ensure that they detail the current individual care needs of people living in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans contained details, which provided staff with information on residents’ likes and dislikes and their preferences related to personal care. The care plans for three residents were examined and cross-referenced with all available records related to each resident. Examination of care plans show that they did not consistently contain all the information needed to support staff when meeting the needs of residents in their care. Care plans did not show that they were regularly updated to ensure that they identified all current care needs to describe the range of personal and health care needs of the residents. Some staff spoken with were knowledgeable about the residents in their care. The lack of up to date documented information and the lack of knowledge of some staff in being able to describe the care needs of people living in the WCS - Newlands DS0000004267.V337940.R01.S.doc Version 5.2 Page 17 home, particularly staff in charge means that there is a risk of inconsistent care being delivered to residents. Examples of areas in care files where residents care plans did not detail fully the level of support required from care staff include the care plan of a resident who needed to be seated in a special chair for support. The plan of care did not detail how this person should be supported to sit in their specially adapted chair during the day. Observation of this person on the day of inspection noted that they were not correctly supported to ensure that they were sitting in the chair safely. The main concern was the lack of support to this person’s head. This could lead to risk of discomfort and injury to the resident. A further example is for a resident who had wounds on their abdomen because of a scald. A conversation with this resident and their family raised concerns. After reading the care plan, the Inspector was left with the belief that this was a minor incident. The resident’s care file did not provide sufficiently detailed information on how the incident occurred. A plan of care was not written, there were no details as to whether medical advice had been sought and the details of action taken by staff to provide appropriate care was not consistently documented. Talking to this person, they said a similar incident had occurred previously. The resident allowed the inspector to look at her abdomen in the presence of their family. Dressings had been applied to two separate areas on the abdomen. An entry in the ‘daily diary’ dated 4 July 2007 states: “Drop tea on (Resident) at 11:50am in Unit … lounge. Back in (Resident’s) room cold compression applied stat… Seen by (Nurse) advised to dress Tegaderm 12x12 cm 2 on abdomen and one on left thigh applied. Risk assessments were not available related to tea making for any of the residents and the Commission had not received notification regarding this incident. The Home Manager will be asked to provide further details. Daily statements were not consistently written by care staff to describe the day-to-day wellbeing of resident’s living in the home. A care record sheet has been introduced as part of the new documentation but this also contained scanty information and was not consistently completed. The lack of information in these documents does not demonstrate that care has been given as planned and does not allow for effective audit of care provided in the care home to be carried out. WCS - Newlands DS0000004267.V337940.R01.S.doc Version 5.2 Page 18 Risk assessments are carried out on all residents admitted to the home these include falls, moving and handling and mobility both in and outside the home. It was not always clear from risk assessments what criteria was used and therefore what determined the scores that were made. Carrying out risk assessments will ensure residents take managed risks with support as required and protect them from potential harm. Specialist healthcare advice regarding the management of residents has been sought through GP’s and community psychiatric and district nurses. Support services are accessed for the specific needs of individual residents as necessary. The manager indicates in the AQAA that future plans are to support residents to access appointments in the community this includes visits to the dentist and GP. Two people’s relatives who were visiting the home spoke very positively about the service provided, indicating they were happy with the quality of the care that is given and confirming that they had been kept involved in changes in their relatives care. Each person living at the home has lockable cupboards in their bedrooms for the safe storage of medication. Discussions with staff report that medication is recorded into the home on individual residents’ Medication Administration Record (MAR) charts. The MAR charts of the three residents followed through the case tracking process were examined these were complete. Staff confirmed that only the unit leaders as the nursing staff are allowed to administer medication. Issues were raised at the last inspection about the need for a Physiotherapist to assess and improve the physical capabilities of people living in the home. The manager has demonstrated in the questionnaire returned to the Commission that the services of two physiotherapists have been employed to visit the home weekly. Where action is required in the way of a programme of physiotherapy staff are instructed on the action they need to carry out the exercises. The manager also indicated that the PCT (Primary Care Trust) longterm neurological team have approached her to provide support to the home. The plan is for the team to work with the home in order to decrease the need for hospital admissions. Support from other community professionals such as occupational health will also be arranged. WCS - Newlands DS0000004267.V337940.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome group is adequate. Complaints are investigated and people using the service feel their complaints will be taken seriously. Staff failing to monitor, record and continue with treatment that is no longer appropriate exposes people to the risk of abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are policies and procedures in place to ensure that complaints are dealt with effectively. Two residents said that if they had a complaint they would go to their key worker, team leader or the owner. Speaking with care staff, they were able to demonstrate that they would know if a resident was concerned or unhappy about their life in the home. Replies demonstrated that they had a good understanding of the residents in their care. Staff responses include observing the resident’s body language and their tone of speech when in conversation. Responses in questionnaires from people who use the service indicate that the majority of residents know how to make a complaint and whom they would complain to. One comment made states: “I prefer to talk to the manager.” A few said that sometimes they know who to speak to and some were not aware of how to make a complaint. WCS - Newlands DS0000004267.V337940.R01.S.doc Version 5.2 Page 20 Speaking with residents they expressed that they felt safe in the home and residents were seen to be relaxed with each other and the staff. Discussions with staff show that they are aware of their role and responsibility in reporting any suspicion of, or actual harm to residents. Comments made by staff confirmed that they have seen the procedures and several staff said that they had recently had vulnerable adult abuse training. The Commission has been advised about concerns received related to the management of wound care in the home. The local Social Services department under the Protection of Vulnerable Adult procedures is investigating this incident formally. The allegation of possible abuse referred to above was reported to social services by a hospital in line with local and national policies. There was evidence at this inspection related to the lack of written information in care plans to describe the ongoing care of a resident receiving treatment for skin wounds. Further details are recorded under the ‘Personal and Healthcare’ section of this report. WCS - Newlands DS0000004267.V337940.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 and 30 Quality in this outcome area is adequate. The home is comfortable and well equipped to meet the needs of the people living there. However, inconsistent cross infection procedures in the home do not always protect the health and well being of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The owner of the home provides accommodation, nursing and personal care and support services for up to 26 male and female adults with a physical disability. Residents’ ages vary between 16 and 65 years. The home is a purpose built dwelling situated in a residential area of Kenilworth near to shops and other local facilities. The home and garden area well maintained. The home presents a homely environment, which meets the needs of the resident’s. Each resident has their own bedroom thirteen of these have separate en suite facilities, consisting of wash hand basins and a toilet. A number of bedrooms were viewed with permission of the residents and these include the three residents involved in the case tracking process. All bedrooms were furnished with personal items and made homely to meet individual WCS - Newlands DS0000004267.V337940.R01.S.doc Version 5.2 Page 22 needs. Some rooms had specific adaptations to support meeting the needs of individual residents. The home is well equipped with specialist beds, mattresses, and moving and handling equipment. There are three separate living units, each with it’s own specially supported bath and shower facilities lounge and dining areas. The home is all at ground floor level and provides suitable wheelchair access and sufficient space for people with disabilities. Two of the three lounges are decorated to a standard, which makes them look homely, comfortable and inviting for residents to sit and socialise. The remaining lounge did not present as a homely area for people who live in the home to sit and relax. Protective clothing and gloves were seen in use by care staff when providing care for residents. Care staff do all the laundry in the home and washing procedures have improved to ensure suitable arrangements are in place for managing soiled and infected laundry, which promotes safe infection control procedures in the home. Staff uniforms are also laundered in the home in an attempt to control the spread of cross infection. This was a contradiction in terms however due to the fact that staff were seen to wear their uniforms home during the day when going for their dinner breaks. WCS - Newlands DS0000004267.V337940.R01.S.doc Version 5.2 Page 23 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 33 Quality in this outcome group is poor. Residents do not benefit from having sufficient numbers of experienced staff on duty to ensure that their care needs will be consistently met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of the inspection, the home was short of staff and was reliant on one member of staff working between two units. Agency staff were working on both the early and late shift to support staffing levels. Duty rotas examined showed that there would normally be three staff in each unit and one nurse on duty during the day. These numbers reduce to two staff on duty in each unit during the evening. During the inspection, some staff were observed to leave the home for breaks, which did not leave appropriate levels of staff in the home in case of an emergency. Further observation noted that some units were left with one member of staff at any one time. This practice would mean that units in the home would be left unattended and where two carers were required to meet the care needs of residents, they would have to wait. WCS - Newlands DS0000004267.V337940.R01.S.doc Version 5.2 Page 24 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Not assessed at this inspection. Quality in this outcome group was assessed as good, at the last inspection. Satisfactory systems were in place for maintaining quality in the home and for ensuring a safe environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: This outcome group was not inspected at this inspection visit. There had been no outstanding requirements from the inspection carried out on 26 July 2006. WCS - Newlands DS0000004267.V337940.R01.S.doc Version 5.2 Page 25 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 Standard No Score 1 3 2 3 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 2 STAFFING Standard No Score 31 X 32 X 33 1 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 2 15 2 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 2 3 X X X X X X X X WCS - Newlands DS0000004267.V337940.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? Yes 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 YA18 Regulation 18 Requirement Timescale for action 31/08/07 2. YA19 15 3. YA19 15 4 YA19 13(4) All staff must be trained to in the use of equipment specially designed for the use of individual residents to ensure their comfort, safety and care needs are met. All persons using the service 10/08/07 must have an up to date detailed care plan this will ensure that they receive person centred support which meets their needs. Daily records including those 10/08/07 made by care staff working nights must be: • Sufficiently detailed. • Linked to care plans. • Demonstrate actions taken by staff to deliver prescribed care. • Fully inform staff about changes that have taken place. This action will ensure that staff are provided with up to date and accurate information and allow the home to monitor that residents receive care, which meets their individual needs. Any identified risk to a persons 31/08/07 health and wellbeing must be DS0000004267.V337940.R01.S.doc Version 5.2 WCS - Newlands Page 27 5 YA23 13(6) 6 YA33 18 recorded, assessed, monitored and appropriate care and support provided. This will ensure that all people using the service have their individual needs met. The prescribed treatment and 10/08/07 care of people living in the home must be monitored and reviewed to ensure that the care is effective and appropriate. This will ensure that residents are not exposed to the risk of abuse due to inappropriate care The number and skill mix of staff 31/08/07 working in the home must be continuously reviewed to ensure that sufficient number of staff are working in the home at all times. This will ensure that people who live in the home are in safe hands at all times and will have their care needs met. 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 YA14 YA15 Good Practice Recommendations The views of people who use the service should be sought when making decisions about activities that take place in the home. This will ensure that their needs are met. Staff should receive training, which raises awareness and provides specialist guidance on sexuality and people in their care. This will ensure that people living in the home are able to make choices in their lives. The views of people who use the service should be sought on the quality of food provided in the home. This will ensure that they receive person centred care. Staff working in the home should be made aware of the procedures for the wearing and laundering of staff uniform to ensure that residents are not placed at risk of infection or cross contamination. 3 4 YA17 YA30 WCS - Newlands DS0000004267.V337940.R01.S.doc Version 5.2 Page 28 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 - Newlands DS0000004267.V337940.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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