Inspection on 03/05/05 for Weatherstones House Nursing Home

This inspection was carried out on 3rd May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Weatherstones House Nursing Home 10/12/08

Weatherstones House Nursing Home 18/12/07

Weatherstones House Nursing Home 31/05/06

Weatherstones House Nursing Home 05/09/05

Weatherstones House Nursing Home 10/02/05

Weatherstones House Nursing Home 02/06/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Weatherstones House Chester High Road Neston Wirral CH64 7TD Lead Inspector Gill Matthewson Unannounced 3 May 2005 9:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. 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. Weatherstones House F51 F01 S18819 Weatherstones V224119 030505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Weatherstones House Nursing Home Address Chester High Road Neston Wirral CH64 7TD 0151 3368383 0151 353 0563 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) Weatherstones House Care Ltd Old age, not falling within any other category (31) Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places Weatherstones House F51 F01 S18819 Weatherstones V224119 030505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 No more than 31 Service Users may be in receipt of personal care with nursing 2 3 Service Users may be in receipt of either personal care with nursing or personal care only Date of last inspection 10/02/05 Brief Description of the Service: Weatherstones House is a large sandstone detached property which is a listed building and is set in two acres of grounds. It is situated on the A540, close to the village of Willaston and the town of Neston. A private drive leads to the house and there are good parking facilities. Accommodation for residents is on two floors, with a passenger lift providing access to the first floor. In certain areas ramps have been constructed to provide access to rooms which are on different levels. A large basement houses the laundry, kitchen storage, and a repair and maintenance facility. On the ground floor there are two lounges, a conservatory and a dining room. The ground floor also has 11 bedrooms, an office, nurses station and the kitchen. The first floor has a small sitting area, 13 bedrooms and the clinical room. There are assisted toilets and bathrooms on both floors and a nurse call system and fire alarm system are installed throughout.The home is registered to provide nursing care to frail older people and is staffed by registered nurses at all times. The home also employs care assistants, administration, domestic, kitchen and laundry staff, and a maintenance person. Weatherstones House F51 F01 S18819 Weatherstones V224119 030505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out by two inspectors of the Commission. The lead inspector spent two hours planning the inspection by reviewing previous inspection reports and the service history over the last twelve months. The inspection took place over six hours and included a tour of the building, inspection of records and discussion with five service users, five members of staff and a visiting health professional. Feedback was given to two company representatives and the deputy manager of the home. What the service does well: What has improved since the last inspection? Residents’ care plans have improved and contain more detail as to what action needs to be taken by staff to ensure that residents’ needs are met. They are reviewed regularly and updated as required. The staff induction programme covers all of the Skills for Care induction standards, including training in how to recognise and report any abusive practices. More recreational activities are being provided. Arrangements have been made to ensure that staff receive ongoing training in moving and handling. Weatherstones House F51 F01 S18819 Weatherstones V224119 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. Weatherstones House F51 F01 S18819 Weatherstones V224119 030505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Weatherstones House F51 F01 S18819 Weatherstones V224119 030505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 & 3 Residents are not provided with quite all the information they need in order to make a decision whether to take up residence in the home. EVIDENCE: The home provided residents with a statement of purpose and service user guide, which detailed the services and facilities available. The numbers of single and double rooms were incorrect in the information. See Requirement 1. Care management assessment documentation was obtained for residents placed by the local authority and there was evidence of the manager assessing prospective service users. However, detailed information about the person’s needs was not recorded to provide other staff with the information they would need to plan care for those residents who were privately funded if the manager was not there at the time of admission. A recently admitted service user had a diagnosis of ‘Alzheimers, chronic depression, and drug induced Parkinson’s ’. There was no evidence of a psychiatric assessment before admission to the home was agreed. See Requirement 2. Weatherstones House F51 F01 S18819 Weatherstones V224119 030505 Stage 4.doc Version 1.30 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 & 10 Residents’ care plans ensure that staff know what action to take to meet service users’ needs. Residents’ health care needs are met, with the exception of wound care, where further training is needed. Residents are treated with respect and their dignity is maintained. EVIDENCE: A sample of care plans were looked at. In the main, they contained all the information necessary to enable staff to provide the appropriate care to meet residents’ needs. Wherever a need was identified, for example from the pressure sore risk assessment or nutritional assessment, a care plan had been written to show how this need would be met. Most care plans were reviewed regularly each month and this had improved since the last inspection. A few inadequacies in the care plans were noted. One recently admitted resident was confused and wandering and the care plan identified that he needed ‘constant monitoring’ as he had tried to leave the building on several occasions. The nurse who had written this clarified that he needed checks at least hourly during the night and at all times during the day. Another resident had a post-operative wound that required dressing on alternate days. The care plan did not contain an adequate description of the wound and had not been Weatherstones House F51 F01 S18819 Weatherstones V224119 030505 Stage 4.doc Version 1.30 Page 10 evaluated since admission approximately two weeks earlier. Handling assessments had been completed, however one was not dated, and another did not make it clear whether a stand-aid or a sling hoist was to be used. Bed rails risk assessments had been completed but one was undated. See Recommendation 1. Visits from other health care professionals were recorded. A new resident to the home had been visited by a doctor within 48 hours of moving in. A recent complaint, which was substantiated, identified that staff needed updated training in wound care. The registered provider had arranged for the manager to attend a training day run by the local tissue viability service a few days after the inspection. See Recommendation 2. Residents spoken with commented on how helpful all the staff were, that staff treated them with respect and helped them to maintain their privacy and dignity. One resident’s care plan detailed that she wished to have only female staff for personal care. Call bells were answered very promptly. Extension leads were provided to enable the call bells to reach chairs for those residents who chose to stay in their rooms. Residents were particularly complimentary about how helpful and friendly the handyman was. Weatherstones House F51 F01 S18819 Weatherstones V224119 030505 Stage 4.doc Version 1.30 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 More consultation is needed to ensure that activities provided reflect residents’ interests. EVIDENCE: The deputy manager had responsibility for organising activities for the residents. These included giant crosswords, word search puzzles, indoor bowls and reading and letter writing with some of the more dependent people. A file was kept of activities that had taken place and who had participated. In the previous month there had been a visit from the hairdresser, a keep fit session and two film shows. An organist was due to visit the following day to entertain the residents. Residents did not have access to an activities programme that would let them know what is taking place and when. Residents spoken with said they had not been consulted about what activities they would like. See Requirement 3. Weatherstones House F51 F01 S18819 Weatherstones V224119 030505 Stage 4.doc Version 1.30 Page 12 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 17 &18 Residents’ rights as citizens are upheld and the home’s protection policies minimise the risk of abuse. EVIDENCE: Postal votes had been arranged for residents in preparation for the forthcoming election. The home had satisfactory adult protection policies and procedures in place, including information for staff on whistle blowing. Training records demonstrated that staff received training in these matters during their induction period, which included familiarising themselves with the policies and procedures. Weatherstones House F51 F01 S18819 Weatherstones V224119 030505 Stage 4.doc Version 1.30 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 26. 19, 23, 24 & In the main the home provides a pleasant, comfortable environment although furnishings need to be reviewed in some bedrooms and planned maintenance or renewal undertaken so that a good standard is maintained. EVIDENCE: A tour of the home showed that the home was generally well-maintained and adequate bedroom furniture was provided. However, some carpets were stained. Cleaning staff said that they were constantly shampooing carpets but the stains did not always come out. The bedrooms identified as having stained carpets were 10,12, 13, 15, 16, 17 and 23. There was an unpleasant odour in one bedroom on the ground floor. One of the upstairs corridor carpets was also stained. A few items of bedroom furniture were damaged, for example in room 21 the bed and other items of furniture were damaged and in room 13 the headboard was ripped. Weatherstones House F51 F01 S18819 Weatherstones V224119 030505 Stage 4.doc Version 1.30 Page 14 There was a hole in the ceiling outside room 16. The home’s maintenance person explained that it had been caused by recent work carried out to the roof. Repair work was being carried out during the inspection to make good the damage. There are seven double rooms. One double room contained two beds with bedside cabinets, a double wardrobe, one chest of drawers and one chair. The registered provider was planning to provide another chest of drawers. One of the occupants, who chose to spend her time sitting in the room, said that her visitors had to sit on the other person’s bed when they visited her. She had no objections at all to sharing a bedroom and said that she got on well with the other person sharing the room. This service user had brought with her a large reclining chair, which she needed following major surgery to her hip. Both residents required the use of a hoist for transfers in and out of bed, and this meant that staff had to move furniture in order to assist them. For shared rooms the needs of both residents and any specialist equipment should be taken into account when deciding on the suitability of the room to be used. All the other double rooms had enough furniture for two residents. See Recommendation 3 & Requirement 4. Weatherstones House F51 F01 S18819 Weatherstones V224119 030505 Stage 4.doc Version 1.30 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28 & 30 The number, skill mix and training of staff ensures that residents’ needs are met. EVIDENCE: Twenty seven people were resident, all requiring nursing care. The home provided seven care staff in the morning, four in the afternoon and evening and three at night. These numbers included one registered nurse throughout the twenty four hour period and an additional one from 8am to 2pm. The manager and deputy were over and above these numbers. Two catering staff were on duty from 8am to 6pm plus domestic, administration and maintenance staff. Fifteen care staff are employed to provide care in addition to registered nurses. One of the care staff had attained an NVQ Level 3 in Care and three had attained an NVQ Level 2. Another carer was undertaking Level 2 and two more were due to start in September. This would give a total of 7 care staff with training in care up to NVQ Level 2. The registered provider said that several staff had worked there for many years and were reluctant to undertake formal training, but they were experienced and competent to do their jobs. The home had an induction programme that covered all the induction targets set by Skills for Care. All new staff appointed since its implementation went through the programme in the first six weeks and the deputy said that existing Weatherstones House F51 F01 S18819 Weatherstones V224119 030505 Stage 4.doc Version 1.30 Page 16 staff were in the process of receiving training in the sections which were not included in the previous induction programme. Weatherstones House F51 F01 S18819 Weatherstones V224119 030505 Stage 4.doc Version 1.30 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 & 38 The home has satisfactory systems in place to safeguard residents’ money, although some minor adjustments are needed to improve the record of audits. Arrangements to ensure the health and safety of residents and staff are improving. EVIDENCE: Weatherstones House F51 F01 S18819 Weatherstones V224119 030505 Stage 4.doc Version 1.30 Page 18 Most residents had a family member who looked after their financial affairs. Residents could keep personal money in the home’s safe if they wished. A detailed record was kept of all transactions for each resident and entries were double signed for checking purposes. However, all the money was kept in one container in the safe, therefore it was not possible to assess whether the balance for an individual resident was correct. Although residents’ money was kept together, there was no evidence to suggest that it was ‘pooled’. The deputy manager kept a record to demonstrate that the amount was audited fortnightly, but this did not record the amount or have a second signature. See Recommendation 4. All staff received training in safe working practices on induction. At the last inspection it was noted that moving and handling training updates were overdue. The registered provider had arranged for the manager and deputy to attend a moving and handling trainers’ course later in the month in order to provide the updates for the other staff. The provider had also arranged for staff to receive updated food hygiene training. Records showed that fire safety systems and hot water temperatures were tested at the required intervals. A Fire Safety Officer had inspected the home in January and had made several requirements. The home’s handyman was in the process of fitting smoke seals to all the doors identified and four fire drills had been held since his visit. Records of these showed that only four night staff had attended a fire drill this year. See Requirement 5. Weatherstones House F51 F01 S18819 Weatherstones V224119 030505 Stage 4.doc Version 1.30 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 x COMPLAINTS AND PROTECTION 3 x x x 3 2 x 2 STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x 3 3 x x x x 3 x x 2 Weatherstones House F51 F01 S18819 Weatherstones V224119 030505 Stage 4.doc Version 1.30 Page 20 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP1 Regulation 4(1)(b) Requirement Timescale for action 30.06.05 2. OP3 3. OP12 4. OP23 5. OP38 The registered persons must correct the numbers of single and double rooms in the statement of purpose. 14(1)(b&d The registered persons must ) carry out a full assessment of needs of any prospective resident, document the findings and confirm in writing to the person that, having regard to the assessment, the home is suitable for the purpose of meeting their needs in respect of health and welfare. 16(2)(m& The registered person must n) consult with residents about their social interests and provide them with a programme of activities. 23(2)(f) The registered person must take into account any furniture a resident may wish to bring into the home before determining whether a room is suitable for their needs. 23(4)(d&e The registered person must ) provide fire training by a competent person twice a year for day staff and four times a year for night staff. F51 F01 S18819 Weatherstones V224119 030505 Stage 4.doc 30.06.05 31.07.05 30.06.05 30.11.04 Weatherstones House Version 1.30 Page 21 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. 3. 4. Refer to Standard OP7 OP8 OP19 OP35 Good Practice Recommendations Care plan entries should be dated and signed and wording should be unambiguous. All registered nurses employed in the home should be enabled to access wound care training updates. A review of furnishings should be carried out and a programme of maintenance and renewal be produced and implemented. The deputy manager should maintain more detailed records of her fortnightly audits of residents monies. Weatherstones House F51 F01 S18819 Weatherstones V224119 030505 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Unit D, Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Weatherstones House F51 F01 S18819 Weatherstones V224119 030505 Stage 4.doc Version 1.30 Page 23 - 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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