CARE HOME ADULTS 18-65
Weir End House Weir End House Glewstone Ross-on-Wye Herefordshire HR9 6AL Lead Inspector
Christina Lavelle Unannounced Inspection 28th November 2005 03:45 Weir End House DS0000024745.V269292.R01.S.doc Version 5.0 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 Weir End House DS0000024745.V269292.R01.S.doc Version 5.0 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. Weir End House DS0000024745.V269292.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Weir End House Address Weir End House Glewstone Ross-on-Wye Herefordshire HR9 6AL 01989 567711 01989 767077 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) Parkcare Homes (No. 2) Limited Mrs Ann Fletcher Care Home 13 Category(ies) of Learning disability (13), Mental disorder, registration, with number excluding learning disability or dementia (13) of places Weir End House DS0000024745.V269292.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 3 residents with mental disorder in addition to their learning disability can be accommodated. 30th June 2005 Date of last inspection Brief Description of the Service: Weir End House became a care home in 1989 and was taken over by Parkcare Homes (a subsidiary company of Craegmoor Healthcare) eight years ago. The home provides accommodation and personal care for thirteen adults aged less than sixty-five who must need care due to learning disabilities. Service users could have a stable mental health disorder as well as a learning disability and may also use behaviour that can be challenging. Current service users are aged from in their thirties and most of them have lived at the home for years. The property comprises of a big old house, which is situated about a mile from the market town of Ross-on-Wye. There is a small extension next to the main house in which three of the service users have bedrooms. The property is set in lovely large grounds which includes a walled vegetable garden and a woodland area that are home to a donkey, goat and chickens. There are two shared and nine single bedrooms. Service users also have two large sitting rooms, a conservatory and a separate dining room for them all to use. The home has shared toilets/bathrooms and a laundry, kitchen and office. Weir End House DS0000024745.V269292.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This routine unannounced inspection took place in less than three hours on a late Monday afternoon in the winter. The aim was to obtain a snapshot of life at the home and to confirm it continued to provide a very good quality service. Time was spent with the manager discussing service users’, their care and any changes that had taken place since the last inspection. One staff member was interviewed about their training and experience of working at the home. Most service users were at home today and at least six of them were spoken with individually. Some were very pleased to show the inspector their bedrooms and to talk about their lives and feelings about living at Weir End House. The service users and staff on duty were very welcoming and it was evident (and service users confirmed) that they were very happy living at the home. Various records were checked and some parts of the house looked at. All the communication between the home and the Commission since the previous inspection was also taken into consideration. This includes notifications of any events and reports made by the provider following their required monthly visits to check how the home is running and to obtain staff and service users’ views. What the service does well:
The house was clean and comfortable and is a “real home” for service users. Although thirteen people live at Weir End House there is a very homely, family atmosphere and it was good to see how well they all supported and got on with each other. Service users said they like the manager and staff and feel they are approachable. They clearly had every trust and confidence in them. All the service users have busy and interesting lives and are supported by staff to take part in a wide range of activities they enjoy. They are also able to choose their own daily routines and their independence is encouraged. Where possible service users have work placements and are doing training courses to develop their social and life skills. Meetings are held regularly with the service users to involve them in making decisions about the home and choosing such as what they would like to eat, where to go on holiday etc. A new service user had recently moved into the home. Their admission had been very carefully planned to ensure their needs could be suitably met. Also to make sure they would fit in well with the people already living there. There is a very stable and well-trained staff team and the home is very well run. The manager and staff are enthusiastic and committed to giving good care and support to service users. They make sure that all service users’ social, personal and health needs are met properly.
Weir End House DS0000024745.V269292.R01.S.doc Version 5.0 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. Weir End House DS0000024745.V269292.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Weir End House DS0000024745.V269292.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 & 4 Very thorough assessment procedures were followed which helps to ensure that only people whose needs could be suitably met (and who are compatible with the current service users) would be admitted to the home. EVIDENCE: Although not reviewed in this inspection it was previously confirmed the home provides all the required information documents for prospective service users. A new service user had moved in the week before and the manager described their admission process. This had appropriately involved the home carrying out a full assessment of care needs in consultation with staff from her current care home, the service user and relevant other people. The manager had also attended care review meetings at her previous care home. All the information obtained had been made available to the staff team at Weir End House so they were all familiar with this person’s needs and goals before their admission. The prospective service user had spent a year visiting Weir End House and latterly one day a week there before the move was arranged. She had joined the local college group during these introductory visits. It was planned for the manager of her former home to visit once a week during her three-month trial stay for support and to keep the placement under review. Professional health care input had also been arranged during this trial period. A decision about the suitability of the placement would then be made with relevant people involved. Weir End House DS0000024745.V269292.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These Standards were not fully assessed. However it was previously confirmed that service users had detailed care plans drawn up with them by the home, which were reviewed monthly with their key workers. Plans covered all areas of service users’ individual needs (with their goals and preferences) and showed the support each person needed from staff to meet their identified needs. The home had also undertaken relevant risk assessments to minimise any risks to their safety and welfare. Care reviews were carried out regularly with input from service users, their families and significant others. A sample of care records was checked in the last inspection and one person’s care records looked at briefly today. This confirmed the home has a “person centred” (PCP) approach to care planning, as is expected. It is also positive the manager had arranged to meet soon with the local PCP co-ordinator. The home should then become familiar with work going on to develop this system in the county as well as develop a useful link with another “care” professional. The manager discussed the introduction of ”passports” for service users to help them communicate their needs and wishes. The home was working with a Speech Therapist on this project and the intent is that service users will hold their own information as a passport to show other people when they want to.
Weir End House DS0000024745.V269292.R01.S.doc Version 5.0 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 14 & 16 Service users are supported to take part in appropriate leisure and other activities to make their lives more interesting and to develop their skills and independence. They are also enabled to make choices and decisions about the home and in their daily lives and routines. EVIDENCE: Service users continued to participate in a wide range of educational and work related activities, including courses at college. They also talked about going to Leisure Link, Ryefields day service and out on various outings and holidays. Keyworkers ensure service users’ individual interests are known and support them as and when needed. A few service users and staff were going for a few days to Germany to the Christmas markets and were very excited about this. Service users confirmed they are able to make choices in their daily lives and routines e.g. about their activities, food and when to get up/go to bed. Regular service users meetings are held when such as holidays, menus and other home matters are discussed and they are involved in making decisions.
Weir End House DS0000024745.V269292.R01.S.doc Version 5.0 Page 11 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 20 Suitable arrangements were in place to promote service users’ good health. Medicines are managed safely by the home. EVIDENCE: The manager said that service users recently had flu jabs and one person that she had visited the dentist today. It was also confirmed that staff make sure service users receive specialist health care input whenever necessary and that routine health care checks are arranged. One service user had been in hospital recently and staff were now monitoring his condition very closely. The home recently had a full medication audit carried out by the provider, which is based on the National Minimum Standards. A community pharmacist also reviews the home’s medication system periodically. Medication records were checked and appropriately there were photographs of each service user and their signed consent to staff administering their medicines when needed. The administration and other required records were being maintained properly and all staff designated to administer medicines had attended a safe handling of medicines training session. Weir End House DS0000024745.V269292.R01.S.doc Version 5.0 Page 12 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These Standards were not fully assessed. However no complaints or vulnerable adults issues had been raised with the home or the Commission since the last inspection. In addition the open climate in the home and obvious trust and confidence service users have in the manager and staff indicates that any concerns or protection issues would be picked up and dealt with appropriately. Weir End House DS0000024745.V269292.R01.S.doc Version 5.0 Page 13 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Weir End House provides a homely, comfortable, safe and well-maintained home for service users, with due attention paid to good hygiene and cleanliness. Their privacy and individuality could be enhanced if they all had single bedrooms and there were less people living together as a group. EVIDENCE: Weir End House is suitable to meet the needs of this physically able group of younger adults and the impression obtained is of a homely and comfortable environment. Its location and extensive grounds are also a great asset. The main house was currently having a new roof and other external repair work done, to be followed by redecoration. Since the last inspection a couple of bedrooms had also been redecorated and bathroom flooring replaced. The upgrading and maintenance of the property is ongoing and the accommodation is well presented and in a good state of repair, furnishings and fittings. The home was seen to be very clean and tidy and it was evident staff and service users ensure that good hygiene is maintained. Comprehensive infection control policies and procedures are in place and suitable arrangements were made for waste disposal.
Weir End House DS0000024745.V269292.R01.S.doc Version 5.0 Page 14 Some service users readily agreed to show the inspector their bedrooms and were clearly proud of them. Most choose to lock them and to hold their own keys and the rooms were very well personalised. However the Standards specify that bedrooms in care homes should all be single. Also that by April 2007 they should be organised in clusters of no more than ten people. Consideration was already being given to address these matters and if a shared place or a single room becomes vacant those people in the shared bedrooms should be given the opportunity not to share. Weir End House DS0000024745.V269292.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 & 35 A very stable, suitably trained and well-motivated team appropriately staff and manage the home. This promotes the delivery of effective and consistent care and so has positive outcomes for service users. EVIDENCE: The home’s staffing arrangements had not changed since the last inspection. The manager; staff member on duty and service users expressed their view that there was still always sufficient staff on duty to meet their needs. It was good too that staffing is arranged flexibly to fit in with service users’ needs. One staff member was interviewed and has extensive prior experience in care. Since working at Weir End House he had completed the LDAF induction and foundation programme and had started NVQ. He had also completed all the mandatory health & safety training as well as topics relevant to people with learning disabilities, such as autism awareness and epilepsy. His view of the staff team was very positive and reaffirmed the opinion that there is a wellmotivated and committed staff team. Regular staff meetings are held when they are all consulted and involved in decisions about and the development of the home. Staff also received individual supervision. All staff had now completed the LDAF training and those who had not already achieved an NVQ qualification were working towards doing so.
Weir End House DS0000024745.V269292.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These Standards were not fully assessed. However the home’s management arrangements had not changed and it was evident it was still being well run by a competent manager with an open and positive management approach. The provider had introduced a comprehensive quality assurance system. The manager had attended a training session and had made progress to implement it. Questionnaires were soon to be sent to service users, their families, friends and other stakeholders to obtain their views of the service. The feedback obtained must form the basis of a programme for the continual development of the service, which should also result in periodic reports. These reports must be sent to the Commission and be made available to other interested parties. It was good that risk assessments had been carried out in respect of the building work to ensure the safety of service users, staff and visitors. It was apparent the manager and staff take their responsibility for safety seriously Weir End House DS0000024745.V269292.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 4 4 3 X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X X X Standard No 24 25 26 27 28 29 30
STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 3 12 3 13 X 14 3 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X X 3 X 3 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Weir End House Score X 3 3 X Standard No 37 38 39 40 41 42 43 Score X X X X X X X DS0000024745.V269292.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? NA 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. 1. Refer to Standard YA24 Good Practice Recommendations Consideration should be given to how each service user could have their own bedroom. When a place in a single room or shared room becomes vacant current service users should be given the opportunity not to share. Consideration should be given to organising the home into groups of up to ten service users by 1st April 2007. 2. YA25 Weir End House DS0000024745.V269292.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Hereford Office 178 Widemarsh St Hereford Herefordshire HR4 9HN 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 Weir End House DS0000024745.V269292.R01.S.doc Version 5.0 Page 20 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
