CARE HOMES FOR OLDER PEOPLE
Welland House Care Centre Welland House Lime Grove Welland Nr Malvern Worcestershire WR13 6LY Lead Inspector
C Presley Announced Inspection 22nd September 2005 09.00 am X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Welland House Care Centre DS0000063986.V250265.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 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. Welland House Care Centre DS0000063986.V250265.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Welland House Care Centre Address Welland House Lime Grove Welland Nr Malvern Worcestershire WR13 6LY 01684 310840 01684 310848 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) Welland House Care Centre Ltd Ann Walton Care Home 51 Category(ies) of Dementia - over 65 years of age (51), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (51), Old age, not falling within any other category (51), Physical disability over 65 years of age (51) Welland House Care Centre DS0000063986.V250265.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 21st February 2005 Brief Description of the Service: Welland House Care Centre provides accommodation and nursing for 51 older people. Residents may come under the following categories, old age, physical disability, dementia and people with mental health needs. The home is owned by the Redwood Care Home Group and is managed by Mrs Ann Walton. Welland House is situated in a small village approximately five miles from Malvern. There is a local shop, public house and Church. The home is a partly adapted and partly purpose built home which was first registered in 1984. It is on two floors and has a passenger lift. The home was previously registered as two units but has changed registration in order to offer places for personal care as well as nursing care. The main purpose of the home is to provide a safe, comfortable environment where all aspects of residents needs are met. Welland House Care Centre DS0000063986.V250265.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The announced inspection took place during the morning, time was spent with the registered manager, the responsible individual and key nursing staff. This inspection concentrated on recruitment procedures, policies and procedures which reflected areas of risk for residents and care plan documentation. What the service does well: What has improved since the last inspection?
Since the last inspection the home has investigated the value of dementia mapping and has had some training. The home is piloting a study for the Gold Standard Framework for palliative care.
Welland House Care Centre DS0000063986.V250265.R01.S.doc Version 5.0 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. Welland House Care Centre DS0000063986.V250265.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Welland House Care Centre DS0000063986.V250265.R01.S.doc Version 5.0 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 the following standard(s): 2, 3, 4 & 5 Residents are assessed prior to admission by the registered manager who has the necessary expertise to ensure their needs can be met by the home. EVIDENCE: All residents had a contract with the home, included in the contract was insurance for personal items and a trial period of 28 days where there was no notice period required by the resident during this time. The registered manager carried out all assessment of needs on potential new residents. The assessment of need was based on the daily activities of living and included information related to recognition of the level of dementia if any of the new resident. The document seen had been filled in appropriately and a care plan could be drawn up from information collated at the assessment. Residents needs are met by staff who are kind and have the necessary expertise to deal with residents who have complex physical and mental health needs. Welland House Care Centre DS0000063986.V250265.R01.S.doc Version 5.0 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 the following standard(s): 7, 8 & 10 Care plans and risk assessments ensured residents are cared for in a safe environment and their complex nursing needs are identified and met by staff. EVIDENCE: Care plans are of a high standard and contain information specific to each residents needs. Risk assessments are in place and are re-evaluated as necessary; these include those residents at risk of falling, developing pressure sores and being nutritionally at risk. Families are kept informed of changes in care and medication regimes. Staff had received specific training in diseases of the elderly and dementia. The home was currently accessing training in dementia mapping and felt this would improve the care of those residents with dementia. Resident’s privacy and dignity was paramount and staff were heard speaking to residents in a kindly manner. The home has some shared rooms and discussions about sharing take place before admission to the home. Welland House Care Centre DS0000063986.V250265.R01.S.doc Version 5.0 Page 10 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 the following standard(s): 12,13 & 14 Residents are offered a stimulating programme of activities specific to their capabilities which ensures they live as full a life a possible. EVIDENCE: The home employs a full time activities co-ordinator who spends time with residents in either a group forum or 1:1 she also visits residents who remain in bed in their bedrooms. Her aim is to spend time with each resident at least once a week. There are three enclosed gardens which residents have access to, weather permitting. There are regular Church services and involvement with the local community, especially during the festive seasons. The home does not have a facility for safeguarding personal items such as jewellery or money, residents are invoiced for extras on a monthly basis. Care plans contained documentation relating to personal furnishings belonging to residents and reasons why residents were not offered a key to their bedroom door. Further documentation was required regarding residents not having lockable storage space in their bedrooms. Welland House Care Centre DS0000063986.V250265.R01.S.doc Version 5.0 Page 11 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 the following standard(s): 16 & 18 There are robust policies and procedures with regard to the protection of the vulnerable adult, which ensure residents, are safeguarded at all times against any form of abuse. EVIDENCE: There have been no complaints to the home or the Commission for Social Care Inspection since the last inspection. The complaints policy and procedure is available to residents and families and has set time scales for dealing with a complaint. Policies and procedures are in place for the protection of the vulnerable adult and staff receive in house and external training in this field, in addition staff receive a typed statement on protection issues during their induction period to ensure residents are kept safe at all times. Welland House Care Centre DS0000063986.V250265.R01.S.doc Version 5.0 Page 12 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 the following standard(s): None of the standards in this section of the report were inspected EVIDENCE: There was evidence staff had received fire training and fire equipment was tested and serviced regularly. Welland House Care Centre DS0000063986.V250265.R01.S.doc Version 5.0 Page 13 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 There are robust recruitment procedures in place which ensure residents are safe guarded and staff have an induction and foundation training programme. EVIDENCE: Four staff files were inspected and contained robust procedures, which had been followed to ensure staff working with both physically, and mentally frail residents were safe to do so. The home will meet the target of 50 of care staff achieving an NVQ training award in direct care by the end of 2005. Senior care staff continue with further training following an NVQ award to ensure their care practice is up to date. All care staff have an induction and foundation training programme to follow. Welland House Care Centre DS0000063986.V250265.R01.S.doc Version 5.0 Page 14 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33,34,35,36,37 & 38 The registered manager of the home ensures the health and safety of residents living in the home through policies, procedures, risk assessments and safe working practices. EVIDENCE: There is a quality assurance programme in place, which incorporates all stakeholders including other members of the multidisciplinary team. Staff receive internal and external mandatory training, which includes, moving and handling, fire safety, food hygiene, infection control and first aid. Equipment in the home is regularly serviced and service records are in place. The registered manager is the health and safety officer and has regular updated training to ensure staff are aware of their responsibilities.
Welland House Care Centre DS0000063986.V250265.R01.S.doc Version 5.0 Page 15 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 x x x x x x x x STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 3 3 3 3 3 3 Welland House Care Centre DS0000063986.V250265.R01.S.doc Version 5.0 Page 16 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP13 Regulation 12,13 Requirement Residents must be offered lockable storage space for medication, money and valuables and a key which he or she can retain unless the reason for not doing so is explained in the care plan The bolt on the outside of the room containing cleaning machines must be removed Timescale for action 31/12/05 2 OP19 13 22/09/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Welland House Care Centre DS0000063986.V250265.R01.S.doc Version 5.0 Page 17 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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