Inspection on 05/02/09 for Wellcroft

This inspection was carried out on 5th February 2009.

CSCI found this care home to be providing an Good service.

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

Wellcroft 13/02/07

Wellcroft 13/02/06

Wellcroft 20/07/05

Wellcroft 22/02/05

Wellcroft 27/09/04

Wellcroft 15/03/04

Wellcroft 20/01/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Wellcroft 75 Church Road Gatley Stockport Cheshire SK8 4EY     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Michelle Haller     Date: 0 5 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 32 Information about the care home Name of care home: Address: Wellcroft 75 Church Road Gatley Stockport Cheshire SK8 4EY 0161-4285361 01614281216 wellcroft@boroughcare.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Borough Care Limited Name of registered manager (if applicable) Miss Jennifer Eccles Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: The registered person may provide the following category of service only: Care Home only - Code PC To Service Users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia - Code DE Mental disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is: 39 Date of last inspection Brief description of the care home Wellcroft is a two-storey home which provides specialist care for residents with mental health problems. It is currently registered for up to 39 residents. The home provides permanent residential care services, short stay and day care services. Wellcroft has recently undergone a major refurbishment programme; this included Care Homes for Older People Page 4 of 32 care home 39 Over 65 0 0 39 39 Brief description of the care home making nine bedrooms with en-suite bathrooms and the remaining 30 into single rooms. Wellcroft is one of 12 homes owned by Borough Care Limited. The registered manager is Jenny Eccles. The home is suitable for wheelchair users and has a lift to assist residents to the first floor. It is structured into three separate units, each staffed by its own team of carers. The home employs an activities co-ordinator who provides activities most mornings, to both permanent and day care service users. The home is located at the far end of Gatley village. It is set in its own grounds. A large car park is available at the front and side of the building. The home charges #417 per week or #430 for ensuite. Care Homes for Older People Page 5 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was a key inspection which means that the manager did not know that we were visiting to inspect on the day. We took into account the outcome of an Annual Service Review (ASR) completed by the Commission for Social Care Inspection in February 2008. For that review we looked at the information we had received about a service during the previous year. We used this information to decide whether the service continued to provide good outcomes for service users or whether there was evidence that things had changed. The ASR indicated that there been no change to the quality of the service in the previous year. For this key inspection the manager returned to us the Annual Quality Assurance Care Homes for Older People Page 6 of 32 Assessment (AQAA) that was sent to her. The information provided included data about staff training, the development of policies and procedures and compliance with health and safety checks. This information influenced the outcome of the inspection. The inspection process was conducted through speaking to the manager and 3 members of staff about working at Wellcroft residential home. We also looked at the care and support received by four services users. We did this by looking at their health and social care assessments, risk assessments, care plans, communication reports and other correspondence and records concerned with their support and care. We also discussed their needs and how these were met with the manager and members of staff. The people chosen included the most recent referral and someone with more complex health needs. Other documents concerned with the running of the home were also examined, these included the staff training files and health and safety records. We sent out staff surveys so that people working for the service could give their opinions. We received nine back and the information has been included in relevant sections of the report. We spoke to four people living at the home and two relatives. The information provided is included in the appropriate sections of the report. No service user surveys were returned. What the care home does well: What has improved since the last inspection? What they could do better: We found that the manager needs to make sure that staff have all the equipment necessary to follow infection control guidelines, this includes a means for drying their hands. This is to prevent the spread of germs that might cause preventable illnesses. We found that the manager needs to ensure that staff report problems to her. This so that she is given an opportunity to deal with problems before they have an effect of people concerned with the home. We found that the manager needs to familiarise herself with the rules about informing CSCI about incidents and occurrences, under the Care Standard Act 2000 Regulation 37 notifications. This is so she informs us of occurrences that have or might have a detrimental effect on people living at Wellcroft. This is important because it gives us a Care Homes for Older People Page 8 of 32 chance to check that the correct steps have been taken to protect users of the service. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 32 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 32 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager ensures that staff have enough information to meet peoples needs as soon as they are admitted into Wellcroft. Evidence: We found that peoples needs were assessed before they were admitted to Wellcroft. We found that manager sought information from the new resident, their family and the referring agency so that steps could be taken to meet the persons needs. We found that some assessments were more detailed than others but this did not affect the standard of the actual support provided when people became permanent residents at Wellcroft. We found that at in some cases there was good information about peoples individual preferences in relation to personal care, diet and family involvement, and that this Care Homes for Older People Page 11 of 32 Evidence: information had been available before they moved into the home. We found that staff knew what to do help people to settle in and also make sure that they remained as healthy as possible. People spoken to said that they were given the opertunity find out about Wellcroft before moving in. Comments included: The home was recomended to us and ....came here on day care and enjoyed it. Care Homes for Older People Page 12 of 32 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager at Wellcroft care home makes sure that peoples physical and emotional health needs are met, and that support in offered and provided in a way that promotes their dignity and is respectful. Evidence: We found that some of the care plans had been developed from the information gained through the assessment process. These care plans were detailed and gave staff good information about how peoples needs were to be met. It was also evident that the resident and their relative had been involved in producing the care plan so that things would be done in a manner best suited to the individual. We also found, however, that some care plans lacked detail and were not individualised, and so did not provide enough information about of peoples needs. This was the case especially in relation to the affects of dementia on peoples lives. We found that the situation had changed slightly since the last key inspection when we visited the home. Care Homes for Older People Page 13 of 32 Evidence: Speaking to the manager confirmed that she recognised the importance of having peoples social histories as this will help to identify ways of working with different people successfully. It is also important, however, that the manager is able to show that at least a basic assessment of a persons mental state is carried out so that staff are are always provided with some information about how to relate to the person in a way that suites them. We found that overall the information in care plans had improved since the previous inspection because risk assessment were now routinely completed in relation to the management and assessment of falls; moving and handling; pressure area care and nutritional needs. We found that the most recent admission had a detailed and comprehensive assessment with corresponding care plan and risk assessment. These were individualised and provided care staff with clear and precise information about the persons needs and how they should be met and monitored. The manager stated that senior staff were now responsible for completing assessments and updating these and care plans. She said that she is in the process of auditing the care plans to make sure that they are all of a similar standard. We discussed possible training courses that may assist staff in understanding what information is needed. We also discussed the care plan form itself. This is because it is a document with care needs already written on and so some staff only identify how these prepopulated needs are to be met, while other staff clearly refer to the assessment and so add extra when relevant. The manager agreed to take these issues into account when auditing the care plans and when in conversation with more senior managers at Borough Care. We found that health care provided to people living at Wellcroft meets their needs. Evidence including letters, appointment cards, daily records and the health-care contact sheet confirmed that people had ready access to general practitioners; dentists; podiatrists; district nurses and opticians. We observed that people were wearing glasses and or hearing aids that had been prescribed. We also found clear evidence that people received specialist and emergancy care as required. Daily records confirmed that staff supported residents to attend outpatient appointments, and people were referred to specialist services such as the memory clinic, continence advisory service and falls prevention clinic. While examining the care files and case tracking peoples care we found that some documents were not clearly dated. This matter was discussed with the manager as it is Care Homes for Older People Page 14 of 32 Evidence: important to have accurate dates on all documents because this helps to monitor a persons progress. We looked at the daily records. These had been completed using respectfull language. However the information provided did not always reflect the support people had received during the day as an individual and neither did the information always relate to the care-plans. It was not always possible to get a good picture of a persons day from the information written. This was discussed with the manager because the daily records are an important tool in monitoring the progress people have made and also helps to identify whether changes are needed in the persons care plan. Some daily records, however, clearly identified changes that had taken place and the progress made by people from day to day. The manager stated that one of her goals is to improve the information provided by staff in the daily records so that they were all of a constantly high standard. We found that, although some pressure area care monitoring documents needed to be completed more thoroughly, staff are diligent in making sure that people received preventative care and fast treatment in relation to pressure area care. Daily records confirmed that staff are able to recognise the first of signs of a pressure sore developing, and that they respond by contacting the district nurses. We found that the district nurses commented, in their records, on the fact that staff follow instructions in respect of pressure area care with respect to identifying, preventing and treating wounds. We looked at the administration and handling of medication. The medication policy is clear and easy to follow. The person responsible for ordering and managing medication in the home was spoken to. She said that her last in depth medication training took place in 2004, however she had also attended medication update briefings. This person also said that those responsible for managing medication in the home had a good rapport and relationship with the pharmacist who provided the medication. She agreed to speak to them about additional training to update her knowledge. We found that medication is stored securely. The recording of controlled medication was looked at and found to be in order. The medication administration records of four residents were also looked at and no gaps in their medication regime were noted. We found that medication is stored securely. The recording of controlled medication was looked at and found to be in order. The medication administration records of four residents were also looked at and no gaps in their medication regime were noted. We observed that throughout the day people were treated with dignity and all personal care was completed in private and with discretion. Staff spoke to people quietly. On Care Homes for Older People Page 15 of 32 Evidence: the day of inspection the dentist provided treatment to people in the home. The examinations were carried out in private. We checked the names on the clothing in some peoples rooms and found that these were correct, this showed that the manager aims to ensure that people always wear their own clothes. People who were seen were clean and well groomed. They had neat and brushed hair, their clothes, including their slippers or shoes were clean. People were fully dressed and all wore tights, stockings or socks. We found that people who talked to us about health and personal care were complimentary about and satisfied with the standard. One relative said: I feel they would get medical assistance - staff are very friendly to me and have asked me about the medication- we agreed that the medication needs to be re-looked at with .........s doctor. Residents comments included: Staff are very good indeed they get the doctor in and do all the necessary. And Staff are pretty good- staff get used to you and they know when you are upset or if somethings wrong. We observed that throughout the day people were treated with dignity and all personal care was completed in private and with discretion. Staff spoke to people quietly. On the day of inspection the dentist provided treatment to people in the home. The examinations were carried out in private. We checked the names on the clothing in some peoples rooms and found that these were correct, this showed that the manager aims to ensure that people always wear their own clothes. People who were seen were clean and well groomed. They had neat and brushed hair, their clothes, including their slippers or shoes were clean. People were fully dressed and all wore tights, stockings or socks. We found that people who talked to us about health and personal care were complimentary about and satisfied with the standard. One relative said: I feel they would get medical assistance - staff are very friendly to me and have asked me about the medication- we agreed that the medication needs to be re-looked at with .........s doctor. Residents comments included: Staff are very good indeed they get the doctor in and do all the necessary. Care Homes for Older People Page 16 of 32 Evidence: And Staff are pretty good- staff get used to you and they know when you are upset or if some-things wrong. Care Homes for Older People Page 17 of 32 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People at Wellcroft are offered a lifestyle designed to meet their expectations and meals that are nourishing and which they enjoy. Evidence: We found that the manager has started to make sure that a record of peoples interest and social history is completed so that staff can offer activities which are of interest to individuals. We found that the home employs an activities coordinator who is keen to provide a variety of things for people to do at Wellcroft, in the local community and further afield. The coordinator has looked at different ways of organising transport so that people can afford to go to events. This has included signing people up for the local ring and ride bus service which provides door to transport for people who are eligible. Through reading the activities calender and records we were able to confirm that people enjoyed events that included board games, musical entertainers, arts and crafts and parties. People also enjoyed excursions and days out. We also found that staff took people shopping in the local community. Care Homes for Older People Page 18 of 32 Evidence: We found that peoples spiritual needs were taken into account as a Christian act of worship takes place at the home each week. Staff said about the activities at Wellcroft: We have good activities we put music on and we get people up to dance, we go to shows, have entertainers, and weve done a beetle drive. And We help them to socialise with days out and live their lives to their full potential. Relatives felt welcome to the home and were observed visiting people at different times of the day. There was no restriction on people going to their rooms with visitors. Comments from relatives included: Staff are friendly and they get activities. My... ...will talk about what she does and others talk to each other about what they have done, trips and things like music nights. We found that records and reports confirmed that people or their families were kept informed about what happening, and family involvement kept up. Comments included We are never kept waiting and they explain what is happening. And Yes, staff help her to keep in touch with her sister and Im updated when I visit. When we looked into peoples rooms we found that they were encouraged to have their own belongings around them and to continue buying things that liked. We looked at the menu, observed lunch time and talked to people to find out about meals and mealtimes. We also looked at weight charts and other information to find out if people were well nourished or looked after properly if they lost weight. We noted that the dining area was clean and nicely prepared for lunch. People were able to choose where they sat. The meal on the day of inspection was fish and chips and mushy peas, followed by rhubarb crumble and custard. Everyone observed ate all of their meal. While we were observing we noted that people sat at the dining table waiting to be served for longer than 20 minutes. We felt that this was too long because some people began to have disagreements and become irritated by one another. And although staff did speak to people we observed that this was not often enough to keep them content while they waited. We thought that the long wait was because the regular cook was not in work on the day of inspection but people also said:I think they get us to the table too early- it means we argue. This issue was discussed with the manager. Care Homes for Older People Page 19 of 32 Evidence: We looked at the menu and this showed that a variety of dishes were served and included traditional British items such as liver and bacon and corned beef hash and more modern items such as pizza. The manager said that Borough Care were currently reviewing the menus for the organisation. Weight charts showed that people mostly put on weight when they moved into the home. The manager stated that her aim was to introduce nutritional screening for all new people who use the service. This will benefit people because a specialist care plan will be written to show staff the people who need to have their diet monitored so that changes for the worse are noticed quickly. We found that people enjoyed the meals, felt satisfied with the food and were given a choice of meal. They told us: The food is pretty good and its varied each day, and I say if I dont like something and it is changed. and I eat well. We found that people were given a choice about what they did during the day routines were flexible. Care Homes for Older People Page 20 of 32 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager makes sure that people are protected from harm through providing and following clear and effective complaints and adult protection guidelines and policies. Evidence: We found that the information recorded in the complaints log book showed that complaints are taken seriously by staff and the manager of the home. It was clear that investigations were fair and open and that changes were made to make sure that everyone was happy with the outcome. The homes adult protection policy was looked at. We found that it provided staff with clear information about the steps they must take to protect people from abuse and to make sure that it is dealt with if they feel that abuse has occurred. Information in the policy showed that it was in keeping with Stockport All Agency adult protection procedure. We found that the staff training matrix confirmed that staff had received adult protection within the last two years and that new staff received this training as a part of their induction when they begin to work at Wellcroft. The manager said that she was experienced in providing adult protection training. People who were spoken to told us that the staff were approachable and that concerns Care Homes for Older People Page 21 of 32 Evidence: were dealt with. One person said: I have registered a concern and it was dealt with. The manager stated that there have not been any adult protection issues investigated in the home since the previous inspection. Care Homes for Older People Page 22 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Wellcroft benefit from a comfortable environment which is well equipped and spacious enough to meet their varied needs. Evidence: We looked around the building and found that most areas were clean, warm and well maintained. We found that livingrooms and bathrooms were fully accessible and people were seen using the facilities independently and with the assistance of staff. We found that more care needs to be taken to ensure that people can keep to the infection control and hand washing guidelines. This is because there were no means for drying hands in two bathrooms. Handwashing is one of the most important factors in preventing the spread of germs and so it is essential that a means of hand drying is always available, this is so people are encouraged to wash their hands. We found that one bedroom held an unpleasant smell and that neither care or domestic staff had reported this to the manager. We would have expected staff to report any odours that they could not get rid of so that additional checks could be made and problems dealt with. We found the manager was responsive to suggestions and planned to use the ongoing Care Homes for Older People Page 23 of 32 Evidence: refurbishment of the home as a way of providing facilities that are of particular benefit to people with dementia. This includes supplying memory boxes to be used outside bedroom doors. These see-through boxes would contain memorabilia such as pictures or items that were special to that person. We found that maintainance stickers confirmed that moving and handling equipment had been serviced with in the previous six moths of the this inspection, and fire safety equipment had been serviced within the previous year. Care Homes for Older People Page 24 of 32 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager provides staff in sufficient numbers and who have received appropriate training to meet the needs of people living at Wellcroft. Evidence: We found on the day of inspection that the home was sufficiently staffed to meet the needs of people living there. The staff compliment included the manager, a senior care worker and a number of support workers. Domestic staff were also working in the home. In the surveys that we sent we asked staff about whether there were enough on duty to meet peoples needs. Nine staff returned surveys, five felt that the home was always well staffed and four felt that the home was usually well staffed. The duty roster provided information about the staff who worked each shift in the home. We found that the staff at Wellcroft are suitable qualified because in the information the manager returned she confirmed that the majority of staff (20 out of 28) had achieved the National Vocational Qualification (NVQ) in Care level 2. Care Homes for Older People Page 25 of 32 Evidence: We found that recruitment and selection procedure used by the home was robust and protected against employing those who may be unsuitable for working with vulnerable people. The process included getting two references, verifying peoples identity and completing criminal record bureau (CRB) and protection of vulnerable adult (POVA) checks. We found that staff are provided with good training opportunities. During 2008 staff had received training a number of topics that would help them to do their jobs well and keep them up-to-date with new ways of working. The topics included: food safety; infection control; moving and handling; fire-safety; night staff training; food hygiene; pressure area care: Yesterday Today and Tomorrow dementia care training; first aid; moving and handling key trainer and mental disorder and older people. This training was provided by Borough Care training department and Stockport Metropolitan Borough Council (SMBC) Training Partnership. We found that staff were satisfied with the training they received and all assessed that the training they received prepared them for all aspects of their work Very well. We found that staff had a very positive attitude toward the people using the service and talked about their role as supporting people to be happy, comfortable and able to choose for themselves. One person described their role as: Providing a secure and stable home for each, make sure all are treated as individuals so that all is done to maintain a good quality of life for all residents. We found that people living at Wellcroft liked the staff and comments made included: The staff are very good indeed. and The staff cannot be faulted. Care Homes for Older People Page 26 of 32 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People at Wellcroft live in a home where the management and administration promotes there best interests and keeps them safe from harm. Evidence: When we inspected Wellcroft we found that a new manager had been employed since the previous inspection, this person has been in post since August 2007. The manager has successfully completed the Registered Managers interview. This is a process to register with the Commission for Social Care Inspection (CSCI) which includes an interview and, employment, qualifications and Criminal record checks. This helps to confirm that the person is suitable to manage a care home. When this is complete the managers name will be put on the homes registration certificate. The manager returned the Annual Quality Assurance Assessment (AQAA). The information she provided was useful and gave clear descriptions of the good things that were happening at Wellcroft. The information also described the areas that could Care Homes for Older People Page 27 of 32 Evidence: be improved in the coming year and how this was to be achieved. This is important because a manager should always be able to identify how things can be improved for the people they work with. Staff felt that the manager communicated well through staff meetings and been generally available, they also felt that she was supportive- comments from staff included: There is a lot of support for staff and relatives. The staff work very well as a team and any concerns are usually dealt with efficiently. We discussed how the manager makes sure that people can comment on the service at Wellcroft. The manager told us that Borough Care have a quality assurance program and this included sending questionnaires. The result was published and used to influence changes. In the AQAA she wrote that an improvement would be To hand out more questionnaires. The manager has also introduced a suggestions box so that people can make comments when they want to. We discussed the management of service users money with the administrator and looked at the system for dealing with this. We found that there is a robust and effective system for managing finances which protected people from financial exploitation. The finances are managed through a computerised finance system and people are billed for what they spend. A running total is available for printout. The manager stated that peoples finances were managed by their relative or a solicitor. She also stated that Borough Care complete an audit of these accounts once a year. We found that health and safety matters in the home are well managed and that people who live in or visit the home are protected from harm by the health and safety protocols in use. We found that all equipment including gas safety, electrical safety, moving and lifting equipment and fire safety equipment had been serviced or maintained in keeping with the expected timescales. This information was provided through the information the manager gave to us and also by checking stickers that had been placed on equipment by the engineer. We found that kitchen and food hygiene was managed through the SMBC Safer Food better Business protocol. We found that falls, accidents and incidents were dealt with effectively in that medical treatment was sought and steps taken to reduce the risk of repeat accidents. We also Care Homes for Older People Page 28 of 32 Evidence: found that the manager did not always record these incidents in the Reporting of incidence, disease and dangerous occurrences (RIDDOR) accident book, and neither did she always inform us under Care Standards Act 2000, Regulation 37. These matters were discussed with the manager as it is important that CSCI are informed of occurrences that have had a detrimental effect on people, this is so we can assess that the correct steps have been taken to keep people safe. Care Homes for Older People Page 29 of 32 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 30 of 32 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 The registered person should make sure that assessments and care plans includes information about how best to meet a persons psychological and emotional needs. The information would provide guidance in how to support and monitor a persons individual needs in these areas, so that they would benefit from staff who understood how to prevent or reduce the risk of anxiety or emotional upset and how best to deal with this if it occurs. The registered person should make sure that people who use the toilet facilities at Wellcroft are always able to wash and dry their hands this is to reduce the risk of germs through spread because of dirty or wet hands. The registered person should ensure that staff have a mechanism for reporting bad odours that persist. This is so that people always breath air which is free of unpleasant odours and also feel that they are is a clean place. The registered person should make herself fully familiar with Regulation 37 of the Care Standard Act so that she knows what needs to be reported to us. This will make sure that we are given the opportunity to make sure that serious incidents are been dealt with properly. 2 26 3 26 4 38 Care Homes for Older People Page 31 of 32 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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