Inspection on 13/04/05 for Wellesley House Residential Care Home

This inspection was carried out on 13th April 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

Wellesley House Residential Care... 29/09/06

Wellesley House Residential Care... 26/03/06

Wellesley House Residential Care... 17/09/04

Wellesley House Residential Care... 27/04/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Wellesley House Residential Care Home 10 Wellington Road Bury Lancashire BL9 9BG Lead Inspector Rukhsana Yates Unannounced 13 April 2005 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Wellesley House Residential Care Home CS0000008427.V216954.R01.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Wellesley House Residential Care Home Address 10 Wellington Road Bury Lancashire BL9 9BG 0161 761 6932 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) Mrs Linda Bell Mrs Janet Kinsella Mrs Linda Bell Mrs Janet Kinsella CRH Care Home 4 Category(ies) of LD Learning Disability : 4 Places registration, with number of places Wellesley House Residential Care Home CS0000008427.V216954.R01.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: The Home is registered for a maximum of 4 service-users to include: Up to 4 service-users in the category LD (Learning Disabilities). The service should employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. Date of last inspection 17 September 2004 Brief Description of the Service: Wellesley House is home to four people who have learning disabilities and need support to lead independent lives. The house is a large terraced property half a mile from the centre of Bury. There is a park opposite the house, and main bus routes and various amenities are within easy reach. There are two lounges, a kitchen and separate dining room on the ground floor. Upstairs, there are four single bedrooms with en-suite facilities, and a separate bathroom. Wellesley House Residential Care Home CS0000008427.V216954.R01.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over 6 hours. Methods used during the inspection included a tour of the premises and discussions with the management representative and three staff members. Half of the time was spent talking with three residents in the home and observing practice. A brief discussion took place with another resident who had been at college for most of the day. A placing social worker was consulted by telephone. Key records were examined. Since the last inspection the two registered providers of the home have also become the home’s registered managers. What the service does well: What has improved since the last inspection? Management cover has improved, and residents spoke highly of the managers and the new deputy. This improvement has meant more choice of activities and better mental health for residents, with one resident saying “I feel more positive now, it’s got much better”. Staff now have the time they need to assist residents, work on care plans and develop their skills. They described working well as a team and the management support as “very good”. Wellesley House Residential Care Home CS0000008427.V216954.R01.doc Version 1.20 Page 6 Residents felt the redecoration that had taken place made the home a nicer place to live. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Wellesley House Residential Care Home CS0000008427.V216954.R01.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection Wellesley House Residential Care Home CS0000008427.V216954.R01.doc Version 1.20 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 standard(s) 2 The people living at Wellesley House had their needs and compatibility with others in the home assessed and agreed with them before admission. They therefore knew what to expect of the service, and felt confident that their needs, goals and aspirations were understood from the outset. EVIDENCE: Records showed that care management assessments were obtained before admission. The manager also assessed prospective residents to ensure suitability and compatibility for all concerned, and that admission criteria were met. Although there have been no new admissions in recent years, two residents recalled meeting the manager and other residents before coming to live at the home. They said that all the residents get on well together most of the time, and described the move to Wellesley house as a very positive choice. All of the residents said that individual needs and goals are regularly discussed and agreed with them and were able to look at their files if they wanted to. They expressed confidence in the home’s suitability and felt that staff understood their needs. Wellesley House Residential Care Home CS0000008427.V216954.R01.doc Version 1.20 Page 9 Needs, goals and aspirations were clearly recorded. Individual support requirements were documented. The manager and staff members interviewed demonstrated a very good knowledge of residents’ changing needs and wishes. Wellesley House Residential Care Home CS0000008427.V216954.R01.doc Version 1.20 Page 10 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 standard(s) 6, 7 and 9 Plans of care clearly and accurately reflect each person’s changing needs, choices, goals, support requirements and risk assessments. Plans are implemented and progress assessed with the individual. These measures are highly effective in supporting residents to remain safe, and to increase their independence, self-esteem and ability to make informed choices. EVIDENCE: Residents’ personal, social and healthcare needs were documented in individual plans of care, and reviewed with the resident. Care plans, including risk and behaviour management strategies, were up to date. Staff interviewed understood the strategies and described their effectiveness in practice. Discussions with residents confirmed their awareness of, and involvement in, personal goal setting and review. They described examples of practical staff support and encouragement, resulting in a greater sense of fulfilment and achievement in particular areas of their lives. Examples included new learning, leisure and employment opportunities. Each person’s progress was reflected in daily reports and accessible plans of care. Wellesley House Residential Care Home CS0000008427.V216954.R01.doc Version 1.20 Page 11 There was evidence of residents making decisions individually and as a group. Staff supported individual’s choices about the day’s activities, such as shopping for groceries, or using personal monies to buy new clothes. One resident had made a positive decision to stop attending a drop-in centre as it was no longer meeting his needs. Decision-making affecting the household was reflected in minutes of residents’ meetings. Each resident said that they made their own decisions, with staff support if needed. The potential risks to the safety of residents and others were recorded and regularly reviewed. Risks were assessed for activities inside and outside the home, and outlined the support required for each activity. Risks were managed so as not to limit preferred activities. Residents gave examples of enjoying activities, such as swimming and cycling, accompanied by a staff member. Wellesley House Residential Care Home CS0000008427.V216954.R01.doc Version 1.20 Page 12 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 standard(s) 12, 13 and 16 Residents take part in activities that develop their strengths, and that they value and find fulfilling. Residents use local amenities and feel part of the community. Care practices ensure residents’ rights are upheld and they recognise their responsibilities. EVIDENCE: Activities enjoyed by people living at Wellesley House included the use of local colleges, sport, leisure and entertainment facilities, pubs and shops. Since the last inspection residents had become better motivated and more satisfied with their daily routines. One resident described how much he enjoyed his new part time job. Two people were taking more exercise and described feeling healthier and happier as a result. All of the residents looked forward to karaoke at their local pub each week. Each person was aware of their responsibilities in making sure the house ran smoothly. These included tasks such as helping with shopping, cleaning and meal preparation. Although there was a little disagreement between residents about doing their fair share, staff were aware of this and sensitive in dealing with it. The helpful attitudes and encouragement of staff have resulted in more Wellesley House Residential Care Home CS0000008427.V216954.R01.doc Version 1.20 Page 13 settled behaviour and, for one resident, a better ability to manage anxiety. This has widened his choice of activities. Individual rights were promoted. Residents were given their mail unopened, chose where to spend their time, and each had a key to their own room. Wellesley House Residential Care Home CS0000008427.V216954.R01.doc Version 1.20 Page 14 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 standard(s) 19 and 20 The support provided is effective in improving the physical and mental health and wellbeing of residents. Medication procedures are generally satisfactory and promote good health. There are certain medicines that need guidelines to ensure that staff understand when they should be used. EVIDENCE: Each person had a separate file that includes information about his or her medication, appointments with doctors, psychiatric consultants and other health services. The records showed positive reviews and prompt follow up action by staff to health problems identified. Medication was reviewed regularly and records of medication received and administered were clear and accurate. One person self medicates and a risk assessment has been carried out for this arrangement. Medicines were securely stored, and staff have received training to ensure safe procedures are followed. Two people had drugs prescribed to be used PRN (as required). Although rarely used, there was a need to provide guidelines for staff about their use to ensure these drugs were administered only when necessary. The self – medication plan also needed to be updated. Wellesley House Residential Care Home CS0000008427.V216954.R01.doc Version 1.20 Page 15 The attention paid to encouraging healthy diets and exercise had helped residents to feel better about themselves. One person reported feeling calmer, and another healthier and more positive towards other people. Residents said that staff at the home had helped them with these achievements. Staff demonstrated motivation and commitment by taking the initiative in introducing and assisting with these changes. Wellesley House Residential Care Home CS0000008427.V216954.R01.doc Version 1.20 Page 16 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 standard(s) 22 and 23 The views of residents are listened to and acted on to their satisfaction by managers and staff. Policies and practices ensure the protection of residents from abuse. EVIDENCE: Residents said they have had the complaints procedure explained to them. They gave examples that showed their confidence in raising issues and felt that staff and managers always listened to them. Issues raised and actions needed to resolve them were documented in minutes of residents’ meetings. There have been no complaints received by CSCI over the past year. One complaint was made jointly made by the four residents during the same period. Records show that the manager took prompt and appropriate action to protect their well being. There were written procedures for whistle blowing and responding to allegations of abuse. Staff members interviewed understood these, having covered this topic in vocational training, and further training has been planned. Wellesley House Residential Care Home CS0000008427.V216954.R01.doc Version 1.20 Page 17 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 standard(s) 24 and 30 Wellesley House provides a safe, clean, comfortable and homely environment for the people living there. EVIDENCE: Wellesley House is a large, terraced property that is not identifiable as a care home. Residents each had had their own bedroom with an en-suite shower, wash-basin and toilet. They were happy with the privacy and comfort provided, and said that no-one entered bedrooms without their permission. One resident was particularly pleased with her new bed and involvement in plans to redecorate her room. Ongoing redecoration had been taking place in line with the written maintenance plan. This has ensured continuing improvements to the décor since the last inspection. Residents made use of the two lounges, separate dining room and kitchen. The office was in the basement, which meant that managers and staff did not intrude on living space when carrying out administration work. Wellesley House Residential Care Home CS0000008427.V216954.R01.doc Version 1.20 Page 18 Measures were in place to ensure a safe living environment. These included regular checks of fire alarms, lighting, heating systems and water temperatures. It was apparent that the cleaner employed at the home has continued to maintain high standards of cleanliness and hygiene. Wellesley House Residential Care Home CS0000008427.V216954.R01.doc Version 1.20 Page 19 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 Since the last inspection, staff have received more of the training and support they need to meet the individual and joint needs of residents. EVIDENCE: Staff members interviewed had benefited from a range of training, including health and safety topics, medication, physical intervention techniques and managing challenging behaviour. Four of the six staff members had achieved NVQ qualifications and improved their specialist knowledge through the Learning Disability Awards Framework. Training records were kept. As a result of the training received, staff had gained the confidence and ability to support residents in more community activities. This had made a positive impact on the choice of activities available to residents, and to their ability to cope with experiences in the community. A need to improve management cover at the home was identified at the last inspection and has been successfully addressed. Staff expressed complete confidence in the management and described significant improvements in recent months, including better direction, and more time to assist residents in their chosen activities at their chosen times. Wellesley House Residential Care Home CS0000008427.V216954.R01.doc Version 1.20 Page 20 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 9 Managers at Wellesley House are committed to seeking residents’ views and reviewing quality to improve practices. The home has yet to produce a plan that will show residents and others how their views are being used to develop the service. EVIDENCE: The home was looking at ways to share ideas about good practice, from senior management level to support staff. Time had been set aside to thoroughly review care planning records and the aims and objectives of the service. Residents were consulted about their daily routines and had completed satisfaction questionnaires covering a good range of topics. One placing social worker said he liked the ‘person-centred’ care provided. It was clear from these examples that quality matters in this home. However there was no development plan to reflect residents’ experiences and how they Wellesley House Residential Care Home CS0000008427.V216954.R01.doc Version 1.20 Page 21 contributed to future plans. Residents need a quality development plan in a format they understand so they can see how their views underpin the improvement process. 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No Wellesley House Residential Care Home Standard No 31 32 Score x x Version 1.20 Page 22 CS0000008427.V216954.R01.doc 11 12 13 14 15 16 17 x 3 3 x x 3 x 33 34 35 36 x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 2 x x x x Wellesley House Residential Care Home CS0000008427.V216954.R01.doc Version 1.20 Page 23 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. 2. Standard 20 39 Regulation 13 24 Requirement Medication plans and guidelines must be current and cover the use of PRN medication. A quality development plan must be produced following quality review. The plan must be made available to residents, CSCI and other interested parties. Timescale for action 06 June 2005 01 September 2005 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 Good Practice Recommendations Wellesley House Residential Care Home CS0000008427.V216954.R01.doc Version 1.20 Page 24 Commission for Social Care Inspection Turton Suite, Paragon Business Park Chorley New Road Horwich Bolton BL6 6HG 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 Wellesley House Residential Care Home CS0000008427.V216954.R01.doc Version 1.20 Page 25 - 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. 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