CARE HOMES FOR OLDER PEOPLE
Wellfield House 38/42 Athol Road Whalley Range Manchester M16 8QN Lead Inspector
Mr Wesley Cornwell Unannounced Inspection 21st January 2009 10:30 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 Wellfield House DS0000042777.V373826.R01.S.doc Version 5.2 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. Wellfield House DS0000042777.V373826.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Wellfield House Address 38/42 Athol Road Whalley Range Manchester M16 8QN 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) 0161 881 9700 Wellfield Estates Limited Mrs Bernadette O`Rourke Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places Wellfield House DS0000042777.V373826.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The registered person may provide the following categories of service only: Care home only - Code PC, to people of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP. The maximum number of people who can be accommodated is 23 2. Date of last inspection 15th January 2008 Brief Description of the Service: Wellfield House is a care home that provides accommodation and personal care for up to 23 people of both sexes. The home was originally four terraced properties, which have been converted into one detached property. The accommodation for people is provided on two floors accessed via a passenger lift and stairwells. The kitchen, laundry and storerooms are situated in the basement of the building with the main office on the second floor. There are fifteen single rooms and four shared rooms. The home has an enclosed garden at the rear of the property with seating available. People who live at the home are able to access the garden via steps or ramps. The home is located to the south of the city centre in a quiet residential area within walking distance of the local shops. The home has a Statement of Purpose and Service User Guide providing information about the care provided, the qualifications and experience of the owners and staff and the services people can expect if they choose to live at the home. A copy of the Service User Guide and most recent inspection report is available from the manger to help people make an informed choice whether to move into the home. The fees charged at the home are £379.14 covering all aspects of care, food and accommodation. The manager provided this information on 21st January 2009. Wellfield House DS0000042777.V373826.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This unannounced visit was undertaken as part of the home’s Key Inspection and commenced at 10:30am and took place over five and a half hours. Prior to the site visit the manager of the home completed an Annual Quality Assurance Assessment form (AQAA) providing detailed information about the service they are providing. A number of people living at the home, staff members and a Healthcare Worker were contacted prior to the visit and their views about the home have been included in the report. In addition, we spoke to five people, four staff members, two visitors and the manager during the visit. Staff, care, maintenance and financial records were examined during the visit and a full tour of the premises was undertaken with the manager. What the service does well:
The home’s assessment procedures were very thorough and care plans had been structured to ensure staff recognise the diverse needs of the people they support. Observation of practice and discussion with staff members on duty confirmed the staff team had been provided with appropriate training to assist them in understanding and meeting the needs of the people in their care. One staff member said, “I was given the training I needed on how to meet the individual’s needs. I also have access to the care plan which tells you everything about the individual from the care they need, their religious beliefs and their dietary needs. My up to date training as an National Vocational Qualification (NVQ 2) candidate enabled me to gain more confidence to meet the needs of the people in our care”. People we spoke to said the staff team provided sensitive and flexible care support and confirmed they liked living at the home and felt well cared for. They were positive in their comments about the staff who were described as being caring and conscientious. One person said, “I am very happy here and well looked after. I find the staff very attentive”. The relative of one person said, “My mum used to be in another care home but we moved her because she was unhappy. She is very happy here. There is a lovely homely atmosphere and the staff are so friendly”. Wellfield House DS0000042777.V373826.R01.S.doc Version 5.2 Page 6 People spoken to said they enjoyed the quality and variety of food being provided and the activities being organised. The relative of one person said, “Mum doesn’t eat a lot and can be fussy. She appears healthy and has gained some weight”. Staff employed by the home are well trained and are competent to do their jobs. Observation of care practices throughout the day confirmed the people they support are treated with respect and dignity. The home has over 80 of staff who have achieved National Vocational Qualifications (NVQ) ensuring people are supported by competent and qualified staff. What has improved since the last inspection? What they could do better:
We tested hot water temperatures during a tour of the building and found that, in some bedrooms, water was very hot potentially placing people at risk of being scalded. The manager told us she was aware of this problem and arrangements had been made with the home’s plumber for the matter to be dealt with. We expressed our concern that people were at risk and having spoken to the home owner our concerns were addressed ensuring people living in the home and the staff who work there are protected and safe.
Wellfield House DS0000042777.V373826.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Wellfield House DS0000042777.V373826.R01.S.doc Version 5.2 Page 8 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 Wellfield House DS0000042777.V373826.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The admission and assessment procedures were clear to ensure the care needs of people were met. EVIDENCE: The care plan records of two people admitted to the home had full assessment information, including their religious/cultural and relationship needs. The assessment had identified the nutritional needs of the people and risk assessment information advising staff members of the action to be taken to minimise identified risks and hazards. The staff members on duty confirmed they had access to this information and were fully aware of the care needs of the people living at the home. The staff member responsible for the preparation of meals said they were informed about people who had special dietary needs and these are always accommodated. Wellfield House DS0000042777.V373826.R01.S.doc Version 5.2 Page 10 The relative of one person recently admitted said they had been involved in the assessment process and were more than happy with the care being provided. The person said, “We moved mum from another care home because we were unhappy with her care. We came to look around the home unannounced and were made very welcome. We were fully involved in mum’s assessment and admission into the home and we are very happy with her care”. People spoken to during the visit confirmed they were happy with the care being provided and their needs were being met. This home does not provide intermediate care. Wellfield House DS0000042777.V373826.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Promotion of health is taken seriously and people’s welfare is closely monitored and met. EVIDENCE: Individual records are kept for each person with a plan of care setting out the action that is needed to be taken by support staff to ensure all aspects of health, personal and social care needs of the people living at the home were met. Significant events had been recorded and daily entries made setting out the care given. The care plans were structured and were being reviewed with the people or their relative/advocate and updated to reflect any changing needs and these were being actioned as required. Wellfield House DS0000042777.V373826.R01.S.doc Version 5.2 Page 12 We looked at records of two people and these described their healthcare needs. Discussion with staff members on duty confirmed they were fully aware of the healthcare needs of people living at the home and these are monitored and their care plans kept up to date. Entries made on care plans showed good communication between the home and healthcare professionals. Daily entries made on the care plans confirmed staff members were following the instructions of healthcare professionals and an appropriate level of care was being provided. People we spoke to said they liked living at the home and were well treated by staff members. One person said, “I am very happy here and well looked after. I find the staff are very attentive”. The relative of one person commented, “I am very happy with the care provided for my mum and I am always kept informed about her welfare whenever I visit”. They always inform me immediately if mum is unwell and I am kept updated about any changes to her care or medication following the doctor’s visit. I have been fully involved in mum’s care from the day of her admission and have access to her care plan”. Medication practices we observed were safe and good records had been maintained. The staff members responsible for the administration of medicines had received or were receiving accredited training to ensure they had basic knowledge of how medicines are used and how to recognise and deal with problems in use. People we spoke to said the staff team respected their privacy and they could spend time on their own if that was their wish. Wellfield House DS0000042777.V373826.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Social activities and meals are both well managed, creative and provide daily variation and interest for people living in the home. EVIDENCE: People we spoke to said routines within the home were flexible and they were able to make their own decisions about how to live their lives. One person said, “My routine hasn’t really changed from when I was living at home. I still go to bed and get up when I want . It’s just like being at home”. We spoke to people about the arrangements in place for receiving their visitors and were told they were happy with these. The relative of one person commented, “Whenever we visit the home , it appears to be welcoming and friendly. It’s a pleasure to visit”. Wellfield House DS0000042777.V373826.R01.S.doc Version 5.2 Page 14 People spoken to confirmed they enjoyed the food provided by the home. The staff members responsible for the preparation of meals were able to confirm they had information about people with special diets and personal preferences. One person commented, “Always look forward to my meals. Good home cooking and plenty to eat”. The relative of one person commented, “The meals appear to be variable and substantial”. Meal times were served in a relaxed and unhurried manner. Staff members we observed were being very attentive to the needs of people. People we spoke to were very happy with the arrangements in place for social activities. These were varied and arranged individually and in groups. Wellfield House DS0000042777.V373826.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Arrangements for complaints are handled well and taken seriously ensuring people feel listened to. EVIDENCE: The home has a detailed complaints procedure, which is made available to everyone on his or her admission. People spoken to were aware of how to make a complaint and felt these would be listened to and acted upon. The relative of one person commented, “There is a lovely homely atmosphere and the staff are so friendly. I am sure if we had any concerns they would be dealt with appropriately”. At the time of this site visit no complaints had been referred to the Commission for Social Care Inspection. The home has a procedure in place for dealing with allegations of abuse. Staff members have received training in the protection of vulnerable adults and showed a good understanding of the procedures to be followed in the event of any allegations or suspicion of abuse or neglect. The staff members on duty said they wouldn’t hesitate to report any concerns they had about care practices to ensure people living at the home are protected from potential harm or abuse. Wellfield House DS0000042777.V373826.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24, 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. People live in a comfortable, homely, clean and safe environment. EVIDENCE: There has been some progress in upgrading the environmental standards in the home since the last visit and a number of issues that had been identified as requiring attention had been addressed. The sun lounge is no longer used as smoking room and a designated area has now been created outside the home for the one person who smokes. The extractor fan in the sun lounge has been repaired and was working. The freestanding electric heaters used in the sun lounge have been removed and are no longer in use, ensuring people who live in the home are no longer at risk of burning themselves. Wellfield House DS0000042777.V373826.R01.S.doc Version 5.2 Page 17 Since the last inspection the dining room has been redecorated and a new carpet fitted providing a pleasant environment for people to enjoy their meals. The manager said improvements to the environment were ongoing and there are plans for refurbishment within the home. People we spoke to were happy with the improvements being made. A tour of the building confirmed people had been encouraged to personalise their bedrooms with their own belongings. People we spoke to said they were happy with their rooms and said they had the choice of spending time on their own or in the lounge areas. Whilst completing a tour of the building we tested hot water temperatures and found that, in some bedrooms, water was very hot, potentially placing people at risk of being scalded. The manager said she had identified this problem when undertaking an audit of the home in December and had made arrangements with the home’s plumber to fit pre-set valves to all sinks and baths throughout the home. These will ensure water is delivered at a safe temperature in line with health and safety guidelines. Following discussion with the owner of the home, arrangements were made for the valves to be fitted as a matter of urgency and we were informed the work would commence within days. As a precaution, we asked the manager to identify any potential risks to people prior to the work commencing and place warning notices in all bedrooms and sinks informing people about the hot water. This will ensure that every effort has been made to protect the health and safety of people living in the home and the staff who work there. It was observed during the visit the home was clean and hygienic ensuring a pleasant environment in which to live. Wellfield House DS0000042777.V373826.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Staffing levels are sufficient to meet the needs of people living at the home. EVIDENCE: Staffing levels were sufficient for the number of people living at the home. People spoken to said they were happy with the care they were receiving and were well treated by the staff. The relative of one person said, “Always plenty of staff on duty. I have absolute confidence in the staff team. Very caring people”. The staff members we spoke to said they were clear about their role and work well as a team to ensure the individual and collective needs of the people in their care are met. The relative of one person said, “Very happy with the care provided. The manager and her staff are brilliant”. Records show all staff members have access to a structured training and development programme ensuring the people in their care are being supported by a well trained and competent staff team. In addition, 80 of staff members have achieved National Vocational Qualifications (NVQ) ensuring people are in the safe hands of qualified and competent staff. Wellfield House DS0000042777.V373826.R01.S.doc Version 5.2 Page 19 Examination of staff records confirmed the home has thorough and robust systems in place for recruiting staff members ensuring the protection of people living there. Wellfield House DS0000042777.V373826.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The home is well run and ensures the health and safety of staff and people living there are promoted and protected. EVIDENCE: The manager of the home has many years’ experience in caring for elderly people and has achieved a relevant care and management qualification. She is well supported by the owners of the home who visit regularly. Records seen confirmed the manager has access to training to ensure her knowledge and skills are updated. Wellfield House DS0000042777.V373826.R01.S.doc Version 5.2 Page 21 People we spoke to were very positive in their comments about the manager and her staff who were described as being friendly, approachable, very helpful and professional. The manager has effective quality assurance systems in place to monitor the level of service being provided for the people in her care. An annual quality assessment of standards is undertaken by a professionally recognised organisation who completes an audit of the care being provided and seek the views of the people who live at the home and their relatives. In addition, the home has its own quality assurance systems in place to gather the views of people and keep them informed about events being organised by the home. People spoken to confirmed they are consulted about any changes taking place within the home and kept fully informed about forthcoming events being organised. The manager told us she does not retain any monies on behalf of the people in her care. We were informed relatives are always encouraged to accept responsibility for the personal finances of people moving in the home. The manager told us that, where this is not possible, the local social services department would accept responsibility. The manager said this policy ensures the financial interests of people in their care are safeguarded. Inspection of maintenance records confirmed facilities and equipment was being maintained as required by health and safety legislation to provide a safe environment for people and staff. As discussed previously in this report, an issue identified with hot water temperatures was dealt with promptly by the home owner to ensure the health and safety of people living in the home and the staff who work there is protected. Wellfield House DS0000042777.V373826.R01.S.doc Version 5.2 Page 22 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 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Wellfield House DS0000042777.V373826.R01.S.doc Version 5.2 Page 23 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. 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. Refer to Standard Good Practice Recommendations Wellfield House DS0000042777.V373826.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection NW Area Office Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 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
© 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 Wellfield House DS0000042777.V373826.R01.S.doc Version 5.2 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. 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!
