Inspection on 24/02/06 for Wellhay Resource Centre

This inspection was carried out on 24th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Wellhay Resource Centre 07/02/07

Wellhay Resource Centre 30/07/05

Wellhay Resource Centre 03/02/05

Wellhay Resource Centre 02/09/04

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

CARE HOMES FOR OLDER PEOPLE Wellhay Resource Centre Knole Lane Bristol BS10 6GH Lead Inspector Sandra Garrett Unannounced Inspection 24th February 2006 09:30 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 Wellhay Resource Centre DS0000037063.V283826.R01.S.doc Version 5.1 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. Wellhay Resource Centre DS0000037063.V283826.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Wellhay Resource Centre Address Knole Lane Bristol BS10 6GH 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) 0117 3772591 Bristol City Council Christine Ruth Bryant Care Home 10 Category(ies) of Dementia (2), Dementia - over 65 years of age registration, with number (8) of places Wellhay Resource Centre DS0000037063.V283826.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. May accommodate 8 persons aged over 65 years of age with Dementia May accommodate 2 persons aged 50 years and over with Dementia Two un-named persons with dementia aged over 50 years may receive respite care at the Centre 30th July 2005 Date of last inspection Brief Description of the Service: Wellhay Resource Centre is operated by Bristol City Council and registered to provide personal support and temporary accommodation for eight people who are over 65 and two people over 50 years. All service users accommodated have a diagnosis of dementia. The centre provides respite and also day care for people living in the community plus support for their carers. Wellhay is purpose built and is able to provide day care for up to 24 people with dementia. The premises are accessible for disabled older people and there are a number of vehicles available for the centres use. Wellhay Resource Centre DS0000037063.V283826.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was made to follow up requirements made at the last visit in July ’05. Five people were staying in the unit for respite at this visit and another person was admitted for respite. Further a maximum of twenty other service users were attending for day care. Eight service users were spoken with at this visit. A range of documents was examined including newly developed support plans, complaints and accident records. What the service does well: What has improved since the last inspection? Four out of five requirements made at the last visit in July ’05 had been met. It was pleasing to note that work had been done to put new ‘support plans’ in place for each service user. Those seen were comprehensive and met all the elements of the Standard, were signed by service users or their relatives and gave clear information about how the centre would meet assessed needs. Copies of pre-admission assessments were available with care records to show service users assessed needs and how the support plans would ensure they could be met. Wellhay Resource Centre DS0000037063.V283826.R01.S.doc Version 5.1 Page 6 Access to the centre’s complaints records was now available as the manager stated officers had changed their working patterns and the office is open at weekends. Service users and their relatives can be confident that their complaints will be addressed and taken seriously at any time. Service users were seen using all parts of the home at this visit and all doors were unlocked so that they had easy access to their bedrooms. Although the day was cold service users were also seen able to go out in the garden and wander around. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Wellhay Resource Centre DS0000037063.V283826.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Wellhay Resource Centre DS0000037063.V283826.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 4 &5 Satisfactory admission arrangements ensure service users’ needs can be met or action is taken quickly to find a more suitable placement that meets specialist needs. EVIDENCE: Enhanced level care plans from mental health services teams were seen in the front of care files. For one service user the enhanced care plan seen was dated July ‘03. This identified some risks in respect of her/his mental health although these had not been transferred into the current Wellhay care plan. Further some details in the care plan were seen to be no longer current at ’03 but the centre’s stated they were. The manager said if the ‘03 care plan had been reviewed she or her staff would have been invited to a review and as far as she was aware all the elements of the Wellhay plan were current and correct. Wellhay Resource Centre DS0000037063.V283826.R01.S.doc Version 5.1 Page 9 The inspector had been sent a care plan review of another resident that had been carried out by the mental health team. The review identified changing care needs that Wellhay were now unable to meet. The service user had therefore been offered a permanent place at a care home for people with dementia and would not be returning to Wellhay for respite. Evidence was seen in another service user’s daily records of a trial visit to another care home for people with dementia. Clear records demonstrated that a decision is awaited as to when the service user will be admitted to the home permanently. A feature of Wellhay is the daily report meeting that is attended by all staff including managers. The inspector attended the meeting at this visit. Each service user is discussed whether staying at the centre or as part of their day care. Issues such as reviews, trial visits at permanent care homes, mood, sleep patterns and health issues were discussed. The meeting is an effective way of informing all staff and discussing with them, service users care needs on a daily basis and is good practice. Wellhay Resource Centre DS0000037063.V283826.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 &9 Improved care records demonstrate that service users are looked after well in respect of health and personal care needs. Clear medication records demonstrate that service users medication needs are well managed. EVIDENCE: A requirement in respect of care plans made at the last visit was met. Each service user now has a support plan that identifies assessed needs. The deputy manager said he has responsibility for compiling support plans for each of the respite care service users. A range of care plans were examined and the following noted: Support plans were clear detailed and person centred. Photographs of each service user were seen together with their preferred name. Risk assessments e.g. for smoking were clear and detailed. Further manual handling risk assessments were detailed with evidence of needs in respect of dementia that could affect a service user’s mobility. Risk assessments also indicated any history of falls. Wellhay Resource Centre DS0000037063.V283826.R01.S.doc Version 5.1 Page 11 All care plans included personal profiles. Consent to share information forms were seen having been signed by service users themselves. Support plans were comprehensive and contained a range of assessed needs: i.e. washing, bathing, dressing, continence, senses, oral health, communication, memory, anxiety and orientation. Clear details of how assessed needs including healthcare needs are to be met were seen. Medication administration sheets were seen kept in individual service users files. Details of medication and times of giving were highlighted and all records were appropriately signed with no gaps. All medication is kept in a locked medication cupboard in a locked room. No service user keeps their own or self medicates although each room has its own metal cabinet that can be used for this purpose. Wellhay Resource Centre DS0000037063.V283826.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 Wellhay continues to provide service users with the opportunity to experience a stimulating and varied life where various formal and informal activities are regularly made available. EVIDENCE: Daily activities are a regular feature of life at Wellhay and the centre is well equipped with its own activities/craft room, a ‘workshop’ where male residents like to congregate, a snooker table and an accessible garden. The craft room was open at this visit although service users weren’t seen using it. Evidence was seen however of paintings and items made by service users. Photographs on the walls also showed service users involvement in a range of different activities. One service user was seen playing snooker by himself and the inspector joined in. Service users were seen wandering in the garden although one found it hard to find her/his way back in and had to be assisted. However they expressed keenness to visit the garden although the day was cold. The deputy manager said that he acts as key worker for each service user staying at the centre for respite. He said he spends time with them doing activities such as playing snooker, chatting and other quality involvement. Service users were seen coming to the office to chat to him and his calm, quiet and person-centred approach was noted with each. Wellhay Resource Centre DS0000037063.V283826.R01.S.doc Version 5.1 Page 13 Care staff were also seen around the home talking with service users and reassuring them if they needed it. The same calm approach was used and it was noted service users clearly benefited from this. Wellhay Resource Centre DS0000037063.V283826.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Satisfactory complaints management and recording ensures service users and their relatives can feel confident in raising concerns about any aspect of their care. Satisfactory arrangements for protecting residents from harm ensure that service users are protected as far as possible. EVIDENCE: A requirement made at last visit in respect of access to complaints records was met. The centre’s complaints file is kept in the office but this is kept open as managers have changed shift pattern and now cover weekends. On examining the file no new complaints had been received. Wellhay has very low volume of complaints overall. Over twenty ‘thank you’ cards sent over last two years were contained in the file that demonstrates high levels of relatives’ satisfaction with care given to service users. Eleven staff have had training in safeguarding adults. The manager said the centre often works with service users who are subjects of protection plans and Wellhay is used as a place of safety for people at risk of abuse. She gave examples of some of the situations faced by service users. Wellhay staff are therefore able to monitor day care service users who may be at risk of abuse as part of their job. The manager said she attends strategy meetings and is involved in protection plans. Wellhay Resource Centre DS0000037063.V283826.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24 & 26 Service users staying at the centre for either respite or on day care benefit from having a comfortable, clean, safe standard of accommodation that is accessible and secure. EVIDENCE: Wellhay offers a high standard of accommodation for both service users on respite and day care. The home was exceptionally clean and hygienic at this visit and smelled fresh and pleasant. Service users were seen using all parts of the centre. A requirement made at the last visit in July ’05 was met. All bedroom doors were unlocked together with the craft room, making these rooms accessible to service users staying at the centre. Each bedroom is decorated in pastel colours with white furnishings that give a clean, fresh look to the rooms. Staff were seen cleaning areas of the centre at the time of the visit. Wellhay Resource Centre DS0000037063.V283826.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the standards were inspected at this visit. Standards 27 and 30 were met at the visit in July ’05. EVIDENCE: Wellhay Resource Centre DS0000037063.V283826.R01.S.doc Version 5.1 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 35, 37 & 38 Service users and staff continue to benefit from an experienced manager who encourages an open style of management. Attention is needed to ensure the registered provider regularly monitors the service and reports to Commission for Social Care Inspection. Satisfactory recordkeeping ensures service users are respected and the quality of their lives whilst at the centre is regularly monitored. Attention is needed to ensure records of incidents affecting service users include clear and accurate details of outcomes and actions taken to prevent occurrences. Wellhay Resource Centre DS0000037063.V283826.R01.S.doc Version 5.1 Page 18 EVIDENCE: Both the manager and the deputy manager were on duty at this visit. The manager has many years experience in working and running residential care homes for the local authority and has previously managed a care home for people with dementia. The manager demonstrated her knowledge of issues affecting people with dementia and operates an open and inclusive management style. Service users were observed coming in and out of the office to talk to both the manager and deputy and all were treated with dignity and respect. It was disappointing to note that despite a requirement made at the last visit in July’05 and contact between the manager, the team manager and the Commission, no application for a person to act as Responsible Individual on behalf of the service provider (Social Services and Health), had been received. Service users, their relatives and Commission for Social Care Inspection therefore may not be confident the service is monitored regularly. Failure to meet the requirement could lead to enforcement action. A good practice recommendation made at the last visit in July ’05 in respect of ensuring service users are given receipts for monies held whilst at the centre had now lapsed. The issue had arisen with regard to one service user staying at the centre at that time who had now left. The manager said that currently no monies were being held for service users whilst they were staying at the centre. Daily records though mainly factual, were all written in respectful language. The records gave clear information about service users stay and how they enjoy themselves, with qualitative records of enjoyment of activities and entertainment. Care records were kept secure and confidential in the main office. The centre’s accident records were examined. These were mainly recorded on the local authority’s own incident forms. The manager showed the inspector a copy of an email from the Health and Safety department congratulating on 100 score on a recent audit. However it was noted that some of the accident records were brief and gave no indication of actions taken when someone was admitted to hospital after a fall. One record stated bruising and grazes only but boxes ticked showed paramedics were called; the service user was taken to hospital and kept in more than 24 hrs. No reason was given on the sheet as to why this had been needed. The manager looked up her records and noted that the service user was kept in for observation but no serious injury was found. A good practice recommendation is therefore made in respect of the level of detail in accident records together with action taken to prevent occurrence. Lots of recorded falls showed no injuries to service users. The inspector had received no recent notices under regulation. Wellhay Resource Centre DS0000037063.V283826.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 N/A X X X 3 X 3 STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 1 X X X 3 2 Wellhay Resource Centre DS0000037063.V283826.R01.S.doc Version 5.1 Page 20 YES 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. Standard OP33 Regulation 7(2(c(i)26 (2(c) Timescale for action The registered person must 30/04/06 appoint a named person to act as responsible individual who is fit to carry out the registered persons duties. This person must also make monthly internal monitoring visits to the home and send copies of these visits to the Commission (Timescale not met from inspection) the July ’05 Requirement 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 OP38 Good Practice Recommendations The centre’s accident records should give clear information about incidents affecting service users showing outcomes and actions taken to prevent occurrence Wellhay Resource Centre DS0000037063.V283826.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 Wellhay Resource Centre DS0000037063.V283826.R01.S.doc Version 5.1 Page 22 - 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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