CARE HOME ADULTS 18-65
Wellington House 63 Little Wood Street Norton, Malton North Yorkshire YO17 9BB Lead Inspector
Mavis Pickard Unannounced Inspection 11th January 2006 09:30 Wellington House DS0000007824.V277031.R01.S.doc Version 5.1 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 Wellington House DS0000007824.V277031.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 Adults 18-65. 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. Wellington House DS0000007824.V277031.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Wellington House Address 63 Little Wood Street Norton, Malton North Yorkshire YO17 9BB 01653 696282 01653 696282 wellingtonhouse1@btconnect.com 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) Ryedale Care Homes Care Home 16 Category(ies) of Learning disability (16) registration, with number of places Wellington House DS0000007824.V277031.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Registered for 16 Service Users with Learning Disabilities some of whom may also have a Physical Disability and some of whom may also be over 65 18th October 2005 Date of last inspection Brief Description of the Service: Wellington House, Norton, is registered to provide residential personal and social care for up to 16 people with a Learning Disability, some of who may also have a physical disability. The home a detached property is situated in a residential area of Norton near Malton in North Yorkshire. Residents accommodation is arranged over 2 floors. There is no passenger lift however the four people accommodated who have mobility problems live in the ground floor area of the home. Wellington House DS0000007824.V277031.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was carried in January 2006 and is the home’s second inspection during this inspection year April 2005-March 2006. The registered providers, one of whom is also the registered manager were available throughout the inspection. Although residents have communication skills not all are able to communicate verbally. Therefore the inspection is based on direct and indirect observation of residents and their interaction with each other and with staff. A range of records were examined and a short tour of the building undertaken with the manager’s assistance. What the service does well: What has improved since the last inspection?
The providers continue to keep up to date with current legislation and good practice by obtaining recent publications and sharing these with the staff. As a result of recommendations of the previous report the home now ensures that the training of the staff in respect to protection of vulnerable adults is undertaken. Consultation is made with residents arrangements to be made after death. or their relatives regarding the Staff is encouraged to undertaken NVQ level 2 training. However the registered manager is not confident that the home will achieve the standards required, as staff are reluctant to undertake this training. Recording of hot water temperatures is now undertaken weekly. Wellington House DS0000007824.V277031.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Wellington House DS0000007824.V277031.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Wellington House DS0000007824.V277031.R01.S.doc Version 5.1 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 the following standard(s): 1 and 4 Systems are in place to ensure that proposed residents would have the information they need to make a choice to be accommodated and that they would be given the opportunity to visit the home prior to admission. EVIDENCE: There have been no recent admissions to the home and the registered manager said that it is unlikely that there will be in the foreseeable future. However systems are in place to ensure that proposed residents would have the information they need to make a choice to be accommodated and that they would be given the opportunity to visit the home prior to admission. Wellington House DS0000007824.V277031.R01.S.doc Version 5.1 Page 9 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 the following standard(s): 10 Confidential information is maintained securely. EVIDENCE: The registered manager and staff ensure that all information maintained in the home is secure and only examined by people who have a right to see it. Staff working at the home are provided with appropriate guidance in respect to ensuring that all confidences are kept, it is part of the home’s induction and supervision processes that staff understands policies and procedures, this would include a written confidentiality policy. Wellington House DS0000007824.V277031.R01.S.doc Version 5.1 Page 10 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 the following standard(s): 11 and 14 Residents have opportunity for personal development and engage in appropriate leisure activities. EVIDENCE: The home exhibits craftwork that residents and staff have made; many visual, stimulating pieces of work are noted throughout the home. Residents have the opportunity to take part in at least 3 activities each day, the manager says these could include, foot and/or hand care, crafts, music and movement, car trips and/or shopping trips into Norton or beyond. During a tour of the home some residents private rooms were seen, these rooms gave evidence that people accommodated are provided with stimulating leisure pursuit’s including music, video’s and/or DVD’s, television books etc. Rooms were seen to be individually decorated in themes of the residents choosing. The way in which the providers and staff ensure that residents enjoy and get the most they can out of life is commendable.
Wellington House DS0000007824.V277031.R01.S.doc Version 5.1 Page 11 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 the following standard(s): 21 The home maintains policies and procedures as guidance for staff in respect to the aging, illness and death of residents. EVIDENCE: The home has appropriate policies with respect to this issue. The manager maintains detailed information showing the wishes of residents and/or their family following death. Many residents have lived at the home a long time and some are aging. The manager said that management and staff would care for a resident until death if in the opinion of the individuals GP and/or family that were best for the resident. Wellington House DS0000007824.V277031.R01.S.doc Version 5.1 Page 12 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 the following standard(s): 23 People accommodated are protected from abuse. EVIDENCE: From direct observation of the way management and staff interact with residents it is clear that people are respected and protected as far as is possible. The home has been part of the local community for some time and local people know and are familiar with residents, when residents go out to shop or other reasons staff accompanies them. The home provides video training for all people who work at the home in respect to recognising and dealing with abuse. The manager understands what constitutes abuse and knows what to do should she suspect that an abusive situation has taken place or may take place. It is however recommended that the providers consider more formal external Adult Protection training for at least the manager and senior support workers. Wellington House DS0000007824.V277031.R01.S.doc Version 5.1 Page 13 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 the following standard(s): 25 Residents bedroom suite their lifestyle. EVIDENCE: In general the home provides a comfortable and safe environment for people accommodated. A recommendation of the previous report is that an identified carpet in an upstairs bedroom be replaced as it is in a dangerous condition. The carpet has not to date been replaced as the manager is negotiating with the service use/their family and care manager regarding work that has to be carried out to the floorboards in the bedroom. This work will entail the resident moving to another bedroom. The manager confirms that when negotiations are completed and should it be agreed the resident will move to another bedroom. Following remedial work being carried out a new carpet will be laid. [Please refer to standard 42 and requirement 1 of this report.] Wellington House DS0000007824.V277031.R01.S.doc Version 5.1 Page 14 It is not clear if the resident will, should this take place, return to the bedroom or stay in their new surroundings. It is important that detailed records are maintained regarding the resident’s choice in all these dealings. This will be examined at the next inspection. Wellington House DS0000007824.V277031.R01.S.doc Version 5.1 Page 15 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 and 32 A consistent and effective team supports residents. EVIDENCE: The management and many support staff have worked at the home some time and know residents well. The same is said of residents who have lived at the home many years and know and trust staff who support them. From direct observation and from speaking with staff it is clear that they understand their roles and responsibilities. The home is quite small and has a ‘family home’ feel about it that ensures that experienced staff are never far away from residents. Both the providers, one of who is the manager, are ‘hands on’ supporters and understand the needs of people who live at the home. Wellington House DS0000007824.V277031.R01.S.doc Version 5.1 Page 16 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38 and 42 The residents and staff benefit from good leadership and management. Not all fire safety issues are met. EVIDENCE: The providers, one of who is the registered manager ensures that the home runs smoothly. The atmosphere in the home is comfortable, respectful and open. The views of residents and/or their family and other interested parties are sought with respect to the providers monitoring the service they provide. It was noted during the tour of the home that fire routes and fire exits throughout the home are not marked as such. The report of the most recent fire authority visit dated 25 February 2004 was examined. The report gave requirements, one of which has been met. However the report required that Pictograms showing fire routes and fire exits be posted. This has not been met. Please refer to standard 25 with reference to unsafe carpet.
Wellington House DS0000007824.V277031.R01.S.doc Version 5.1 Page 17 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. 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 3 2 X 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 2 ENVIRONMENT Standard No Score 24 X 25 3 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 3 32 X 33 3 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X 3 LIFESTYLES Standard No Score 11 3 12 X 13 X 14 4 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X 3 X 3 X 3 X 1 X Wellington House DS0000007824.V277031.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA42 Regulation 13(4)(a) Timescale for action The carpet identified during the 30/03/06 inspection as being unsafe must be replaced following the planned remedial work to the floorboards. Following consultation with the 11/01/06 Fire Authority the registered person must ensure that instructions of any schedule 1 & 2 reports of the Fire Authority are carried out as instructed. Requirement 2 YA42 23(4)(b)& (c)(iii) 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 Wellington House DS0000007824.V277031.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Wellington House DS0000007824.V277031.R01.S.doc Version 5.1 Page 20 - 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!
