Inspection on 03/07/07 for Wellington House

This inspection was carried out on 3rd July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Wellington House 05/07/06

Wellington House 11/01/06

Wellington House 18/10/05

Wellington House 05/01/05

Wellington House 08/06/04

Wellington House 21/01/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 Wellington House 63 Little Wood Street Norton, Malton North Yorkshire YO17 9BB Lead Inspector Karen Ritson Unannounced Inspection 03/07/2007 09:30 Wellington House DS0000007824.V335877.R01.S.doc Version 5.2 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.V335877.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 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.V335877.R01.S.doc Version 5.2 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 vacant post Mr Terence Greene Mrs Kathleen Barbara Greene Care Home 16 Category(ies) of Learning disability (16) registration, with number of places Wellington House DS0000007824.V335877.R01.S.doc Version 5.2 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 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 whom may also have a physical disability. The home is a detached property, situated in a residential area of Norton, North Yorkshire and is close to local transport networks. A bus service runs through Norton and the train station is in neighbouring Malton. 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. The home charges between £341 and £894 per week according to assessed needs. Fees exclude chiropody and hairdressing, which are charged at cost. This information was provided to the Commission on 20th April 2007.The home has a statement of purpose and service user guide; these, with the CSCI report are available on request. Wellington House DS0000007824.V335877.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection for this service took 12 hours. This includes time spent gathering information and examining documentation before and after an unannounced site visit and in writing the report. The site visit took place on 03/07/2007 between 9:30am and 2pm. Information for this inspection was gathered from the following: • • • • • • • • • • • A tour of the premises. Observations of care throughout the day of the site visit. Speaking with service users. Speaking with the manager. Speaking with staff. Case tracking service users on the day of the site visit. Looking at information provided by the home in a pre inspection questionnaire. Notifications sent to the commission from the home since the last inspection. Examining policies, procedures and records kept at the home. Examining information regarding the home on the file kept by CSCI. Considering comments made by relatives, health care and social services staff. All key standards were looked at during this inspection. The manager was present throughout the day of the site visit. What the service does well: This home provides an excellent service for those in its care. Each person living at the home is well known to the manager and staff. Most have been resident for many years. The care each person needs is written down and regularly updated. The staff listen to what health care professionals advise and put this into practice. One health care professional said: ‘I found the home made an excellent response to our suggestions. Staff were enthusiastic and really showed they wanted the best for the service user.’ Service users are protected from risks and helped to live as full and stimulating life as possible. Because the manager and staff have taken the time and effort to get to know each person well, all service users are understood and can make choices about the way they live their lives. There is opportunity to get involved in different activities both in and out of the home. Relatives and Wellington House DS0000007824.V335877.R01.S.doc Version 5.2 Page 6 friends are welcomed and there is good communication between all the people who are involved in care. One relative said: ‘They consult me and I am involved in discussions if there are any changes to care.’ The home provides good food and service users are asked what they prefer. Specialist needs regarding food are written down and acted on which ensures service users receive a balanced diet. The home is very well decorated and provides a comfortable living space. There are interesting pictures and objects to look at, and a sensory room for all service users to enjoy. The manager is very experienced and the staff are well trained and enthusiastic. The views are service users and others are surveyed and the results are used to plan improvements to the care offered. Health and safety is a priority. This protects service users welfare. What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Wellington House DS0000007824.V335877.R01.S.doc Version 5.2 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.V335877.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 People who use the service experience good quality outcomes in this area. Prospective service users and their representatives have the information needed to choose a home, which will meet their needs. They have their needs assessed and are clearly told about the service the will receive. This judgement has been made using a range of evidence including a visit to the service. EVIDENCE: No new admissions have been made since the last inspection. The manager however is fully aware of the requirements if a new service user was to be admitted and has the assessment tools available. Wellington House DS0000007824.V335877.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8 and 9 People who use the service experience excellent quality outcomes in this area. Individuals are involved in decisions about their lives, and play an active role in planning the care and support they receive. This judgement has been made using a range of evidence including a visit to this service. EVIDENCE: The care plans for two of the service users were examined. These showed detailed instructions for appropriate care, covering all areas including specific conditions. Each plan focuses upon the individual and is written with a holistic approach. Strengths and personal preferences are incorporated and future care needs and goals have been taken into consideration. Service users and relatives are involved in the development of the care plan and are consulted at review. Choices and the way in which individuals are able to indicate choice are recorded. Staff not only have thorough training in relevant areas of care, most Wellington House DS0000007824.V335877.R01.S.doc Version 5.2 Page 10 also have a long history of involvement with each service user where changing and complex needs are understood over time. This ensures that care is focused and appropriate for each individual. A relative said: ‘They ring me up or I can ring them. They consult me. They also think about what (my relative) will need in the future and plan for that now. They know him so well they make sure he has no unnecessary risks.’ One service users’ needs had changed significantly since the last inspection. Health and other professionals had been consulted and the care plan had been regularly updated to reflect this. Risk assessments were available for each service user. These were tailored to meet specific needs and ranged from physical care and safety to mental health strategies. Care needs are anticipated and changes in care planning are introduced in a measured and well thought out manner. All limitations on a service users freedom are explained and only in place when necessary. This person centred approach to individual needs and choices ensures service users receive an individual, tailored service. Wellington House DS0000007824.V335877.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 People who use the service experience excellent quality outcomes in this area. Residents are able to choose their life style, social activity and keep in contact with family and friends. Social, cultural and recreational activities meet resident’s expectations. Residents receive a healthy, varied diet which they enjoy. This judgement has been made using a range of evidence including a visit to this service. EVIDENCE: Each service user has an individual programme aimed at developing skills and staff are available to support service users in this. Three activities are on offer each day. Activities include going to the cinema, shopping, visiting teashops and going out for days in the home’s own transport. Others include, spending Wellington House DS0000007824.V335877.R01.S.doc Version 5.2 Page 12 time in the sensory room, drawing, art and craft. Most of the service users have complex care needs and their days are planned to take full account of each individual and what will help stimulate and entertain that person. Responses to activities are recorded in diary entries. Staff said they were given plenty of time to spend with service users on a one to one basis as key workers. Observations were made from time to time throughout the day and service users were obviously contented and engaged in activities that were stimulating and meaningful to them. Three of the service users go out with friends or family members and visit the family home, other service users, who have more complex needs receive visitors at the home. One relative had travelled from another area to spend time with her son, and was staying as a guest at the home. The service user, relative and manager were to have an outing the afternoon of the site visit. Menus were seen and showed a variety of nutritious options. A midday meal was observed and service users were obviously enjoying their food. Residents are helped to choose what they would like to eat through the use of photographic prompts if needed and assisted at meal times in a kind and sensitive way. Meals include fresh vegetables and all regular supplies are sourced locally. Menus are used as a guide and there is much room for individual choice. Most meals including deserts are home made and baking is carried out on the premises. The dietician is involved where necessary and all recommendations recorded and followed. One dietician said: ‘The staff came to meetings at the hospital and were very keen to be trained in dealing with the nutritional needs of (the service user). ‘ This service user requires specialist nutrition and this is clearly set out in the care plan. All menu choices are recorded in order to build a view of preferences and to ensure that service users have a balanced diet. At the close of each month the record is examined and any problems addressed. The staff use this as a training guide for future meal planning. Wellington House DS0000007824.V335877.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 People who use the service experience excellent quality outcomes in this area. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. This judgement has been made using a range of evidence including a visit to this service. EVIDENCE: All personal care needs including the way in which care is to be offered are recorded in care plans. All service users have a key worker who will assist with personal shopping or visit the hairdressers for example. Staff ensure that care is person led. Personal support is consistent as there is little turn over of staff, and staff are able to meet the changing needs of the residents. Aids and equipment encourage service users to have maximum independence. All staff have received manual handling training. Wellington House DS0000007824.V335877.R01.S.doc Version 5.2 Page 14 Staff are alert to changes in mood and close observations are recorded each day. They are also aware of the particular needs of those service users who remain immobile for long periods of time. This was observed during the day and is written into care plans. Without exception care was offered with consideration, involving the service users by speaking to them throughout, consulting with them and explaining what was to be done. This ensures that service users receive personalised and appropriate health care. Medication is stored, recorded and administered appropriately and all staff who handle medication have completed training. The home has a medication policy and procedure. Comments from health care professionals indicated that staff listened to and acted on their advice, and that they were always able to see their patients in private. This ensures that service users needs regarding medication are met. Wellington House DS0000007824.V335877.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use the service experience excellent quality outcomes in this area. Residents have access to a robust, effective complaints procedure; their complaints are listened to and acted on. Service users are protected from abuse and have their legal rights protected. This judgement has been made using a range of evidence including a visit to this service. EVIDENCE: The home has an effective complaints procedure and policy. Feedback from health care professionals indicated that there was always a senior person in charge who could be approached if there were any concerns, however, none were aware of any complaints made about the service. The home keeps a book for the purpose of recording complaints and their outcomes but none had been received since the last inspection. Service user care plans clearly showed the way in which care was to be offered and daily diary sheets recorded service users responses to care offered and adjustments made where necessary. Staff said they met regularly to discuss care needs, make certain that the care offered was appropriate and to discuss any niggles. Wellington House DS0000007824.V335877.R01.S.doc Version 5.2 Page 16 All staff have now received adult protection and abuse awareness training and were able to demonstrate this awareness in discussion. Policies are in place. The manager has updated her training in abuse awareness with an external provider. (York University). The home has compiled an abuse awareness flow chart which is displayed within the staff area of the home. This provides a visual prompt to remind staff about the possible causes of abuse and ways to avoid unintentional abuse of vulnerable adults. This emphasis upon constantly challenging practice helps protect service users welfare. Wellington House DS0000007824.V335877.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People who use the service experience excellent quality outcomes in this area. Service users live in a safe, well-maintained, stimulating and comfortable environment, which encourages independence. This judgement has been made using a range of evidence including a visit to this service. EVIDENCE: The building is well maintained and homely. It is accessible throughout to those service users who have upstairs rooms. Those who have mobility problems are accommodated on the ground floor. It is clean, light and odour free. Each private room is decorated to individual taste and with all required equipment. The communal areas of the home are very appropriately decorated for the needs of those living there. Some have been redecorated since the last inspection. There are photographs of service users, family and notice boards Wellington House DS0000007824.V335877.R01.S.doc Version 5.2 Page 18 with photos of days out and activities throughout the home. This creates a sense of home for each individual. One lounge has a fish tank and there are textured and other pictures throughout the home. There is a mini sensory area at the foot of the staircase where service users enjoy soft coloured lights, mobiles and light catchers. An upstairs room is entirely set aside as a sensory room where service users enjoy music, lights and experience a number of textures and colours. This has been improved since the last inspection with new seating. Other areas create interest yet maintain a sense of calm and relaxation. Those service users who have severe mobility restriction have access to items such as soft coloured balls and books by their chairs, which they can look at either on their own, or with assistance. The home has two hoists, (Oxford mini and midi hoists,) which are stored away from main areas. There is a call system to each room and the home has a Parker bath, in addition to other bathing and shower facilities. A new shower room has been fitted since the last inspection. Visual prompts are pinned up in bathrooms and bedrooms wherever necessary to assist service users maintain as much independence as possible in daily care tasks. The laundry is suitable and situated away from the main home. Wellington House DS0000007824.V335877.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35 People who use the service experience excellent quality outcomes in this area. Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service, in line with their terms and conditions, and to support the smooth running of the service. This judgement has been made using a range of evidence including a visit to this service. EVIDENCE: Staff files were examined. They are well recruited with all documentation in place. Staff are also well trained. They all receive TOPSS induction and foundation training with certificates on file and all have a training profile. Sufficient staff are on duty to allow service users to receive one to one attention when needed and for the key-worker system to work effectively. Staff were observed speaking with service users and offering care in a kind and thoughtful way. They were approachable and obviously understood each service users care needs well. Comments received from health care Wellington House DS0000007824.V335877.R01.S.doc Version 5.2 Page 20 professionals indicated that they had a good working relationship with care staff, that they communicated effectively and that advice was acted upon. Staff said they received good support from the home’s management and had regular supervision. This ensures that service users needs are met by well trained and supported staff. Wellington House DS0000007824.V335877.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 People who use the service experience good quality outcomes in this area. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager. This judgement has been made using a range of evidence including a visit to this service. EVIDENCE: The proprietor/manager has many years of experience in managing the home. She takes every opportunity to access training to update her skills. She is studying for a management degree at present but is unlikely to finish this in the near future, however she has set up a folder in order to evidence her ongoing training. She works to continuously improve the service and provide Wellington House DS0000007824.V335877.R01.S.doc Version 5.2 Page 22 an increased quality of life for residents with a strong focus on equality and diversity issues which is apparent in care plans and in daily recording. Staff said they received good support from the manager and they were obviously enthusiastic about providing quality care. The manager demonstrated her awareness of current developments and plans the service with these in mind. The home has an annual quality monitoring system, where the views of service users, families, advocates and health care professionals are canvassed. The results of questionnaires are used to inform future practice. This ensures that service users views underpin practice. The home works to a clear health and safety policy, all staff said they were fully aware of the policy and are trained to put theory into practice. Safeguarding is given high priority and the home provides a range of policies and guidance to support good practice. The home has a consistent record of meeting relevant health and safety requirements and legislation, and closely monitoring its own practice. The manager ensures risk assessments are completed and taken into account in planning the care and routines of the home. This ensures the safety of service users. Wellington House DS0000007824.V335877.R01.S.doc Version 5.2 Page 23 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 x 32 3 33 X 34 4 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 4 4 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 3 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 x 3 X 3 X X 4 X Wellington House DS0000007824.V335877.R01.S.doc Version 5.2 Page 24 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. 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 Wellington House DS0000007824.V335877.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Wellington House DS0000007824.V335877.R01.S.doc Version 5.2 Page 26 - 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!