Inspection on 13/03/06 for Wells Court

This inspection was carried out on 13th March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Wells Court 10/06/08

Wells Court 29/10/07

Wells Court 21/03/07

Wells Court 26/07/05

Wells Court 02/02/05

Wells Court 15/09/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Wells Court Herbert Road Salcombe Devon TQ8 8HD Lead Inspector Wendy Baines Unannounced Inspection 13th March 2006 10:00 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 Wells Court DS0000003852.V269087.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. Wells Court DS0000003852.V269087.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Wells Court Address Herbert Road Salcombe Devon TQ8 8HD 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) 01548 843484 01548 843484 Wells Court Limited Care Home 24 Category(ies) of Dementia - over 65 years of age (24), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (24), Old age, not falling within any other category (24), Physical disability over 65 years of age (24) Wells Court DS0000003852.V269087.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Age 55/65 Date of last inspection 26th July 2005 Brief Description of the Service: Wells Court is a detached two- storey property in the estuary town of Salcombe in the South Hams area of South Devon. It is part of the Court Group of care homes, and is registered to provide care for 24 older persons who may also have a physical disability and/or Dementia. Accommodation is provided in single en suite bedrooms. Communal rooms are spacious and are situated on the ground floor. There is a small garden at the front of the property. There is a passenger lift, chair lifts and appropriate aids and adaptations. The service users have access to the Court Group minibus for outings. Wells Court DS0000003852.V269087.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place on the 13th March 2006 between 10am and 5pm. The acting manager for the home, Mrs Mary-Ellen Hooper was available throughout the day. The inspection included a tour of the premises, meeting residents and relatives, talking to the District Nurse, and discussing the changing approach to regulation with Mrs Hooper. The inspector was able to observe staff whilst they provided care and support to residents and was able to meet and talk with all staff on duty. A sample of care-plans, assessments’, documents and other records were viewed. Lunch was taken with the residents in the main dining room. What the service does well: What has improved since the last inspection? Wells Court DS0000003852.V269087.R01.S.doc Version 5.1 Page 6 New flooring has been fitted in one bedroom as recommended at the previous inspection. A new commercial washing machine and tumble dryer has been purchased. The washing machine has the specified programming ability to meet disinfection standards. All staff have now received training in first aid. An application has been forwarded to the Commission to register a manager for the home. 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. Wells Court DS0000003852.V269087.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 Wells Court DS0000003852.V269087.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): 1.3.4.5. Prospective residents are provided with sufficient information about the home to enable them to make an informed choice about where they live. The admissions procedure ensures that service users needs are assessed and can be met. EVIDENCE: A colour brochure was available with detailed information regarding the home and services provided. This information has been made available to all current and prospective residents. Following referral to the home either by an individual or Social Services the home completes a pre-admission assessment of the individuals needs. This information is gathered through a range of sources including; meeting with the individual and family, and requesting information from the GP and other agencies involved in the individuals care. Prospective residents are invited to visit the home but may not always choose to do so. The management should inform service users and/or their representatives in writing that their assessed needs can/cannot be met. Wells Court DS0000003852.V269087.R01.S.doc Version 5.1 Page 9 Discussion took place with the family of a resident who had more recently moved to the home. They confirmed that they had been given information about the home and had been invited to visit. They said that staff had been very kind and helpful during the time their relative moved in. Relatives spoken to expressed some concern regarding long-term arrangements and agreements when their relative had completed a trial period in the home. The Registered Provider should consider a review arrangement following a trial period particularly when relatives live away and may have issues they need to discuss. On the day of the inspection the manager met with relatives of a new service users and reassured them regarding their concerns. Wells Court DS0000003852.V269087.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): 7.8.10. Residents can be assured that their health care needs will be recorded, monitored and reviewed and advice will be sought from health care services when required. EVIDENCE: A sample of service user records, care plans and risk assessments were seen. These included information relating to all areas of health and social care. The manager said that the home has recently joined the ‘Falls Register’ and have received documentation to complete risk assessments and records of residents at risk of fall and fractures. Care plans are reviewed on a monthly basis. Some of the detail in care plans did not reflect the amount of care described by staff and management. Discussion took place with the manager for the need to ensure that care plans are sufficient in detail to ensure consistency and continuity of support. More detailed information should be recorded for residents with complex health needs or deteriorating conditions such as Dementia. This information should detail clear guidelines for staff, any training issues and other agency responsibilities. Wells Court DS0000003852.V269087.R01.S.doc Version 5.1 Page 11 Daily communication records confirmed that good systems are in place to monitor any changes in residents’ health. Risk assessments had been completed for residents at risk of falling, fractures and Pressure sores. The home has a good working relationship with local GP practices and other health care professionals. The inspector was able to meet with a visiting District Nurse who confirmed the quality of care provided and said that the staff follow their guidance and complete clear and accurate records when requested. Residents spoken to with specific health care needs gave a good account of the care and support they receive. They said they were treated with utmost respect, their privacy was always observed when washing or bathing, and that staff were gentle, kind and considerate. Throughout the inspection most staff were observed providing care in an appropriate and respectful manner. Discussion took place with the manager for the need to ensure that all staff speak to residents in courteous a respectful manner at all times and that this is an area that should be covered in induction and as part of the homes on-going training programme. Wells Court DS0000003852.V269087.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): 12.13.14.15. Residents living at Well Court enjoy a relaxed homely atmosphere in which they are encouraged to make decisions and choices about their lifestyle. EVIDENCE: Routines within the home are flexible to ensure that residents can choose how to spend their time. Residents said there were no rules about getting up or going to bed. They said they could have a lie in if they wanted and go to bed early if they wished. Several residents spoken to said they choose to spend most of their time in their rooms and said that staff visit them regularly, deliver their meals and drinks and respect their privacy. Activities are provided in the main lounge and these can include visiting entertainers, quizzes, and games. One resident has a regular visit by a friend to pursue his interest in chess. Many service users lived in Salcombe prior to their admission and have local connections. Some residents make their own social arrangements either independently or with family and several use local bus and community transport services. The home also has the use of a mini-bus for planned outings. Information regarding individuals’ religious preferences were recorded as part of the admissions process and residents are supported to attend church or partake in a service within the home. Wells Court DS0000003852.V269087.R01.S.doc Version 5.1 Page 13 The home should consider ways of improving the information brought in and provided to residents regarding events in the local community. Residents said that family and friends are welcomed at all times. The inspector was able to meet with several visitors who all gave a very positive view of the home. They said that staff were always welcoming, helpful and friendly. The residents who invited the inspector to sit with them for lunch expressed their satisfaction with the food they receive. The meals served on the day of the inspection were of a good standard. Residents’ records included details regarding likes, dislikes, allergies and special diets. Not all residents who chose to spend their day and mealtimes in their bedrooms were clear about whether they could request snacks and drinks after the routine meal times. Wells Court DS0000003852.V269087.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. Residents can be confident that their views and comments will be listened to and any complaints will be dealt with within agreed timescales. EVIDENCE: The home has a written complaints procedure and residents spoken to said that they feel the staff listen to, and address any of their concerns. If they have a complaint they know whom to approach. No complaints have been made to the Commission about this home. All comments and concerns received in the home are recorded with a record kept of the homes response. Wells Court DS0000003852.V269087.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): 19.20.23.24.25.26. Residents are provided with accommodation that is comfortable, attractive and clean. EVIDENCE: A tour of the communal parts of the home and some service user bedrooms took place during the inspection. The home was found to be clean and tidy throughout. The inspector and manager noted that parts of the house, particularly the main entrance and corridors felt cold, although residents’ bedrooms and the sitting room were warmer. The previous inspection recommended that additional radiators should be fitted in the upstairs corridor and the en-suite facility in bedroom 15. This has been a recommendation in two previous inspections and remains outstanding. Since the last inspection the layout of the second, smaller sitting room has been re-organised to make this more comfortable for residents, however this room is also being used to store equipment. Wells Court DS0000003852.V269087.R01.S.doc Version 5.1 Page 16 New flooring has been fitted in one of the service users bedrooms but this still needs completing in bedroom 12 as recommended in the previous inspection. The home has a call bell system and staff were observed responding promptly to all calls throughout the day. Since the last inspection the home has purchased a new commercial washing machine and tumble dryer. The washing machine has the specified programming ability to meet disinfection standards. There is a small garden at the front of the property with a seating area, but the garden is not secure for use by residents with Dementia. The manager said that staff supervise residents when they are in the garden and this has not resulted in anyone being restricted or unsafe when using this area. The home should continue to review the use of the garden area as residents’ needs change and increase. The home is in the process of completing their phased programme to fit temperature regulator valves to all hot water outlets. Valves have been fitted to baths and showers and wash hand basins in three new bedrooms. Wells Court DS0000003852.V269087.R01.S.doc Version 5.1 Page 17 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): 27.28.30. Residents can feel assured that staff have the skills and experience to meet their needs. EVIDENCE: Staff seen on duty were friendly and good-natured. Those spoken to were able to give a good verbal account of resident’s needs and their role within the home. Staff were observed throughout the day providing care services, serving meals and drinks, administering medication, and talking to residents and visitors. Most of the staff employed in the home had been there for a considerable time. Staff turnover is generally low although the manager said that there had been a recent unsettled time due to staff sickness and changes in management. The manager said that there are sufficient staff employed to meet residents needs by day and night. There is one waking and one sleeping-in member of staff at nighttime. Staffing levels are kept under review dependent on the needs of the service users. The staff team has a good range of skills to meet the assessed needs of residents. Staff said that they are encouraged to undertake training and this was confirmed by the staff training records, which covered; Induction, health and safety and specialist training, as part of the homes on-going training plan. Over 50 of care staff have now achieved a NVQ Level 2 or above in care. Since the last inspection all staff have completed training in First aid. Wells Court DS0000003852.V269087.R01.S.doc Version 5.1 Page 18 Wells Court DS0000003852.V269087.R01.S.doc Version 5.1 Page 19 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): 31.32.33.36.37.38. Residents and staff benefit from an open, inclusive and positive style of management. Residents live in an environment where most health and safety standards are met and maintained. There is a lack of protection from some unregulated hot water outlets. EVIDENCE: Mrs Mary-Ellen Hooper was appointed Acting manager in March 2005. Since the last inspection she has submitted an application to the Commission to be appointed as Registered Manager for the home. Mrs Hooper holds an NVQ4 in care and is also in the process of completing the Registered Managers award. During the day Mrs Hooper was able to speak with the inspector regarding changes in regulation and was very passionate in her wish to provide a high quality service. Wells Court DS0000003852.V269087.R01.S.doc Version 5.1 Page 20 Staff spoken to said that she is supportive and listened to their views. Residents said that the manager was regularly in the home and would make a point of meeting and ‘chatting’ with them. Monthly quality audits are undertaken by the responsible individual’s representative to examine all aspects of the provision of the service to ensure standards are maintained. Copies of these reports are forwarded to the Commission. The staff team were very open and had a good understanding of service users needs. The systems of recording and staff handovers ensure that any issues are communicated to all the team. Formal staff supervision takes place on a regular basis and this information is documented. Staff said that they felt well supported by the manager and other staff members. The acting manager said that she receives good support from Head Office and other managers within the organisation. All records inspected were found to be in good order and up-to date. The main staff office is at the front of the house with a large window. This room would benefit by having a blind fitted to ensure the confidentiality of residents’ information. Necessary records are maintained to ensure the safety of service users and the effective and efficient running of the home. Health and Safety in the home is covered in policies and procedures for safe working practices. All radiators in the home have been covered. There is a phased programme to fit water temperature valves to all water outlets but this has not been completed. The manager advised that valves have been fitted to all baths and the en-suite washbasins in the three newly built bedrooms. The Registered Provider must ensure that this programme is completed for all wash hand basins in the home. Since the last inspection all staff have completed training in first aid. Wells Court DS0000003852.V269087.R01.S.doc Version 5.1 Page 21 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 2 X 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 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 X 3 3 X X 3 2 2 3 STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 2 2 Wells Court DS0000003852.V269087.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 OP24OP24 Regulation 13/23 Requirement The Registered Provider must renew the floor covering in bedroom 12 as required in the previous inspection. (Previous timescale 26/09/05 The Registered Provider must provide adequate facilities for the storage of equipment. The Registered Provider must ensure that the home is sufficiently heated and fit radiators in the upstairs corridor and en-suite facility of bedroom 15, as recommended in the previous inspection. The Registered Provider must fit a blind or other form of screening to ensure that residents information stored and displayed in the main office are kept safe and confidential at all times. The Registered Provider must complete the programme to fit water regulator valves to all hot water outlets in the home (Previous timescale not met26/11/05) Timescale for action 01/06/06 2 OP25OP25 13 01/07/06 3 OP37OP37 23 01/05/06 4 OP38OP38 13 01/06/06 Wells Court DS0000003852.V269087.R01.S.doc Version 5.1 Page 23 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 OP1OP1 Good Practice Recommendations The Registered Provider should ensure that as part of the homes admissions process new residents and/or their representatives are informed in writing that their assessed needs can be met. A meeting/review should be arranged following a trial period to agree long- term arrangements. Care plans should be sufficient in detail to reflect the changing and increasing needs of residents The Registered Manager should consider ways of improving the way information is made available to residents about events happening in the home and the local community. 2 3 OP7OP7 OP14 Wells Court DS0000003852.V269087.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Wells Court DS0000003852.V269087.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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