Inspection on 21/03/07 for Wells Court

This inspection was carried out on 21st March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Wells Court 10/06/08

Wells Court 29/10/07

Wells Court 13/03/06

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 Jane Gurnell Unannounced Inspection 21st March 2007 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.V302857.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Wells Court DS0000003852.V302857.R01.S.doc Version 5.2 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 F/P 01548 843484 Wells Court Limited Mrs Mary-Ellen Hooper 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.V302857.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Age 55/65 Date of last inspection 13th March 2006 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 and mainly 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 residents have access to the Court Group minibus for outings. Information relating to the services provided at Wells Court can be obtained directly from the home. The current level of weekly fees range from £306 to £445. Wells Court DS0000003852.V302857.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over 2 days, the 21st and 22nd March 2007 between 10am and 4pm on the first day and 10am and 1pm on the 2nd day. Mrs Mary-Ellen Hooper, the Registered Manager was present on both days and a company director was present on the 2nd day. The inspector spoke to all of the residents as well as the staff on duty, 4 visitors and the District Nurse. A tour of the premises was made and records relating to the care needs of the 4 residents were examined in detail. Prior to the inspection the Commission had sent written surveys to a sample of staff and residents to allow them to comment directly to the Commission regarding their views of the quality of the service provided at Wells Court. All of those returned by staff confirmed they were well supported and received training relating to the care needs of older people. All but one of the surveys returned by the residents said that they received the support they required promptly. What the service does well: What has improved since the last inspection? Maintenance and improvements of the property have continued: the ground floor bathroom and first floor shower room have been refurbished and new equipment purchased making these rooms easier to use by residents with restricted mobility. All radiators have been covered to prevent the risk of burns from the hot surfaces. Temperature control valves have been fitted to a number of sinks in bedrooms to reduce the risk of scalds from hot water and a programme of works will ensure that over a period of time all sinks will be fitted with valves. Three new radiators have been fitted to the upper floor Wells Court DS0000003852.V302857.R01.S.doc Version 5.2 Page 6 hallways to ensure these were sufficiently warm during the winter months. New garden furniture has been purchased making the garden a pleasant place for residents to sit in warmer weather. 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.V302857.R01.S.doc Version 5.2 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.V302857.R01.S.doc Version 5.2 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 and 5 Quality in this outcome area is good. 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 residents’ needs are assessed and can be met. EVIDENCE: A colour brochure was available with detailed information regarding the home and services provided. 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. A newly admitted resident confirmed that she had been able to visit the home and spend time meeting the other residents and staff before making a decision to move in. She said that she had been made very welcome and that the staff had been very kind and thoughtful. Wells Court DS0000003852.V302857.R01.S.doc Version 5.2 Page 9 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, 10 and 11 Quality in this outcome area is adequate. Care plans do not provide an accurate description of residents’ needs and may place residents at risk from inconsistency in the quality of care provided. EVIDENCE: Over the 2-day period of the inspection the inspector spoke to all of the residents. The majority said that the staff were kind and caring and that they received assistance promptly. Comments such as “it’s lovely here”, “it couldn’t be better” and “a real home from home” were made. A small number of residents said that they found some of the staff to be more thoughtful than others, more willing to spend time in conversation, and with whom they felt less rushed. During the inspection, the inspector had the opportunity to observe care staff in their day-to-day tasks and interactions with residents. Whilst it was noted that staff spoke very respectfully to the residents and appeared to have a friendly and relaxed manner, additional attention was needed to ensure that the resident’s personal hygiene and continence needs are fully attended to, that assistance was given during meal times for those residents who have a Wells Court DS0000003852.V302857.R01.S.doc Version 5.2 Page 10 poor appetite and who were unable to cut up their food, as well as attending to the pressure area care of those residents who may be at risk from developing pressure sores. A discussion was held with the Registered Manager about these observations and she gave assurances that this did not reflect the usual practice of the home: it should be noted that on the first day of the inspection a member of staff was absent from the home due to sickness and that one of the staff on duty had only been employed for a few days and was lacking in experience. On the 2nd day of the inspection, the District Nurse was present and she confirmed that either she or one of her colleagues visits the home every day and they have no concerns over the care of the residents. Care plans are the documents that record the care needs of each resident and the action required by staff to meet these needs. It is therefore essential that these provide an accurate description to ensure care needs are fully met in a consistent manner. Four care plans were examined in detail and the information in these plans did not reflect the amount of care being provided as described by staff or the resident themselves: for example, the pain management for a resident with osteoarthritis was not identified although she was receiving regular medication, and a bowel condition of another resident that was causing her considerable discomfort was not identified, although staff were fully aware of this. Discussion took place with the Registered Manager to ensure the care plans reflect the current level of care being provided. 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. The Registered Manager gave assurances that she would review all of the care plans and, with the assistance of the District Nurse, ensure that these accurately reflect the care needs of the residents. It was agreed that if additional staff training needs were identified she and the District Nurse would attend to these as well. Residents with terminal illnesses may remain at the home if they wish as long as the District Nursing Service and the care staff can continue to meet their needs. Medication is stored safely and each resident is identified by a photograph which demonstrates very good practice as two residents have the same name. Records of the administration of medication, including controlled drugs, were accurate. Those staff with the responsibility to administer medication had received training to ensure they were knowledgeable about safe medication practices. Wells Court DS0000003852.V302857.R01.S.doc Version 5.2 Page 11 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 and 15 Quality of this outcome area is good. 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 said they choose to spend most of their time in their rooms and that their privacy is respected. Residents said that the meals were very nice and plentiful. Additional snacks and drinks were available upon request and also available for visitors. Activities are provided in the main lounge and these can include visiting entertainers, quizzes, and games. Many residents 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 minibus for planned outings. Wells Court DS0000003852.V302857.R01.S.doc Version 5.2 Page 12 Information regarding individual’s religious preferences was recorded as part of the admissions process and residents are supported to attend church or partake in a service within the home. The inspector had the opportunity to speak with four visitors to the home. All said that they were made welcome and one who visits the home frequently particularly commented upon the friendly atmosphere with the home. One relative said that she and her family were kept fully informed of their mother’s care needs and felt she was being well cared for. Wells Court DS0000003852.V302857.R01.S.doc Version 5.2 Page 13 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 and 18 Quality in this outcome area is good. 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. Care staff have received training in the protection of vulnerable adults and were aware of their responsibilities should they suspect a resident is at risk from abuse. Wells Court DS0000003852.V302857.R01.S.doc Version 5.2 Page 14 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, 21, 22, 23, 24, 25 and 26 Quality in this outcome area is good. Wells Court provides a very comfortable home for its residents. EVIDENCE: The home was found to be very clean and tidy. The home had 2 lounge rooms, one with a conservatory area with views over the estuary, and a dining room on the ground floor. These rooms were well maintained, pleasantly decorated and had several vases of fresh flowers. Residents said that it was usual to have fresh flowers in the home and that they appreciated the efforts made by the staff and manager to make the home look very pleasant. The home had 4 shower rooms and a bathroom all of which were suitable for use by residents with restricted mobility. All the bedrooms are single and many provide views over the estuary and surrounding countryside. Twenty-one of the twenty-four bedrooms provide en suite toilet facilities and all but one are fitted with a lock that enable residents Wells Court DS0000003852.V302857.R01.S.doc Version 5.2 Page 15 to maintain their privacy and the security of their belongings when not in their room. Staff can override these locks in the case of an emergency. Some beds had been fitted with plastic mattress covers and the Registered Manager was advised to use additional mattress covers between the plastic and the bed sheet to improve the comfort for residents. All radiators are covered to prevent the risk of burns: 3 new radiators had been fitted to the first floor hallway to ensure this area is sufficiently warm during the winter months. The Company Director gave assurances that should any resident find that their rooms or en suite toilets were not warm enough then additional heating would be provided and currently residents found their rooms warm enough. Hot water temperature control valves had been fitted to the bath and a number of sinks to reduce the risk to residents of scalds from hot water: the Registered Manager conformed that an ongoing programme of works will ensure that all sinks will be fitted with these valves. Risk assessments are in place for those hot water outlets not yet controlled. 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 Registered 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. Wells Court DS0000003852.V302857.R01.S.doc Version 5.2 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): 27, 28, 29 and 30 Quality in this outcome area is good. Staff are employed in sufficient numbers to meet the needs of those currently living in the home. EVIDENCE: The Registered Manager confirmed that there are sufficient staff employed to meet residents’ needs by day and night: 3 care staff were on duty from 8am until 8pm. 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. In addition staff are supported by catering and domestic staff and the Registered Manager works until 6pm each weekday. The Registered Manager was informed of the comments made by a number of residents about the less thoughtful attitude of some staff and she gave assurances that she would consult with each resident and address these issues through staff meetings, individual supervision sessions and additional training. 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 to the care staff role, health and safety, first aid and manual handling as part of the homes on-going training plan. Over 50 of care staff have now achieved a National Vocational Qualification Level 2 or above in care. Wells Court DS0000003852.V302857.R01.S.doc Version 5.2 Page 17 A newly employed member of staff confirmed that she is undertaking the nationally recognised Skills for Care induction training which includes information about the principles of good care practice. She also confirmed that she is working alongside an experienced member of staff. A sample of care staff personal files were examined and found to contain all the necessary pre-employment checks, including 2 written references and Criminal Records Bureau checks, ensuing as far as possible only suitable staff are employed. Wells Court DS0000003852.V302857.R01.S.doc Version 5.2 Page 18 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, 5, 36, 37 and 38 Quality in this outcome area is good. Residents and staff benefit from an open, inclusive and positive style of management. EVIDENCE: Mrs Mary-Ellen Hooper was appointed manager in March 2005 and has since the last inspection successfully registered with the Commission. Mrs Hooper holds an NVQ4 in Care and is also in the process of completing the Registered Managers award. Mrs Hooper was very open when listening to the comments made by the inspector in respect of the observations made during the first day of the inspection. She gave assurances that this was not the standard of care she expected from her staff team and would take steps to address these issues through consultation with residents, staff supervision and training. Residents said that Mrs Hooper was regularly in the home and would make a point of meeting and ‘chatting’ with them. Wells Court DS0000003852.V302857.R01.S.doc Version 5.2 Page 19 Monthly quality audits are undertaken by a Company Director to examine all aspects of the provision of the service to ensure standards are maintained. Residents confirmed that this Director visits the home each week and spends time talking to them: the inspector observed that she was well known by the residents. Both residents and their families were formally consulted in January 2007 about their views of the quality of the service provided at Wells Court: the results of this consultation were available and were overwhelmingly positive about the care and support provided by the home. 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. Mrs Hooper said that she receives good support from Head Office and other managers within the organisation: regular meetings are held where issues of service improvement and good practice are discussed. All records inspected were found to be in good order and up-to date. The home holds money for safekeeping for 12 residents and records and monies are held individually: a sample of these was examined and found to be accurate. Wells Court DS0000003852.V302857.R01.S.doc Version 5.2 Page 20 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 3 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 4 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 3 Wells Court DS0000003852.V302857.R01.S.doc Version 5.2 Page 21 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 OP7 Regulation 15 Requirement Timescale for action 30/04/07 2 OP8 12 Each resident must have a care plan that accurately reflects their care needs and that identifies the action required by staff to meet those needs. The Registered Manager must 30/04/07 consult with the District Nursing Service regarding the health care needs of each resident to ensure these are properly identified and are met in a consistent manner by all staff. All care staff interventions to reduce the risk of deteriorating health must be clearly documented. 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 OP24 Good Practice Recommendations The mattresses that are covered with plastic should be DS0000003852.V302857.R01.S.doc Version 5.2 Page 22 Wells Court made more comfortable for residents by using additional mattress covers between the plastic and the bed sheet. Wells Court DS0000003852.V302857.R01.S.doc Version 5.2 Page 23 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.V302857.R01.S.doc Version 5.2 Page 24 - 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!