Inspection on 22/06/05 for Wentworth

This inspection was carried out on 22nd June 2005.

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

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

Other inspections for this house

Wentworth 02/10/07

Wentworth 25/07/06

Wentworth 22/11/05

Wentworth 15/11/04

Wentworth 06/07/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Wentworth 59 South Street St Austell Cornwall PL25 5BN Lead Inspector Philippa Cutting Unannounced 22 June 2005 9:30 a.m. nd 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 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. Wentworth D52-D04 S8923 Wentworth V214701 220605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Wentworth Address 59 South Street St Austell Cornwall PL25 5BN 01726 72941 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Heather Patton Mrs Pauline Stockman Mrs Nancy Gilbert Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Wentworth D52-D04 S8923 Wentworth V214701 220605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Care and accommodation may be provided for one named person under the age of 65 years. Date of last inspection 15TH November 2004 Brief Description of the Service: Wentworth is an older property that has been extended and now provides care and accommodation for up to 20 older people. It is situated on higher ground overlooking part of St Austell and the surrounding countryside but is still within walking disatnce of the facilities in town for anyone with reasonable mobility. As a family owned and run home, one or more of the registered providers are in the home daily. Accommodation is provided on three floors with stairlift access available to first and second floors. Communal areas are provided on the ground floor and comprise a dining room, two adjacent sitting rooms and a conservatory. The sitting rooms and conservatory overlook the gardens. The home is a non smoking establishment. Wentworth D52-D04 S8923 Wentworth V214701 220605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection made between 9.30 a.m. and 4.45 p.m. on a weekday. The inspector spoke with service users, one of the registered persons and the staff on duty. The premises were inspected and records reviewed. An exercise class had been organised for that morning with the instructor visiting from an outside organisation. The majority of people in the sitting room took part and joined in with the quiz that accompanied it. Apart from the serious mistake in medication recording, the home was seen to be providing a good service to its residents who stated that they were happy and had confidence in the staff What the service does well: What has improved since the last inspection? The office has been reorganised and now provides better space for administration work. The programme of refurbishment has continued with new windows being installed in some rooms. Training in basic care needs has continued for all staff. Staff appraisals have been undertaken. Wentworth D52-D04 S8923 Wentworth V214701 220605 Stage 4.doc Version 1.30 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. Wentworth D52-D04 S8923 Wentworth V214701 220605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Wentworth D52-D04 S8923 Wentworth V214701 220605 Stage 4.doc Version 1.30 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 standard(s) 1,3,4, Wentworth has a good reputation; it seeks and provides information about their services and service users’ needs and how these will be met before offering accommodation. EVIDENCE: A copy of the service users guide was seen in a bedroom and a service user said she had chosen the home because she had spent some time in there previously for respite and she had been supported in her own home by Wentworth’s domiciliary care team. Information is gathered prior to a person’s admission. The registered person said that frequently the home has had some contact with a prospective service user before admission but she visits to assess peoples’ needs in order to discuss with them how the home can assist. Wentworth D52-D04 S8923 Wentworth V214701 220605 Stage 4.doc Version 1.30 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 standard(s) 7,8,9,10 The delivery of care to promote the health and well being of service users is handled well but more information should be included in the care plans to substantiate this. Attention to detail is important as a drugs error showed. EVIDENCE: Generally the service users are in reasonable health and many are still quite active and alert. Six care plans were looked at in some detail. The services of professionals ancillary to medicine are used when necessary, especially the community nursing service. Care plans were satisfactory up to a point but in some cases they needed to contain more detail; for example where a service user has a problem this is noted but it would be good practice to include what action should be taken when the problem occurs. In speaking to staff they said what they did but this is not recorded. It may be that different staff use a different approach, so fuller recording would ensure consistency and may indicate which actions are most beneficial where differences exist. Wentworth D52-D04 S8923 Wentworth V214701 220605 Stage 4.doc Version 1.30 Page 10 The home is reminded that care plans should be reviewed monthly and need to be signed and dated. If not, their validity is reduced, particularly if someone wants to review a service user’s situation over a period of time. People had no concerns about the way in which the staff offered help and were, in fact, complementary about this. Two serious errors were noted with the controlled medication in that two numerical mistakes had been made in the entries in the controlled drugs (CD) book. This appeared to be due to carelessness rather than a deliberate attempt to misrepresent medication but it is of concern that other people had not noticed or queried the excessive number of tablets recorded. The administration of controlled medication was seen to have been witnessed by a second person. It must be stressed that this is required to prevent mistakes from happening and the second person signing should check the register as well as the dose and not merely be a ‘cosmetic’ signature. In this instance the registered person & the inspector did a full count of the CDs and were able to track the errors and reconcile the tablets and numbers so they were confident that the medication had been correctly given to the service users concerned. The registered person undertook to instigate a more rigorous system of checking and recording. Staff said that a course in the safe handling of medication has been arranged. Other medication is dispensed via a monitored dose system and was seen to be correctly maintained, recorded and administered. Wentworth D52-D04 S8923 Wentworth V214701 220605 Stage 4.doc Version 1.30 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 standard(s) 12,13,14,15. People living at Wentworth are encourage to remain active and are provided with opportunities to exercise choice and control in their lives. EVIDENCE: The home arranges activities and entertainments for the service users and encourages people to take part but the wish not to do so is respected. Visitors come and go frequently during the day. The inspector had some concerns that after lunch people seemed to be left for nearly two hours in the lounge without staff being in attendance until a cup of tea was offered. The registered person said that as there had been an exercise class that morning she felt service users were content to rest and the staff had been diverted onto care duties (such as bathing) as people who would have bathed in the morning had wanted to take part in the exercises. She said normally she would have been in the lounge herself but had had some essential tasks to complete. In fact it was a hot day and many service users were sleepy. A new shift came on duty about three o’clock and the change over provide a stimulus for service users. The timing of breakfast was discussed. A number of service users said they had this very early - some from 6.0am onward. The inspector had concerns Wentworth D52-D04 S8923 Wentworth V214701 220605 Stage 4.doc Version 1.30 Page 12 that this had become custom and practice over the years and was convenient for staff. However reassurance was given that people were always asked what time they wanted breakfast and whether this was in their rooms or downstairs. The choice of an early breakfast did therefore appear to be peoples’ wish. Wentworth D52-D04 S8923 Wentworth V214701 220605 Stage 4.doc Version 1.30 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 standard(s) 16 The home receives few complaints but when it does they are taken seriously and addressed. The complaints procedure is made available to service users. EVIDENCE: Service users and their relatives are provided with information about the home’s complaints procedure. There have been no complaints since the last inspection. Wentworth D52-D04 S8923 Wentworth V214701 220605 Stage 4.doc Version 1.30 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 standard(s) 19,20,21,22,23,24,25,26, Service users can be confident that the home is properly maintained, the facilities provided are clean and hygienic and they can have their own possessions around them. EVIDENCE: An inspection of the premises showed that they were in a good state of repair and decoration. People were able to have their own possessions with them in their rooms. People said they were pleased with their accommodation. The majority of people choose to sit in the sitting rooms during the day and almost all eat together in the dining room. Toilet and bath equipment to aid independence was seen as well as individual walking frames etc. Staff said they had had training in the use of hoists and lifting belts but at the present time there were no service users needing these. The staff were confident that they were able to use these correctly should the situation arise. An assessment from an external lifting assessor (such as the community nurse) would be requested if a problem arose. Wentworth D52-D04 S8923 Wentworth V214701 220605 Stage 4.doc Version 1.30 Page 15 Bathrooms and toilets were maintained in a clean and satisfactory manner. The home was aware of an odour problem in two rooms and deals with this regularly. Radiators are guarded to prevent scalds or other injuries. The inspector and registered person discussed how the garden could be made more accessible to service users, for instance the provision of handrails and additional seating on the lawn might encourage people to go outside more. The entrance to the home and the location/security of the bedroom by this door was also raised and a risk assessment should be carried out regarding this. Wentworth D52-D04 S8923 Wentworth V214701 220605 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 Staff receive training to enable them to firstly provide service users with appropriate care and secondly understand the need for the care required. EVIDENCE: Staff are all encouraged to undertake National Vocational Qualifications training and those with whom the inspector spoke said they had either completed at least level ll or were considering moving onto level lll. The induction port-folio for a new member of staff was seen. It is important that the member of staff should sign the elements that have been completed as well as the instructor. Staffing levels were discussed after the inspector’s observations about staff availability during the early afternoon. At present there are three staff in the morning, two in the afternoons and evenings and two waking night staff. The registered person said she and other family members were close at hand and were on call if needed. Staffing must be kept under review as staff are expected to undertake housekeeping tasks as well as caring duties. Whilst the level of service users’ independence is currently good, this may change with new admissions. Wentworth D52-D04 S8923 Wentworth V214701 220605 Stage 4.doc Version 1.30 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,3637, The registered person with whom the inspector spoke is competent and experienced but there is a danger of her having too much to do. Thought needs to be given as to how tasks can be delegated satisfactorily. EVIDENCE: Wentworth operates a domiciliary care service as well as providing care and accommodation. This has obviously increased the level of paperwork entailed. The bulk of this appears to devolve to two members and although others assist, it is important that personal time away from the business is programmed in. The registered person who was in attendance during this inspection is experienced and capable. One person, not currently on the registration certificate, has almost completed his registered manager’s award. How this will be best utilised within the business will need to be considered. Wentworth D52-D04 S8923 Wentworth V214701 220605 Stage 4.doc Version 1.30 Page 18 Staff appraisals have been undertaken but there is also a requirement to record regular supervisory sessions with staff. The regular meeting of all staff to discuss and hand over shifts is good but not sufficient. Staff should have the opportunity to have individual discussion regarding any problems and the development of their own skills and expertise. For staff undertaking National Vocational Qualifications training this can form the main part of supervision but recorded sessions are still needed. The home should, for instance, work towards the senior care staff undertaking care plan reviews etc. Wentworth D52-D04 S8923 Wentworth V214701 220605 Stage 4.doc Version 1.30 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 3 3 x x 2 3 x Wentworth D52-D04 S8923 Wentworth V214701 220605 Stage 4.doc Version 1.30 Page 20 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement Care plans must show evidence that they are reviewed MONTHLY and service users, or their representatives, sign them to show consent and agreement. If for any reason a service user declines or refuses to sign his/her care plan, this should be recorded. This requirement has been drawn to homes attention following the last two inspections. Compliance is now required or enforcement action could follow. The home must introduce a system, with training where necessary, to ensure that CD medication is counted and recorded accurately with regular monthly audits when new supplies are received. Staff witnessing the administration of CDs must receive instruction in their responsibilites as a witness and ensure independently that the record is accurate. Care staff should receive formal supervsion at least six times a year. A written record of it should be maintained Timescale for action 30.11.2005 2. OP9 17(1)(a) Schedule 3 Immediate on receipt of this report. 3. OP36 18(2) 30.11.2005 Wentworth D52-D04 S8923 Wentworth V214701 220605 Stage 4.doc Version 1.30 Page 21 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. 2. Refer to Standard 19 19 Good Practice Recommendations Improved access to garden should be considered by the provison of handrails and seating etc. A risk assessment should be carried out on the security & use of the room by front access to home. Wentworth D52-D04 S8923 Wentworth V214701 220605 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection John Keay House Tregonissey Road St Austell, Cornwall PL25 4AD 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 Wentworth D52-D04 S8923 Wentworth V214701 220605 Stage 4.doc Version 1.30 Page 23 - 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. 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