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Inspection on 02/07/08 for Wentworth Croft

Also see our care home review for Wentworth Croft for more information

This inspection was carried out on 2nd July 2008.

CSCI found this care home to be providing an Good service.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home is a large purpose built building and it is situated in its own grounds. There are lounge areas in each of the four houses, plus other quiet areas for people to use if they wish. Staff members are polite and talk to people with respect. We talked to people during this inspection and they said the staff are nice, respect their privacy and one person said, "we are not just people to the staff we are persons in our own right". Assessments are completed before people move into the home, they have contracts with the home and they say they have enough information before they move in. Comments from two people are, "came for respite and ended up staying" and "came for afternoon before coming in to live here, very happy". People can have visitors when they want and there are places where they can meet in private. Visitors said the home helps people keep in touch with then and relatives told us they are kept up to date with issues that arise. One person`s relative said, "Mum has dementia, but staff always tell Mum I ring and when I am going to see her, which is every other day".There is a choice of main meals each day and staff members stay with people who need help to eat. Everyone we spoke to said they like the meals and the food is good. There have been 12 complaints made to the home in the last year. These are looked at properly and information to show why the home has taken action, if it needed to, is also kept. People who make complaints have a response in the correct timeframe. People said they know who to talk to and how to make complaints and one visitor said, "any issue I have ever raised has been sorted out straight away". Staff members have training in how to keep people safe and what to do if they think abuse has happened. There have been four safeguarding referrals in the last year. The home looked at three of these and health care professionals in the community looked at the fourth referral. Recruitment checks are completed properly before people start working at the home, so that new staff members are safe to work there. Staff members are given induction training when they first start working at the home. There are updates of mandatory training when this is needed, and staff have other training, such as care of dementia, to help them care for people properly. One staff member said, "training is excellent and extremely thorough". Nonnursing qualified care staff also complete National Vocational Qualifications but at the time of this inspection only about 15% of staff had it. A quality assurance survey is carried out every year at the home, where people are asked what they think of the care and the environment in which they live. Action is taken about issues that are found, like a drop in the number of people who are happy with activities. The improvement in activities is talked about in the next section. Money that is kept and transactions that are made on behalf of people at the home is documented on a central computer. Interest is paid on this money and this is also recorded. The whole system is audited every year. Records are also kept of the health and safety checks that are carried out, which means the home can show if things are in good working order and what they have done to repair problems.

What has improved since the last inspection?

The amount of personal information written in care plans has improved through all the houses in the home. They give staff members` details about how people like to be looked after and what they should do in particular circumstances. For example, when someone gets upset when they can`t say clearly what they want to say. People are referred to health care professionals, like dentists, opticians and dieticians. These visits are recorded in their care records. There is an activities co-ordinator in each house in the home. They organise trips, activities and events for people in the house they work in. There is information in care records about what people like to do, so that care staff can plan to do things around the activities. Although, some staff members and a visitor said there is not enough staff to spend time with people, lots of people were happy with the activities that are provided for them. One person said, "being blind, it is not possible to take part in every activity, but the activities organiser is very hardworking and always tries to come up with new ideas".

CARE HOMES FOR OLDER PEOPLE Wentworth Croft Bretton Gate Peterborough PE3 9UZ Lead Inspector Lesley Richardson Unannounced Inspection 2nd July 2008 10:50 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 Wentworth Croft DS0000024308.V367675.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. Wentworth Croft DS0000024308.V367675.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wentworth Croft Address Bretton Gate Peterborough PE3 9UZ 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) 01733 269200 01733 269665 www.bupa.com BUPA Care Homes (CFHCare) Ltd Henry Mutambo Care Home 156 Category(ies) of Dementia - over 65 years of age (73), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (32), Old age, not falling within any other category (156), Physical disability (2), Physical disability over 65 years of age (83) Wentworth Croft DS0000024308.V367675.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Two named individuals with Physical Disabilities who are below 65 years of age (PD) for the duration of their residency Physical disability over 65 years of age (PD(E)) not exceeding 83 places. Mental disorder, excluding learning disability or dementia over 65 years of age (MD(E)) not exceeding 32 places Dementia over 65 years of age (DE(E)) not exceeding 73 places. Service users who are over 65 years of age, not falling within any other category (OP) not exceeding 156 places. Date of last inspection Brief Description of the Service: Wentworth Croft is situated in Peterborough City 4 miles from the city centre and is accessible by public transport. The home is situated in well-maintained and landscaped gardens including an enclosed garden for those living at Harvester House. Wentworth Croft is arranged into 4 houses: Yeoman and Hayward provide up to 82 places for people over 65 years of age who have nursing needs; Harvester provides up to 32 places for people over 65 years of age with both nursing and mental health needs; Woolsack provides up to 42 places for people over 65 years of age with personal care needs. Current fees range from £387.03 to £755.70. Additional costs include those for chiropody, hairdressing and private taxis. A copy of the inspection report is available on request at the home or via the CSCI website. Wentworth Croft DS0000024308.V367675.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was a key inspection of this service and it took place over 6 hours and 55 minutes as an unannounced visit to the premises. It was spent talking to the manager and staff working in the home, talking to people who live there and observing the interaction between them and the staff, and examining records and documents. The requirement from the last inspection has been met. There have been no further requirements or recommendations made as a result of this inspection. Information obtained from the Annual Quality Assurance Assessment and from returned surveys was used in this report. Twenty-nine surveys were returned from people who live at the home, and eleven were returned from visitors to the home. We received four surveys from staff members. Information from an expert by experience, who visited the home with us, was also used in this report. What the service does well: The home is a large purpose built building and it is situated in its own grounds. There are lounge areas in each of the four houses, plus other quiet areas for people to use if they wish. Staff members are polite and talk to people with respect. We talked to people during this inspection and they said the staff are nice, respect their privacy and one person said, “we are not just people to the staff we are persons in our own right”. Assessments are completed before people move into the home, they have contracts with the home and they say they have enough information before they move in. Comments from two people are, “came for respite and ended up staying” and “came for afternoon before coming in to live here, very happy”. People can have visitors when they want and there are places where they can meet in private. Visitors said the home helps people keep in touch with then and relatives told us they are kept up to date with issues that arise. One person’s relative said, “Mum has dementia, but staff always tell Mum I ring and when I am going to see her, which is every other day”. Wentworth Croft DS0000024308.V367675.R01.S.doc Version 5.2 Page 6 There is a choice of main meals each day and staff members stay with people who need help to eat. Everyone we spoke to said they like the meals and the food is good. There have been 12 complaints made to the home in the last year. These are looked at properly and information to show why the home has taken action, if it needed to, is also kept. People who make complaints have a response in the correct timeframe. People said they know who to talk to and how to make complaints and one visitor said, “any issue I have ever raised has been sorted out straight away”. Staff members have training in how to keep people safe and what to do if they think abuse has happened. There have been four safeguarding referrals in the last year. The home looked at three of these and health care professionals in the community looked at the fourth referral. Recruitment checks are completed properly before people start working at the home, so that new staff members are safe to work there. Staff members are given induction training when they first start working at the home. There are updates of mandatory training when this is needed, and staff have other training, such as care of dementia, to help them care for people properly. One staff member said, “training is excellent and extremely thorough”. Nonnursing qualified care staff also complete National Vocational Qualifications but at the time of this inspection only about 15 of staff had it. A quality assurance survey is carried out every year at the home, where people are asked what they think of the care and the environment in which they live. Action is taken about issues that are found, like a drop in the number of people who are happy with activities. The improvement in activities is talked about in the next section. Money that is kept and transactions that are made on behalf of people at the home is documented on a central computer. Interest is paid on this money and this is also recorded. The whole system is audited every year. Records are also kept of the health and safety checks that are carried out, which means the home can show if things are in good working order and what they have done to repair problems. What has improved since the last inspection? The amount of personal information written in care plans has improved through all the houses in the home. They give staff members’ details about how people like to be looked after and what they should do in particular circumstances. For example, when someone gets upset when they can’t say clearly what they want to say. People are referred to health care professionals, like dentists, opticians and dieticians. These visits are recorded in their care records. There is an activities co-ordinator in each house in the home. They organise trips, activities and events for people in the house they work in. There is Wentworth Croft DS0000024308.V367675.R01.S.doc Version 5.2 Page 7 information in care records about what people like to do, so that care staff can plan to do things around the activities. Although, some staff members and a visitor said there is not enough staff to spend time with people, lots of people were happy with the activities that are provided for them. One person said, “being blind, it is not possible to take part in every activity, but the activities organiser is very hardworking and always tries to come up with new ideas”. 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. Wentworth Croft DS0000024308.V367675.R01.S.doc Version 5.2 Page 8 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 Wentworth Croft DS0000024308.V367675.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 6 Quality in this outcome area is good. People have enough information before moving into the home, which means they are able to decide if they would like to live there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two thirds of the people living at the home and all of the visitors and relatives we received surveys from said they had enough information before moving to the home. Comments from two people are, “came for respite and ended up staying” and “came for afternoon before coming in to live here, very happy”. Three quarters of the people who returned surveys also told us they have received a contract from the home. Staff members told us that assessments are completed before people move into the home and assessments by health and social care teams are also obtained to provide more information. We looked at the care records of five people who had moved into the home since the last inspection. There are Wentworth Croft DS0000024308.V367675.R01.S.doc Version 5.2 Page 10 written assessments completed by the home, which give staff members enough information to know how to care for the person. Assessments from previous care providers, and health and social care assessments, are also obtained before the person moves into the home. The home does not provide accommodation specifically for intermediate care or for rehabilitation purposes. Wentworth Croft DS0000024308.V367675.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. Care records are completed in enough detail and staff care for people in a positive way, which ensures the health and welfare of people living at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who commented in surveys said they get the care and support they need from staff members and during the inspection people told us care staff are nice, are polite and treat them with dignity and respect. We saw this during the inspection and that staff knock on doors before entering rooms. People we spoke to said staff are nice and one person commented, “we are not just people to the staff we are persons in our own right”. A comment from one of the visitors who returned a survey was, “Mum can be very difficult at times due to her dementia. And all members of staff have always and continue to care for her in a manner that maintains her dignity & meets her needs”. Care plans for eight people were looked at as part of this inspection. They show that each person has a plan that gives staff members’ information about Wentworth Croft DS0000024308.V367675.R01.S.doc Version 5.2 Page 12 what they need to do to meet most of the identified needs. Risk assessments, for things like falls and moving and handling, are completed and reviewed regularly. We found the care plans gave staff members’ advice about how to meet most of people’s needs, but that the level of detail varied between different people. Care plans for care needs generally told staff how each person likes to be cared for and what their preferences are, and there were some plans that gave staff a lot of information about people. For example, one person whose first language is not English and who does not speak and only understands very limited English has cards with common questions and answers in both languages in her room. Her family are involved and have written comments on a sample menu to help staff at meal times. Another person’s plan tells staff very clearly what they should do and how they should behave towards that person when he finds it difficult to say what he wants. Most people or their relatives said they are able to look at the plans and say if they agree with them or not. One person’s relative did tell us during the inspection that he had never seen his mother’s care plan. Plans are reviewed monthly and we saw that some information and changes are recorded, and the plans are rewritten to give staff updated guidance. Most of the people (28 out of 29) who returned surveys said they receive medical attention when they need it. Comments they made show most people are happy with the medical attention they get; “they got my legs better when for years I had ulcers on them” and “I don’t need a lot of medical support but I know it’s there when I need it”. There is information in care records to show health care professionals, such as specialist nurses, opticians and chiropodists, are contacted for advice and treatment. Even though some plans are updated, not all changes about medical needs are written into plans. One person’s plan for anxiety had not been updated with everything that had been recommended by a specialist nurse. The plan for medication had not been updated with a recommendation from a health care professional that medication should be in liquid form because of swallowing problems. When we looked at this person’s medication, it had all been supplied in liquid form. We also looked at records that show what people eat and when and which position they are turned to. These are not completed in enough detail to show the person is getting enough to eat, or which position they are turned to. We talked to staff about one person, whose weight is low, and they said she usually eats everything they give her. She also has not got a pressure sore. The other person’s weight was not low enough for it to be a cause for concern. Because the outcomes for these people are good we expect staff to take action and improve the information that’s written in these records, rather than making a requirement. Wentworth Croft DS0000024308.V367675.R01.S.doc Version 5.2 Page 13 Medication administration records (MAR) were looked at in two of the four houses we visited. The MAR sheets are completed and there are very few records with entries missing. Prescriptions are clear and entries for variable dosage medication also show the dosage of the medication. However, there was one medication for one person where the total of the remaining medication did not add up to the total that should be left according to the MAR. There were 5 extra tablets for this medication. We found one MAR in each house with a prescription for ‘as required’ medication. Neither of these medications had care plans in the persons records to guide staff in when to give the medication. Stock levels of medications are acceptable; we saw only one medication that had been out of stock for one day and no stores of medication nearing it’s expiry date. Medication fridge and storage room temperatures are taken and recorded as being at an acceptable level for the safe storage of medication. We talked to the unit manager on one unit about the need to reset the fridge thermometer every day, so that a new maximum temperature is available. We expect staff to be able to improve these areas in safe medication handling without the need for a requirement, as they affected such a small number of the records we looked at. Wentworth Croft DS0000024308.V367675.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. Staff members have a good understanding of peoples needs, and care records show how people are supported to live as they would like. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has activities co-ordinators in each of the four houses in the home. This person arranges for entertainers to visit the home, activities and events in the home. One relative told us, “new activities co-ordinator is doing much more for them than the previous one, but my Mum does not want to join in”. There is a section in each house that displays the activities available and those that people have taken part in. 21 of the 29 people who returned surveys to us said there are activities that they can take part in, but 21 (one fifth) said that activities are only sometimes or never available to them. The activities co-ordinators record information about time they spend with people on individual sheets. There is information written into care plans about what people like to do, which means that staff members are able to plan care around social needs or even be able to meet some social needs. The expert by experience who came with us for the inspection saw an activities co-ordinator Wentworth Croft DS0000024308.V367675.R01.S.doc Version 5.2 Page 15 taking part in a game with people in one house. She said they were enjoying the game. Most people we spoke to said there are activities for them at the home. In one of the houses we were told about the fund raising that allows staff to organise 3 trips a year. Comments from people include, “I like the things that we do and I like to go out and we do”, “I enjoy Ladies Day with other residents”, “being blind, it is not possible to take part in every activity, but the activities organiser is very hardworking and always tries to come up with new ideas”. We asked one staff member what had improved and she told us about the trips out of the home, events in the home like cheese and wine evenings, and that a console game had been bought for people in one house, who really enjoyed playing the games. When we asked her about what could be improved she said, “more time to sit with residents and chat”. One person’s relative said there should be more one to one time and there isn’t enough stimulation, although they didn’t say what they would like to see people doing. Although another person’s relative said, “there are choices of food, activities and bedtime, along with open visiting. She can either stay in her room or out in the small or large lounge – whatever she wants to do”. People are able to make everyday choices about when to get up and go to bed, how to spend their days, whether that is in their own room, in the main lounge/dining area. We saw and listened to how staff members interact with people and found they ask what people would like and how they would like it rather than telling people or giving limited options. Staff members we spoke to know the people they care for and were able to tell us their preferences and how they like to be cared for. The home has an open visiting policy and people can have visitors at any time of the day. Ten out of eleven visitors who returned a survey said the home helped people keep in touch and they all said they are kept up to date with issues concerning that person. Two comments were, “Mum has dementia, but staff always tell Mum I ring and when I am going to see her, which is every other day” and “in every case, last year Mum was admitted to hospital and I was immediately informed and was given full support from the staff with Mum requiring to attend follow up appointments at the hospital clinics”. The main meal is served at lunchtime and there is a choice of two hot meals every day. We saw lunch being served in two of the main dining rooms in two houses. Food was served appropriately in a relaxed and unhurried way and drinks were offered throughout the meal. Everyone we spoke to said they like the meals and the food is good. Staff help people if they need this and we saw them being attentive and concentrating on what they were doing without being distracted. Comments were received in surveys and during the inspection include, “food excellent. Staff always eager to change menu to suit resident” and “Mum has never complained about the food, and what she gets looks lovely”. Wentworth Croft DS0000024308.V367675.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. People know how to make complaints and concerns known and can be confident that these will be listened to. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Twenty three of the twenty nine people returning surveys said they know who to speak to and almost all of the said they know how to make a complaint if they have to, and that staff listen to what they say and act on it. Most people we spoke to during the inspection also said they know what to do if they’re not happy about something. Ten of the eleven visitors who returned surveys said know how to make a complaint and they are appropriately dealt with. Everyone we spoke to during this inspection said they are happy with the service given to them. Although two visitors said that verbal complaints made to staff don’t always seem to get through to the manager and things are not always dealt with quickly. One of these people also said that things had improved recently. One of these visitors and another visitor said there have been big improvements in the home recently, and comments we received also show this. Two of these are, “I am quite happy in my ways and have nothing to complain about”, “it (complaints procedure) is displayed near the entrance to the home but I have found the staff sort out any minor problems straight away” and “any issue I have ever raised has been sorted out straight away”. Wentworth Croft DS0000024308.V367675.R01.S.doc Version 5.2 Page 17 The home has a complaints procedure and keeps a complaint log to show how they have looked at and the outcome of complaints that have been made. We were told before the inspection there have been 12 complaints made to the home in the last 12 months. All complaints have been investigated and all but one responded to within the correct timeframe. We were told of two of these complaints. We asked the home for information about one complaint at the time and were satisfied that staffing numbers were at an acceptable level. The other complaint has been treated as a safeguarding issue. The staff training matrix shows that nearly all staff members, care staff and housekeeping staff, have received training in safeguarding (adults protection) within the last year. We talked to care staff in different areas of the home, who all said they had received training in safeguarding people. One nurse we spoke to told us what should be done if abuse was suspected. Information provided to CSCI before the inspection shows there have been two safeguarding referrals and investigations in the last 12 months, plus one investigation that was being carried out at the time of this inspection. Wentworth Croft DS0000024308.V367675.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. The home is generally clean and provides a safe environment, giving most people a pleasant place to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is a large purpose built property situated on the outskirts of Peterborough. People living at the home have access to a number of communal areas in each house, including fenced garden areas around the property. The general décor in most parts of the home is satisfactory, and it was clean and tidy, with no offensive smells. Everyone returning surveys said the home is clean and tidy and people at the home said the home is clean. Comments include, “my house is nice and comfortable” and “housekeeper cleans everyday”. We looked around the home but found that this wasn’t the case in every house, although most areas were clean and pleasant. In one house people Wentworth Croft DS0000024308.V367675.R01.S.doc Version 5.2 Page 19 living there told us that there is always a strong smell, that chairs in the communal lounge are dirty and one person said their room was dirty and needed redecorating. When we walked around this house we found these comments were accurate, but also that one person’s room had an unsightly brown stain on the wall. The expert by experience visited this house and said the carpet in one person’s room needed cleaning, not only from dust but also from stains. Other concerns about the laundry and garden railings in one house were also mentioned, although these were not echoed by anyone else in the home. Because these concerns were seen in one area only and were not reflected in all parts of the home we expect the manager to improve the housekeeping without the need for a requirement. Wentworth Croft DS0000024308.V367675.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. There are enough staff members most of the time with the training and skills to be able to care for people properly. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The training matrix shows new staff members are given induction training, which includes mandatory health and safety training. Staff members who returned surveys said, “training is excellent and extremely thorough” and “training sessions exist to understand the clients needs and there is support from within the home and outside agencies i.e. GP and mental health”. Additional training is given to staff so that they are able to properly meet people’s needs, although this is not well recorded on the training matrix. For example, care of people with dementia and catheter care are two training sessions available to staff. The matrix shows only 10 staff members (5 for each training course) had received training in these subjects. One visitor described how the training has had a positive effect for her relative, “my Mum has dementia and at her previous care home they did not have the staff with the required skills to meet her needs. This has become very obvious since she has been at Harvester, her mood swings are less on the volatile side, Wentworth Croft DS0000024308.V367675.R01.S.doc Version 5.2 Page 21 and more on the better side of her nature, due to the staff having the correct training to calm her during the difficult times”. We spoke to three staff members who told us they have National Vocational Qualifications at level 2 or above, but information in the AQAA tells us only 15 of non nursing qualified care staff have the qualification. There are another 9 staff members working towards the qualification. The recommended number of staff with a NVQ is 50 . Twenty-six people who returned surveys said staff members are available when they are needed and that they get the care and support they need. Two comments from the surveys were, “they are usually always around somewhere” and “each person seems to have their own nurse and carer. You only have to call and someone is always ready to come to you”. People we spoke to during the inspection said there is usually enough staff on duty during the day, but that night duty staffing is a problem. One person said they sometimes have to wait up to half an hour for help and another person said, “night staff don’t answer calls quickly – seem sleepy when they do come as if they have just woken up – bad attitude when you use the call bell at night”. Three quarters of the staff members who returned surveys said they didn’t feel staffing levels are high enough and this stops them from spending time with people. One staff member said, “There is a shortage of staff in each shift. Although residents needs are met less time is spent with the residents”. However, this experience isn’t the same in all houses, as one visitor said, “I have often found carers sitting chatting to her in her room when I have arrived”. When we walked round the home we saw staff members in most places where people were sitting and along corridors in houses most of the day. We talked to one person who uses a hand bell to attract staff attention, and we tried this out to see if it worked as we could hear a staff member carrying out other duties close by. That staff member did not come to the person’s room, although the unit manager did, but on another matter. We felt there are enough staff available to help people when this is needed, although they might have to wait a short while sometimes. There are a lot of staff members from overseas, especially on night duty. Two people commented during the inspection that sometimes it is difficult to understand them. One person also said that overseas staff often talk in their own language to each other. This should not happen while they are caring for people. We spoke to the manager about this and the length of time it takes night staff to help people in one of the houses. We looked at recruitment records for three staff members employed since the last inspection and they all contained the appropriate recruitment documents including references, application forms, and POVA/CRB checks. Wentworth Croft DS0000024308.V367675.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. The home is a safe place to live and people are asked their opinion so that things they are not happy with are changed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is a nurse and is registered with the Nursing and Midwifery Council. He has been managing the home since January 2007 and in that time has gained a management qualification equivalent to a NVQ level 4. One comment from a staff member shows he is highly thought of by staff, “it’s a lovely home to work in and most of the staff are extremely dedicated, particularly the manager, Henry, who works hard to ensure that residents are given the best care possible. I wouldn’t want to work anywhere else”. Wentworth Croft DS0000024308.V367675.R01.S.doc Version 5.2 Page 23 An annual quality assurance survey was carried out by the home in October 2007, a report has been written and shows the issues that were found. There was a big drop in the amount of satisfaction people had in the activities provided. The manager said this prompted the home to have an activities coordinator in each house. As can be seen in the section on Daily Life and Social Activities, this has had the desired effect and generally people are happy with what is available for them to do. The manager also told us that housekeeping was also an issue and we saw in all but one part of the home that this has improved. One house in the home also carries out it’s own satisfaction survey every month. The staff feed back the results to the people living in that house and talk to the manager about issues every three months. We asked the home to complete and return an Annual Quality Assurance Assessment (AQAA) before the inspection. They did this within the time we asked for it and they gave us the information we asked for. People going to live at the home are given written information about how their money is taken care of and the procedures involved in debiting an account. Statements are sent on a monthly basis, which shows the incoming and outgoing transactions, and any interest earned. Although individuals’ money is all placed into the same account, each person using the system has a separate written account and record on computer. Information provided before this inspection shows equipment, like hoists, lifts and fire-fighting equipment has been serviced or tested as recommended by the manufacturer. We looked at fire equipment around the home; this has been tested within the last 12 months. We were provided with a report from the fire safety officer before this inspection, where a number of concerns were found. The manager told us what the home is doing to improve this. Wentworth Croft DS0000024308.V367675.R01.S.doc Version 5.2 Page 24 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 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 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 3 3 X X X X X X 2 STAFFING Standard No Score 27 2 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Wentworth Croft DS0000024308.V367675.R01.S.doc Version 5.2 Page 25 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. 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 Wentworth Croft DS0000024308.V367675.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Wentworth Croft DS0000024308.V367675.R01.S.doc Version 5.2 Page 27 - 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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