CARE HOMES FOR OLDER PEOPLE
Wentworth Croft Bretton Gate Peterborough PE3 9UZ Lead Inspector
Elaine Boismier Unannounced 23rd August 2005 @ 09:10 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 Croft I03 I53 S24308 WENTWORTH CROFT V242257 230805 STAGE 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Wentworth Croft Address Bretton Gate, Peterborough PE3 9UZ 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) 01733 269200 01733 269665 BUPA Care Homes (CFHCare) Ltd Mr Alan Bristow Care home with nursing 134 Category(ies) of Dementia - over 65 years of age (32) registration, with number Mental Disorder, excluding learning disability or of places dementia - over 65 years of age (32) Old age, not falling within any other category (125) Physical disability (2) Physical disability over 65 years of age (58), Terminally ill over 65 years of age (58) DE(E)-7 named individuals Wentworth Croft I03 I53 S24308 WENTWORTH CROFT V242257 230805 STAGE 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: 1) Two named individuals with Physical Disabilities who are below 65 years of age for the duration of their residency 2) No more than 92 beds to provide nursing care 3) Service users who are over 65 years of age, not falling within any other category (OP) not exceeding 125 places for the duration of Condition 1 & 8 4) Terminally ill over 65 years of age (TI(E) not exceeding 58 places for the duration of Condition 1 5) Physical Disability over 65 years of age (PD(E) not exceeding 58 places for the duration of Condition 1 & 8 6) Mental Disorder, excluding Learning Disability or Dementia over 65 years of age (MD(E) not exceeding 32 places 7) Dementia over 65 years of age (DE(E) not exceeding 32 places 8) 7 named individuals over 65 years of age with dementia for the duration of their residency only- DE(E) 9) The maximum number of places accommodated in the home at any one time is 134 Date of last inspection 17/05/05 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 60 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. The Commission for Social Care Inspection has approved variations of registration for 2 named people below 65 years of age with personalcare needs and 7 additional people, over 65 years of age, with mental health needs, to live at the home. Wentworth Croft I03 I53 S24308 WENTWORTH CROFT V242257 230805 STAGE 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This is the second inspection of Wentworth Croft for 2005/6. This unannounced inspection was carried out by two inspectors between 9:10 and 13:20 and took 4 hours to complete. The inspection focused on two of the four houses, Yeoman House and Hayward House. On the day of the inspection there were 51 residents living between both houses and 9 of these residents were spoken to. Staff, including the Deputy Manager, were spoken to and a tour of the two houses was made. Examination of documentation was carried out to complete the inspection process. The Responsible Individual was present at the beginning of the inspection and comments made by him are included in this report. Representatives of Wentworth Croft continue to be in discussion with the Commissioners of the contracted places on Hayward House. As a result of this ongoing discussion not all the standards and requirements made following the last inspection of the home were assessed on this occasion. These will be assessed during the next inspection of the home. What the service does well:
The home does well in a number of areas: • Residents said that Wentworth Croft was, “ A lovely home. I never regretted it (moving in)”, and, “ (We) have good food. If I want anything I only have to ask”. Yeoman House offers a homely environment and gardens are wellmaintained and accessed by residents. Dining tables in both houses were well presented with decorations, tablecloths and a selection of condiments and sauces. The senior management team visit residents every day to ask them if they have any problems and how things are for the residents. Staff are caring. There is a commitment to refurbish the home to promote the comfort of residents. • • • • Wentworth Croft I03 I53 S24308 WENTWORTH CROFT V242257 230805 STAGE 4.doc Version 1.40 Page 6 What has improved since the last inspection?
Following the last inspection there were 11 requirements and two recommendations made. Eight of 9 requirements that were assessed have been met and 1 of 2 recommendations assessed on this occasion has been considered. As a result of these findings the home has improved in the following areas: • The home must not admit people outside the categories and conditions of registration. A requirement was made about this and this has been met. Residents admitted for intermediate and interim care must be riskassessed about safe self-medication practices, including any rehabilitation/training needs of the residents. A requirement was made about this and this has been met. The lack of locks on bedroom doors poses a risk to the privacy and dignity of residents. A requirement was made about this and this has been met. On Hayward House the values of choice, independence and dignity are not always respected. Three requirements have been made about this. Two of these have been met in relation to choice and dignity. The number of baths on Harvester must be available to meet residents’ needs. A requirement was made about this and this has been met. Satisfactory information must be obtained about staff before they start employment. A requirement was made about this and this has been met. Duty rosters should have the full name of the individual staff, rather than one name only. A recommendation was made about this and this has been considered. • • • • • • What they could do better:
The home could improve in 2 noticeable areas: • Independence of residents must be respected to promote the value of dignity. A requirement was made about this and this requirement remains.
I03 I53 S24308 WENTWORTH CROFT V242257 230805 STAGE 4.doc Version 1.40 Page 7 Wentworth Croft • The standard of cleanliness on Hayward House must be improved. A requirement has been made about this. 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 Croft I03 I53 S24308 WENTWORTH CROFT V242257 230805 STAGE 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Wentworth Croft I03 I53 S24308 WENTWORTH CROFT V242257 230805 STAGE 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3 & 6 Systems are in place to ensure the home is suitable to meet the needs of prospective residents EVIDENCE: A copy of the Statement of Purpose was seen and this contained information about the services Wentworth Croft provides, including intermediate care services. Two care files of residents receiving intermediate care services had preadmission assessments of the residents’ needs. These assessments were for the home to make a decision whether the home was suitable to meet the needs of the individual and that there was no infringement of the categories and conditions of registration of the home. This is a requirement that has been met. The Responsible Individual stated that arrangements have been made for the training of staff in how to care for residents assessed to have rehabilitation needs. This is a requirement that has been met.
Wentworth Croft I03 I53 S24308 WENTWORTH CROFT V242257 230805 STAGE 4.doc Version 1.40 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 8, 9 & 10 Residents’ health care and privacy are respected although the value of dignity is compromised. EVIDENCE: On the day of the inspection residents and staff of Hayward House were receiving care and support from health care professionals supplied by the Primary Care Trust. Residents in receipt of intermediate care had mixed experiences of how care was provided. One resident considered that she was receiving the right level of care to meet her needs. However another resident, able to carry out self-care tasks, had these carried out by care staff including shaving with an electric razor and washing and dressing. A requirement was made that residents receiving rehabilitation must be provided with supervision. As a result of this finding this requirement remains. Two care files of residents living on Hayward House included their written for staff to take full responsibility of the residents’ medication. The Deputy Manager stated that the majority of temporary residents wish to relinquish such a responsibility. However the Deputy Manager reported that there are
Wentworth Croft I03 I53 S24308 WENTWORTH CROFT V242257 230805 STAGE 4.doc Version 1.40 Page 11 systems to carry out risk assessments for any resident who chooses to selfmedicate. At the time of the inspection there was no resident, receiving intermediate care, who had chosen to take this responsibility. As a result of this finding this requirement has been met. Concerns, made by relatives that there were no locks provided on bedroom doors and as such, the privacy of the residents was put at risk was noted at the last inspection. Following the inspection the Responsible Individual reported to the Commission that an assessment had been made on this issue. At this inspection the Deputy Manager indicated that action is being taken to provide locks on doors for residents who have requested this facility. As a result of this, this requirement has been met. Residents considered that staff spoke to them in an adult, and respectful way and made favourable comments about the staff, to include, “ Staff are wonderful. So caring”. This is a requirement that has been met. Wentworth Croft I03 I53 S24308 WENTWORTH CROFT V242257 230805 STAGE 4.doc Version 1.40 Page 12 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 Residents have a choice how they wish to live. EVIDENCE: Residents spoken to said that they were able to get up when they chose to and go where they pleased. This is a requirement that has been met. Activities provided for residents included painting, collages, reading and going out into the well-maintained garden areas. Gardening was an activity also engaged by some residents. Wentworth Croft I03 I53 S24308 WENTWORTH CROFT V242257 230805 STAGE 4.doc Version 1.40 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) EVIDENCE: None of these standards was assessed on this occasion. Wentworth Croft I03 I53 S24308 WENTWORTH CROFT V242257 230805 STAGE 4.doc Version 1.40 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, 21, 22 & 26 Not all residents live in a clean and homely environment although systems are in place to improve the environment to make residents’ place of living more homely. Provision of equipment values independence and dignity of residents. EVIDENCE: Yeoman had a homely, relaxed and comfortable feel when entering the House compared to that of Hayward House. Discussion with the Deputy Manager indicated that this may be as a result of the temporary stay of residents admitted to Hayward House for intermediate and interim care. Dining tables in both houses were well presented with decorations, tablecloths and a selection of condiments and sauces. Gardens were well-maintained and residents confirmed that they had free access to these outside areas. The Deputy Manager reported that arrangements have been made for new blinds and replacement curtains. Yeoman House was clean, light and fresh smelling although Hayward House was less clean, particularly in the dining area. Walls were stained and the replacement flooring was unclean. A requirement has been made about this.
Wentworth Croft I03 I53 S24308 WENTWORTH CROFT V242257 230805 STAGE 4.doc Version 1.40 Page 15 The Deputy Manager confirmed that, on Harvester, a bath has been recommissioned, following the last inspection. This is a requirement that has been met. During the tour of the premises it was noted that residents had access to call bell systems. This is a requirement that has been met. Wentworth Croft I03 I53 S24308 WENTWORTH CROFT V242257 230805 STAGE 4.doc Version 1.40 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, 29 & 30 Residents receive care from a sufficient number of well-recruited, trained and qualified staff. EVIDENCE: Copies of rosters for kitchen and care staff were seen and these indicated that there was sufficient number of staff to meet the needs of the service and needs of residents. Both rosters included the full names of the member of staff and as such this is a recommendation that has been considered. Four staff files were seen and included all required satisfactory information about the staff for the protection of residents. This is a requirement that has been met. Three of the staff files examined included copies of certificates of training attended that included induction and foundation training, training in moving and handling and fire safety. Wentworth Croft I03 I53 S24308 WENTWORTH CROFT V242257 230805 STAGE 4.doc Version 1.40 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) 35 Residents’ finances are safeguarded. EVIDENCE: Two residents’ records of transactions of personal monies, kept for safekeeping by the home, were seen. The residents signed transactions and records of balances kept on database correlated with the record signed by the resident. Wentworth Croft I03 I53 S24308 WENTWORTH CROFT V242257 230805 STAGE 4.doc Version 1.40 Page 18 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 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 x 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 x
COMPLAINTS AND PROTECTION 3 x 3 3 x x x 2 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x 3 x x x Wentworth Croft I03 I53 S24308 WENTWORTH CROFT V242257 230805 STAGE 4.doc Version 1.40 Page 19 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 OP 8 Regulation 12(1)(b) Requirement Timescale for action 01/09/05 2. OP 26 23(2)(d) The Registered Person must ensure that service users are provided with treatment, education and supervision. This is a requirement brought forward The Registered Person must 15/09/05 ensure all parts of the home are kept clean. 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 Good Practice Recommendations None Wentworth Croft I03 I53 S24308 WENTWORTH CROFT V242257 230805 STAGE 4.doc Version 1.40 Page 20 Commission for Social Care Inspection CSC1, Capital Park Fulbourn Cambridge CB1 5XE National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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