CARE HOMES FOR OLDER PEOPLE
Wentworth House 283 Clifton Drive South St Annes Lancashire FY8 1HN Lead Inspector
Lillian McMullen Unannounced 19th July 2005 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 House F57 F09 S9755 Wentworth House V194966 190705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Wentworth House Address 283 Clifton Drive South St Annes Lancashire FY8 1HN 01253 724367 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 Margaret Garthwaite Mrs Margaret Garthwaite Care home only 15 Category(ies) of OP Old Age (15) registration, with number of places Wentworth House F57 F09 S9755 Wentworth House V194966 190705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 23rd August 2004 Brief Description of the Service: Wentworth House provides residential accommodation for up to 15 older people who do not require nursing care. The home is located in a convenient position on a main road position and in close proximity to the main shopping centre, local amenities and the Promenade. The home is arranged over two floors and offers individual bedroom accommodation to all service users which are comfortably furnished and personalised to suit the preferences and needs of the occupant. The majority of bedrooms provide an en-suite facility and a stair lift facilitates ease of access to the upper floor. Communal areas of the home are domestic in character, furnished to a high standard and designed to meet the needs of service users accommodated. Wentworth House F57 F09 S9755 Wentworth House V194966 190705 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over a period of six hours and was carried out in conjunction with the inspection of its sister home Villa Rose. The inspector spoke with the senior staff and individual discussion also took place with the cook and a care assistant. In addition, discussion also took place with five residents. A number of records, including care records, and policies and procedures were also examined and a partial tour of the building took place. What the service does well:
This is a care home where residents are well looked after. The staff team work well together and show a good understanding of the needs of the residents in the home. The residents spoken to say that they were very happy and felt well cared for. One resident said ‘Mr and Mrs Garthwaite do everything possible to make her as comfortable as possible’. The atmosphere in the home is very relaxed and friendly. Visitors are made welcome and residents confirmed that they could invite their visitors at any time. Meals are varied with an alternative available if required at each mealtime. Residents were pleased with the choice and variety. The home and grounds are maintained to a good standard, and residents live in comfortable surroundings. Wentworth House F57 F09 S9755 Wentworth House V194966 190705 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? 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 House F57 F09 S9755 Wentworth House V194966 190705 Stage 4.doc Version 1.40 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 House F57 F09 S9755 Wentworth House V194966 190705 Stage 4.doc Version 1.40 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) 3 Prior to moving into the home, a full comprehensive assessment takes place, which ensures that needs can be met. EVIDENCE: The Inspector examined the records of the last two residents to be admitted and found that in both cases a full assessment of needs had been carried out prior to admission, therefore ensuring that the home could meet the residents needs. The senior care assistant informed the Inspector that through discussion before admission with any prospective resident and their relative, they confirm verbally that the home can meet their assessed needs. Also on file was information from other sources such as hospital discharge information. One residents spoken to confirmed that she had looked at three homes prior to choosing Wentworth House, she further confirmed that the homeowner was extremely helpful and gave her details of the facilities and service offered at the home.
Wentworth House F57 F09 S9755 Wentworth House V194966 190705 Stage 4.doc Version 1.40 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) 7,8,10 and 11 There is a good care planning process in place that details the care needs of the residents. These could be developed further to incorporate any social and cultural needs. EVIDENCE: Individual records are kept for each resident with a plan of care setting out in detail the action that needed to be taken by care staff to ensure all aspects of health and personal care needs of the residents were met. Significant events had been recorded and daily entries made setting out the care given. Evidence was seen to confirm that care plans are reviewed on a monthly basis the senior care assistant explained that all reviews are carried out in consultation with the individual. However the care plans were not signed by the resident and the inspector advised following the review the resident should be asked to sign their agreement to the care plan. Risk assessments accompany the care plan and are reviewed also on a monthly basis. The inspector advised that staff should sign the risk assessments once they have read and understood the content.
Wentworth House F57 F09 S9755 Wentworth House V194966 190705 Stage 4.doc Version 1.40 Page 10 The health needs of the residents are monitored and daily diary entries provided evidence that health professionals are involved in the care and treatment of the residents. One resident said “Mr and Mrs Garthwaite take me to the doctors or to hospital appointments in their car”. Two Residents also commented that staff are very good indeed, if some thing is not to your liking they will do their best to put it right Staff spoken to had a good understanding of the care needs of the residents and confirmed that they have good management support. The inspector observed staff assisting residents and was pleased to see they had good relationships with residents and carried out all tasks in a friendly and sensitive way. Wentworth House F57 F09 S9755 Wentworth House V194966 190705 Stage 4.doc Version 1.40 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 and 15 Social activities and meals are both well managed to suit the individual and group. Contact between residents and their families are encouraged to help them maintain relationships. EVIDENCE: No visitors were present during the inspection, however residents confirmed that they could entertain their guest as they please. A number of residents were spoken to and all confirmed that they are free to come and go as they please, one resident said “I enjoy going for a walk and people watch”. Other residents confirm that they have regular contact with their families and one resident is taken to church every Sunday. A limited activity programme is in place, which includes bingo twice a week and walks out. The senior staff explained that they have tried other activities but the residents presently accommodated are not interested and prefer to read or watch television. Residents spoken to confirmed that in the main they were happy with what the home provided. One resident did comment that she would like more social interaction, as she sometimes feels isolated. The senior care assistant said he would look into this and try to arrange something that
Wentworth House F57 F09 S9755 Wentworth House V194966 190705 Stage 4.doc Version 1.40 Page 12 she would enjoy. A number of residents said they enjoyed sitting in the garden when the weather is good. A dedicated cook makes meals on the premises, and she confirmed that there were no budget constraints and that Mrs Garthwaite will have only the best. Menus are based on providing a balanced and nutritional diet. The inspector was able to observe the lunch being served, it was well presented and appetising. The cook was able to confirm she had information about residents with special diets and personal preferences. Meal times are set although flexible enough to accommodate personal preferences. The inspector ate a light lunch, during the inspection, which was appetizing and enjoyable. One resident stated, “ the food is excellent and there is plenty of it”. This was further evidenced when speaking to staff members, who commented on what residents like and don’t like at mealtimes. Wentworth House F57 F09 S9755 Wentworth House V194966 190705 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) 16 Arrangements for complaints are handled well and taken seriously ensuring people feel listened to and protected. EVIDENCE: The home has a detailed complaints procedure, which is made available to all residents on admission. General discussion with the residents revealed that they were aware the home had a complaint procedure and said that if they were unhappy about their care they would know who to speak to. They were very positive about the care and treatment they receive and stated that they could speak to anyone of the staff or management if they had concerns. Wentworth House F57 F09 S9755 Wentworth House V194966 190705 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) 19,20,21and 26 The planned maintenance and renewal programme for the redecoration and refurbishment of the home ensures that residents live in a comfortable and homely environment. EVIDENCE: Wentworth House is decorated and furnished to a good standard. The Inspector was pleased to see that a new bathroom has been created, this has improved the facilities available as the fittings and equipment are to a high specification and suitable for residents who have poor mobility and movement. The communal rooms were comfortable and furniture provided is appropriate to meet the needs of the residents. Residents spoken to confirmed that they are very happy with their personal accommodation and stated that they are able to bring with them items of a personal nature that make them feel at home. Wentworth House F57 F09 S9755 Wentworth House V194966 190705 Stage 4.doc Version 1.40 Page 15 The home is clean and free from offensive odours. The laundry room is situated in the cellar and from observation the inspector noted that bleach was being stored not the original, therefore suggesting it has been decanted for ease of use. The inspector reminded the senior care assistant that all hazardous substances should be stored as per COSHH regulations. The inspector further advised that for the safety of residents the cellar door should be kept closed and a lock fitted. Wentworth House F57 F09 S9755 Wentworth House V194966 190705 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) EVIDENCE: Whilst none of the above standards were assessed at this inspection, adequate staff was on duty that had a good knowledge of the needs of the residents. Wentworth House F57 F09 S9755 Wentworth House V194966 190705 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) EVIDENCE: None of the above standards were assessed at this inspection. Wentworth House F57 F09 S9755 Wentworth House V194966 190705 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 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 3 3 x x x x 2 STAFFING Standard No Score 27 x 28 x 29 x 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 x x x x x x x x Wentworth House F57 F09 S9755 Wentworth House V194966 190705 Stage 4.doc Version 1.40 Page 19 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. 2. Standard 26 7 Regulation 23 15 Requirement All hazzardous substances must be stored as per COSHH Regulations. Risk assessments for the use of cot side must be an integral part of the care plan. Timescale for action 25/7/05 31/8/05 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. 3. Refer to Standard 7 7 19 Good Practice Recommendations Care plans should be signed by residents Consideration should be given to developing the care plans to include social and cultural needs. the cellar door should be kept closed nd consideration given to fitting a lock. Wentworth House F57 F09 S9755 Wentworth House V194966 190705 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Unit 1, Tustin Court Portway Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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