Inspection on 22/12/06 for Wentworth House

This inspection was carried out on 22nd December 2006.

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 House 07/09/07

Wentworth House 24/02/06

Wentworth House 27/10/05

Wentworth House 10/11/04

Wentworth House 26/05/04

Wentworth House 28/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Wentworth House 8 Blantyre Road Swinton Gtr Manchester M27 5ER Lead Inspector Adele Berriman Unannounced Inspection 10:00 22 December 2006 nd 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 House DS0000008339.V310822.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 House DS0000008339.V310822.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wentworth House Address 8 Blantyre Road Swinton Gtr Manchester M27 5ER 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) 0161 793 9090 Mr Antonio Belvedere Mrs Christine Belvedere Mr Antonio Belvedere Care Home 19 Category(ies) of Learning disability over 65 years of age (1), Old registration, with number age, not falling within any other category (18) of places Wentworth House DS0000008339.V310822.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service user category (LD) (E) is specifically for one named individual. If this person leaves the service user category will revert to (OP). 24th February 2006 Date of last inspection Brief Description of the Service: Wentworth House is a home that provides residential care for up to 19 service users over the age of 65. The home is situated on a quiet residential road in the Swinton area of Salford. The home is situated close to local amenities and close to public transport routes. Bedrooms are situated on both the ground and first floor of the accommodation. A passenger lift serves both floors. There are several communal lounges and communal dining rooms that are situated on the ground floor of the accommodation. The home continues with on-going refurbishment to provide a pleasant environment. Wentworth House DS0000008339.V310822.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place on Thursday 21st December 2006, a second visit was made to the service on 22nd December 2006. During the visit the inspector spoke to several residents, a visitor to the service, a member of care staff, the manager/proprietors of the service and the cook. A selection of care plans, staff files, policies and procedures were assessed during the visit. A selection of bedrooms, communal areas, the kitchen and the exterior area of the building were assessed. Throughout the visit the inspector observed a pleasant atmosphere around the home with lots of conversation taking place between residents, staff and visitors. The home was very clean and tidy and was pleasantly furnished to meet the needs of the residents. What the service does well: What has improved since the last inspection? Improvements had been made to the recording of people’s needs, wishes and routines in their care plans and there was evidence that they were reviewed and updated on a regular basis. Hot water temperatures had been regulated to deliver at approx 44°c and the temperature was being monitored in a regular basis. Training for care staff had been arranged to ensure that staff would be able to continually meet the needs of people. Wentworth House DS0000008339.V310822.R01.S.doc Version 5.2 Page 6 Staff were receiving regular supervision with their manager. Staff meetings were being formally recorded. 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 DS0000008339.V310822.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Wentworth House DS0000008339.V310822.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Information is available about the home for people considering moving in. People’s needs are assessed before they are admitted to the home. EVIDENCE: Since the previous inspection the home had reviewed and updated its Service User Guide which now includes brief information about the many aspects of the service provided including cost of service, staffing, details of the accommodation, the homes principles and philosophy of care, activities, contracts and terms and conditions, complaints, notice of termination of residency, chargeable services within the home, insurance, finances, fire safety, gifts, confidentiality and the homes quality assurance and standards. All three people who completed written questionnaires said that they had been given enough information about the service before they moved into the home. The home ensures that prior to an individual moving into the home a manager of the service assesses the person’s needs and wishes to ensure that the Wentworth House DS0000008339.V310822.R01.S.doc Version 5.2 Page 9 person’s needs can be met by the staff team at Wentworth House. Copies of pre-admission assessments were present on residents’ personal files. Wentworth House does not provide intermediate care facilities. Wentworth House DS0000008339.V310822.R01.S.doc Version 5.2 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 the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The service ensures that people’s healthcare needs are met. However, some minor improvements are needed to medication storage. EVIDENCE: Each resident had their own individual file that contained information relating to their care and support. This information included a copy of the needs assessments form which included the opportunity for people’s personal care and physical wellbeing and medication history to be recorded, next of kin details, copies of peoples annual review of care with the local authority, a copy of the homes confidentiality policy and a copy of the services ‘residents charter of rights’ and the homes quality policy statement. Care plans were included in people’s individual files. A requirement was made following the previous inspection that care plans and individual risk assessments were required to be reviewed and updated on a regular basis and contain all the information required about the persons needs and wishes. Several care plans were assessed during this visit and there was evidence of improvement in the detail of information contained in the documents and further evidence that they were being reviewed on a regular basis. Some of Wentworth House DS0000008339.V310822.R01.S.doc Version 5.2 Page 11 the notes contained in people’s files were difficult to read due to the style of some individuals’ handwriting. Written records available clearly demonstrated that residents have access to healthcare professionals when needed. There was evidence of visits from general practitioners, a psycho-geriatrician and the local district nursing teams had taken place. A district nurse visited the service at the time of the inspectors visit. The management of the service demonstrated a thorough knowledge of the resident’s healthcare needs. Medication was stored in secure locked cupboards and a lockable medication fridge was also available. One cupboard contained some excess stock of medication. Some medication was found not to contain labels that detail the name of the resident, name of the medication, dosage and date of dispensing. Discussion took place with the manager of the service regarding the need to have all prescribed medication stored in their appropriately labelled boxes /containers at all times. The manager demonstrated a commitment to address these issues immediately. All staff who administer medication have received training from the managers of the home. The proprietor of the home stated that all staff were to receive medication training in March 2007 from Boots. Medication Administration Records (MAR) were in use for staff to record when they had administered prescribed medication. Several MAR sheets were assessed and were found to have been signed appropriately. Residents spoke positively about the service they received from the staff team at the home. Wentworth House DS0000008339.V310822.R01.S.doc Version 5.2 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 the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Routines in the home were flexible to meet the needs of residents. Some activities were available and the home considered people’s religious needs and wishes. EVIDENCE: The service offered several activities for residents including a domino group, music sessions and reminiscence sessions. Entertainers visit the home on a monthly basis. A representative of a local church of England visits the home on a regular basis and a representative from a local Roman Catholic church visits on a weekly basis to give communion. Of the three people who completed written questionnaires one person said that there was always activities arranged by the home that you can take part in, one person said there was usually activities arranged and went on to write “I never wish to join in the activities although I am always asked to.” One person stated that there were never any activities that they were able to take part in. Residents confirmed to the inspector that they were able to receive visitors at all times. During the visit to the service several visitors were seen arriving and departing from the building. One visitor commented to the inspector that he Wentworth House DS0000008339.V310822.R01.S.doc Version 5.2 Page 13 was always made to feel welcome when he visited and that the home had a good atmosphere. Information was available to residents, their families and their representatives relating to how to access local advocacy services for an independent person who will act in their interests. Meals are served in communal dining rooms situated on the ground floor of the building. A selection of drinks was offered to residents on several occasions throughout the visit. Residents who spoke to the inspector during the visit said that they were happy with the food that they received. One person wrote on their questionnaire that they usually like the meals at the home and went on to write that there was no cooked breakfast and only one cooked meal a day. Two residents stated in their questionnaires that they always liked the meals in the home and one resident wrote, “The food is always very good and varied.” Wentworth House DS0000008339.V310822.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents are confident that they would be listened to if they made a complaint and staff had an awareness of adult protection. EVIDENCE: The home had a complaints policy and a procedure for dealing with any complaints received. Information relating to the homes policy and how to make a complaint about the service is also contained in the homes Residential Guide. During the visit the inspector spoke to four residents and asked them if they would be comfortable in raising a concern/complaint if they were not happy with the service they receive. One resident said that she’d speak to the manager and another resident said that she’d speak to whoever was in charge. All four residents said that they had never needed to complain. Two people who completed written questionnaires stated they always knew who to speak to if they were not happy or had a complaint, and one person wrote that they sometimes knew who to speak to if they were not happy or had a complaint. The home had not received any complaints since the previous inspection. The home had a policy for the protection of vulnerable adults along with a copy of Salford Social Services joint agency adult protection policy. There was evidence that staff had some awareness training in adult protection on individual staff files. One member of staff who had been recruited since the previous inspection told the inspector that she had received awareness training Wentworth House DS0000008339.V310822.R01.S.doc Version 5.2 Page 15 in adult protection. A manager of the service demonstrated some awareness of Salford Social Services adult protection procedures. It is recommended in this report that a senior member of staff attends awareness training in Salford Social Services adult protection procedures. Wentworth House DS0000008339.V310822.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 25 & 26 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service. Residents benefited from a clean, tidy and comfortably furnished environment. EVIDENCE: At the time of the visit major construction work was taking place to extend the home. The interior of the home was safe, comfortable and pleasantly furnished for the residents. However, the immediate exterior of the home was extremely congested with building materials and equipment which created a hazard for anyone needing to evacuate the building in an emergency. Concerns about the safety measures in place were raised with the proprietor of the home who immediately contacted the manager of the building project. The inspector contacted Greater Manchester Fire and Rescue and a representative from the service visited the home and advised the proprietor. Immediate action was taken to ensure the safety of all, which included ramps being fitted to external fire escape routes to provide level evacuation if needed and all building materials were tidied. Wentworth House DS0000008339.V310822.R01.S.doc Version 5.2 Page 17 A requirement was made following the previous inspection that hot water temperatures were monitored and recorded on a weekly basis and that residents and staff had access to hot water heated to a temperatures of 44°c at all times. During the visit a random selection of hot water provisions were assessed and the water was found to be the appropriate temperature. The home was found to be warm, clean and hygienic with no unpleasant odours. Wentworth House DS0000008339.V310822.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to the service. Sufficient care staff were on duty to meet the needs of residents. Appropriate training was planned to ensure that residents’ needs can be met. However, recruitment procedures need to be improved. EVIDENCE: At the time of the visit there were two carers and a manager of the service on duty to meet the needs of the residents. Staff rotas demonstrated that three staff, including a senior member of staff were on duty throughout the day. Two waking night staff are on duty throughout the night. A cook and domestic staff are also employed to maintain the service within the home. All three people who completed written questionnaires said that staff listen and act on what they say. Two people wrote that staff are always available when they needed them and one person wrote that staff were usually available when they needed them. The home had a recruitment procedure that demonstrated that an application form was to be completed by any candidate and that two acceptable written references and an appropriate Criminal Records Bureau check were received prior to any person commencing employment. Since the last inspection the home had recruited six new members of staff. Several staff files were assessed during the visit. All files assessed contained an application form. However, other documents required to be maintained under Regulation 19 and Wentworth House DS0000008339.V310822.R01.S.doc Version 5.2 Page 19 Schedule 2 of the Care Homes Regulations were not available. Four staff files did not contain a valid Criminal Records Bureau check and some files did not contain evidence that a POVA 1st check had been carried out prior to the person commencing employment. An immediate requirement was made that the home ensures that Criminal Record Bureau/POVA 1st checks are carried out on all care workers. The proprietor of the service began to taken appropriate action to address the situation immediately. All care staff were in the process of going through induction training to ‘Work in Social Care’ by Skills for Care. Since the previous inspection some staff had received training in 1st Aid and moving and handling. The manager and a senior member of staff has just completed a ‘healthy hips and hearts’ course to carry out with the residents. The proprietor of the service stated that further training relating to medication was arranged for March 2007 and Food Hygiene training was in the process of being arranged with Salford Social Services. All senior members of the care staff had completed their NVQ level 3 qualification and the proprietor stated that all other staff will commence their NVQ level 2 qualification with Age Concern at the beginning of 2007. Wentworth House DS0000008339.V310822.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 37, 38 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to the service. The home is run in the best interests of the residents, however, improvement is needed in the risk assessing procedures. EVIDENCE: The home is owned and managed by Mr & Mrs Belvedere who are both trained nurses and have extensive experience in working with older people. The home has a questionnaire that they use to gain peoples views of the home. However, the proprietor stated that the last time that the questionnaires were distributed very few people responded. A recommendation has been made in this report that the home explores other ways of gaining the views of residents and their families. Wentworth House DS0000008339.V310822.R01.S.doc Version 5.2 Page 21 The service has a procedure for dealing with residents’ finances. Weekly personal allowances are managed on behalf of some residents. All monies are put into a dedicated residents account. Receipts are given and maintained for all money transactions. The proprietor stated that money was always accessible for staff to access on behalf of residents. The proprietor stated that following a requirement from the previous inspection staff are receiving supervision on a regular basis and that senior care staff are supervised by the managers of the home and care staff are supervised by senior care staff. Policies and procedures were in place to maintain the health and wellbeing of residents and staff. However, the manager stated that he was in the process of reviewing and updating these policies and procedures. The home did not have a policy on the use of restraint. The proprietor stated that it was the policy of the home not to physically restrain people. Discussion took place regarding the need to implement a policy to guide and advise staff about all types of restraint, for example mechanical restraint. The home were appropriately recording any accidents that occurred within the service and copies of accident reports relating to residents were available n their personal files. Two accidents reports that were read detailed visits to the local accident and emergency department. These accidents had not been reported to the Commission for Social Care Inspection as notifiable incidents. A sample of certificates was seen that demonstrated that regular servicing and maintenance of equipment of equipment was taking place. There was evidence that regular monitoring and testing of fire detection equipment taking place with weekly fire bell tests being recorded. The most recently recorded fire drill for the building took place on 20.11.06, however, the names of the staff members who attended drill were not recorded. A fire risk assessment for the building was available. However, the risk assessment did not identify all known hazards in and around the building whilst the construction work was underway. An immediate requirement was made that the homes fire risk assessment be reviewed and updated. The proprietor of the service confirmed that the risk assessment had been updated. Several residents had been assessed by the District Nursing team as needing bed rails. No risk assessments were available to demonstrate that all known risks had been identified regarding the use of bed rails. Wentworth House DS0000008339.V310822.R01.S.doc Version 5.2 Page 22 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 3 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 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 2 2 Wentworth House DS0000008339.V310822.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 OP9 Regulation 13 Requirement The home must ensure that any excess medication is returned to the pharmacy. All medication is required to be stored in/contain the labels which were issued at the time of the medication being dispensed. 2. OP29 19 All staff records need to demonstrate that all appropriate checks have been prior to a person commencing employment and contain all the documents listed in Schedule 2 of the Care Homes Regulations 2001. The home is required to notify the Commission for Social Care Inspection of all notifiable incidents occurring at the home. The home is required to ensure that all identified risks are assessed and the assessments reviewed and updated on a regular basis. 22/12/06 Timescale for action 14/02/07 3. OP37 12 14/02/07 4. OP38 12 22/12/06 Wentworth House DS0000008339.V310822.R01.S.doc Version 5.2 Page 24 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 OP7 Good Practice Recommendations It is strongly recommended that the home continues to improve the recording of details in the care plans and ensure that they are written in a manner that is legible. It is recommended that consultation takes place on a regular basis regarding what activities and social opportunities are made available to residents. It is recommended that regular consultation take place on a regular basis regarding the menu served at the home. It is strongly recommended that a senior member of staff/manager of the service attends an awareness course on Salford Social Services joint agency adult protection policy. It is recommended that the home explores alterative ways of gaining residents views on the service. It is recommended that the names of staff attending fire drills are recorded. 2. OP12 3. 4. OP15 OP18 5. 6. OP33 OP38 Wentworth House DS0000008339.V310822.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection CSCI, Local office 11th Floor West Point 501 Chester Road Old Trafford, Manchester M16 9HU 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. 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