CARE HOMES FOR OLDER PEOPLE
Wentworth Lodge Wentworth Road Bushbury Wolverhampton West Midlands WV10 8EH Lead Inspector
Mr Ian Harris Unannounced Inspection 10th November 2005 08:00 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 Lodge DS0000020877.V264280.R01.S.doc Version 5.0 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 Lodge DS0000020877.V264280.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Wentworth Lodge Address Wentworth Road Bushbury Wolverhampton West Midlands WV10 8EH 01902 570208 01902 570208 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) Mrs Sandra Ann Dell Mrs Valerie Tanner Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Wentworth Lodge DS0000020877.V264280.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The number of person for whom residential accommodation with both board and personal care is provided at any one time shall not exceed 30 persons category I. That is females 60 years and above and males 65 years and above. 18th July 2005 Date of last inspection Brief Description of the Service: Wentworth Lodge is a care home providing accommodation and personal care for 30 older people. It is one of two homes that are privately owned by Sandra Dell. The home is located in the Bushbury area of Wolverhampton and is close to the local shops and amenities. The home was first registered in 1998 and consists of a two- storey building. All the bedrooms are single occupancy of which two have en-suite facilities. There are a variety of sitting/lounge and dining areas. The gardens are well maintained and are easily accessible. Wentworth Lodge DS0000020877.V264280.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over 4 hours. The main purpose of the inspection was to check the progress made by the home regarding the recommendations and requirements made in the last inspection report. This home has a history of meeting and exceeding national minimum standards and providing a good service for people; consequently on this occasion only those standards identified as “key” by CSCI have been inspected. The fullest co-operation was given to the inspection officer by the Care Manager staff and residents. During the inspection a tour of the premises took place and staff and care records were inspected. Also staff rotas and general records regarding the maintenance of the home were checked. 5 of the 20 care staff were on duty, and 15 of the 30 residents were spoken to. All the residents who could express themselves in a meaningful way stated that they were happy and contented and, “well looked after”, “The staff are golden. What the service does well: What has improved since the last inspection?
There is a good rolling programme of maintenance within and outside the home and it was noted 2 bedrooms, 1 lounge, 2 toilets and the kitchen ceiling have been redecorated and 1 bedroom has been re-carpeted since the last inspection. Wentworth Lodge DS0000020877.V264280.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Wentworth Lodge DS0000020877.V264280.R01.S.doc Version 5.0 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 Lodge DS0000020877.V264280.R01.S.doc Version 5.0 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,and 4 The home provides clear and accurate information to prospective residents on the services provided, enabling them to make a properly informed choice about the home. All residents are given a written contract on admission to the home. EVIDENCE: Each resident is provided with a detailed service users guide and statement of terms and conditions when they move into the home. A copy of the service users guide is placed in every resident’s bedroom. This statement contains all the required information. The statement is clear on what the fees do and do not cover. Residents are encouraged to visit the home prior to admission. An introductory visit is always offered to prospective residents, on some occasions the visits are declined and relatives visit on behalf of the prospective resident prior to admission. A trial period is included in the statement of terms and conditions of residence and the homes contracts. It was confirmed by a resident recently admitted to the home that they had been invited to the home for lunch before moving in. A trial period is included in the statement of terms and conditions of residence and the homes contracts.
Wentworth Lodge DS0000020877.V264280.R01.S.doc Version 5.0 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 the following standard(s): 9,10 and 11 The systems for the administration of medication are good with clear and comprehensive recording arrangements in place to ensure resident’s medication needs are met. Staff are sensitive to the individual needs of each resident in the terminal stages of life and meet these in a professional manner. EVIDENCE: Medication is administered by means of a monitored dosage system. From observation made during the inspection and the inspection of the records the system appears to be working very well. The home receives good support from the local pharmacist who does a three monthly audit of the homes medication. All Care Staff have been trained to use the system before they are allowed to administer medication. The home has very good policies and procedures, which are an integral part of the staff induction programme. Residents’ wishes with regard to terminal care and arrangements after death are obtained at the assessment stage, if possible. Family members are involved in these discussions if appropriate. Unless there are medical reasons for not doing so, service users are able to spend their final days in their own rooms. Where the needs of service users change, re-assessments are requested. The home has clear policies with regard to dying and death.
Wentworth Lodge DS0000020877.V264280.R01.S.doc Version 5.0 Page 10 The Care Manager and Care Staff are conscious of the need to provide extra support to the residents in their final days at the home. All the Staff are very aware of the need to be particularly sensitive, caring and attentive to the residents needs prior to their death. The care manager is also aware of the support the staff should provide to relatives and colleagues. Resident’s relatives are encouraged to be fully involved in the residents care at this particular time. Wentworth Lodge DS0000020877.V264280.R01.S.doc Version 5.0 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 the following standard(s): 14 and 15 Individuals are enabled to exercise choice and control over their lives wherever possible balancing the rights and risks with each individual The meals in the home are good homely type offering both choice and variety and also catering for special dietary needs. EVIDENCE: The residents and staff stated that the residents are consulted regarding the day-to-day running of the home through residents meetings and by feedback from their key-workers. The key-workers also identify interests that the residents wish to pursue The observations made, examination of menus and the comments received from the residents and their relatives confirmed that particular attention is given to the residents’ individual preferences. Comments made by residents regarding the quality, quantity and variety of food provided were highly complimentary. Wentworth Lodge DS0000020877.V264280.R01.S.doc Version 5.0 Page 12 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 and 17 The home has a satisfactory complaints system and there is evidence that residents’ and their families feel that their views are listened to and acted upon All residents are assisted to exercise their legal rights, either by family, staff or where appropriate by an advocate provided by Care Aware. EVIDENCE: The home has a comprehensive complaints procedure. The residents and relatives are made aware of the procedure through the statement of their terms and conditions of residence the service users guide and copies are also placed on the notice board in the hall. The home has a complaints file in which all complaints are recorded. It was noted that the home has not received any formal complaint since the last inspection and all minor complaints are dealt with appropriately and quickly. Residents are assisted to exercise their legal rights, either by family or care staff. All permanent residents are registered on the electoral register to vote. They may vote if they wish either by post, or they are assisted to go to the polling station if this is requested and most residents voted in the last general election. Wentworth Lodge DS0000020877.V264280.R01.S.doc Version 5.0 Page 13 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 and 26 The standard of the environment within the home and the garden is very high providing the residents with a very attractive, comfortable, homely and safe place to live. EVIDENCE: The home is long established and has undergone alterations over the years in order to provide appropriate accommodation for older people. The home is maintained to a very high standard, as are the gardens and grounds and provides a very comfortable homely and safe atmosphere. The home offers excellent facilities and communal space. There is a choice of lounges and sitting areas within the home that are decorated and furnished to a high standard. All the shared spaces within the home provide a warm, friendly, safe and comfortable environment. It was noted 2 bedrooms, 1 lounge and 2 toilets have been redecorated and 1 bedroom has been re-carpeted. The provision of a small bathroom cabinet in each bedroom by the sink would be an improvement. Also the ground floor shower room should be re-decorated and the window that the seal has failed in room 17 needs repairing or replacing.
Wentworth Lodge DS0000020877.V264280.R01.S.doc Version 5.0 Page 14 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 and 30 The home is well staffed with adequate numbers and skill mix. All care staff are trained and competent to carry out the duties for which they are employed The home has good policies and procedures regarding the recruitment of staff, which includes all the appropriate checks and references. There is a good training programme in place that ensures the staff are competent to do their job. EVIDENCE: The inspection of staff rotas and discussions with residents and relatives all indicated that the home is well staffed by caring competent staff. There is a good balance within the staff group, which includes experience, mature and younger staff who are embarking on a new career. The home operates an efficient recruitment procedure and is registered with the Criminal Records Bureau in order to complete the appropriate checks on staff. There was evidence within the home that all the checks are being carried out. All staff at the home are committed to developing their knowledge and skills through training and have regular opportunities to do so through external and internal training activities. The home has a programme of N.V.Q. training has now exceeded the minimum standard. Also the care staff have attended courses on Safe handling of medication, Risk assessment, Dementia care, and Moving and lifting, First Aid, Dealing with Challenging Behaviour and Fire Prevention.
Wentworth Lodge DS0000020877.V264280.R01.S.doc Version 5.0 Page 15 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, 32, 33, 34 and 35. The manager has very good leadership skills and has a clear development plan and vision for the home, which she has effectively communicated to the residents’, staff and relatives. The home is well managed, where service users interests and welfare are well processed and promoted. The systems for resident consultation are good with evidence suggesting that their views are sought and acted upon The residents’ finances, are being handled appropriately by designated senior staff. EVIDENCE: The Care Manager is a qualified in both practice and management and has considerable experience in caring for older people in a residential home settings. She has very good links with other agencies whom she consults with in order to improve the service provided by the home. There are clear lines of
Wentworth Lodge DS0000020877.V264280.R01.S.doc Version 5.0 Page 16 accountability within the home and the manager is very supportive of staff and residents. Observations made and discussions with residents and staff indcated that the Care Manager is very approachable and operates an open door policy. The staff and residents who could express themselves stated that they are happy to approach the Care Manager with any problems they might have. The routines and activities within the home are flexible and built around the needs of the residents. There was also evidence to show that staff consult with the residents regarding the choice of meals and activities within the home. There are regular residents meetings where residents are consulted about menus and entertainment etc. Also the Key-Worker system in operation is designed to ensure residents’ wishes are responded to. All the Financial records and administrative procedures within the home that were, inspected were found to be well ordered and maintained. It was noted that formal supervision is taking place on a regular basis. Wentworth Lodge DS0000020877.V264280.R01.S.doc Version 5.0 Page 17 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 x 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 x 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 x x x Wentworth Lodge DS0000020877.V264280.R01.S.doc Version 5.0 Page 18 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. 1 Standard OP19 Regulation 23 (2) (b) Requirement The registered person must ensure that the steamed –up widow in bedroom 17 is repaired or replaced. The registered person must ensure that the shower room on the ground floor is re-decorated Timescale for action 01/01/06 2 OP19 23 (2) (b) 01/01/06 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 OP19 Good Practice Recommendations That the provision of shelving or a small cabinet for toiletries be provided in residents bedrooms by the sink. Wentworth Lodge DS0000020877.V264280.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Wolverhampton Area Office 2nd Floor St. Davids Court Union Street Wolverhampton WV1 3JE National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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