CARE HOMES FOR OLDER PEOPLE
Wheatsheaf Court Nursing Home Sheaf Street Daventry Northants NN11 4AB Lead Inspector
Keith Williamson Unannounced 27 September 2005 08.45
th 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. Wheatsheaf Court Nursing Home C51 C08 S12658 Wheatsheaf Court V246753 270905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Wheatsheaf Court Nursing Home Address Sheaf Street Daventry Northants NN11 4AB 01327 705611 01327 705613 None Interhaze Limited 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. Andrea Goodall Care Home with Nursing 58 Category(ies) of DE(E) Dementia - Over 65 Years (58) registration, with number OP Older People (58) of places Wheatsheaf Court Nursing Home C51 C08 S12658 Wheatsheaf Court V246753 270905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 7th July 2004 Brief Description of the Service: Wheatsheaf Court is a home for 58 residents. It is situated in the centre of Daventry and has easy access to all local shops and green space, with the bus station being within a short walk from the home, and rai ststion some 4 miles away. The home provides services to the elderly and elderly mentally frail, in a building, which dates back to the 16th century and was formerly a hotel. The building has its own large car park and has a secure inner courtyard, which is planted out with various tubs and hanging baskets, these were grown by the residents as part of the activity programme, this area offers privacy and shelter for residents. The home also has a small enclosed front garden. Wheatsheaf Court Nursing Home C51 C08 S12658 Wheatsheaf Court V246753 270905 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over one day, commenced at 8.45 am and was completed in six and a quarter hours by one inspector. An opportunity was taken to view the care plans and other records in detail. Nine residents were spoken with on this visit; samples of the comments made from those residents are enclosed in this report. No comment cards were returned to the inspector prior to the inspection therefore no comments from residents’ relatives have been included in this report. Five members of staff were also interviewed. The manager assisted with the inspection, spending time with the inspector discussing the management of the home. This is the first inspection visit to this home with the current manager, and overall the inspector recognised the home, continues to function very well and provides a homely and secure environment for residents’ and staff. What the service does well:
Very good written information is provided to residents. This gives good detail about what residents can expect from the home. There is a clear assessment process and care plans are individually detailed are well defined and detail the needs of residents and how these should be met. Clear guidance is given to staff members regarding keeping residents’ care records up to date. Good attention is paid to monitoring if residents have falls and what kind of help they might need to prevent this from happening. Health care needs are well met, and residents have access to the appropriate treatment when needed. Medication stocks and records are in good order, with safe systems in place. The registered person provides a homely and comfortable atmosphere for the residents. Residents spoken with indicated that they feel safe residing in the home and that they are well taken care of. A tour of the premises took place, which indicated that the premises are maintained to a good standard creating a homely environment for residents. The registered providers are committed to raising and maintaining good standards of care for this service based on the outcome of the inspection. Residents and staff spoke positively about the approach to managing the home indicating that it creates an open and inclusive atmosphere. There is an excellent relationship between the management of the home, residents and staff group.
Wheatsheaf Court Nursing Home C51 C08 S12658 Wheatsheaf Court V246753 270905 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. Wheatsheaf Court Nursing Home C51 C08 S12658 Wheatsheaf Court V246753 270905 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 Wheatsheaf Court Nursing Home C51 C08 S12658 Wheatsheaf Court V246753 270905 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) 1, 2, 3, 5 & 6. The assessment process is detailed and effective. The entire staff team are very committed to delivering good quality care. EVIDENCE: The Statement of Purpose and Service User Guide were viewed; residents could not confirm to the Inspector that these documents were supplied prior to moving into the home. Resident assessments are completed prior to their admission, these are detailed and care plans compiled from the information supplied. Contracts between the resident and the home are in place, and were placed appropriately in files. All residents enter the home on a trial basis, to assist them to make positive choice in their future accommodation needs The home does not provide accommodation under Standard 6.
Wheatsheaf Court Nursing Home C51 C08 S12658 Wheatsheaf Court V246753 270905 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 & 9. Residents are looked after well in respect of their health and personal care needs. EVIDENCE: On the inspection of five residents’ care plans these indicated that all aspects of personal and health care needs are being met. The detail in the plans is excellent and the manager and inspector discussed how new plans are being implemented and individual resident abilities now form the basis for these updated plans of care. None of the residents interviewed passed comment on knowledge of their care plan, though a number are signed by relatives. Evidence is in place to confirm contact with community health professionals. The daily care records were inspected and these are filled in appropriately. The medication system was seen to be administered appropriately, with medication being stored in two separate areas of the home. Observations made by the inspector indicated that residents’ privacy is maintained for example staff were observed knocking on residents’ bedroom doors before entering their rooms, residents also stated that the staff were “very helpful” and “kind and caring”.
Wheatsheaf Court Nursing Home C51 C08 S12658 Wheatsheaf Court V246753 270905 Stage 4.doc Version 1.40 Page 10 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, 14 & 15. Giving residents’ choices over their daily lifestyles and providing a wellbalanced meal is managed very well for residents in the home. EVIDENCE: A varied programme of activities is offered to residents, a sample programme being viewed by the inspector; a resident commented that they were “taken out regularly” intimating walks in the grounds and trips from the home. Personal choice is offered throughout the home, and evidence is in place to suggest the homes practices were flexible, promoting resident’s individuality and independence. Comment passed by residents indicated that the home was very accommodating to visitors, the residents’ knowing of no restrictions placed on visiting. No visitors were available to comment. The menu system offers a well-balanced dietary choice. The majority of comments from the residents indicated that the food was of a good quality and the times of being served were varied, one resident stating “you can have your breakfast at 11.30 if you want”, though another stated that the quality of meals had recently taken a downturn, this was perceived by the manager to indicate a recent change in the catering staff, and has commenced the process to employ replacement catering staff. Wheatsheaf Court Nursing Home C51 C08 S12658 Wheatsheaf Court V246753 270905 Stage 4.doc Version 1.40 Page 11 Another resident indicated their preference to eat in their bedroom, which a number of residents have taken the opportunity to do, and added, “ I prefer the peace and quiet”. Wheatsheaf Court Nursing Home C51 C08 S12658 Wheatsheaf Court V246753 270905 Stage 4.doc Version 1.40 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 standard(s) 16. Procedures are in place for the protection of residents in the home in the event of a complaint. EVIDENCE: The complaints procedure is publicly displayed in the foyer of the home, and is also included in the Statement of Purpose; this makes clear the process of making a complaint, the contact details of the Commission for Social Care Inspection are also included, as are the details of assistance from an independent advocate if deemed necessary. Residents stated they felt “at home” and “safe” in the home, another added if there were a complaint “matron would deal with it”. Wheatsheaf Court Nursing Home C51 C08 S12658 Wheatsheaf Court V246753 270905 Stage 4.doc Version 1.40 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 standard(s) 19, 24 & 26. The home is generally safe, and meets the needs of residents in the home. EVIDENCE: The general décor in the home is reasonable with the manager prioritising through the plan of routine maintenance the areas in the home most needing attention. Residents’ bedrooms are individually personalised, and all bedrooms are subject to a refurbishment when empty. An inspection of the premises found them to be clean and hygienic, the staff showing and excellent knowledge of hygiene and control of infection issues. Wheatsheaf Court Nursing Home C51 C08 S12658 Wheatsheaf Court V246753 270905 Stage 4.doc Version 1.40 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 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) None. No standards were viewed on this occasion. EVIDENCE: Wheatsheaf Court Nursing Home C51 C08 S12658 Wheatsheaf Court V246753 270905 Stage 4.doc Version 1.40 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 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) 33 & 37. The management approach promotes effective care practice in the home for residents’ care and protection. EVIDENCE: Evidence of quality assurance questionnaires was offered at the inspection these are periodically given to residents and their relatives; evidence of advocacy assistance is in place to assist residents who have no relative contact, a suggestion box is also situated in the foyer of the home. Records are kept securely in the home, and in line with the Data Protection Act. Wheatsheaf Court Nursing Home C51 C08 S12658 Wheatsheaf Court V246753 270905 Stage 4.doc Version 1.40 Page 16 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 3 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 3
COMPLAINTS AND PROTECTION 3 x x x x 3 x 3 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 3 x x x 3 x Wheatsheaf Court Nursing Home C51 C08 S12658 Wheatsheaf Court V246753 270905 Stage 4.doc Version 1.40 Page 17 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 Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard 2 9 15 15 Good Practice Recommendations It is recommended that the residents bedroom number be added to their contract. It is recommended that all medication is reciepted when into the home. It is recommended that all menu boards are completed on a daily basis to ensure residents are aware of meal options. It is recommended that when sauce or gravy accompanies a meal, that residents are offered a choice to the amount put on the plate. Wheatsheaf Court Nursing Home C51 C08 S12658 Wheatsheaf Court V246753 270905 Stage 4.doc Version 1.40 Page 18 Commission for Social Care Inspection 1st Floor, Newland House Campbell Square Northampton NN1 3EB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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