Inspection on 09/02/06 for Wick House

This inspection was carried out on 9th February 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

Wick House 26/02/09

Wick House 26/02/07

Wick House 28/09/05

Wick House 30/03/05

Wick House 26/01/05

Wick House 09/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Wick House Buttermere Liden Swindon Wiltshire SN3 6LF Lead Inspector Stuart Barnes Unannounced Inspection 9th February 2006 09:30 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 Wick House DS0000035463.V278524.R01.S.doc Version 5.1 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. Wick House DS0000035463.V278524.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Wick House Address Buttermere Liden Swindon Wiltshire SN3 6LF 01793 641189 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) Swindon Borough Council Valerie Timms Care Home 48 Category(ies) of Old age, not falling within any other category registration, with number (48) of places Wick House DS0000035463.V278524.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Any person outside the category of `Older People` who were receiving care and accommodation at the home as at 30th October 2003 may remain living in the home, subject to an assessment or review of their needs at least every 6 months that the home is able to satisfactorily meet their needs. 28th September 2005 Date of last inspection Brief Description of the Service: Wick House is a single storey purpose built care home that provides care and accommodation for up to 48 older people over 65 years. The home includes a rehabilitation unit that accommodates up to 18 people for a period of typically less than 3 months, 4 crises care beds and 26 long term beds. Additionally there is a day care facility for people who live in the wider community that is integrated within the home. The home is situated in the Liden area of Swindon and is owned and managed by Swindon Borough Council. Those living in the home have their own single bedrooms and there is a large well maintained secure garden. Car parking is available. Typically the home is staffed by 10 care staff per shift covering the main house and 5 staff per shift in the rehabilitation unit. Additionally there are support staff who clean, housekeep, administrate and garden. At night, 4 awake staff cover the whole of the service who also have access to on-call staff if needed. The day centre is staffed separately. Wick House DS0000035463.V278524.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection, which was unannounced, was carried out by 2 inspectors and lasted approximately 4 hours. The main focus of the inspection was to progress the requirements and recommendations made at the previous inspection. This was carried out in September 2005. Additionally a small number of core national minimum standards (NMS) not inspected in September were inspected this time. The standard on dealing with death and dying was not inspected as planned due to special circumstances on the day. The inspectors spent time talking to several users of the service to obtain their views about the service they receive and also spoke to several staff who were on duty at the time as well as examining various documentation kept in the home. In total 10 out of 39 NMS were inspected in line with the Commission’s risk assessment methodology for this service. What the service does well: 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. Wick House DS0000035463.V278524.R01.S.doc Version 5.1 Page 6 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 Wick House DS0000035463.V278524.R01.S.doc Version 5.1 Page 7 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): 4 Service users and where appropriate their families, are being informed in writing whether the service can meet their assessed needs. EVIDENCE: The case documentation of two recently admitted people was examined and both included letters confirming the outcome of their assessment and a statement that the service was able to meet their assessed needs. The manager also confirmed that where appropriate such letters would also be copied to family’s members acting on behalf of residents. Wick House DS0000035463.V278524.R01.S.doc Version 5.1 Page 8 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): None of these standards were inspected on this occasion. EVIDENCE: Wick House DS0000035463.V278524.R01.S.doc Version 5.1 Page 9 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): 15 The home provides service users with a varied and nutritious diet. EVIDENCE: The home operates a four-week repeating menu, which is normally changed every three months. Discussion with the chef and examination of the menu confirmed service users are offered a choice at each meal. The main meal of the day is provided at lunchtime. This is normally a three-course meal offering a choice for each course. Discussion with service users confirmed they were satisfied with the quality and quality of meals served. Comments received from service users included “ the food is good”, “ I always have a choice” and meals are “excellent”. One of the inspectors observed part of the lunchtime meal. Where service users required assistance with their meals staff provided support in a sensitive and discreet manner. Service users food likes and dislikes are kept on display in the kitchen so as to prompt staff. As a matter of good practice the chef has developed a separate menu for soft and liquidised diets, when needed. This ensures that service users who require these special diets are provided with choices that are appropriate and not just a liquidised version of the main menu. The chef was advised of the need to keep a record of any changes to the menu, when they occur. Wick House DS0000035463.V278524.R01.S.doc Version 5.1 Page 10 The chef and manager confirmed the kitchen is to be updated as part of the refurbishment plans for the home. Arrangements are in place to ensure service users continue to receive their meals during this period, which is expected to be for several weeks. Wick House DS0000035463.V278524.R01.S.doc Version 5.1 Page 11 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): 18 Those working in the home appear to have sufficient awareness of what to do if someone alleges abuse has occurred, and that training is made available to them. EVIDENCE: Discussion with staff demonstrated a good awareness of what action to take to report any concerns affecting the welfare of service users. One member of staff confirmed they had received awareness training on abuse. Examination of staff records also show that a significant proportion of staff have undertaken similar training. The manager shows good understanding of what to do if an allegation of abuse is made and has working knowledge of the local procedures and protocols. Care staff confirmed they have received a copy of Wiltshire and Swindon’s “no secrets” guidance. At the time of the inspection there were no active complaints or concerns arising from allegations of abuse or neglect. Discussion took place about the need to report to the Commission injuries sustained by service users when they accidentally fall and receive outpatient hospital treatment but are not admitted to hospital. Wick House DS0000035463.V278524.R01.S.doc Version 5.1 Page 12 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. The home is taking steps to ensure service users are provided with a comfortable and safe living environment. The manager provided details of the proposals for a major refurbishment of the home, which is expected to commence in the spring of 2006. It will include a new fire sprinkler system; call bell system, re wire of electrics, improved heating and lighting, kitchen upgrade, toilet and bathroom upgrade, redecoration of communal areas and refurbishment of bedrooms. It is anticipated this refurbishment will take 6/8 months to complete and will be done in phases. When complete service users with be provided with a high standard of accommodation. EVIDENCE: The home is situated in a quiet residential area of Liden and provides accommodation to service users on one level. The inspector’s viewed all communal living areas and the majority of service users bedrooms. The home was clean, tidy and free from offensive odours. Radiators are guarded or have low surface temperatures. Hot water is regulated in the bathrooms close to 43c. However hot water temperatures in toilets and service users bedrooms were not individually regulated and the Wick House DS0000035463.V278524.R01.S.doc Version 5.1 Page 13 inspectors found hot water temperatures in excess of 50c. This was brought to the attention of the manager to ensure action is taken to reduce the risk of scalding to service users. There is a separate laundry area that is situated away from any food preparation areas. Discussion with service users indicated they were generally satisfied with the laundry service at the home. Separate sluice areas are located around the building. Contingency plans are in place to phase in the refurbishment programme. The plan is to reduce the number of service users by transferring the rehabilitation unit and day centre and reducing short term placements until the refurbishment is completed. During the inspection the fire alarm sounded. Inspectors observed staff respond in a calm, efficient and proper manner. Wick House DS0000035463.V278524.R01.S.doc Version 5.1 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): 29 On the whole recruitment checks are satisfactory except for applicant’s not needing to declare dates when previously employed. EVIDENCE: The council has detailed policies and procedures in respect of recruitment of staff which services are expected to follow. The manager of the home is able to access specialist advice and support from a designated human resources department. Four staff recruitment files were selected at random and checked. All files included;• Completed application form • Relevant criminal record bureau checks (CRB) • Declaration of medical fitness • Three satisfactory references including most recent employer • Proof of identity. However it was noted that the application form that is in current use does not require people to declare the dates they were previously employed. This limits the ability to establish whether there are any gaps in a persons employment history that need further explanation, e.g. a period of imprisonment. The manager reported that the service is due to commence new recruits on the 12 week skills for care induction course and those successfully completing the induction will be automatically registered for National Vocational Qualification level 2 training, if they have not previously obtained it. Discussion took place Wick House DS0000035463.V278524.R01.S.doc Version 5.1 Page 15 regarding the protocols in place for ensuring the manager of the home is informed as to what training staff employed by employment agencies but assigned to Wick House have undertaken before they are deployed in this home. While some progress has been made to meet the requirement made at the previous inspection there remains a need to have further clarification. Wick House DS0000035463.V278524.R01.S.doc Version 5.1 Page 16 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): 35, 36, 38 Service users financial interests are well guarded. Supervision arrangements though improving still show some slippage. Attention to undertaken monthly management reports is poor and ineffective. EVIDENCE: The home was holding money on behalf of residents. The inspector’s examined a sample of four of these records and found accurate records were being kept of all transactions. As a matter of good practice two members of staff were signing for all money received and given to service users. Where possible service users also sign to confirm receipt of their money. Records showed receipts have been obtained for larger purchases. The administrator confirmed that the regular checks are made every three or four weeks on all service users money to ensure accuracy. There are secure facilities in the home for the storage of service users money and valuables. Wick House DS0000035463.V278524.R01.S.doc Version 5.1 Page 17 One of staff files examined by the inspector shows that the person only had 4 formal supervision meetings in the previous 12 months. The standard expects 6 meetings in that time. Where supervision has been provided it can be seen that it is well recorded, relevant to the job role and indicates reflective learning. Records show that the Commission are not receiving regular monthly management reports. Wick House DS0000035463.V278524.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 X X X X X 2 3 STAFFING Standard No Score 27 X 28 X 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 2 X 1 Wick House DS0000035463.V278524.R01.S.doc Version 5.1 Page 19 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 OP38 Regulation 26(2) Requirement Timescale for action 01/11/05 2 3 OP15 OP25 The responsible person must ensure that for each calendar month a suitable person undertakes an unannounced visit to the home and writes a report as to the conduct of the home; a copy of which must be left in the home and sent to the Commission. Note; this requirement is carried forward from the previous inspection. 17(2) The registered person must record any changes made to the menu. 13(4)(a)(c The registered person must ) complete risk assessments on the distribution of hot water in service users bedrooms and toilets. Where a risk is identified action must be taken to reduce the risk to service users. 09/03/06 19/04/06 Wick House DS0000035463.V278524.R01.S.doc Version 5.1 Page 20 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 OP37 Good Practice Recommendations It is recommended that there is a policy and/or guidance on tissue viability which relevant staff can reference. Note; this requirement was made at the previous inspection. There is a policy but in the opinion of the inspector it should be updated, in consultation with an appropriate specialist nurse. It is strongly recommended that application forms for jobs applicants require people to give the dates that they were employed in previous jobs. That the manager undertakes periodic auditing of when people meet with their supervisor so as to ensure any slippage or cancellations can be picked up and remedied more quickly. 2 3 OP29 OP36 Wick House DS0000035463.V278524.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB 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. Extracts may not be used or reproduced without the express permission of CSCI Wick House DS0000035463.V278524.R01.S.doc Version 5.1 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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