Inspection on 15/02/07 for Wickwar Nursing & Residential Home

This inspection was carried out on 15th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Wickwar Nursing & Residential... 02/02/06

Wickwar Nursing & Residential... 02/08/05

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

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 Wickwar Nursing & Residential Home Castle House Sodbury Road Wickwar South Glos GL12 8NR Lead Inspector Grace Agu Key Unannounced Inspection 15th February 2007 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 Wickwar Nursing & Residential Home DS0000065198.V326601.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. Wickwar Nursing & Residential Home DS0000065198.V326601.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wickwar Nursing & Residential Home Address Castle House Sodbury Road Wickwar South Glos GL12 8NR 01454 294426 01454 294936 wickwar@ashbourne.co.uk www.southerncrosshealthcare.co.uk Ashbourne (Eton) Limited 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 Amanda Waldron Care Home 45 Category(ies) of Old age, not falling within any other category registration, with number (45) of places Wickwar Nursing & Residential Home DS0000065198.V326601.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. May accommodate up to 35 persons aged 65 years and over requiring nursing care. May accommodate up to 20 persons aged 65 years and over requiring personal Care only. Manager must be a RN on part 1 or 12 of the NMC register. Staffing notice dated 30/05/2001 applies. May accommodate up to 3 persons aged 50 years and over requiring nursing care. 2nd February 2006 Date of last inspection Brief Description of the Service: Wickwar Nursing Home is owned by Southern Cross Healthcare and is situated on the Sodbury Road in the village of Wickwar. There is a bus service up to 3 times a day. The village has a post office, hairdresser, coffee shop, newsagent and public house. The home is a converted property providing accommodation on 2 floors; there is adequate lift access. There are single and double rooms; all have a wash hand basin, but there are no en-suite facilities. Communal space is spread across seven areas. Utility/bathroom areas are well equipped for the residents’ assessed needs in the home. The home is pleasantly situated and has a well-maintained garden that is enjoyed by the residents. There is an activities organiser and regular activities are arranged. Fees range from £480 - £600 per week. Wickwar Nursing & Residential Home DS0000065198.V326601.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which was undertaken over eight and a half hours to review the care practice to ensure that it is in line with legislation and that best practice is followed at the Home. The inspection also followed up a complaint made by a relative in relation to meeting a particular individual’s needs leading to the person’s admission to hospital. Review of the notes, discussion with the Manager and staff showed that the Home had comprehensive care strategies in place to meet the resident’s complex and demanding needs. A full report in regarding this matter can be found in the body of the report. A tour of the building was undertaken and a number of records were viewed. Eight residents, thirteen staff members and two relatives were spoken with on the day. What the service does well: Generally, the Home was found warm, well lit clean, tidy and free from unpleasant odours. The residents were found to be relaxed and looked well cared for in their homely environment. The Manager and staff were noted interacting with the residents in a dignified and sensitive manner Prospective residents are assessed before admission to the Home and the Home ensures that the Service Users Guide is given to them to enable them to make an informed choice about moving to the Home, residents and relatives are informed on admission about the one month trial period to enable them to make a decision whether to stay. The home provides high quality for residents care through developing individualised Care plans that are reviewed monthly and when changes in need occur. To ensure that the residents’ health needs are continually met, the home has good relationships with the General Practitioners, Social Workers and other health professionals and also seeks advice that would benefit the residents when necessary. The Home provides meaningful activities for its residents and ensures that individual interaction is provided if necessary. Wickwar Nursing & Residential Home DS0000065198.V326601.R01.S.doc Version 5.2 Page 6 In order to ensure adequate nutrition for residents, good meals are provided and are not hurried; those who are unable to feed themselves are fed in a respectful manner. Residents’ nutrition is also monitored through individual assessments and action is taken regarding any issues that may be raised. At a discussion with the Home Manager and her team on the day of inspection, they informed the inspector that the home has an open door policy that enables residents, relatives and visitors to ‘approach us’ with any concerns or complaints. The manager stated “We provide a homely environment for our residents and we respect them and ensure that their dignity is upheld” Residents are protected and are enabled to complain through a robust complaint procedure and the home would ensure that all complaints are thoroughly investigated and the complainant informed of the outcome. In addition, to ensure that residents are adequately protected, on-going training courses are provided for staff and stringent recruitment procedures are followed for all potential employees at the Home. The Home is adequately staffed to include care and domestic staff. The Home ensures that aids and equipment are provided in sufficient quantity to assist staff with meeting the needs of residents. What has improved since the last inspection? The organisation has invested resources into on-going refurbishment of the Home; different areas of the Home have been re-decorated. The carpets have been replaced in various rooms and new bed spreads and curtains have been purchase for residents’ maximum comfort. Various pieces of equipment have been replaced to assist staff with providing high quality care for the residents and to promote independence. Examples of such equipment are: - ‘Stand Aid’ and Slings. Other improvements made include purchase of four ‘profile’ beds, three drug trolleys, weighing scales, drug fridge, washing machine, dishwasher, and a new boiler. Evidence shows that residents are consulted about programmes of activities organised at the Home on a one to one basis and at residents/relatives meetings to ensure participation. To ensure that residents are adequately protected, extra smoke detectors have been installed throughout the home. Wickwar Nursing & Residential Home DS0000065198.V326601.R01.S.doc Version 5.2 Page 7 A new care planning system has been implemented following the take over of the home last year by ‘Southern Cross Health Care’. 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. The summary of this inspection report can be made available in other formats on request. Wickwar Nursing & Residential Home DS0000065198.V326601.R01.S.doc Version 5.2 Page 8 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 Wickwar Nursing & Residential Home DS0000065198.V326601.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The process of admission of prospective residents is comprehensive, detailed and well planned to enable the residents to make an informed choice of moving to the home with the assurance that their needs will be met. EVIDENCE: The Home’s Statement of Purpose has detailed information about services and facilities provided at the Home. The Home also has a Service Users’ Guide, which is given to the prospective resident or their representative when they visit the Home to enable them to make an informed choice of moving to the Home. These have been reviewed following the take over of the home last year by Southern Cross Health Care. Wickwar Nursing & Residential Home DS0000065198.V326601.R01.S.doc Version 5.2 Page 10 During a discussion, the Home Manager stated that the home has an “open door” for potential residents to visit the Home with their relatives and interact with existing residents to ask questions and find out more about the services provided at the Home. The Home Manager or her representative would assess all care needs of residents before admission and confirms to the resident/representative in writing that the Home is able to meet their needs. This confirmation (Agreement to Provide Care) was seen in the care file reviewed. The home’s capacity to meet the assessed needs of the resident is dependent upon the skills of the staff and their relevant and effective training. It was evident from discussion with the manager and her deputy and review of the training records that staff are provided with relevant and ongoing training. Residents are informed on the day of initial visit or on admission of the onemonth trial period during which she/he can change their mind. One care file of a resident admitted recently contained pre-assessment information in relation to activities of daily living, social activities, likes and dislikes, family involvement, spiritual and emotional wellbeing and medication. The above information is evaluated and care plans are provided on how the assessed needs are to be met The care file reviewed contained a written contract/statement of terms and conditions of their stay at the Home. The agreement is provided to both selffunded and Social Services funded residents. A sample of comment cards received from residents in relation to their contract states “ A clear and concise document which enables us to know exactly where we all stand”. Wickwar Nursing & Residential Home DS0000065198.V326601.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 Quality in this outcome area is Excellent. This judgement has been made using available evidence including a visit to this service. The home offers care and support to service users throughout their lives and towards the end, it also protects service users by reviewing their health needs and appropriate drug administration. EVIDENCE: Two care plan documents were reviewed. There was evidence that the residents were assessed before admission and care plans gave clear information and direction to staff to enable them to deliver the appropriate care to the residents. Staff was seen accessing these documents throughout the inspection. Whilst reviewing the care files it was noted that one resident who recently transferred from hospital to the home for care due to terminal illness had pre existing pressure area problems. The individual’s care file contained appropriate care plans in relation to treating the pressure areas, controlling Wickwar Nursing & Residential Home DS0000065198.V326601.R01.S.doc Version 5.2 Page 12 pain, nutrition and medication management. These were reviewed monthly and when required. There were entries on a daily basis describing how the needs were being met. It is commendable to note that the wound care plan and the clinical expertise of the trained nurses are reflected in the outcome of the healing of the pressure sore. To ensure that the resident’s clinical, emotional and spiritual needs are adequately met, the home had established contacts with the General Practitioner (GP), district nurses, hospice nurses, and local vicar. Entries in the care file included visit by the Head and Neck specialist and medication review by the GP. There was regular discussion between the resident and the deputy manager regarding the individual’s emotional health. One entry stated that the resident was pain free and felt more satisfied with the care provided. A family member was also spoken with to offer reassurance regarding their relatives illness. Records show that staff have attended palliative care training and have acquired skills and personal experiences to enable them to care sensitively for residents’ terminal illness. The care file for a resident whose relative complained of inadequate care and subsequent admission to hospital was reviewed. There were comprehensive care plans in place to meet the individual’s health and personal care needs. There was regular discussion and visits from the GP and there were daily entries of how the needs were met. Also recorded were actions taken by the home in relation to a particular health need before the individual’s admission to hospital. A full report regarding the complaint can be found under standard 16. Both care files contained comprehensive risk assessments in relation to moving and handling, nutrition, pressure sores. The system of recording the administration and storage of medicines were found to be very good. A local ‘Boots’ pharmacy provides medication using a monthly monitored dosage system. The pharmacy supply printed medicines administration record sheets each month. Records of administration of medicines were clear. A check of the blister packs indicated that medication had been administered as recorded. Wickwar Nursing & Residential Home DS0000065198.V326601.R01.S.doc Version 5.2 Page 13 All medication seen was stored securely. Medicines trolleys are used to transport medication around the home. The home has a medicine fridge and temperature is recorded daily. Controlled drugs were stored correctly and recorded in a register. A policy is available to enable residents to look after their own medicines. All medication is ordered and received by staff. The local ‘Boots’ pharmacy continues to provide a monitoring and advisory service to the home. Wickwar Nursing & Residential Home DS0000065198.V326601.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Home enables the residents to maintain contact with families, friends and the local community. It provides meaningful activities and choice in respect of meals and meal times. EVIDENCE: Staff are aware of the residents’ wishes in regards to the times to assist with their care as far as is practicable and also their wishes getting up and retiring to bed. The home employs an Activities Co-ordinator who arranges a programme of activities and entertainment for the residents. This includes bingo, baking, craft making and mobile shop. One resident informed the inspector at a discussion “ We make cards, we play bingo, we make all sorts of things and I also do a lot of crosswords”. There is a permanent display of craft made by the residents on the ground floor next to the manager’s office. The Activities person also organises Wickwar Nursing & Residential Home DS0000065198.V326601.R01.S.doc Version 5.2 Page 15 functions such as cream tea and has recently finalised arrangements with ‘Willow Trust’ to take residents on a canal boat trip to Slimbridge on April 13. Residents are supported to maintain links with the local community and also make social visits. Relatives visit regularly and can have lunch with their loved ones. This was evident on the day of inspection. The home would contact an individual’s next of kin should they need to be informed of issues, which affect the well being of a person living at the home. One comment card received from a relative stated, “We are kept informed about activities which we can share with my mother and we are always welcomed warmly when we participate in these activities” The Home manager said that she sees the residents daily to discuss any concern that they may have and ensure that action is taken to deal with it. It was evident that residents are enabled to choose the decorations in their room and arrange personal possessions as they wish. One resident spoken with stated that they are enabled by the care staff to choose when to have a bath and their clothes every day. The inspector observed residents having their meal at lunchtime. The meal was relaxed and residents were given the meals based on the choices they made after consultation on the meals available to them. Residents who were unable to feed themselves were given appropriate support; staff approached the residents in a sensitive manner and treated them with dignity and respect. Residents spoken with on the day said that they enjoyed their meal. One comment card received from a relative before the inspection stated, “cook makes a lovely variety of really enjoyable meals as I have experienced when dining with my mum”. The kitchen was found very clean; there was a cleaning schedule in place. The home was inspected by the South Gloucestershire Council Environmental Services in June 2005 and was awarded a ‘five star’ rating on food safety. There was a kitchen risk assessment in place. All staff working in the Kitchen have attended Basic Food Hygiene updates. Their certificates were displayed in the kitchen area Wickwar Nursing & Residential Home DS0000065198.V326601.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are enabled to complain and are confident that their complaint will be listened to. Practices at the Home ensure protection of residents from harm and abuse. EVIDENCE: Appropriate procedures are in place for the management of any complaints. It was evident that the Home Manager and other senior staff are always readily available to talk to residents and their relatives and to respond to any concerns that are raised promptly. The inspector was also informed that senior personnel in the Organisation are always available to be contacted should there be a problem needing their support. The Commission for Social Care Inspection received a complaint from a relative regarding the care of an individual with a medical condition and challenging behaviour who was subsequently admitted to hospital. In line with the Commission’s policy the provider was contacted and advised to investigate the complaint using their complaint procedure in the first instance. Wickwar Nursing & Residential Home DS0000065198.V326601.R01.S.doc Version 5.2 Page 17 The complaint was recorded in the home’s complaint book and response regarding the actions the organisation was going to take was seen in the complaints book and also sent to the complainant. There were three other recorded complaints since the last inspection. Records indicated that appropriate procedure was followed and that the complaints were satisfactorily investigated and action taken to prevent them from occurring again. Residents responses noted on the comment cards evidenced that residents are aware of whom to complain to. One resident stated, “I have no reason to complain”. One comment card received from a relative states “ I visit 2 or 3 times a week and have never yet been aware of anything that I could make a negative comment about. I have already built a rapport with the staff and feel that if I were unhappy we could discuss it and resolve it without resulting in any formal procedure”. Staff are aware of the Whistle Blowing policy and would report any bad practices to the Manager without fear of reprisal. There is evidence of staff training in relation to Protection of Vulnerable Adults from Abuse. There is a copy of the South Gloucestershire Council policy on The Protection of Vulnerable Adults from Abuse at the Home to ensure that the Home is aware of the protocol to be followed if incidents of abuse occur. Records of recently employed staff members were viewed and contained personal information and record of identity. Other statutory information to include two satisfactory references, record of previous employment, and satisfactory Criminal Record Bureau disclosures were seen in the care file reviewed. Staff are aware of the rights of residents and would enable then to use the postal voting system. Wickwar Nursing & Residential Home DS0000065198.V326601.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a safe, clean and well-maintained environment with comfortable bedrooms, it also provides specialist equipment suitable for residents needs. EVIDENCE: The Home was found clean, tidy and free from unpleasant odours. Clinical waste is disposed of correctly and the facilities and equipment support good practice for the prevention of spread of infection. The home has a policy in infection Control to guide staff on actions to be taken should an infection occur. Whilst walking around the Home, it was evident that maintenance is ongoing and that several parts of the Home have been refurbished. For example, carpets have been replaced in some bedrooms, lighting has been replaced in Wickwar Nursing & Residential Home DS0000065198.V326601.R01.S.doc Version 5.2 Page 19 the sun lounge and extra smoke detectors have been installed throughout the home for residents safety. Residents met in their rooms confirmed that they were comfortable and liked their bedrooms and that they were satisfied with the décor. All the corridors have handrails fitted on both sides. The toilets and bathrooms have grab rails and various manual handling equipment and aids to assist staff meeting residents’ needs. The bathroom was noted to be clean. The home continues to access the services of the community Occupational Therapist and Physiotherapist to assess residents’ equipment needs as required. The laundry, situated outside the building, was noted to be clean and tidy. There are two washing machines and two dryers available to ensure that clean clothing and bedding are provided for the residents at all times. The washing machines have appropriate sluicing facilities to ensure that infection control is maintained. The laundry staff met on the day has been booked to attend Control of Substances Hazardous to Health (COSHH) training. There is a risk assessment in place and COSHH sheets provided for all the chemicals used at the laundry. Wickwar Nursing & Residential Home DS0000065198.V326601.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The recruitment procedure of the Home is robust and offers protection to residents at the Home. There are adequate numbers of staff that are competent to meet the needs of residents. EVIDENCE: On the day of inspection there were forty-three residents at the home and two residents in hospital. Evidence from the rota showed that good staffing level is maintained at the home and that the home is complying with the staffing Notice served to the home in May 2001. The Home Manager is a registered nurse and although she works ‘supernumerary’ hours to the staffing levels, the manager is always available to support the staff on the floors when necessary to ensure that the needs of the residents are met. There are adequate numbers of domestic, laundry, catering, and maintenance Staff. The home also employs an Activities Person and office administrator. Wickwar Nursing & Residential Home DS0000065198.V326601.R01.S.doc Version 5.2 Page 21 One relative was met on the day of the inspection and another was spoken with on the phone, comments received from both were positive and complimentary. One comment stated, “ The staff are very good. Another relative stated, “ the girls are lovely, they look after mum very well.” A comment card received from a Health professional states “ Much better than any other nursing home in the area. Continuity of staffing has been very important in maintaining standards. I have had patients here for about 20 years and have always been happy with their standard of care”. From evidence gathered during the inspection, the inspector concludes that staff members employed at Wick war Care Home have a range of skills and experience, which enables them to adequately meet the needs of the residents. The home employs a Training Coordinator whose responsibility is to ensure that all staff attend training in order to provide high quality care to the residents. For example significant numbers of staff have achieved National Vocational Qualification (NVQ) at level 2 and 3 in care with the previous providers and the recent providers are working towards ensuring that more care staff undertake NVQ at level 2. Some senior care staff have achieved NVQ3 and are able to undertake supervisory responsibilities All staff have attended core training, which includes Moving and Handling, Fire Awareness, Health and Safety, First Aid, Protection of Vulnerable Adults and other training programmes relevant to the needs of the residents. Other training attended included palliative care, dementia awareness, a continence study day and infection control. Trained nurses have attended training on Physical Aspects of Ageing, Infection Control, Diabetes and Venepuncture. The home’s recruitment documentation of two staff members demonstrated good employment practice and necessary checks being carried out. The home’s induction programme is robust and comprehensive. All new staff members have individual record of induction and the training given covers all areas of service provision including manual handling and health and safety. The manager stated that the home ensures that the induction process is completed before the staff member is allowed to work independently with a resident. This process could take up to three months. Wickwar Nursing & Residential Home DS0000065198.V326601.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36,37,38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The Home benefits from good leadership and management. Its practices have offered protection to the health and safety of residents. EVIDENCE: Mrs Amanda Waldron has managed Wickwar Nursing and Residential Care Home for many years. Mrs Waldron is a first level Registered Nurse and had recently completed the Registered Managers Award. On the day of inspection there was a friendly and interactive atmosphere in the home. Residents looked well cared for and were seen talking to staff in an informal way. Wickwar Nursing & Residential Home DS0000065198.V326601.R01.S.doc Version 5.2 Page 23 The manager had a clear understanding of her role and responsibility within the home and was able to demonstrate understanding of the needs of the residents. The manager and her team were positive and motivated throughout the inspection process. There was evidence that the manager and her team were committed to maintaining good levels of service provided at Wickwar Care Home and also to improving services. This is an evidence of the Manager’s leadership and management style. The manager stated that she sees the residents on a daily basis to ensure that there is regular communication to enable the residents to discuss any concerns or compliments. There is a detailed ‘hand over’ time between staff at shift change and the home maintains a daily diary where all communications and any actions required by staff in relation to residents’ health and welfare are recorded. There was evidence that relatives feel that they have good access to the manager and staff to discuss their person’s care. One relative was met on the day of inspection and another person was contacted on the phone from the home on the day. Both relatives were very complimentary of the home and management and said that they were regularly informed about activities in the home verbally when they visited and through a Newsletter. Evidence from staff records showed that staff have received regular supervision. Staff spoken with confirmed that they have received supervision and that they benefited from the exercise. It afforded them the opportunity to express their opinion about the services provided at the home and to discuss areas of concern in relation to residents’ care. The Home has different ways of monitoring the quality of its services. These include monthly reviews of pressure sores, accidents, deaths, falls, weight and social activities audits by the Home Manager, care planning review process, residents and staff meetings, policies and procedure reviews and three monthly meeting of all heads of departments within Wickwar Nursing Home The provider completes monthly visits and inspects records. The Commission for Social Care Inspection receives copies of the reports in relation to the Regulation 26 visits completed by the provider on a monthly basis. The fire logbook was viewed and was found well-maintained; all staff have attended a fire drill twice in the last year. All other health and safety checks to Wickwar Nursing & Residential Home DS0000065198.V326601.R01.S.doc Version 5.2 Page 24 include, Five year electrical and annual gas inspection, service contract for hoist and lift were in date. There was evidence of risk assessments on various areas of the home. The Home also maintains individual residents’ accident reports from the first day of admission to date. Regulation 37 notifications are sent to the Commission for Social Care Inspection to report any incidents/serious accidents as required by the regulation The Home’s policies and procedures on Abuse, Manual Handling, Complaints, Health and Safety and Death and Dying are in place and accessible to staff members working at the Home. The inspector reviewed residents’ money with the administrator and noted that detailed records are kept of the day–to day management of several personal allowances. The balances stored in the safe tallied with the amounts recorded. All other confidential information concerning the residents were securely locked away. Wickwar Nursing & Residential Home DS0000065198.V326601.R01.S.doc Version 5.2 Page 25 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 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 3 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 3 18 3 3 3 3 3 3 3 3 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 4 3 3 X 3 3 3 4 Wickwar Nursing & Residential Home DS0000065198.V326601.R01.S.doc Version 5.2 Page 26 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. 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. Refer to Standard Good Practice Recommendations Wickwar Nursing & Residential Home DS0000065198.V326601.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Wickwar Nursing & Residential Home DS0000065198.V326601.R01.S.doc Version 5.2 Page 28 - 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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