Inspection on 02/08/05 for Wickwar Nursing & Residential Home

This inspection was carried out on 2nd August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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... 15/02/07

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

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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 Announced 2 & 3 August 2005 09:30 nd rd 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. Wickwar Nursing & Residential Home D56_D05 S26596_Wickwar_V240221_020805_Stage4.doc Version 1.30 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 Gracechurch Homes Ltd 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 Amanda Waldron Care Home with Nursing for Older People 45 Category(ies) of OP Old age for 45 registration, with number of places Wickwar Nursing & Residential Home D56_D05 S26596_Wickwar_V240221_020805_Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 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. Date of last inspection Not applicable Brief Description of the Service: Wickwar Nursing Home is owned by Ashbourne 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. There is an activities organiser and regular activities are arranged. The home is pleasantly situated and has a well-maintained garden that is enjoyed by the residents. Wickwar Nursing & Residential Home D56_D05 S26596_Wickwar_V240221_020805_Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is an announced inspection which was undertaken over fourteen and a half hours to review the requirements made at the last inspection and also 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 concern raised by a social worker in relation to the Home’s ability to meet a particular resident’s need. Review of the notes, discussion with the Manager, staff and other residents showed that the Home had comprehensive care strategies in place to meet the resident’s complex and demanding needs. During the two days of inspection, the resident was found to be calm, relaxed and he/she was cared for in a sensitive manner. The Social Worker stated that the Home had plans to ask for a reassessment of the resident and a possible alternative placement for this resident. The Manager stated that the Home continues to meet the resident’s need and had no plans of seeking an alternative placement for this resident. The Social Worker had been contacted and informed of the findings after the inspection and the Inspector believes that this matter had been satisfactorily resolved. At the last inspection six requirements were made in relation to different areas of service provision at the Home. It was pleasing to note that the Home had made considerable effort to ensure that all the requirements made were met. This is commendable. Generally, the Home was found warm, well lit, 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. A tour of the building was undertaken and a number of records were viewed. Seven residents and one staff member were spoken with on the day. Wickwar Nursing & Residential Home D56_D05 S26596_Wickwar_V240221_020805_Stage4.doc Version 1.30 Page 6 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. Wickwar Nursing & Residential Home D56_D05 S26596_Wickwar_V240221_020805_Stage4.doc Version 1.30 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 Wickwar Nursing & Residential Home D56_D05 S26596_Wickwar_V240221_020805_Stage4.doc Version 1.30 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) 1,2,3,4,5, The process of admissions 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. During a discussion, the Manager stated that the prospective resident is encouraged to visit the Home for a day, have lunch and interact with existing residents and receive more information about the services provided at the Home. The Manager assesses all care needs of residents before admission and confirms to the resident/representative in writing that the Home is able to meet their needs. Wickwar Nursing & Residential Home D56_D05 S26596_Wickwar_V240221_020805_Stage4.doc Version 1.30 Page 9 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 resident admitted recently contained pre-assessment information in relation to activities of daily living, social activities, likes and dislikes, medical history and medication. The above information is evaluated and care plans are provided on how the assessed needs are to be met. A letter to a prospective resident detailing possible questions and answers about services provided by the Home was noted in the resident relatives information file outside the Manager’s office. The Manager explained that this letter is usually sent or given to the resident on or before admission. The care file reviewed contained a ‘resident’s agreement’ detailing the terms and conditions of stay at the Home. The agreement is provided to both self-funded and Social Services funded residents. Wickwar Nursing & Residential Home D56_D05 S26596_Wickwar_V240221_020805_Stage4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10,11 The Home offers care and support to residents throughout their lives and towards the end it also protects residents by reviewing their health needs and good care planning however, it fails to protect the resident by inappropriate drug administration and storage. EVIDENCE: At the inspection, four care plans were reviewed. There was evidence of preassessment before admission of a resident to the Home. This assessment is to enable the Home to determine whether the Home is suitable and that they are able to meet the resident’s needs. The resident is reassessed on admission before comprehensive individual care plans are provided detailing how the assessed needs are to be met. This is followed up by monthly reviews and intervention as needs change. There was evidence of a letter sent to the resident’s representative to inform them of the allocated key worker and to ascertain consent and agree the care plan. Wickwar Nursing & Residential Home D56_D05 S26596_Wickwar_V240221_020805_Stage4.doc Version 1.30 Page 11 The care file of a resident recently admitted with demanding needs was reviewed. The Manager stated the information gathered about the needs of residents before admission was different from what was observed when the resident arrived at the Home. The resident was reassessed and a comprehensive individualised care plan tailored to the specific needs of the resident was drawn up. It was noted from the daily entries that the plans were followed; plans reviewed daily and when required, there were medication reviews by General Practitioner (GP) regularly between 26/05/05 and 02/08/05. The Manager stated that the resident is more settled and that the Home would continue to monitor the care and medical needs and would seek the advice of other professionals as necessary. The other care file seen had care plans, which were person centred and had evidence of GP, dentist, chiropodist and optician visits. One resident spoken with stated that “staff look after me well”, “staff let me get up when I want to” and “nothing is too much for them”. There was evidence of risk assessment for pressure sores and appropriate intervention in relation to any occurrence of pressure sores. Wound care plans were in place along with treatment required for managing the wound in one care file viewed. Medication administration was reviewed: it was noted that the Home obtained three residents’ consent for self-medication and that all self-medicating residents were assessed and had lockable cupboards for the storage of their medication. There was evidence of records of current medication for each person and the d the balance was correct and correctly stored and two nurses signed the controlled drug book when medicine is administered. However, three Sheriproct suppositories were found loose in the drug trolley without the original labelled box. It was not possible to ascertain whose medication it was, Paracetamol noted in a blister pack for a resident on the ground floor labelled two tablets, three times a day was noted to be dispensed as when required. A requirement was made to ensure that prescribed medication is given as labelled or to consult the GP to review the medication for new instructions. Care staff were noted to be knocking at the door before going into the resident’s room to assist them with personal care. One service user stated that “staff treat one with respect and always wrap you up well if they are taking you in the corridor for a bath to make sure you are not showing your body”. There was evidence in the care files viewed of details of residents’ wishes in the event of death. One staff member interviewed confirmed knowledge of policies and procedure for dealing with a dying resident and at the time of death. One staff member spoken with stated that she/he is aware of the importance of keeping information about resident’s confidential. Wickwar Nursing & Residential Home D56_D05 S26596_Wickwar_V240221_020805_Stage4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15 The Home enables residents to maintain contact with family, friends and community. It also provides meaningful activities and choice in respect of meals and mealtimes. EVIDENCE: Residents spoken with stated that staff supported them to maintain contact with their friends and families. One resident stated that his/her daughters visit regularly, another resident stated, “son comes quite often”. A letter confirming that visitors could visit the Home anytime was noted in the resident/relative information file outside the Manager’s office. Staff spoken with stated that visitors are not restricted from coming into the Home. The Home’s visitor’s book evidenced that there are a number of regular visitors to the Home. The Home’s activities programme was reviewed. It was noted that a letter was written in May 2005 to individual residents and relatives informing them of the list of outings and events organised at the Home including strawberry cream teas with families and friends, open day, mobile cinema and sing along. Wickwar Nursing & Residential Home D56_D05 S26596_Wickwar_V240221_020805_Stage4.doc Version 1.30 Page 13 The residents and families were offered the opportunity to comment on the activities and confirm participation. On the day of the inspection, ten residents were noted playing a game of bingo. Information about other activities was displayed in the lounge and dining area for the week included – Monday craft; Tuesday bingo; Wednesday sing along; Thursday bingo and Friday play your cards right and armchair keep fit. One resident spoken with stated that she would join in some of the activities but spends his/her day reading magazines, newspapers and favourite books. Another resident stated that she/he goes out occasionally but does not join in the activities provided at the Home. The Home’s activities organiser consults with the resident on admission to enable the Home to plan a suitable activity based on details obtained from the resident or the representative. Records of activities sessions participated by residents were noted to be recorded. Information in relation to a planned mobile shop was noted displayed at the Home. Two weeks menus seen contained varied nutritional meals. There was a choice of two meals at lunchtime on the day of the inspection. The Chef stated that the menu is prepared by the Company but the Home can change it to suit the residents’ needs. The kitchen is contracted to another company who supplies the Home with food and staff. Residents spoken with stated that they enjoyed their meals and that staff come round in the morning with the menu to ensure that they make a choice and request for an alternative if they are not satisfied with what was on the menu. The Chef stated that all staff working at the Home have basic food hygiene certificates. All staff working in the kitchen attend a course on ‘Quality through Hygiene’ validated by Occupational Safety and Health. The Chef supported the staff with the above course. The kitchen was noted to be clean, new flooring was noted in place, the fridge and freezer temperatures were regularly recorded and all food in the fridge was labelled. Control of Substances Hazardous to Health information sheets were noted in the file in the kitchen and within easy reach of the kitchen staff. A recent food safety award was noted displayed at the entrance hall. Wickwar Nursing & Residential Home D56_D05 S26596_Wickwar_V240221_020805_Stage4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,17,18 Residents are enabled to complain and are confident that the home is able to protect them from harm and abuse EVIDENCE: The Home has a robust complaints procedure, which is displayed, in the main entrance hall. The complaints procedure has information about the Commission for Social Care Inspection (CSCI) to enable residents and their representatives to contact the Commission if they are not satisfied with the outcome of their complaint. Residents spoken with stated that they would complain to matron if they had any concerns. The complaint book viewed contained no complaints. There was a policy on Protection of Vulnerable Adults from Abuse and a copy of South Gloucestershire’s Joint Protection of Vulnerable Adults from Abuse is to be obtained by the Manager to ensure that the correct procedure is followed in the event of suspicion of abuse or harm of a resident. The Home has a whistle blowing policy and procedure to enable staff to report any bad practice without fear of reprisal. Care staff spoken with stated that she/he would report any abuse to the Manager. Two new staff files viewed contained Criminal Records Bureau checks and two suitable references that had been obtained before commencing employment. Evidence from the records showed that Registered Nurses working at the Home had their Personal Identification Numbers verified by the Nursing and Midwifery Council (NMC) before commencing employment to ensure that the residents are adequately protected. Wickwar Nursing & Residential Home D56_D05 S26596_Wickwar_V240221_020805_Stage4.doc Version 1.30 Page 15 Records of resident’s monies viewed corresponded with the amount. At the last inspection a requirement was made in relation to the large amount of money noted in the safe. It is commendable to note that the amount of money kept in the Home is minimal; the Home encourages the residents’ families to manage the residents’ monies. The Home’s Administrator manages six residents’ monies. Individual accounts viewed corresponded with the balance in the safe. Residents spoken with stated that they were able to vote at the election using the postal voting system. Wickwar Nursing & Residential Home D56_D05 S26596_Wickwar_V240221_020805_Stage4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,23,24,25,26 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 to be clean, tidy and free from unpleasant odours. Whilst walking around the Home, it was noted that several parts of the Home have been refurbished. The two lounges had new comfortable chairs and coffee tables, new flooring and were pleasantly decorated. The corridors on the first floor have been re-carpeted including some bedrooms viewed. The Manager stated that ten sets of new bedroom furniture have been purchased and that it is proposed that all the bedrooms would have new furniture in due course. One of the newly furnished bedrooms was viewed and it was noted to be tastefully decorated. Residents met in their rooms confirmed that they were comfortable and liked their bedrooms and that they were satisfied with the décor. Wickwar Nursing & Residential Home D56_D05 S26596_Wickwar_V240221_020805_Stage4.doc Version 1.30 Page 17 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 on the ground floor was recently fitted with a new Parker bath on 18/04/05. The bathroom was noted to be clean. Staff were noted wearing aprons and gloves whilst attending to residents, indicating awareness of infection control. 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 stated that she/he has attended COSHH training and that she/he puts residents clothes away in their wardrobes to ensure continuity and avoid residents’ clothes being misplaced or lost. There is a risk assessment in place and COSHH sheets provided for all the chemicals used at the laundry. The garden was well maintained and one resident stated that he normally sits out in the garden when the weather is good. Wickwar Nursing & Residential Home D56_D05 S26596_Wickwar_V240221_020805_Stage4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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) 27,28,29,30 The recruitment procedure of the Home is robust and offers protection to residents at the Home. There are adequate numbers of staff who are competent to meet the needs of residents. EVIDENCE: There is a robust recruitment policy and procedure in place at the Home to ensure that only appropriate and well-qualified staff are recruited at the Home. Records of two recently appointed staff members contained required information to include CRB disclosures, two satisfactory references, record of previous employment and proof of identity. Registered Nurses working at the Home have satisfactory checks from the NMC (Nursing & Midwifery Council) for proof of registration. All staff have job descriptions in the files and staff spoken with demonstrated knowledge of their roles and responsibility in relation to meeting the residents’ needs. There is evidence of a comprehensive induction programme for all new staff and the Manager stated that all staff induction lasts for three months to ensure that staff are competent before working independently with residents. Evidence from the staff-training file showed that eight care staff have completed NVQ Level 2; three care staff have completed NVQ Level 3 and eight care staff are to commence NVQ Level 2 shortly. This shows that the Home would achieve 50 NVQ Level 2 in Care by the year 2005. Wickwar Nursing & Residential Home D56_D05 S26596_Wickwar_V240221_020805_Stage4.doc Version 1.30 Page 19 The Manager stated during a discussion that one of the trained nurses has attended the four days intensive Home Trainers training course and has been offered the post of Training Officer to the Home. The Training Officer has the responsibility to train all staff in areas of Health and Safety, Manual Handling and residents’ welfare. The Training Officer stated that she sees this as a selfdevelopment for her and a big asset for the home, she is enjoying her new role and that she is making efforts towards ensuring that all staff are adequately trained. The manager stated that all the training given to staff is in line with ‘Skills for Care’ standards. There were posters outside the staff room in relation to different guidelines on Health and Safety issues and various training dates. Other training courses attended by staff included Basic Food Hygiene, Dementia Awareness, First Aid and Vulnerable Adults along with Induction to Client’s Care Plans. All trained nurses have latest publications to keep them up to date with current nursing issues. One of the trained nurses met on the date of the inspection stated that she/he has attended courses on Catheter Care and Care Managers course. Evidence from the rota seen on the days of inspection showed that the Home has adequate numbers of staff to meet the needs of the current category of residents. In addition to the care staff, the Home also employs an activities organiser, two administrators, domestic and laundry staff. Wickwar Nursing & Residential Home D56_D05 S26596_Wickwar_V240221_020805_Stage4.doc Version 1.30 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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) 31,32.33.34,35,36,37,38 The Home benefits from good leadership and management, its practices have offered protection to the health and safety of residents. EVIDENCE: Wickwar Nursing Home is managed by an experienced and well-qualified home manager. Residents and staff members spoken with on the day of inspection commented positively and highly of the Manager’s ability to manager the Home. One resident spoken with stated “Manager is excellent” and that “the Manager comes to see me regularly”. Another resident stated that Matron is very good, “Matron helped me write a letter to my son who did not want to come and see me”, “she arranges trips to the garden centre for us, she is really nice”. Another resident stated that “Matron comes in often to see us and if we have any complaints we tell her”. One staff member interviewed stated that the “Manager is brilliant, you can talk to her and she listens”. Wickwar Nursing & Residential Home D56_D05 S26596_Wickwar_V240221_020805_Stage4.doc Version 1.30 Page 21 Mrs Amanda Waldron stated during discussions that she has almost completed the Registered Managers Award and has only one unit left on the course which is due to be completed in September 2005. She also attended a four-day induction course with Asbourne Health Care, the new owners of Wickwar Nursing Home. In addition, she attended Health and Safety training for Managers and attends Managers meetings within the region. Mrs Waldron stated that she has recently been promoted to Senior General Manager. This role enables her to visit and support new managers with her experience within Asbourne Health Care within the Bristol region, as well as the South West and Wales. Her role is also to assist and support the Regional Manager already in post. She stated that her primary responsibility is Wickwar Nursing Home. She would not leave Wickwar for any reason if there were a problem. However when it becomes necessary to visit and support any of the homes in the Bristol region, the Deputy Manager becomes supernumerary to cover Wickwar. Staff were supervised regularly. Staff members spoken with stated that they have received supervision. One staff member stated that she receives supervision four times a year and that the last one was three weeks ago. There was evidence of supervision in all staff files viewed. The Home has different ways of monitoring the quality of its services. These include monthly reviews of pressure sores, accidents, deaths, falls and weight audits by the Home Manager, Regulation 26 monthly visits by the Provider, care planning reviewed processes, residents and staff meetings, policies and procedure reviews and three monthly meeting of all heads of departments within Wickwar Nursing Home. A complementary letter from one of the GPs was noted in the communication file outside the Manager’s office: The manager visits the home randomly at night and early mornings as part of her quality assurance audit. It was agreed that questionnaires should be sent to residents’ relatives and other health professionals to seek their views with regard to the services provided at the Home. Pre-inspection comment cards received from residents’ relatives were positive and complementary. In addition the Manager completes performance reviews to include budgeting and has the authority to make monetary decisions on any thing that the Home needs to ensure that residents have high quality care. This demonstrates that the Home is financially viable. The fire logbook was viewed and was found to be well maintained. A new nurse call system is in place; twelve staff attended a fire drill on 29/07/05 and eighteen Staff on 7/02/05. All other health and safety checks to include, Five year electrical and annual gas inspection, service contract for hoist and lift were in date. The Home’s policies and procedures on Abuse, Manual Handling, Complaints and Health and Safety are in place and accessible to staff members working at the Home. Wickwar Nursing & Residential Home D56_D05 S26596_Wickwar_V240221_020805_Stage4.doc Version 1.30 Page 22 All accidents were recorded and reviewed and the Manager maintains six monthly reviews of all accidents and the most recent was sent to the Divisional Nurse at the Head Office for her records. The Manager stated that she visits the Home randomly at night at part of her quality assurance audit. The Home also maintains individual resident accident reports from the first day of admission to date. This is commendable. Wickwar Nursing & Residential Home D56_D05 S26596_Wickwar_V240221_020805_Stage4.doc Version 1.30 Page 23 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 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION 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 Standard No 16 17 18 Score 3 3 3 4 4 3 4 3 4 4 4 Wickwar Nursing & Residential Home D56_D05 S26596_Wickwar_V240221_020805_Stage4.doc Version 1.30 Page 24 NO Are there any outstanding requirements from the last inspection? 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 7 Regulation 13 Requirement Ensure that prescribed medication is stored in original and labelled box also that medication is dispensed in accordance with labelled instructions. Timescale for action 16/8/05 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 Good Practice Recommendations Wickwar Nursing & Residential Home D56_D05 S26596_Wickwar_V240221_020805_Stage4.doc Version 1.30 Page 25 Commission for Social Care Inspection 300 Aztec West Almondsbury South Glos BS32 4RG 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 Wickwar Nursing & Residential Home D56_D05 S26596_Wickwar_V240221_020805_Stage4.doc Version 1.30 Page 26 - 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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