Inspection on 16/01/06 for Wild Acres Rest Home

This inspection was carried out on 16th January 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 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

Wild Acres Rest Home 06/12/07

Wild Acres Rest Home 05/06/06

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Wild Acres Rest Home 440 Finchampstead Road Finchampstead Wokingham Berks RG40 3RB Lead Inspector Yvonne Souden Unannounced Inspection 16th January 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Wild Acres Rest Home DS0000065935.V274436.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. Wild Acres Rest Home DS0000065935.V274436.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Wild Acres Rest Home Address 440 Finchampstead Road Finchampstead Wokingham Berks RG40 3RB 0118 973 3670 0118 936 1862 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) Harbhajan Surdhar Mrs Lynne Valerie Cotterell Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Wild Acres Rest Home DS0000065935.V274436.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25/07/05 Brief Description of the Service: Wild Acres provides 24-hour care and accommodation for up to 18 people aged 65 and over. The home is a large bungalow set back from a residential road overlooking countryside, and enjoys a large mature garden to the front with a patio, and parking for several vehicles. Communual space within the home consists of a lounge and dining room; all 18 bedrooms are for single occupancy and five have en-suite facilities. The home is close to local amenities and is within a short drive to the town of Wokingham; public transport is available. Wild Acres Rest Home DS0000065935.V274436.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is Wild Acres second unannounced inspection within this inspection year 2005/2006, but is the first inspection following the registration of the homes new provider Mr Harbhajan Surdhar. This inspection assessed key standards within the Environment, Daily Living, Medication, Health & Safety and Management & Administration. The Inspector viewed records and spoke to staff, management, residents and their visitors. What the service does well: What has improved since the last inspection? What they could do better: The new provider recognised on the purchase of the home that improvements had to be made to ensure a safe, homely and comfortable environment, and has spoken of his plans to improve the environment by December 2006. The provider must forward a copy of their proposed development plan to CSCI that will include their plans to increase the communual space that the provider has recently decreased. Management must improve the routine of daily living and activities available within the home that will promote residents choice and improve information available to them. Residents should be encouraged to use the communual areas on the implementation of an active activity plan, as this would discourage residents from remaining in their rooms without the company of others, when some would choose an alternative. This would improve the residents’ quality of life and would improve comments made for example: Im bored, theres nothing to do, I used to be so active before I came here to live . Management could improve quality control, and should ensure staff receive updated mandatory/specialist training as identified within a training plan. Wild Acres Rest Home DS0000065935.V274436.R01.S.doc Version 5.1 Page 6 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. Wild Acres Rest Home DS0000065935.V274436.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Wild Acres Rest Home DS0000065935.V274436.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1 to 6 were not assessed at this inspection. EVIDENCE: Wild Acres Rest Home DS0000065935.V274436.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 Service users, where appropriate, are responsible for their own medication and are protected by the homes policies and procedures for dealing with medicines, but are not strictly protected by guidelines in place and training of staff. EVIDENCE: Medication is administered from a monitored dosage system as dispensed by a pharmacist and records checked matched stock in place. The audit control of PRN medication is limited to the medication administration record and could be improved to ensure accurate records of those service users who selfadminister. The home does not have a copy of the Royal Pharmaceutical Society guidelines on the administration and disposal of medicines in a care home as had been recommended to the registered manager at the previous inspection, therefore this recommendation have been carried forward. Where appropriate service users independence is promoted within a risk management framework to self-administer their medication. Some staff have received medication training, but no further updating of medication training has taken place in the last three years. Wild Acres Rest Home DS0000065935.V274436.R01.S.doc Version 5.1 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 The lifestyle experience in the home does not strictly match the service users expectations, and therefore service users are not helped to exercise choice and control over their lives. Service users receive a nutritionally balanced diet and are enabled to maintain contact with family and friends. EVIDENCE: Service users spoke of being bored as there are not enough activities within the home, but spoke positively about staffs attitude towards them, with comments for example, they are very nice and very kind and staff are marvellous, they would do anything for you and you dont have to ask them twice. Service users and visitors said that staff are helpful and make visitors welcome. Some service users spoke of being very active prior to coming to live in the home and now find it frustrating that activities are not in place, however service users did speak of recent Christmas celebrations within the home and of a visiting library and visiting minister of the Church. The home does not have an activity plan. There is a residents noticeboard, but it is not utilised enough to ensure service users are informed to base choices around, for example information is not available on community events/services, the homes complaint procedure, outings/scheduled entertainment or weekly/monthly activity plans. The manager spoke of plans to introduce an activity co-ordinator and it was agreed that the service users would benefit from this and from an activity plan. Service users spoke of Wild Acres Rest Home DS0000065935.V274436.R01.S.doc Version 5.1 Page 11 volunteers who had arranged quizzes within the home that was enjoyed by all, but said this appeared to have been a one-off. Service users spoke of a new provider and commented that they are not fully informed and worried about fees going up. Records show that residents meetings do take place, identifying that the last meeting held was November 2005. Service users were generally satisfied with the menu choice and were complimentary of the meals provided. The manager and staff spoke of recent improvements made within menu planning that has improved service user choice. Wild Acres Rest Home DS0000065935.V274436.R01.S.doc Version 5.1 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Service users and their relatives are confident that complaints would be listen to and taken seriously, and systems are in place to protect service users from abuse. EVIDENCE: Staff showed an awareness of the homes adult protection policies and whistle blowing policy, and confirmed training attended. Records show that some staff have attended abuse awareness training, and that the last training date was 2004. The home has a complaints policy, but this is not readily made available to the service users; it was discussed with management that the complaint procedure could be displayed on the residents’ noticeboard. It is evident from records made within the homes complaint logbook that service users are comfortable in raising issues of concern, and that concerns/complaints made are taken seriously by the home, are investigated and have an action plan and outcome recorded. Wild Acres Rest Home DS0000065935.V274436.R01.S.doc Version 5.1 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 25 & 26 Communual space is not sufficient for service users to enjoy social, cultural and religious activities, or visit with family and friends in private. The home requires some décor and repair to meet environmental standards, and does not strictly protect service users from burns and scalds. The home is clean and hygienic. EVIDENCE: The new provider has made changes to the home that has decreased the amount of communual space provided from 4.26 square metres per service user to 3.4 square metres. It was evident that the remaining lounge was not sufficient in size to accommodate up to 18 service users to participate in chosen recreational activities, or meet with visitors in private. The Inspector was informed that the communual space is decreased further on a Thursday as the lounge is used as a hairdressing facility. The provider must ensure service users have the same communal space as provided as at the 31st of March 2002 as an existing care home. Wild Acres Rest Home DS0000065935.V274436.R01.S.doc Version 5.1 Page 14 The provider has recently created an extra bedroom by knocking two bathrooms into one, still leaving sufficient bathroom facilities for the service users. The extra bedroom created enabled the provider on registration to increase the number of service users that could be accommodated from 17 to 18. The Inspector observed that the new bedroom is not finished, as the existing windows would not enable a service user to see out of the window when seated, or in bed, and tiles need to be removed to create a warm and homely environment. It was observed that the home was accommodating 18 service users on the day of inspection, despite evidence in place that identified the extra room was not finished; the home was using what used to be a small lounge as a bedroom, thus the decrease in communal space. Following discussions with the provider on the telephone, on the day of the inspection, the provider agreed to forward a copy of their development plan to CSCI, detailing the exact refurbishment plan that should improve the overall environmental standards within the home, confirming the scheduled completion date to be December 2006. Thermostatic control valves have not been fitted to hot water outlets, and some radiators and pipe work has yet to be covered to protect service users from burns and scalds. The Inspector observed that the lounge had been recently repainted and that curtains were not in situ; the Inspector was informed that new curtains are on order. The lighting within the lounge is not sufficient to facilitate reading and other activities. The Royal Berkshire Fire and Rescue Services carried out a fire safety inspection of the premises on the 14th of November 2005 and detailed four deficiencies with a compliance date as the 9th of January 2006; the manager informed the inspector that the compliance date has not been met and confirmed that the fire officer has rescheduled the visit to the home. Wild Acres Rest Home DS0000065935.V274436.R01.S.doc Version 5.1 Page 15 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 Service users are protected by the homes recruitment policy. EVIDENCE: The Inspector viewed the files of two new staff members; the files identified that the manager had obtained the necessary identification checks, references and CRB of the prospective staff members prior to offering them a position of employment. Wild Acres Rest Home DS0000065935.V274436.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): 33, 35 & 38 The home is not run in the best interests of the service users and the health, safety and welfare of the service users and staff is not strictly promoted. Service users financial interests are safeguarded. EVIDENCE: The home is not strictly run to the best interests of the service users as identified within the Environmental and Daily Life and Social Activity sections of this report. Policies and procedures are reviewed. The home does not have an annual development plan to identify aims and objectives, and there is no evidence to show that the views of family, friends, and stakeholders in the community and service users are sought on the service provided. Resident meetings take place, but these are not regular, and service users commented that they do not feel fully informed. Health and safety policies and procedures are in place and are promoted throughout the home, however some staffs mandatory training is out of date Wild Acres Rest Home DS0000065935.V274436.R01.S.doc Version 5.1 Page 17 and some environmental safety standards are not met as discussed within the environmental section of this report. Records show that staff received fire safety training in 2005 and that fire safety checks are maintained. The home ensures infection control and COSHH procedures are followed. Discussions with staff identified their knowledge and understanding of good practice within health and safety. The home keeps a small amount of money as requested by the individual service user; all individual service user transactions of finances are recorded with two counter signatures, and records were accurate on the day of inspection. Wild Acres Rest Home DS0000065935.V274436.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 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 1 1 X X X X 1 3 STAFFING Standard No Score 27 X 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X 3 X X 1 Wild Acres Rest Home DS0000065935.V274436.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? First inspection of new provider. 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 OP12 OP14 Regulation 16(2) (m)(n) Requirement The manager must produce a programme of activities arranged by or on behalf of the care home. The manager must listen to the views of the service user to develop a programme of their choosing that will ultimately meet their recreational needs within the home and within the community. The responsible individual must submit a development plan that details the homes aims, objectives and timescales to meet the environmental and Health & Safety standards as addressed within the environmental section of this report, and as agreed with the provider on the day of inspection. The provider must ensure service users have the same communal space as provided as at the 31st of March 2002 as an existing care home. Timescale for action 28/02/06 2 OP19 OP25 23(2) a,b,d,p 13(4) 16/02/06 3 OP20 23(2)(e) (f)(g)(h) 28/02/06 Wild Acres Rest Home DS0000065935.V274436.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 OP9 Good Practice Recommendations The registered manager should obtain a copy of the Royal Pharmaceutical Society guidelines on the Storage, Administration and Disposal of medicines in a care home. The manager should develop an annual development plan to identify the homes aims and objectives in providing a quality service. The manager should seek the views of the service users, family and friends and stakeholders within the community, for example GPs, District Nurses, Care Managers etc on the service provided. Staff mandatory training should be reviewed to ensure staff receive updated training that would include medication, and abuse awareness, and the manager should develop a staff annual training plan to monitor training required, attended and due. 2 OP33 3 OP9OP18O P38 Wild Acres Rest Home DS0000065935.V274436.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA 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. 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