Inspection on 06/12/07 for Wild Acres Rest Home

This inspection was carried out on 6th December 2007.

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

Wild Acres Rest Home 05/06/06

Wild Acres Rest Home 16/01/06

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 Sandra Grainge Unannounced Inspection 09:30 6 December 2007 th 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.V353850.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. Wild Acres Rest Home DS0000065935.V353850.R01.S.doc Version 5.2 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 wildacresresthome@tiscali.co.uk 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) Mr Harbhajan Surdhar Mrs Janet Elliott Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (0) of places Wild Acres Rest Home DS0000065935.V353850.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th June 2006 Brief Description of the Service: Wild Acres is a residential care home that is registered to provide care and accommodation for up to 20 people aged 60 and over. The home is a large bungalow situated along a private road in a residential area of Finchampstead. The property overlooks the local countryside and has a large mature garden to the front and side with a patio and parking space for several vehicles. Shared rooms within the home consist of a separate lounge and dining room; all 20 bedrooms are for single occupancy and five of these have en-suite facilities. The home is close to local amenities and is a short drive from the town of Wokingham; public transport is available. The fees at the time of inspection were from £500 to £550 per week. Wild Acres Rest Home DS0000065935.V353850.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the report of an unannounced key inspection site visit carried out by Mrs Sandra Grainge, locum inspector for the Commission for Social Care Inspection (CSCI) using the “Inspecting for Better Lives” process. The manager for the service, Mrs Janet Elliott, was present for the duration of the visit, which lasted for just over six hours. A tour of the premises was carried out and a number of records and documents were sampled, including policies and procedures. Service users’ individual files were seen and care was case tracked for three people. Medication records, staff recruitment and training files were also seen. I spoke to a number of service users, visitors and staff during the visit. An Annual Quality Assurance Assessment (AQAA) was sent to the home and this was completed by the Manager and returned. Information provided in the AQAA informed this report. Prior to the inspection a number of CSCI survey forms were supplied to service users, their relatives and to healthcare professionals involved in the support of service users. The proportion of forms returned was low but the sample contained only positive comments and evidence of service user satisfaction. A large number of requirements were made following the previous inspection in 2006. Since then a new manager has been appointed to the home. I reviewed the requirements and recommendations with the new manager and found that all have been met and in addition the recommendations have been adopted and implemented. Detail is contained in the appropriate sections of this report. What the service does well: The service provides support and care for older people in a care home that is individual and has been adapted to meet their needs. Care is planned using a “person centred” approach. Service users consider that the food is good and the home is always clean and tidy. Staff give skilled care in a respectful and kindly manner and sufficient numbers are on duty to meet service user need. In the time that the manager has been in charge of the home she has recruited and developed a full team of staff as well as meeting all the outstanding requirements of the previous inspection. Wild Acres Rest Home DS0000065935.V353850.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Wild Acres Rest Home DS0000065935.V353850.R01.S.doc Version 5.2 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.V353850.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5 and 6 Quality in this outcome area is good. Service users have enough information about the service before admission to make a choice about entry to the home. All prospective service users have their needs assessed prior to admssion. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has an up to date statement of purpose and service users have a copy and a users guide. The documents include information about the type of care and support offered together with detail of accommodation, staff, the manager and proprietor. The manager has introduced a new assessment process as recommended in the previous inspection report. This is compatible with the assessments of health ad social care staff to be consistent and result in a comprehensive multi disciplinary assessment. There was evidence that each person’s individual needs had been assessed. Wild Acres Rest Home DS0000065935.V353850.R01.S.doc Version 5.2 Page 9 In addition the manager has developed a “person centred” approach to care management in response to the recommendation of the previous report for development of an individual profile and plan for each service user. Evidence was seen that each person has a contract with the service. The manager carries out the assessments alone, as the home does not currently have a deputy manager. Senior carers are being trained to be responsible for areas of management. Social services assessment documents are incorporated in the process. A question was raised during the visit concerning the admission of those who need care for dementia; the service is not currently registered to provide care for those whose primary need is for dementia care. The manager has contacted CSCI registration for information about variation to allow dementia if this is not the main cause for admission. The manager is able to demonstrate that the service has the capacity to meet the assessed needs of service users. Staff were seen to have the necessary skills to meet assessed needs i.e. moving and handling skills and administration of medication. Staff are aware of ethnic and cultural minority needs. Those who wish to enter the home are invited to visit and trial stays can be offered. This service does not offer Intermediate care. Wild Acres Rest Home DS0000065935.V353850.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11 Quality in this outcome area is excellent. The service users health and personal care needs are set out in individual care plans that are generated to meet the assessed needs.Health care needs are fully met and medication is administered correctly. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each person in the home had an individual plan of care. The plan addressed the assessed needs and gave care staff clear instructions of action to take to meet both the social and health care needs of each individual. The care plans are reviewed on a regular basis and they are then updated to reflect changing needs. The review process involves the service user; their relatives and the appropriate social care manager. Service users’ health care needs are met. There are risk assessment processes in use for the management of pressure area care and continence. In addition service users are supported to seek the advice of their GP when they wish. Wild Acres Rest Home DS0000065935.V353850.R01.S.doc Version 5.2 Page 11 There is a risk assessment in place for the use of bed rails that are provided for the safety of service users, as required in the previous report. The use of “person centred” approach as described in the Aqaa was apparent in the care plans and in the use of key workers. Three service users’ care was case tracked; the plans corresponded to the details of assessed needs, the need matched the plans that give clear details of action staff should take. The home has equipment for the disabled including rails, ramps, raised toilet seats, and assisted bath facilities. Care plans included risk assessment for falls. There was evidence of nutritional screening. No one in the service had been assessed as being able to manage to administer his or her own medication. Since her arrival in the home the new manager has reviewed the medication system and revised the process; all staff have been retrained and staff like the new system. I observed the administration of medication at lunchtime. Practice was good, the MAR charts were completed and in order. Medication is stored correctly and the supplying pharmacist gives advice. A record is kept of medication entry and disposal from the home. The requirement of the previous inspection has been met. Service users think that they are treated with respect and the staff practice that I observed confirmed this. The manager was able to give details of the end of life care that had been given to a service user who had been in the home for along time and wanted to continue to stay there until her death. Details of the case were notified to CSCI and there was evidence in the home of good working practice with the local health care staff to meet her needs; the manager had received thanks from the family. All service users’ records include information about the service user wishes concerning end of life care. Wild Acres Rest Home DS0000065935.V353850.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13,14 and 15. Quality in this outcome area is good. Service users have a life style that they enjoy and that meets their leisure , cultural and spiritual neeeds. They are given opportunity to make choices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A long term resident informed me that routines of daily living are flexible to meet her need and wishes. She feels that she is safe and can trust the staff. There is a new activity programme in place as required in the last inspection report. When I arrived a quiz activity was being held in the lounge and many service users were taking part. Outings from the home are arranged when a local bus with facilities for the disabled is hired. Visiting entertainers come to the home and everyone was looking forward to the booked pantomime. Birthdays are acknowledged and celebrated. A returned survey from a service user commented, activities provided -I choose not to join in, but this is respected”. The staff keep a record of service user interests and participation in activity. Wild Acres Rest Home DS0000065935.V353850.R01.S.doc Version 5.2 Page 13 In the aqaa the manager states that “We practice Person Centred Care,promoting choice in all areas for our residents and giving them . confidence. . Each person has a nutritional assessment carried out and his or her weight is regularly monitored. The new cook sees all service users individually and meets their choice as far as possible. Cultural needs can be met. Food served at lunchtime was served attractively in the dining room, where the cook offered seconds. In response to service user comments a fruit platter has been added to the menu for midmorning and fish is served more frequently. All service users told me that they liked the food. This meets the last requirement and service users told me that the food has greatly improved. The service users are making the Christmas table centre decorations as part of their craft activity. Staff were available to assist those who need help to eat and this was carried out skilfully and with sensitivity. All the staff have been trained in food handling hygiene. The kitchen was inspected by the EHO in November and received a good report. Spiritual preferences are recorded and service users are assisted to attend services in the home or to worship in local churches. Wild Acres Rest Home DS0000065935.V353850.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. Service users know how to complain and are safeguarded from harm This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s complaints policy and procedure is displayed, service users and their relatives are aware of it. The manager keeps a record book for complaints and outcomes; all comments, concerns and worries are included together with the action taken in response. No complaints had been made to CSCI. There had been no serious incidents and all concerns had been responded to in the time scale. Service users felt that their concerns are heard. Relatives commented that the manager is good; she and the new owner listen to them. Service users are safeguarded by staff who have been trained in protection of vulnerable adults. Staff were aware of what to do if an allegation of abuse was made and the procedure is in accordance with the local authority multi disciplinary procedure. Wild Acres Rest Home DS0000065935.V353850.R01.S.doc Version 5.2 Page 15 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, 25, and 26. Quality in this outcome area is good. The environment is safe, well maintained and is designed to meet the needs of the people living in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The bedrooms in the home are all for single occupancy and because they are large the service users are able to bring enough of their own possessions with them to make the room feel homely and personalised. All three bathrooms have been refurbished and one now includes a wet room. Since the last inspection much work has been carried out to meet the requirements for the environment. New access has been made to the utility room and the ceiling has been repaired. Wild Acres Rest Home DS0000065935.V353850.R01.S.doc Version 5.2 Page 16 The outside grounds were neat and tidy. Some hard paths lead round the building; a service user and her daughter enjoy this walk. The entry drive also leads to one other property that is not separate from the home. Risk assessments are in place and the owner is considering a better fence that will not obscure the view of the fields, which is enjoyed by everyone. The dining room has new lighting and the manager has provided additional freestanding lights. In the lounge, which had been decorated for Christmas, there are enough new comfortable chairs for everyone to be able to sit and enjoy the view over the countryside. The fire officer has commented on the building and the separation for the staff accommodation has been approved. New fire door operators are in use. Infection control procedures are in place, protective equipment is available, and there is a washing machine capable of sluice and hot wash cycles to infection control standards. There was evidence of good hygiene hand washing practice and clinical waste collection. There were no unpleasant odours in the home and a visiting relative told me that the home was always pleasant and clean. Wild Acres Rest Home DS0000065935.V353850.R01.S.doc Version 5.2 Page 17 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 and 30 Quality in this outcome area is good. Staff have been given training to meet service user needs.There are adequate numbers of staff to provide care and support. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There were adequate numbers of staff on duty to meet service user need and people living in the home informed me that the staff respond quickly to call bells and there always seem to be enough people to help. Agency staff are not used. Staff numbers are increased at busty times of the day and routine tasks are allocated to staff at times when the service users do not need support. The staff recruitment system has been reviewed and practice now meets the standard. Staff records were inspected and the recruitment process included the necessary safety checks for the protection of vulnerable adults. Induction training had been given to all new staff and there is an ongoing training programme for all staff. Senior staff had recently been to training about the mental capacity act. Staff traning records were seen; at least 50 of staff have NVQ level two or above. Responisbility for infection control has beeen delegated to senior carers as part of their development. Wild Acres Rest Home DS0000065935.V353850.R01.S.doc Version 5.2 Page 18 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 and 38. Quality in this outcome area is excellent. Service users live in a home that is run and managed competantly for their benefit.The health, safety and welfare of both service users and staff are promoted and protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is studying for the registered managers award and nvq 4. She is experienced and clearly understands the purpose and objectives of the home. There is an open management approach, regular staff meetings are held and notes are made for those who were unable to attend. Wild Acres Rest Home DS0000065935.V353850.R01.S.doc Version 5.2 Page 19 The manager is very resourceful on behalf of residents and has arranged improvements to the home and better facilities i.e. refurbishment of bathrooms and assistance with travel. She was able to demonstrate use of the material from her course and continuing learning as well as the resources of the Berks care group forum. Ideas form her training course and seminars have been implemented. Quality assurance is in place this was confirmed by a relative who told me of questionnaires and relatives meetings. In the home the complaints record serves as a quality assurance tool. Service users personal allowance money is managed safely according to the procedure. Insurance cover for the home is up to date; the manager uses the insurers to give legal advice and support. Record keeping practice is in order; current electrical and gas certificates are in place. Staff receive regular supervision that is recorded in their folders. Arrangements are in place for moving and handling, fire safety, first aid, health and safety at work, food hygiene, infection control, COSHH and accident reporting. Wild Acres Rest Home DS0000065935.V353850.R01.S.doc Version 5.2 Page 20 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 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 X 18 3 3 3 X X X X 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 4 X 3 3 4 3 Wild Acres Rest Home DS0000065935.V353850.R01.S.doc Version 5.2 Page 21 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 Wild Acres Rest Home DS0000065935.V353850.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU 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 Wild Acres Rest Home DS0000065935.V353850.R01.S.doc Version 5.2 Page 23 - 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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