Inspection on 22/10/07 for Wildacre

This inspection was carried out on 22nd October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Wildacre Raunds Road Chelveston Wellingborough Northamptonshire NN9 6AB Lead Inspector Sarah Jenkins Unannounced Inspection 22nd October 2007 07:30 DS0000070290.V349972.R01.S.doc Version 5.2 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 DS0000070290.V349972.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 Adults 18-65. 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. DS0000070290.V349972.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wildacre Address Raunds Road Chelveston Wellingborough Northamptonshire NN9 6AB 01933 625780 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) jm.sanderson@btinternet.com Mr Julian Sanderson Mrs Catherine Anne Pearce Care Home 6 Category(ies) of Learning disability (6) registration, with number of places DS0000070290.V349972.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered provider may provide the following categories of service only: Care Home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home fall within the following categories: Learning Disability - Code LD The maximum number of service users who can be accommodated is 6. 2. Date of last inspection N/A Brief Description of the Service: Wildacre is a residential care home providing personal care for up to 6 service users under the age of 65, with learning disabilities. The home is located in a rural setting on the outskirts of the village of Chelverston. The owner’s own property is in the same grounds but detached from the residential care home. To the rear of the care home there is parking space, a large outdoor swimming pool, gardens and a field that is sometimes used by Service Users as a games area. Service users have their own rooms some of which have basins or en-suite facilities. There are spacious communal facilities including a large lounge and a dining room. Service users also use the breakfast bar in the kitchen. Information is available about the home from the Registered Manager in the form of the Statement of Purpose and Service Users Guide. The range and details of fees at the home was not available to the inspector or the Registered Manager at the time of the inspection, and information should be sought directly from the Registered Owner. DS0000070290.V349972.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for Service Users and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. The primary method of inspection used was ‘case tracking’ which involved selecting 3 service users and tracking the care they receive through meeting with the service users, a review of their records, discussions with the care staff and observation of care practices. The Inspector visited during the early morning period to observe practices by staff and to meet with Service Users. Service Users have Learning disabilities, but most were able to communicate effectively with the Inspector. The Inspector also undertook observations of care practices, and Service Users’ relationships with staff to establish their levels of contentment with their lifestyles and routines. The Inspector spent nearly 6 hours in the home from 7.30am. The Registered Owner completed the Annual Quality Assurance Assessment (AQAA) prior to the inspection and 4 staff returned questionnaires. The Inspector had a telephone discussion with the relative of one of the service users, and the feedback from this was very positive. The inspection has also been informed by the recent history of the home, and the feedback received from staff and service users at the Inspection. What the service does well: The premises of the home are excellent for people who are happy to live in a rural area, as there are no close local facilities except for a post-box and village pub. However facilities are available in the nearby village of Raunds and transport is provided to Raunds, as required, through the company vehicles and/or staff, who are insured to carry service users. Service Users are treated as an extended family and staff have a clear understanding of their needs. Service Users’ comments about their lives in the home and about the staff were all very positive. Service Users are encouraged to be as independent as possible to maintain and to develop their individual living skills. Service Users have the opportunity of being involved in a number of different daily activities such as day centres, paid and unpaid work. DS0000070290.V349972.R01.S.doc Version 5.2 Page 6 Visitors are welcomed and Service Users are supported to maintain contact with friends and family. 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. DS0000070290.V349972.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000070290.V349972.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. From the information available, admissions would be sensitively undertaken, but there is a need for the Registered Manager to develop assessment systems and formats. EVIDENCE: No new Service Users have been admitted since the implementation of the Care Standards Act 2000 and there are no current vacancies at the home. The Inspector discussed the proposed admission process with the Registered Manager. She was fully aware of the need for any prospective service user to visit and have a flexible introduction to the home; for the needs of the whole group to be considered; and for there to be full consultation, and information availability. There was evidence from this discussion that an assessment process would be undertaken prior to admission, to ensure that prospective Service Users needs could be met, but the system and documentation to support this was not yet in place. DS0000070290.V349972.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are enabled to express their needs and make informed choices. Staff are careful to maintain this balance appropriately. EVIDENCE: Service users’ individual needs and choices are recorded on their care plans and they said that they were happy with the care and help that they receive at the home. Care plans have been developed to a very good standard and are full of relevant information, enabling staff to care consistently for service users who have a wide range of needs. Staff have, or are receiving appropriate supervision and training in dealing with challenging behaviour. There is detailed guidance within care plans, which enables staff to deal with issues consistently. These approaches have been discussed in review meetings and agreed by all parties. The Registered DS0000070290.V349972.R01.S.doc Version 5.2 Page 10 Manager is aware of the need to ensure staff teams on duty have sufficient experience to work appropriately with difficult behaviours from service users. Service Users are consulted on all aspects of their lives at the home and staff strive to keep them fully informed through discussion, involvement, and news sheets. Service users were confident that they are appropriately involved in decisions, through individual discussion and through house meetings. General observations of interactions between Service Users and staff showed that staff focus properly on Service Users wishes and needs. Appropriate and reasonable risk taking is understood in the context of enabling service users to enjoy a good quality of life. DS0000070290.V349972.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service Users are supported to lead active and satisfying lifestyles that reflect their personal choices. Staff are alert to how service users lifestyles may be developed and improved in accordance with their wishes. EVIDENCE: Service users spoke positively about their lifestyles and the opportunities available to them. Service users told the Inspector about their enjoyment of a trip to Irchester Park that they had been on the previous day. They were also keen to tell the inspector about their recent holidays, including a trip to Florida for some in the summer. 2 staff commented that service users sometimes have to compromise at weekends when individual wishes regarding outings cannot always be met. DS0000070290.V349972.R01.S.doc Version 5.2 Page 12 Service Users enjoy happy active lifestyles that reflect their personal interests. Some Service Users attend day centres or work placements during the day and others have chosen to “retire”. Service Users were seen to be relaxed and content when they left for their work placements. Visitors are welcomed and offered hospitality and service users are encouraged and enabled to maintain close contact with relatives and friends. The staff at the home are making particular efforts to support service users to develop and maintain their friendships with others that they meet socially or at work placements. Service Users spoke happily of their daily lives and described how they participate in the running of the home, sharing and taking responsibility for the domestic tasks of daily living according to their abilities. There was a homely atmosphere and staff and Service Users undertook their routines in a companionable manner. Service users were enjoying breakfasts of their choice at the time of the inspection and without exception spoke positively of the provision of food at the home. There is a good balance between the encouragement of healthy eating and ensuring that Service Users individual choices are met when the menu is planned. DS0000070290.V349972.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users receive health and personal support in a manner that preserves their rights, privacy and dignity. EVIDENCE: Staff discreetly assisted and encouraged Service Users in their personal hygiene routines in the early morning period. There was a calm relaxed and unrushed atmosphere. Service Users spoke positively about the support they received and said that they liked their local Doctors. Staff felt healthcare was good. Records showed that service users have regular healthcare checks. The Registered Manager was alerted to a dental visit that had apparently been missed but she assured the inspector that this had been undertaken although the record of this was missing. DS0000070290.V349972.R01.S.doc Version 5.2 Page 14 The Inspector observed medication being given out in the morning by a trained member of staff and saw that this was being undertaken safely and appropriately. Service Users told the inspectors that they always got their medicines on time. Medication is generally well managed but improvements are needed. Advice was given on the need for the full prescription instructions to be recorded on the Medication Administration Sheets, which, for safety reasons, should ideally be produced by the pharmacist, and not written by staff. Medication profiles should be developed and the medication procedure updated. The Registered Manager was advised that this is an important area for development. DS0000070290.V349972.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a good understanding of safeguarding issues among staff, although not all have yet received full training in this area, and service users feel safe. EVIDENCE: Service Users were confident that they could talk to staff, relatives or the inspector if they had a concern. They indicated that staff listened to their problems and helped them with them. There is a good understanding among staff of the need to treat all complaints and concerns seriously and to formalize the processes in order that staff and service users are fully protected. Staff training in this area is delivered as part of the induction process. Staff feel confident to raise any concerns with the Registered Manager. There have been no complaints or safeguarding issues reported to the home or to the Commission for Social Care Inspection since the new registration. Not all staff have yet received full training on Protection of Vulnerable Adults issues. This is an important area of development, which has been recognized by the Registered Manager who has been trying to arrange further training. Advice was given on the need to explore the area fully and thoroughly in staff meetings and supervisions in order that staff may develop a full understanding DS0000070290.V349972.R01.S.doc Version 5.2 Page 16 of the area, especially in relation to the challenging behaviours that they may have to work with. Money kept safe on behalf of service users is fully recorded with receipts and double signatures wherever possible to protect both service users and staff. DS0000070290.V349972.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is comfortable and homely and appropriate for the particular needs and lifestyles of the individual Service Users. EVIDENCE: The home is very well maintained, bright, spacious and attractive. Service Users are encouraged to see it as their own home and are enabled to use all the facilities including the large grounds and the outdoor heated swimming pool. Service users bedrooms are decorated and furnished in accordance with their needs and choices and appropriate adaptations are put in place as required. Locks are available for those service users who wish, and are able, to use them. DS0000070290.V349972.R01.S.doc Version 5.2 Page 18 The home was very clean and tidy throughout. Safety issues must always be kept under review. Advice was given on the accessibility of fire doors in the event of an emergency. One external door was locked and there was some delay when the staff member on duty had difficulty collecting and identifying the correct key. This door was said by the Registered Manager to be a fire door although no fire doors were marked as such. Fridge thermometers were in place but some recorded temperatures were rather higher than would be considered safe storage. The staff on duty said that they thought this was probably because service users had recently opened the refrigerators for breakfast, but no action appeared to have been taken to check this. Advice was given to check temperatures at other times, and for the Registered Manager to overview this. DS0000070290.V349972.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be confident that staff will support them to lead active and fulfilling lives. Staff training is properly organized and undertaken. EVIDENCE: Service Users were complimentary about the staff and felt that they were all “good”. There was one member of staff on duty at the time the inspector arrived. The staff member was trained and experienced and seemed to be assisting with service users breakfasts and morning routines in a thought out, sensible way to ensure support was available as needed. The risk assessment document in relation to lone working was not available and the Registered Manager was advised of the importance of maintaining and reviewing this. Staff speak positively of the training opportunities offered to them and there is a clear commitment to ensuring staff training fully meets standards. National DS0000070290.V349972.R01.S.doc Version 5.2 Page 20 Vocational Qualification qualifications have been worked towards and the Standard for this is met. Staff supervision was evident from records, and discussion with staff evidenced that they feel that this is useful. Staff said that there was a good atmosphere and communication was very open between staff, and that they were well supported in their duties. A staff file was reviewed and was generally well organized with the relevant information showing a professional recruitment and induction process. One staff member commented that their constructive criticism of the induction process that they had experienced had been taken on board by home and that this had now been improved for new staff. DS0000070290.V349972.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,41,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The new Registered Manager has recognized and is addressing many of the areas of this report that are highlighted for further development and the quality of the work being done is good. EVIDENCE: The recently registered Manager has several years experience with the client group and has achieved her National Vocational Qualification, level 4, She shows a high commitment to developing the professionalism of the service, with the involvement of service users and their wellbeing central to this. The Annual Quality Assurance Assessment (AQAA) submitted by the Registered Owner, and inspection processes revealed that there are some shortfalls in DS0000070290.V349972.R01.S.doc Version 5.2 Page 22 management areas, and this was discussed with the Registered Manager. In addition to areas of development already identified on this report there is a need to review, update and add to the homes index of policies and procedures. Health and Safety issues are reasonably well managed but there is a need for some review and fine-tuning to ensure all areas are fully covered and that records reflect this. In particular infection control training and processes need to be developed. The annual development plan and Quality Audit have not yet been fully implemented although there are processes in place to gather service users and their relatives’ views. Overall the service is good, but care must be taken to ensure all areas of development discussed at this inspection are fully addressed in order that the quality of the service is consistently of a high Standard and that this is reflected in its records and formal Quality Audit processes. DS0000070290.V349972.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 x 2 2 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 x 3 x LIFESTYLES Standard No Score 11 x 12 4 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 x 3 x 2 3 x DS0000070290.V349972.R01.S.doc Version 5.2 Page 24 N/A 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 YA42 Regulation 13 Requirement The Registered Manager must review fire escape routes to ensure all fire protection measures meet safety standards, and that service users are properly protected. Timescale for action 14/11/07 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 2 3 Refer to Standard YA2 YA20 YA20 Good Practice Recommendations Procedures and documentation for the assessment of new service users should be developed. Medication profiles should be developed to show a history of the prescriptions and dosages of medicines used by individual service users. Instructions on Medication Administration Sheets should be fully detailed, “as required” instructions should be defined as to the reasons for administration, the maximum dosage in 24 hours and the minimum intervals between dosages. Policies and procedures should be reviewed, revised or developed as recommended at the time of the inspection. The risk in relation to Staff being on duty on their own should be continually assessed, and there should be DS0000070290.V349972.R01.S.doc Version 5.2 Page 25 4 5 YA41 YA42 6 YA42 YA24 documentary evidence of this There should be awareness of risk potential in the service. Lone working, Health and Safety, including Fire protection, food storage/fridge temperatures, and infection control issues identified in this report should be addressed. 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