Inspection on 07/07/05 for Wildashs

This inspection was carried out on 7th July 2005.

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 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

Wildashs 19/01/07

Wildashs 10/11/05

Wildashs 06/01/05

Wildashs 10/09/04

Wildashs 14/01/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Wildashs 68/70 Greentrees Avenue Tonbridge Kent TN10 4NE Lead Inspector Eamonn Kelly Announced 07 July 2005 10:00 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. Wildashs H56-H06 S24047 Wildash V228268 070705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Wildashs Address 68/70 Greentreen Trees Avenue Tonbridge Kent TN10 4NE 01732 356815 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) Miss Corina Wildash Miss Corina Wildash Care Home 7 Category(ies) of Old Age (7) registration, with number of places Wildashs H56-H06 S24047 Wildash V228268 070705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6 January 2005 Brief Description of the Service: Wildashs is a residential home for up to seven older people. The owner, Miss C Wildash, and four senior members of staff are trained nurses (RGN). The stated intention of the owner is to provide a high standard of care for older people and, where possible, to provide a home for life. All service users have single bedrooms. They have easy access to the rear conservatory and to the garden. Prospective service users (and their supporters) are able to obtain information from the owner about the homes services and facilities. Each prospective service user receives a full assessment to ensure the correct level of care can be provided. Care services are provided by both RN’s (registered nurses) and care assistants. There is a range of specialist equipment available to enable care to be provided for very frail older people. The home is in a residential area close to Tonbridge and a bus-route is nearby (Tonbridge-Maidstone road). Car parking is readily available. Wildashs H56-H06 S24047 Wildash V228268 070705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit consisted of meeting 4 service users, meeting with the owner and members of staff and visiting bedrooms and other areas of the home. Some visitors were met and quality assurance questionnaires were received. The report uses information provided in writing (ie. pre-inspection questionnaire) by the owner prior to the inspection visit. What the service does well: What has improved since the last inspection? What they could do better: The written information available to prospective service and their supporters should be presented more accurately. The personal contract should be Wildashs H56-H06 S24047 Wildash V228268 070705 Stage 4.doc Version 1.30 Page 6 improved to ensure that the rights and responsibilities of both parties (the owner and service user) are described. All relevant incidents should be notified to the Commission in writing as soon as possible after they occur. District nurses should be involved in the provision of aspects of care generally regarded as nursing care. 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. Wildashs H56-H06 S24047 Wildash V228268 070705 Stage 4.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 Wildashs H56-H06 S24047 Wildash V228268 070705 Stage 4.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 and 6 Whilst prospective service users obtain information about the home’s services and facilities from several sources, they do not have the benefit of receiving an appropriate information pack that contains full and accurate information about services and conditions. EVIDENCE: Wildashs H56-H06 S24047 Wildash V228268 070705 Stage 4.doc Version 1.30 Page 9 Prospective service users and their supporters have traditionally obtained information about the home’s services and facilities initially by local recommendation and then by visiting and meeting the owner, members of staff and service users. Short residential stays sometimes followed in the form of respite care. Written information is available but it was agreed during the inspection visit that this information should be clarified and presented as a concise information pack. It was also agreed during this inspection visit that the owner would produce a new personal contract for new service users as the existing one did not adequately cover the relevant aspects of the rights and responsibilities of both parties (ie. the service user and the owner). New service users are admitted on the basis of a full assessment and often after a period of respite care. Care services are provided by both RN’s (registered nurses) and care assistants. There is a commendable range of specialist equipment available to enable care to be provided for very frail older people. Prospective service users receive help and guidance in deciding on taking up residence (for example, they are invited to visit and meet with residents and staff and may stay for a ‘trial’ period to help both parties to get to know each other). Pre-admission records indicated that the owner undertakes full initial assessments with the prospective service user, his/her representatives and relevant (health and social care) professionals contributing to decisions. On the rare occasions where service users are admitted only for intermediate care, dedicated accommodation is provided together with specialist facilities, equipment and staff, to deliver short-term intensive rehabilitation for the purpose of enabling service users to recover and return home. District nurses are involved in these arrangements (these arrangements will be outlined in the revised pre-admission information pack). Wildashs H56-H06 S24047 Wildash V228268 070705 Stage 4.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 Service users health (including terminal care) and social care needs are met through the expertise of registered nurses and care assistants and a commendable range of aids and adaptations. EVIDENCE: A service user plan of care generated from the initial pre-admission assessment is drawn up with each service user. This is intended to provide the basis for the care to be delivered. Records seen outlined the actions deemed necessary to ensure all aspects of the service users health, personal and social care needs are met. Dated entries are made in respect of reviews of the resident’s well being. Copies of service user’s general record charts were also seen. The dependency needs of service users are high, akin to what would generally be regarded as requiring nursing care. Over the past few years, care managers have discussed this level of care being provided with the Commission: the mutual conclusion was that the levels of staffing and expertise (registered general nurses supported by care assistants) and the commendable range of aids and adaptations available for the continuing care of service users enabled them to receive an appropriate and consistently high standard of care Wildashs H56-H06 S24047 Wildash V228268 070705 Stage 4.doc Version 1.30 Page 11 (including terminal care). Senior members of staff at the home agree medical intervention with each resident’s GP and/or District Nurse: they monitor the outcome and then act as liaison between the home and the GP. In the examples discussed on this occasion, Miss Wildash indicated that there is full liaison with GP’s and District Nurses and that the level of involvement of District Nurses in relevant aspects of care would be reviewed. The presence of registered nurses at the home is supported by full intervention of district nurses as necessary. Copies of letters from resident’s GPs to the owner were seen (these indicated that GP’s were aware of the nature and treatment in each case and that they approved all treatments given). These letters related to named service users and were not letters of a general nature. Care plan records confirmed that service users have full access to chiropody services, dental, optician, and pharmaceutical services. Members of staff practice physical intervention with the assistance of a General Record Chart. There was evidence that service users receive attention and treatment at specific times determined by their individual care plan. The system for administration of medication was assessed during the previous inspection visit and the recommendations made then had been taken into account during a review by the owner. Wildashs H56-H06 S24047 Wildash V228268 070705 Stage 4.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 Service users are able to maintain as many aspects of their previous lifestyles as possible particularly through contact with friends and family. EVIDENCE: The individual routines of service users vary in accordance with their abilities, expectations and infirmities. Currently, some are largely bed-bound but are helped to spend time in the lounge area and garden. Visitors and friends visit regularly. The high visiting frequency of friends and family was apparent on this and on previous occasions. Service users go out regularly with family and friends. Very frail residents are helped to visit the garden in wheel chairs. Visitors described how service users continued to make their own decisions for as long as possible and how appropriate guidance is available to assist them to obtain suitable independent advice if this becomes necessary. Wildashs H56-H06 S24047 Wildash V228268 070705 Stage 4.doc Version 1.30 Page 13 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 & 18 The home has adequate measures in place to protect service users. EVIDENCE: All members of staff have been checked under recruitment procedures (ie. references, application form, CRB/POVA check, probation, induction training, supervision). The home follows the Kent & Medway Policy for Adult Protection. A complaints’ procedure is in place. Service users and visitors are confident in expressing their views to members of staff, visitors and day centre staff. Wildashs H56-H06 S24047 Wildash V228268 070705 Stage 4.doc Version 1.30 Page 14 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 premises are suitable for the comfort and care of very frail service users. EVIDENCE: The home was comfortable, well furnished and suitable for the care of frail older people. There are good communal facilities for service users, members of staff and visitors. All accommodation is on a single level. Service users bedrooms are furnished and equipped (including additional aids and adaptations agreed with service users and care managers) to enable occupants to have comfort and privacy. Service users have the use of a range of aids and adaptations and written risk assessments exist for the use of each of these. Each service users specific needs are identified and appropriate equipment is obtained with qualified Occupational Therapist support. The garden is suitable for use by frail older people. Wildashs H56-H06 S24047 Wildash V228268 070705 Stage 4.doc Version 1.30 Page 15 The premises were clean, tidy and well-maintained throughout and procedures (outlined by the owner) were in place to control the spread of infection. Wildashs H56-H06 S24047 Wildash V228268 070705 Stage 4.doc Version 1.30 Page 16 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) x These Standards were not assessed on this occasion. EVIDENCE: Wildashs H56-H06 S24047 Wildash V228268 070705 Stage 4.doc Version 1.30 Page 17 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 and 38 Service users benefit from a well managed home and from the maintenance of safe working practices. EVIDENCE: The owner/manager has wide experience in the care of frail older people both in clinical (as an RGN) and residential settings. In view of the changing recommendations relating to NVQ and other training approaches, Miss Wildash is giving active consideration to the Registered Manager’s Award. From discussions with members of staff, service users and visitors, it was apparent that there is an open and positive atmosphere at the home. Members of staff outlined how they worked in an atmosphere where each person understood precisely what was expected from them in order to meet the detailed needs of each service user. Wildashs H56-H06 S24047 Wildash V228268 070705 Stage 4.doc Version 1.30 Page 18 The pre-inspection questionnaire contained a declaration about maintenance checks and associated records. Some of these records were checked on this occasion. A fire safety logbook is maintained which contains a record of all appropriate fire checks carried out. The Environmental Health Officer and Fire Safety Officer have stated that they have devolved responsibility for appropriate aspects of safety to the owner. Wildashs H56-H06 S24047 Wildash V228268 070705 Stage 4.doc Version 1.30 Page 19 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 2 2 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 x COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x x x x 2 Wildashs H56-H06 S24047 Wildash V228268 070705 Stage 4.doc Version 1.30 Page 20 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 1.1 & 1.2 Regulation 4&5 Requirement The registered person shall produce a written guide to the care home... The service users guide and statement of purpose must include the information required as outlined in the Care Home Regulations (Schedule 1 and Regulations 4 & 5) and National Minimum Standards (Standard 1). This should be in the form of a concise information pack. The registered person shall give notice to the Commission without delay of the occurrance of... Notification of relevant events must be notified to the Commission in writing. Timescale for action 01/10/05 2. 38.7 37 25/07/05 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 2.1 & 2.2 Good Practice Recommendations Each service user (should have) a written contract/statement of terms and conditions with the home. It is recommended that a new contract be provided H56-H06 S24047 Wildash V228268 070705 Stage 4.doc Version 1.30 Page 21 Wildashs 2. 8.1 3. 31.2 for any new service users. The registered person promotes and maintains service users health and ensures access to healthcare services to meet assessed needs. It is acknowledged that there are a number of registered general nurses on duty at all times at the home and that the care regime of each service user is supported by a GP. The specific activities relating to what is generally regarded as nursing care should not be carried out without the knowledge and direct approval of district nurses. The owner is requested to review this aspect of care provision and to include an appropriate statement in the revised service users guide. The registered manager has..a qualification at Level 4 NVQ in management and care... It is acknowledged that the owner is considering the options currently available in this respect and also that she is a registered general nurse with wide experience of managing care in clinical and residential settings. Wildashs H56-H06 S24047 Wildash V228268 070705 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane Maidstone, Kent, ME16 9NT 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 Wildashs H56-H06 S24047 Wildash V228268 070705 Stage 4.doc Version 1.30 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!