CARE HOMES FOR OLDER PEOPLE
Willan House Stainfield Wragby Market Rasen Lincs LN8 5JL Lead Inspector
Elisabeth Pinder Unannounced 18 April 2005 09:30 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. Willan House C53 CO4 S59327 Willan House V213025 180405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION
Name of service Willan House Address Stainfield Wragby MARKET Rasen Lincs LN8 5JL 01526 398785 01526 399719 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) Mr J Shiers Mrs C Shiers Mr J Shiers Care Home 16 Category(ies) of DE(E) Dementia - Over 65 - 6 (Six) registration, with number OP Old Age - 10 (Ten) of places Willan House C53 CO4 S59327 Willan House V213025 180405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION
Conditions of registration: Mr Shiers to undertake training within six months of registration, concerning the care of service users with dementia, that will give him the knowledge and awareness to ensure that these service users receive a service appropriate to their needs. Completed July 2004. Date of last inspection 15.11.04 Brief Description of the Service: Willan House cares for older people in a non-smoking environment in a detached property situated in the small village of Stainfield. The home is approximately four miles from the small town of Wragby, and ten miles from the historic city of Lincoln. The home stands in its own grounds and gardens with car parking facilities to the front. The home has two floors and there is a stair lift to the bedrooms on the first floor. There is a variety of aids and adaptations around the building to allow residents to move around the home more independently. Twelve of the bedrooms are single, two of them have an ensuite toilet. There are five communal toilets and two communal bathrooms. Willan House C53 CO4 S59327 Willan House V213025 180405 Stage 4.doc Version 1.20 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over 6 hours and was carried out as the first of two statutory inspections for 2004/5. A partial tour of the premises took place and staff and care records were inspected. Two staff, four of the sixteen residents and a district nurse were spoken to. What the service does well: What has improved since the last inspection?
The home has taken action to address the requirements raised at the last inspection. Training has been undertaken regarding dementia care and staff supervision is now in place. Quality assurance monitoring has further developed and now includes a feedback questionnaire for new residents and relatives. An annual development plan for 2005 has also been drawn up. In March 2005 the home was re-accredited with ‘Investors in People Award’. Willan House C53 CO4 S59327 Willan House V213025 180405 Stage 4.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Willan House C53 CO4 S59327 Willan House V213025 180405 Stage 4.doc Version 1.20 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 Willan House C53 CO4 S59327 Willan House V213025 180405 Stage 4.doc Version 1.20 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) 3 Residents are admitted into the home only after a full care needs assessment has been carried out and written confirmation has been sent assuring them that their needs will be met. EVIDENCE: There is a detailed admission procedure, which identifies the needs of residents coming into the home. Care records of residents admitted since the new owners took over, all evidenced that a pre-admission assessment had been carried out and this formed the basis of their care plan. Although one resident could not remember the arrangements for coming into the home she knew that her daughter had been involved and records examined evidenced this. One member of the care staff spoken to knew about the care needs of residents and was aware of the homes pre-admission assessment procedure. She also confirmed that the owners always discuss the needs of prospective residents prior to admission. The other member of staff spoken to had only been in post for a few weeks and had not yet been involved in the admission procedure. Willan House C53 CO4 S59327 Willan House V213025 180405 Stage 4.doc Version 1.20 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 standard(s) 7,8,9 and 10 Progress has been made in improving care plans to ensure that the health care needs of residents are identified and met. Risk assessments regarding falls are of a good quality, but further development now needs to be carried out in relation to pressure care. EVIDENCE: Individual care plans contain sufficient information to ensure that all aspects of health, personal and social care needs are identified and planned for. Those examined were up to date and showed that residents and/or their representatives have been involved. They also showed appointments made to visit the dentist, opticians and chiropodists. Daily entries are made by care staff and these identified the care given. Risk assessments regarding falls have been drawn up, however, risk assessments regarding pressure care should now be developed where necessary and a risk assessment should also be written for one resident who uses an electric wheelchair. One resident spoken to was able to describe his care needs and these were clearly identified in his care plan. Both staff spoken to were aware of residents needs and said that they are kept informed of all changes by the owners. Willan House C53 CO4 S59327 Willan House V213025 180405 Stage 4.doc Version 1.20 Page 10 Staff responsible for the administration of medication have received training, although this was undertaken before the present owners took over. An update in medication training is currently being arranged. The manager draws up the insulin for one resident to administer himself and the resident told the inspector that he is very satisfied with this arrangement. However, the manager should formalise and record the reviews held with the district nurse regarding this procedure. Four residents comment cards were received and all had ticked the box identifying that staff treat them well and that their privacy is respected. One resident spoken to said that she feels ‘very well looked after’ and another said that ‘staff are very respectful’. Willan House C53 CO4 S59327 Willan House V213025 180405 Stage 4.doc Version 1.20 Page 11 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) 13 and 15 Relatives and friends of residents are made welcome in this home. Meals are well managed and reflect resident’s likes and dislikes. EVIDENCE: A number of people living in the home were spoken to and everyone who commented on the food said how good it was. Menus were inspected and found to be balanced with flexible mealtime arrangements. Care plans evidence resident’s likes and dislikes and dietary requirements. No visitors were seen during the inspection, however, three relative/visitors comment cards were received and these stated that they are ‘always made to feel welcome in the home in a friendly homely manner’. Residents also said that they are able to see their visitors when they want and in privacy and can choose not to see a visitor. They also said that they have the opportunity to be involved in local community groups if they choose and frequently visit the library. One resident attends a weekly luncheon club run by Age Concern. Willan House C53 CO4 S59327 Willan House V213025 180405 Stage 4.doc Version 1.20 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 standard(s) 16 and 18 The home takes the issue of addressing complaints very seriously and residents are confident that their concerns will be listened to and acted upon. There is a complaints procedure for residents and/or their relatives to follow. EVIDENCE: The home has a detailed complaints procedure and this is given to all prospective residents and their relatives/representatives. No complaints have been received by the CSCI or the home since the last inspection. The home uses the Lincolnshire County Council Adult Abuse procedure and the revised version was available. One resident said that he ‘knows the complaints procedure and would dial CSCI straight away’. Another resident said that her daughter would deal with any complaints. All residents spoken to confirmed that the owners are available and approachable. The senior carer on duty said that she was aware of the ‘Whistle Blowing’ policy and confirmed that she had received training and was clear on her reporting responsibilities. Willan House C53 CO4 S59327 Willan House V213025 180405 Stage 4.doc Version 1.20 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 standard(s) 19 Residents living in this home live in a safe and comfortable environment. The standard of the environment is good with the home continuously improving the decor on a planned basis. EVIDENCE: The present owners have now been registered for almost one year, within this period they have made considerable progress in improving the surroundings for residents living in the home. This has included creating a safe outside area to include a pond, patio, and path suitable for residents using wheelchairs or walking frames to access; redecoration and refurnishing of four bedrooms, ensuring water temperatures are safe by installing thermostatic values to outlets and purchasing a digital bath tap. Replacing the flooring in three ground floor toilets and purchasing a new fridge, freezer and washing machine. Two bedrooms were seen and these were bright and comfortable and showed evidence of residents own possessions. During the day one resident was having a telephone line connected. Willan House C53 CO4 S59327 Willan House V213025 180405 Stage 4.doc Version 1.20 Page 14 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) The above standards were not inspected on this occasion. EVIDENCE: Willan House C53 CO4 S59327 Willan House V213025 180405 Stage 4.doc Version 1.20 Page 15 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) The above standards were not inspected on this occasion. EVIDENCE: Willan House C53 CO4 S59327 Willan House V213025 180405 Stage 4.doc Version 1.20 Page 16 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3
COMPLAINTS AND PROTECTION 3 x x x x x x x 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 x x x x x x x x Willan House C53 CO4 S59327 Willan House V213025 180405 Stage 4.doc Version 1.20 Page 17 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 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. 1. 2. 3. Refer to Standard 7 8 8 Good Practice Recommendations A risk assessment should be deveolped for one resident using an electric wheelchair. The manager should involve the services of the tissue viability nurse advisor for information relating to presseure care. The manager should formalise and record the review held with the District Nurse regarding the process for administering insulin medication to one resident, showing that the Nurse retains overall responsibility for the arrangement. Willan House C53 CO4 S59327 Willan House V213025 180405 Stage 4.doc Version 1.20 Page 18 Commission for Social Care Inspection Unity House Weaver Road off Whisby Road Lincoln LN6 3QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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