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Inspection on 04/10/06 for Willow Brook House
Also see our care home review for Willow Brook House for more information
This inspection was carried out on 4th October 2006.
CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.
The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.
What follows are excerpts from this inspection report. For more information read the full report on the next tab.
What the care home does well
There are some very committed staff that are keen to provide a good standard of care for residents. Although staff were under a great deal of pressure due to the low staffing levels on the day of inspection they were working hard to minimise the impact of this on residents. Staff were courteous and friendly in their approach to residents. Residents spoken with during the inspection were happy with the staff team. There is a varied activities programme, which is continuing to be developed. Some alterations to the timing of a bingo session were made at the request of residents on the day of inspection. Visiting arrangements are flexible and relatives were able to visit in private. The home was clean, comfortable and in good decorative order providing a pleasant environment for Residents. Residents were happy with the standards of cleanliness in the home. The majority of the residents spoken with were generally happy with the food.
What has improved since the last inspection?
An activities organiser has been employed and a programme of activities implemented since the last inspection. A requirement was made at the last inspection to provide an action plan detailing how the fire officer`s recommendations were to be implemented. This has now been addressed.
What the care home could do better:
Review of the last inspection report identified that there were no requirements or recommendations made relating to the quality of care provided. The findings of this inspection identifies that there has been deterioration in the standards of care indicating the need for closer monitoring of the care provided. Concerns have been identified in a number of areas though many of them link to staffing levels, staff training and management oversight. There were not enough staff on the day of the inspection to meet the needs of residents and they were waiting for lengthy periods for assistance with washing and dressing and breakfast. For some residents this was around 11am. One resident who had breakfast late was someone who had been identified as losing weight and had been assessed as requiring their food and fluid intake monitored.The care plans, which are tools to guide staff in the care needed by each individual, did not always fully reflect residents` needs. For example there was no information to guide staff in the best way to deal with a resident who is sometimes verbally and physically aggressive. In other cases care plans, were reflective of residents` current needs, having been reviewed recently but were not being followed. An example of this was reference to a menu that was to be set up for a resident who was losing weight. Staff were not aware of this menu and were not carrying out the regular food and fluid monitoring which was required. Some discrepancies were found with medication and advice was given to consult the General Practitioner regarding instructions about the need to check pulse rates prior to administration of a particular medication. Staff appeared to be keen to do additional training however it was identified that training in meeting residents` specific needs has not been provided. For example, diabetes. Dementia training and guidance was identified as being necessary for staff working on the dementia care unit who acknowledged that their knowledge was limited leaving them not able to meet residents` needs fully. There is a complaints procedure in place, which involves the complainant completing a complaints form. However it was identified that concerns/complaints are often raised verbally with staff on duty and that there is no record of these. Discussion with staff indicated that relatives have regularly been raising concerns about staffing levels or care issues, which can be linked back to them. A recommendation has been made to implement a system for recording verbal complaints to provide indicators of areas where improvements are required. There was no evidence of references being taken up prior to a member of staff starting work in the home, which potentially could put residents` at risk. Some outstanding maintenance issues were identified such as no hot water from nine outlets, mainly en-suite bathrooms, electrical wiring checks overdue and the dishwasher had been out of action for seven weeks.