Inspection on 30/11/07 for Willow Gardens Care Home

This inspection was carried out on 30th November 2007.

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.

Other inspections for this house

Willow Gardens Care Home 28/08/08

Willow Gardens Care Home 30/08/06

Willow Gardens Care Home 15/02/06

Willow Gardens Care Home 21/04/05

Willow Gardens Care Home 29/11/04

Willow Gardens Care Home 02/06/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Willow Gardens Care Home St Edmonds Road Bootle Liverpool Merseyside L20 7AJ Lead Inspector Ms Lorraine Farrar Unannounced Inspection 30th November 2007 11:00 X10029.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 Willow Gardens Care Home DS0000059852.V348050.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 and 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. Willow Gardens Care Home DS0000059852.V348050.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Willow Gardens Care Home Address St Edmonds Road Bootle Liverpool Merseyside L20 7AJ 0151 922 4324 0151 922 7437 willow@europeanwellcare.com 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) European Wellcare Homes Ltd ** Post Vacant *** Care Home 46 Category(ies) of Old age, not falling within any other category registration, with number (22), Physical disability (24) of places Willow Gardens Care Home DS0000059852.V348050.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2 named female out of category service users, under pensionable age. The variation applies to the named service users only, should they leave the Home then the variation will cease to apply. Not accommodated in Willow View Unit. The age range between service users in the Willow View Unit should be no more than 25 years . Service users to include up to 22 OP(N) Service users to include up to 24 PD to be accommodated within the unit known as Willow View. Bedroom number 24 to accommodate one named PD service user to be reviewed on the 01/06/06 One named service user accommodated on the unit known as Willow View. To be reviewed on 01/06/06 30th August 2006 2. 3. 4. 5. 6. Date of last inspection Brief Description of the Service: Willow Gardens is situated in the Bootle area of Liverpool. It provides care with nursing for up to twenty two older people and twenty four younger adults with disabilities. The building is purpose built and provides accommodation over two floors. The unit for younger adults is on the top floor with accommodation for older people mainly provided on the ground floor. The younger adults unit is referred to as Willow View and has separate facilities and staff to the older persons service. All bedrooms are single rooms with many providing en-suite facilities and all having sinks. There are gardens to the rear and sides of the home that provide space for people to sit outside in good weather. These are easily accessible from the large ground floor lounge. The home is privately owned and the company has a variety of other homes within the UK. They provide care for people with a wide range of differing needs. There is a shopping centre near to the home and public transport system nearby. There are also some care parking facilities available at Willow Gardens. Willow Gardens Care Home DS0000059852.V348050.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Information for this inspection was gathered in a number of different ways. This included an unannounced site visit where time was spent reading records, talking with the people living there and staff, observing life in the home and looking at the building. ‘Case tracking’ was used as part of the visit. This involves looking at the support a person gets from the service including their care plans, medication, money and bedroom. Case tracking was used to look at life in the home for three of the people living there. Discussions took place with eight of the people living there and six members of staff. In addition comment cards were sent out before the visit, seven of the people living there, eight of their relatives and two GPs returned these and their views are incorporated within this report. The Manager was given the opportunity to provide information about the service prior to the inspection. This information and any other relevant information the CSCI has received about the service, since the last full inspection in 2006, is included within this report. This includes a random inspection carried out on May 2007. Willow Gardens provides support with nursing to both older people and younger adults with disabilities. Scores at the end of this report relate to how the service meets national standards for caring for older people. The summary, judgements and evidence sections of the report, relate to the overall care provided. Fees for living at Willow Gardens range from £315.50 to 463.50 for older people and £637.40 to £793.13 for younger adults. What the service does well: Before anyone moves into Willow Gardens they are provided with information about the service and as much information as possible is obtained about their needs and choices. This helps everyone to decide if Willow Gardens is the right place for the persons to live. Individual care plans are in place for everyone living at the home and the people living there are aware of their care plans and discuss the contents with staff. Willow Gardens Care Home DS0000059852.V348050.R01.S.doc Version 5.2 Page 6 There are a number of activities available for people to take part in both within the home and the wider community. Peoples told us that they “like living here” and that they decide how to spend their time. They also told us that they are offered choices around mealtimes. Regular residents meetings are held so that people can express their views, they are also kept informed of any changes to the home and how it operates. People are provided with support to meet their personal and health care needs and told us that they never wait long if they request help. The building is warm and clean with plenty of space for everyone. The people living their have aids and adaptations to meet their mobility and health needs and are able to personalise their bedrooms as they choose. There are sufficient staff to meet peoples needs and the people living there told us that staff listen to what they say and that they get on well with them. What has improved since the last inspection? What they could do better: The service needs to ensure that when someone’s support needs change this is written in their care plan as well as review. This will help to make sure that everyone is aware of the persons support needs and how to meet them. Senior staff need to monitor the way in which records are written to ensure that they are appropriate and respect peoples right to dignity. When anyone is cared for in their bedroom, clear recording of reasons why their bedroom door is left open must take place, this will help to ensure the persons dignity and privacy as well as their safety are taken into account. Willow Gardens Care Home DS0000059852.V348050.R01.S.doc Version 5.2 Page 7 Senior staff also need to ensure that if a person living at the home has different needs to others based on their culture they do everything they can to cater for the person and ensure they and their representatives feel as informed as possible about the service and as emotionally comfortable as possible living there. Parts of the environment look shabby or clinical and would benefit from a planned approach to improving these areas. Records relating to recruitment checks for staff and the way residents monies are managed need to be available in the home. This will help to provide clear audit trails to ensure that people are being supported by suitable staff and that their money is managed safely on their behalf. 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. Willow Gardens Care Home DS0000059852.V348050.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Willow Gardens Care Home DS0000059852.V348050.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): 3 & 6 – Older people 2 –younger adults. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sufficient information is obtained about and provided to people considering moving into the home to ensure the service is suitable for them and can meet their needs and choices. EVIDENCE: The people living at Willow Gardens all said in their comment cards that prior to moving into the home they received enough information about the service to help them decide if it was the right place for them to live. Willow Gardens Care Home DS0000059852.V348050.R01.S.doc Version 5.2 Page 10 A relative of one of the people living there explained, “The carers are really friendly and made (my relative) feel at home when she had concerns about going to a nursing home, she has a good relationship with them all and enjoys being there”. Records showed that before people are offered a place at Willow Gardens as much information as possible is obtained about their support needs and choices. A copy of their social services assessment is obtained and where possible staff meet with the person and others involved in their care and carry out an assessment of their needs and choices. This is comprehensive and covers the persons physical and mental health needs as well as their hobbies and they way they communicate. This information helps to ensure that before someone moves into the home they can be confident the service can support them in the things they need and prefer. Willow Gardens does not provide an intermediate care service. Willow Gardens Care Home DS0000059852.V348050.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 older people 6, 9, 18, 19 & 20 younger adults. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Peoples’ health and personal care needs and choices are identified and met by the staff team. However more consideration of peoples right to dignity at all times would further enhance the support they receive. Willow Gardens Care Home DS0000059852.V348050.R01.S.doc Version 5.2 Page 12 EVIDENCE: The people living at Willow Gardens all said in their comment cards that they receive the support they need with their personal and health care. A relative of one of the people living there commented, “my (relative) is very well looked after” and Gp’s said that peoples health care needs are met by the service and that their privacy is respected, with one commenting, “Patients always seen in a private room with staff to help”. Everyone living at Willow Gardens has an individual care plan in place. These include assessments of the person’s health care needs such as their nutrition, moving and handling needs and their pressure areas. They also include guidance for staff on the support the person needs and how this is to be provided. Plans are reviewed regularly and the person is involved as much as possible in the contents. However the information available in care plans is variable. One care plan had been updated monthly, however when first written in 2004 the guidance states that the person is independent with their personal care, whilst a review in 2007 states that they need support. The guidance in the care plan had not been altered to reflect this change in the persons support needs. It is important that plans are updated when the review shows the persons needs or choices have changed to ensure that all staff are aware of how to support the person correctly Other care plans contained well written information about the person with clear guidance on how to support them and clear information about their choices and chosen lifestyle. The way in which records relating to the people living at Willow Gardens are written is not always factual or respectful. For example records for one person state that they “can be like a child at times” and states they are “wetting” themselves”. It is not only undignified to describe an adults as being like a child it also demonstrates a lack of insight into their support needs and may impact on the way in which people interact with the person. The people living at Willow Gardens said that if they need support this is provided for them. One person explaining, staff taught me to stand up and walk about, now I do it myself” and another that “you couldn’t get better”. People also said that if they use their call buzzer staff respond quickly, this was noted during the site visit when call buzzers were answered within a couple of minutes. Willow Gardens Care Home DS0000059852.V348050.R01.S.doc Version 5.2 Page 13 During the site visit one of the people living there was being cared for in their bedroom in order to meet their health needs. The bedroom door was left open and staff explained this was so they could check how the person is when walking past. However this information was not recorded in the person’s plan and needs to be considered along with their right to privacy and dignity as well as any safety issues. Throughout the site visit staff were seen to knock before entering people bedrooms and to speak to people appropriately and respectfully. Willow Gardens provides separate storage rooms for peoples’ medication. These are clean and tidy with medication stored correctly. Records for medication were signed when given and were clear. Of the records checked one person’s medication had not been counted on receipt and the amount received recorded. This means there is no clear audit trail to check the person is receiving their medication correctly at all times. Willow Gardens Care Home DS0000059852.V348050.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 – OP 12,13,15 & 17 - YA Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People are generally supported to live a lifestyle of their choosing and are consulted about how they want to do this. However more consideration needs to be given to people whose individual culture differs from the majority of people living there. Willow Gardens Care Home DS0000059852.V348050.R01.S.doc Version 5.2 Page 15 EVIDENCE: The people living at Willow Gardens said in their comment cards that there are always activities arranged that they can take part in and a relative explained that the, “Eucharistic ministers conduct a service once a week and the priest comes once a month and conducts the service which is important to my Mum” Willow Gardens employs a full time activity coordinator to work with the younger adults living there and a part time activities coordinator to work with the older people. In discussion with one of the activities coordinators she explained that arranged activities can be joined in with by anyone living at the home. Regular activities include trips to eat out and to a local community cinema event, activities at home include gardening and art as well as entertainers, bingo and quizzes. One of the people living their explained that they are always asked if they want to join in and another that staff help them daily with exercises and that they enjoy going out food shopping regularly. One person living at Willow Gardens and their relatives speaks a different language to English. No information had been provided in their first language although the company has the facilities to do this. Under meeting the persons religious needs their plan recorded “soft music”. There was no evidence that efforts had been taken to provide familiar things for the person to listen to. This could lead to people having little or no understanding of how the home operates and could have a negative impact on the persons well being. Regular meetings are held with the people living in at Willow Gardens. Records how that their opinions are listened to and that as well as discussing everyday issues such as meals and activities they are also kept informed about hw the home operates. In their comment cards people had various opinions of the meals provided with some people saying they always like them, others usually and one person only sometimes. However during the site visit the new head chef explained that following a meeting with the people living their menus had been recently reviewed. Comments during the site visit about meals were positive, with one person explaining, “the foods nice here especially the breakfasts”. Everyone spoken with said that they are offered a choice of meals and can have something different if they want. Willow Gardens Care Home DS0000059852.V348050.R01.S.doc Version 5.2 Page 16 Afternoon drinks were observed being served in the younger adults unit. This was brought up from the main kitchen and although staff took the time to chat with people and ensure they got the drinks and adapted cups they needed it could be quite disruptive to the afternoon with the trolley being noisy and peoples chosen activities disrupted. As there is a kitchen for use by the people living on the unit it may increase their independence more if they were supported to make their own drinks. A review of menus showed that on some days the planned menu offers only one opportunity to eat fruit or vegetables. As the government guidance is that people should eat at least five portions daily this means people may not be getting the opportunity to eat a healthy diet, which could impact on their health and wellbeing. Willow Gardens Care Home DS0000059852.V348050.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 – OP 22 & 23 - YA Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The people living at Willow Gardens are confident that any concerns they have will be listed to and acted upon. A lack of detailed records relating to concerns may impact on the homes ability to monitor these and response appropriately in the future. EVIDENCE: In discussions with fourteen of the people living at Willow Gardens during a random inspection visit in May 2007 they all said that they know how to raise any concerns or complaints. This was repeated on comment cards received before this site visit, with comments from the people living there including, “I would go to the office”. A relative commented, “I don’t have any concerns about the care (my relative) receives. He is looked after with a great deal of kindness and respect”. Information about how to raise a concern or complaint is displayed in the foyer and made available to people and their relatives via a brochure given to them when they move into the home. Willow Gardens Care Home DS0000059852.V348050.R01.S.doc Version 5.2 Page 18 A record of any concerns or complaints is kept at Willow Gardens, this showed that serious concerns are dealt with by the organisation and less serious concerns by senior staff at the home. However details of how investigations are carried out were not always clear. Therefore it is may not be possible to establish if the correct actions were taken in response to a concern. There are polices and procedures within in the home for dealing with any allegations of abuse and staff have received training in this area. Willow Gardens Care Home DS0000059852.V348050.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 – older people 24 & 30 – younger adults. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Willow Gardens provides an environment, which meets the needs of the people living there. However parts of the home appear clinical in appearance and do not prompt a homely atmosphere. Willow Gardens Care Home DS0000059852.V348050.R01.S.doc Version 5.2 Page 20 EVIDENCE: The people living at Willow Gardens said in their comment cards that the home is always fresh and clean and this was observed during the site visit. The home is purpose built and provides everyone with single bedrooms fifteen of which are en-suite, the remainder having sinks. Bedrooms were clean, tidy, and individually decorated. Some downstairs bedrooms overlook the car park and do not have any nets or blinds for daytime use. One of the people living there said she would like net curtains to help provide more privacy. There are sufficient baths, toilet and living areas throughout the home. However the shower room for younger people shares its space with two toilet cubicles. The use of toilet cubicles with walls that do not fit floor to ceiling is neither homely nor dignified and should be reviewed. A bathroom on the older persons unit had a five litre shower and hair gel stored in the shower cubicle for use by the people living there, stained grout and no window coverings. Although the glass is obscure this contributes to an overall clinical appearance. Several aids and adaptations are in place to support people. These include, hoists, grab rail, a lift, adapted baths and a walk in shower. There are two small lounges and a kitchen on the younger disabled unit. The kitchen has been adapted for use by people with a physical disability. One of the lounges is furnished in a homely manner and looks welcoming and inviting. The other lounge has chairs, which appear institutional, and does not appear as welcoming. Downstairs there is a dining room for use by the older residents and a large lounge. This was being decorated during the site visit and the acting manager advised the views of the people living there as to colour schemes had been taken into account. As well as décor new curtains and carpet were planned. It was unclear as to whether new chairs were being provided. At the time of the site visit there were six different colour chairs for this room, which may give it a shabby appearance. Outside there are gardens wrapped around the home which are nicely maintained and provide places to sit as well as areas for people to take part in caring for plants and vegetables if they wish. Willow Gardens Care Home DS0000059852.V348050.R01.S.doc Version 5.2 Page 21 A member of staff explained that linen supplies are monitored by the company to ensure there are always sufficient supplies available. However some towels for use by the people living at the home were seen to be frayed or have holes in them. Policies are in place for the control of infection in the home and appropriate, disposable equipment is provided. A visit to the laundry room showed that infection control polices are carried out and staff are provided with the equipment they need to help prevent an outbreak of infection. Willow Gardens Care Home DS0000059852.V348050.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 – older people 32, 34, 35 – younger adults. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are sufficient staff working at Willow Gardens to meet the needs of the people living there. EVIDENCE: The people living at Willow Gardens said in their comment cards that staff are always or usually available when needed and that they listen and act upon what they say. A relative commented that “The staff do a good job and are always friendly and there is always someone to talk to”. During the site visit one of the people living there explained, “We get on well with the staff”. Willow Gardens Care Home DS0000059852.V348050.R01.S.doc Version 5.2 Page 23 Staff were observed to spend time talking with people and to understand their needs and their choices. However on the younger adults unit one member of staff was heard singing and talking very loudly to another member of staff. This was disruptive and is not appropriate in peoples home. There were sufficient staff working to response quickly to requests for support and to spend some time talking and engaging in activities with people. Records show that over half the staff team have obtained a qualification in care and other staff are working towards this. This helps to ensure staff have a good understanding of their role and how to support people in line with good practice and health and safety guidance. Training records for staff showed that they undertake basic care courses as well as more specialist training in area such as supporting people who have a learning disability or dementia. Records were examined for four members of staff. These did not contain evidence that all required checks on staff are carried out. For example one file had only one written reference and another had no information to show that a Criminal Records Bureau (CRB) check had been carried out on the person. It is important that all required checks are carried out and documented in order to establish as much as possible that the person is suitable to work within a care environment. Willow Gardens Care Home DS0000059852.V348050.R01.S.doc Version 5.2 Page 24 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 – older people 37, 39 & 42 – younger adults. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Management systems within the home are sufficient to ensure peoples wellbeing and plan some improvements. However detailed recording is not always provided to ensure systems are monitored and audited regularly. Willow Gardens Care Home DS0000059852.V348050.R01.S.doc Version 5.2 Page 25 EVIDENCE: At the time of the site visit there was no registered manager working at Willow Gardens, however a new manager had been recruited and has since commenced work at the home. The deputy manager was acting manager at the time of our visit. He has experience of management within a care setting and is a registered nurse. He was also receiving support from other managers within the organisation. During the site visit he displayed a knowledge of the support needs of the people living at Willow Gardens as well as knowledge of how the home operates and its polices and procedures. There are several systems in place within the home to check on the quality of the service provided. This includes a senior manager from the organisation visiting the home monthly and carrying out a series of checks. These visits include discussions with the people living and working at Willow Gardens as well as checks on records and medication. Following the visit clear reports are provided along with any actions needed to improve the service. Regular residents meetings are held and files showed that twice a year the people living at Willow Gardens are asked to complete a questionnaire in which they can inform the home about the things they are satisfied with and any improvements they would like to see. This is good practice as it gives people the opportunity to air their views, however there was no formal record of responses to any points raised or evidence that the survey results are audited to see if there are any common comments or views. A sample of records and monies held in the home for people were checked during the site visit, these were clear and tallied. However the organisation act as appointee for some peoples’ benefit money and little information is available within the service regarding this. A member of staff from the company head office explained on the phone that money they hold for people living there is kept in a designated residents account, their benefits are paid into this weekly and there is an external audit carried out each year. However although a verbal request was made that evidence of this was forwarded to the CSCI this has not been provided. Without clear records in the home it is difficult for anyone, including the person or their representative to access and audit the way their money is managed and ensure it is handled correctly. Records showed that regular health and safety checks are carried out to ensure the building and equipment are safe for people to use. Willow Gardens Care Home DS0000059852.V348050.R01.S.doc Version 5.2 Page 26 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 X 2 X 3 3 4 X 5 X 6 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 ENVIRONMENT Standard No Score 19 2 20 X 21 X 22 X 23 X 24 X 25 X 26 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 2 32 X 33 2 34 X 35 2 36 X 37 X 38 3 Willow Gardens Care Home DS0000059852.V348050.R01.S.doc Version 5.2 Page 27 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. 1. Standard OP7 Regulation Requirement Timescale for action 30/01/08 15(1)(a)(2)(b) Care plan guidelines must be updated as peoples needs alter. This will ensure that all staff are aware of the support they need to provide. The assessment process must include information on any different needs people have due to their culture and must ensure the service can meet those needs. All staff files must be audited to ensure they contain evidence that appropriate checks have been carried out on the person. This will help to ensure everything possible has been done to ensure the persons suitability to work within a care environment. 2. OP14 14(1)(a)(c) 30/01/08 3. OP29 19(1)(b) Schedule 2 14/02/08 Willow Gardens Care Home DS0000059852.V348050.R01.S.doc Version 5.2 Page 28 4. OP35 17(2) schedule 4(9) Information about how peoples’ money is managed by the organisation must be documented and available within the home. This must include information on how the person can access their financial records quickly if they wish to do so. This will help to ensure people’s money is managed safely and in their best interests. 14/02/08 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 OP10 Good Practice Recommendations 1) The way in which records regarding the people living at Willow Gardens are written should be reviewed to ensure it is appropriate. 2) The practice of leaving bedrooms doors open to check on people should be documented and reviewed. This will help to ensure peoples privacy and dignity are taken into account at all times. 2. OP15 1) The diet available to people should be reviewed to ensure people can choose a healthy diet at all times. 2) The practice of drinks being serving via the main kitchen to the younger adult unit should be reviewed. This will help to ensure people are supported to be as independent as possible. 3. OP16 Full and accurate records of investigations into any concerns raised should be maintained within the home. This will provide a clear audit and monitoring trail. Willow Gardens Care Home DS0000059852.V348050.R01.S.doc Version 5.2 Page 29 4. OP19 An audit of the environment should be carried out to ensure it is as welcoming and comfortable as possible for the people living there. Comments received from the people living at Willow Gardens as part of the company’s quality assurance should be formally responded to and collated. This will help to identity any themes and ensure people are aware of the company’s response to any issues they have raised. 5. OP33 Willow Gardens Care Home DS0000059852.V348050.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection North West Regional Contact Team Unit 1, 3rd Floor Tustin Court Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries.northwest@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. Willow Gardens Care Home DS0000059852.V348050.R01.S.doc Version 5.2 Page 31 - 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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