Inspection on 23/04/09 for Willow Green Care Home

This inspection was carried out on 23rd April 2009.

CQC found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Willow Green Care Home 10/03/08

Similar services:

22 Sandown Road

The Highlands

Turret Villa Retirement Home

Dilston College Of Further Education

West View House

Moor House

Prince Bishop Court

Park View (15)

Extracts from inspection reports are licensed from CQC, this page was updated on 10/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Willow Green Care Home Eastbourne Road Darlington County Durham DL1 4ER     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Tanya Newton     Date: 2 3 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 23 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: Willow Green Care Home Eastbourne Road Darlington County Durham DL1 4ER 01915652294 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: St Martins Care Ltd care home 63 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia learning disability old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 63 The registered person may provide the following category of service only: Care Home with Nursing, Code N To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old Age, not falling within any other category - Code OP, maximum number of places 63 Dementia, Code DE, maximum number of places 63, Learning Disability Code LD, maximum number of places 11 Date of last inspection 63 11 0 Over 65 0 11 63 Care Homes for Older People Page 4 of 23 Brief description of the care home Willow Green is a purpose built nursing home in Darlington owned by St Martins Care Ltd. The home provides nursing care to 63 older people. Some of these people may also require dementia care. It is set in specious well maintained grounds, with ample car park facilities. Care Homes for Older People Page 5 of 23 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: An unannounced visit to the home was carried out on the 23rd April 2009. Prior to the visit the home were asked to complete an annual quality assurance assessment (AQAA) which provides us with information about the service. Time was spent talking to the manger, the staff, people living at the home and visitors. Records were looked at and a tour of the home was taken. Care Homes for Older People Page 6 of 23 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 23 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 23 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are properly assessed prior to them being admitted to the home. Evidence: Each person living at Willow Green is given a contract of residence which sets out the key terms and conditions offered by the home. The contract needs to be updated as it states that CSCI must carry out 2 inspections of the home each year. This information is factually incorrect. The care plans viewed, showed that comprehensive pre-admission assessments had been carried out before people moved into the home. This ensures that the home is able to meet the persons needs. Assessments from the local placing authority were also available. People are invited to visit and spend time at the home prior to moving in. The home does not provide intermediate care. Care Homes for Older People Page 9 of 23 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples dignity, health and personal care needs may not always be being fully recorded or met by staff working at the home. Evidence: Five care plans were viewed during the inspection. Care plans set out the way in which people want their health and personal care needs to be met. Care plans were at varying levels. The home is in the process of updating care plans onto a new format and those which had been updated were far more comprehensively written. Some of the care plans needed to contain further detail, for example some people were on complan shakes following a nutritional assessment but this information had not been included within their individual plan of care. Bed rail assessments were not based on the MDA guidance so the home were told that these required updating. There was evidence of the involvement of specialist health care people which included speech and language, physiotherapist and occupational therapy input. Prior to this inspection being carried out an annual service review was conducted, comments from people living at the home raised concerns about how their health and personal care needs were being addressed. In response to this the home has since implemented handover Care Homes for Older People Page 10 of 23 Evidence: sheets for staff to record baths, food and fluid intake. The home is also carrying out monthly falls analysis. Medication systems were viewed, all medication is administered by a qualified nurse. A new thermometer was required for the drug fridge so that daily temperatures could be recorded and a lock is required on the stock drug cuboard upstairs. Systems for ordering, administering and recording medication were working well. Some issues regarding peoples privacy and dignity were raised. One person said that they had been told not to ring the bell during the night, this was passed to the manager to investigate. Other issues around peoples dignity had been raised in comment cards, the manager was advised to carry out some additional training for staff to address the issues raised. Care Homes for Older People Page 11 of 23 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The social and recreational needs of people are well catered for and people are supported to make daily choices and decisions. Evidence: The home employs an activities co-ordinater who arranges a programme of events at the home. Activities include arts and crafts, karaoke, bingo, hand and nail care, foot massage and trips out to the shops and the park. On the day of the inspection an entertainer was booked for the evening and a pie and peas supper was arranged. A list of the weekly activities was displayed on notice boards within the home. Comments from people living at the home included I spend a lot of time in my room, but thats my choice, I enjoy my books and my TV and I do all my own shopping, I go out alone, I am able to please myself. Visitors were observed coming in and out of the building throughout the day. Comments from visitors include, I spend hours in the home every day, I am made very welcome and offered a meal and I can visit at any time. People were asked if they could make choices and decisions at the home, some of their comments included, I choose when to get up and go to bed, I am a free spirit and I am able to please myself and I can have a shower or a bath when I want and I can choose what I want to eat. Care Homes for Older People Page 12 of 23 Evidence: Everyone said that the food was good, and a choice of meals was offered. People can choose to eat their meals in the communal dining area or in the privacy of their rooms. Comments about the food included, the food is very good here and meals are very good, you get a choice. People were supported during mealtimes where this was needed and specialist diets are catered for by the home. Care Homes for Older People Page 13 of 23 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints and adult protection matters are not always dealt with effectively by the home. Evidence: Although the home does have a complaints procedure in place it is not always being used. Complaints are not generally being recorded and there is no record of any action taken when a complaint has been made. Three complaints were raised during the inspection, two by relatives and one by a person staying at the home. The manager must ensure that complaints are dealt with appropriately so that people living at the home can be confident that any concerns raised will be addressed. Comments from people included,I could tell someone if I had a problem and I have raised concerns previously, they have always been actioned. Feedback in comment cards was mixed, some people said they knew how to complain, others did not. The home has clear polices around safeguarding to support staff if any allegations are made. Staff have received training in the protection of vulnerable adults, and staff spoken to during the inspection, said they would have no hesitation in whistle blowing (telling someone) if they saw or heard something inappropriate. Care Homes for Older People Page 14 of 23 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is furnished and decorated to a high standard. Standards of cleanliness need to be monitored to ensure that they remain high. Evidence: The communal areas are furnished and decorated to a high standard. Prior to the inspection a number of negative comments had been made regarding poor standards of cleanliness within the home, however this was not observed to be the case on the day of the inspection. Previous concerns had been raised about standards of cleanliness in bathrooms and in the dining area at tea time. Some people said that their rooms were not cleaned frequently enough and that their clothes were not put away properly. Others said that staff keep their room clean and tidy. The manager said that she had employed an additional domestic staff member to work on an afternoon between 2:30 and 6:30 pm to help to overcome any problems with cleanliness in the home. A concern was raised about staff using the same gloves to carry out personal care tasks and to handle food. There was no evidence to substantiate this, however the manager was advised to purchase different coloured gloves for each of these tasks. Care Homes for Older People Page 15 of 23 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that staff are trained and on duty in sufficient numbers to meet their assessed needs. Evidence: There were thirty-one people resident at the home on the day of the inspection. The home has five care staff on duty downstairs and four on duty upstairs throughout the day. There are two nurses on duty throughout the day as well as the manager and deputy manager. During the night there are two carers and a nurse on duty. The staff spoken too during the inspection said that staffing numbers were sufficient. Staff recruitment files were looked at. They all contained completed application forms and two written references. The files showed that satisfactory Criminal Record Bureau (CRB) police checks were being carried out. The manager makes sure that staff have the necessary training. This includes an induction when people begin work and a range of other training courses to ensure that staff can care for people properly. There is a high commitment to NVQ training with 21 of the 30 staff having achieved and NVQ at level 2 or 3. Care Homes for Older People Page 16 of 23 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and run. Systems to gain feedback from those living at the home would benefit from further development. Evidence: The manager has the qualifications and skills to manage the home effectively. Staff said that they were well supported and that they could go to the manager if they had any concerns. Systems to manage peoples personal monies were viewed. The home does not act as an appointee and accurate records are maintained for any monies held. Quality assurance systems were looked at. The operations manager visits the home and carries out audits, to make sure that the home is operating to company policy. The manager holds meetings on a quarterly basis for care staff and for the qualified nurses. Meetings are also held for people living at the home. Relative meetings have been advertised but attendance to them is very poor. The home should develop additional ways to gain feedback from those living at the home, other health Care Homes for Older People Page 17 of 23 Evidence: professionals who visit, relatives and staff. Suggestions for gaining additional feedback included the use of a newsletter and surveys. Health and safety systems were looked at. Health and safety checks are carried out on a regular basis and appropriate records are maintained. Staff have basic health and safety training. These measures make sure that the health, safety and welfare of people living and working at the home is promoted. Care Homes for Older People Page 18 of 23 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 19 of 23 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 Care plans which have not 31/07/2009 been updated on to the new format need updating. The home must ensure that care plans reflect fully the way in which the home will meet peoples health and personal care needs. Care plans need to contain up to date information so that staff can meet peoples needs effectively. 2 8 12 Accurate documentation 18/06/2009 must be maintained so that the home can monitor the way in which peoples health and personal care needs are met. To ensure that peoples health and personal care needs continue to be fully met by the home. 3 9 13 A new thermometer was required for the drug fridge so that daily temperatures 18/06/2009 Care Homes for Older People Page 20 of 23 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action could be recorded and a lock is required on the stock drug cuboard upstairs. To ensure the safekeeping of medication within the home. 4 10 12 The manager must ensure 18/06/2009 that at all times the home is run in such a way that the privacy and dignity of service users is maintained. Staff may benefit from some additional training in this area. To ensure that privacy and dignity issues are maintained at all times. 5 16 22 The complaints procedure must be followed for all complaints and an accurate record of any action taken must be maintained. The home must be able to demonstrate that they are dealing with complaints effectively. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 18/06/2009 1 2 The contract should be updated as it states that CSCI must carry out 2 inspections of the home each year. This information is factually incorrect. Care Homes for Older People Page 21 of 23 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 2 3 26 26 Different coloured gloves should be available for personal care and food handling tasks. The manager should carry out regular checks on the environment to ensure that standards of cleanliness are maintained. Additional quality assurance systems should be developed, so that the views of those living at the home, their relatives and other stakeholders can be sought. 4 33 Care Homes for Older People Page 22 of 23 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 23 of 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!