Inspection on 18/10/06 for Willowbrook

This inspection was carried out on 18th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Willowbrook 20/02/06

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

CARE HOME ADULTS 18-65 Willowbrook Willow Crescent Oakham Rutland LE15 6EH Lead Inspector Irene Miller Unannounced Inspection 18th October 2006 11:00 Willowbrook DS0000066433.V316472.R01.S.doc Version 5.2 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 Willowbrook DS0000066433.V316472.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 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. Willowbrook DS0000066433.V316472.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Willowbrook Address Willow Crescent Oakham Rutland LE15 6EH 01572 771001 01572 771028 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) Rutland House Community Trust Ltd Mrs Yvonne Carol Shewring Care Home 10 Category(ies) of Learning disability (10), Physical disability (10) registration, with number of places Willowbrook DS0000066433.V316472.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Care Home will provide personal care to service users who fall within the following service user categories; Learning Disability (LD), Physical Disability (PD). Maximum number registered 10. No person falling within the category PD may be admitted to the home unless that person also falls within category LD ie dual disability. 20th February 2006 2. Date of last inspection Brief Description of the Service: Willowbrook is a care home for people with learning difficulties, some of who also have physical disabilities. The accommodation was purpose built in 1995 and is ground level only. The home has ten single bedrooms, a large lounge/dining room, a ‘quiet’ lounge and a small conservatory and atrium. The home has gardens with seating areas and the administration of the home is undertaken in a separate building located within the grounds. Willowbrook is approximately one mile from the centre of Oakham, which has a range of amenities including a swimming pool, churches, shops, pubs and a library. Willowbrook DS0000066433.V316472.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for Service Users and their views of the service provided. This inspection was a ‘Key Inspection’ that focused on the key standards under the National Minimum Standards and the Care Standards Act 2000 for homes providing care for adults (18-65). The primary method of inspection used was ‘case tracking’ that involved selecting three service users, reviewing their individual care plans (that sets out how the home aims to meet their personal, healthcare, social and spiritual needs), and tracking the care they received. Policies, procedures and records in relation to staffing, quality assurance, medication, general maintenance and upkeep of the home were viewed. Discussion took place with service users and staff and general observations of care practices were made. The inspector spent two hours planning the areas to focus on at this inspection, based upon information gained from reviewing the homes service history, and the last two inspection reports. The inspection took place over a period of approximately six hours. What the service does well: The staff team have a good knowledge of the individual needs of service users and support the service users to achieve their personal goals. The care provided at the home is person centred, and respects the individuality of service users, activities and pastimes were tailored to the service users individual preferences and abilities. There was good communication and support systems in place from the healthcare professions that visit the home, and there was a variety of equipment and aids and adaptations available to promote independence and ease postural discomfort for service users that had a physically disability. Items such as specialist wheelchairs, seating, physiotherapy aids and moving Willowbrook DS0000066433.V316472.R01.S.doc Version 5.2 Page 6 and handling equipment were seen to be in use and there was adapted fittings in place such as a rise and fall sink for wheelchair users. What has improved since the last inspection? What they could do better: 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. Willowbrook DS0000066433.V316472.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Willowbrook DS0000066433.V316472.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2 Quality in this outcome area is good. Information about the home is made available for prospective service users and their families, to enable them to make a decision as to whether the home could meet their needs and aspirations. This judgement has been made using available evidence including a visit to this service. EVIDENCE: One new service user had been admitted into the home since the last inspection visit and through discussion with the staff it was established that in general the admission process follows phased introductory visits to allow new service users time to adjust to their new surroundings and to allow existing service users time to adapt to a new person moving into the home. The homes statement of purpose and service users guide is made available to all prospective service users and their representatives. Assessments of service users needs included specific specialist support required and identified the level of staff support required for the service users to live as independent a life as possible. Willowbrook DS0000066433.V316472.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6,7 & 9 Quality in this outcome area is good. Service users are encouraged and supported in leading as independent a lifestyle as possible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans viewed were person centred, and contained in-depth information on service users individual routines, however information for staff to follow within one of the care plans stated that the service user was to be given medication (through a nebulizer) half hour before their lunchtime meal, through discussion with the staff it was confirmed that this lunchtime medication was no longer being given at the time stated, and therefore the instruction was no longer current. Support systems were in place to provide individual 1-1 support for the service users, through observation it was established that the staff were very skilled in communicating with the service users and with those who were unable to Willowbrook DS0000066433.V316472.R01.S.doc Version 5.2 Page 10 communicate verbally, on speaking with the staff they were very aware of each service users method of non-verbal communication. Through discussion with the staff on duty, it was clear that they had an in-depth knowledge of the individual personalities of each service user. There was a homely atmosphere within the home and the service users appeared relaxed and at ease with the members of staff. Risk assessments had been drawn up for each individual service user dependent upon the social and environmental hazards that posed a specific risk to individuals, there were also generic risk assessments in place that had identified general hazards throughout the home that could pose risks to service users and staff. Willowbrook DS0000066433.V316472.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,15,16 & 17 Quality in this outcome area is good. Service users are enabled to lead fulfilling lifestyles. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Many of the service users attend Oakham day Centre, through discussion with the staff it was established that some service users had been successful in gaining part time paid employment. With support from the day centre staff and the staff from within the home the service users had been active in distributing leaflets and doing garden maintenance work within the local community. On speaking with the staff they said they had noticed how much the self-esteem of the service users had improved since taking up the employment. Willowbrook DS0000066433.V316472.R01.S.doc Version 5.2 Page 12 Through identifying service users individual preferences, leisure and social activities were person centred. Outings hade taken place such as walks out in the countryside, visits to Rutland Water and Rockingham Race Track, and visits to the theatre. One of the service users that the inspector case tracked enjoyed being outside in the fresh air, one of the staff said that the service user “loves to feel the wind in his face”. The service users rights to experience personal relationships, was recognised by the staff and treated with sensitivity and respect. One of the service users case tracked was unable to tolerate any foods or drinks orally and required all foods and drinks to be given through an artificial feeding system, another service user had swallowing difficulties and required foods to be pureed, drinks to be thickened and required full staff assistance with feeding. Through discussion with the staff it was demonstrated that they were fully aware of the dietary needs of all the service users, and that support and advice was provided from a speech and language therapist in meeting the dietary and feeding needs of the service users. Service users that had the capacity were encouraged with staff support to participate in basic food preparation, in the setting up and clearing of the dining tables, and with washing up etc. Willowbrook DS0000066433.V316472.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18,19 & 20 Quality in this outcome area is good. The service users personal and healthcare needs are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The information within the service users care plans for staff to follow was very detailed, however on speaking with the staff it was established that the instruction within one of the care plan in relation to the administration guidelines of a midday medication was no longer current. On speaking with the staff it was established that they were fully aware of the current needs of the service user in this area, and that the information within the care plan required updating. Service users physical and emotional healthcare needs were very closely monitored, there was pressure area care and nutritional risk assessments and treatment plans in place. Willowbrook DS0000066433.V316472.R01.S.doc Version 5.2 Page 14 There was good support from healthcare professionals such as a speech and language therapist, occupational therapist, physiotherapist and a district nurse. Documentation was available to demonstrate that any changes in the service users health were brought to the attention of the appropriate health care professionals and action taken. On the day of inspection a meeting took place between the staff and the district nurse to discuss how the home could continue to meet the healthcare needs of a service user. Service users had full access to healthcare support from their general practitioner, clinical psychologist and records were available of optical, dental and podiatry treatment received. The medication storage and administration records were seen to be in good order, the homes management had acted upon the requirement made by the Commission for Social Care Inspection that all staff receive training on the storage and administration of medication. Staff said that they had found the medication training very informative, copies of the modules covered within the training course were seen and copies of certificates gained by the staff were available to view. Staff said that the pharmacist from the dispensing pharmacy conducts medication audits, however there was no medication audit report available to view. Willowbrook DS0000066433.V316472.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 & 23 Quality in this outcome area is good. There is a complaints system in place for service users and their representatives to raise any concerns or complaints they may have about the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There was a complaints system in place, the Commission for Social Care Inspection had not received any complaints about the home since the last inspection visit taking place Records within the care plans indicated were staff support and intervention was needed to protect service users from potentially abusive situations. Policies and Procedures were in place for the protection of vulnerable adults and staff training was provided on what is abuse and guidance on the reporting procedures should there be any allegations of suspected or actual abuse take place. Willowbrook DS0000066433.V316472.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 & 30 Quality in this outcome area is good. Service Users live in a home that is purpose built, well maintained, clean and homely. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The communal areas and service users personal space was pleasantly furnished. There was specialist seating, pressure relieving and moving and handling equipment in use and there was physiotherapy equipment available for physically disabled service users such as posture aligning floor wedges. Redecoration and refurbishments to the building had taken place and the home looked clean and fresh, however the works had left the home with a strong paint and varnish odour. Staff said that they had endeavoured to eradicate the odour by opening windows (weather permitting). Records of building upkeep such as gas, water and electrical tests were available to view. Willowbrook DS0000066433.V316472.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32,34 & 35 Quality in this outcome area is good. The service users are supported by an appropriately trained and effective staff team. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staffing level at the home was sufficient to meet the dependency needs of the service users living at the home. One member of staff that had recently been appointed and was working under close supervision from two experienced staff. The new member of staff confirmed that they were working through their induction programme, however the staff induction record was unavailable to view as staff take personal responsibility for their induction programme record and in this case it was not held within the home. Through discussion with the staff and observation of care practices it was judged that the service users were being cared for by staff that were skilled within their respective roles and fully aware of the service users needs. Willowbrook DS0000066433.V316472.R01.S.doc Version 5.2 Page 18 Training records demonstrated that mandatory training was provided to all staff such as, food hygiene, fire awareness, first aid, medication and adult protection, and staff were supported in achieving the National Vocational Qualification in care. The requirement made by the Commission for Social Care Inspection that all staff that hold the responsibility of administering medication receive training in the safe handling of medication had been acted upon. Many of the staff team had completed a certificated distance-learning course run by a national awarding body for further education (NCFE). The course was entitled Safer Handling in Medicines. On the day of inspection the registered manager was attending medication training for managers. In addition to statutory training, service user lead training was provided, in areas such as epilepsy, challenging behaviour, physical intervention and nutrition Staff recruitment files viewed demonstrated that staff recruitment and selection procedures were robust. Willowbrook DS0000066433.V316472.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39 & 42 Quality in this outcome area is good. The home is run in the best interests of the service users and their health safety and welfare is protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The building upkeep record-keeping practice was in general good and the administration records seen were up to date and regularly reviewed. Organisational policies and procedures were fully accessible to staff. The service users care plans were very detailed and person centred, although there was some information contained within one care plan that was no longer current, through discussion with the staff it was evident that they had Willowbrook DS0000066433.V316472.R01.S.doc Version 5.2 Page 20 extensive knowledge of the service users individual needs, and their daily routines. Staff said that they enjoy working at the home, and that it caring for the service users was very rewarding. Willowbrook DS0000066433.V316472.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Willowbrook DS0000066433.V316472.R01.S.doc Version 5.2 Page 22 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. 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. Refer to Standard Good Practice Recommendations Willowbrook DS0000066433.V316472.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Willowbrook DS0000066433.V316472.R01.S.doc Version 5.2 Page 24 - 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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