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Inspection on 05/02/09 for Willowdene Care Home

Also see our care home review for Willowdene Care Home for more information

This inspection was carried out on 5th February 2009.

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

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The residents commented positively on the role of the activities coordinator and stated that they enjoy the varied activities that she provides for them. There are good administration and accounting systems in place for handling the residents` finances. The agency provides good training to all the staff, including regular updates on courses like first aid, moving and handling, infection control and fire safety to make sure the staff are up to date with current good practice. The home is clean and kept in good hygienic condition. Both residents and care staff spoke highly of the dedication of the domestic staff in maintaining such high standard of cleanliness in the home.

What has improved since the last inspection?

At the last inspection, there were not requirements or recommendations made for the home to address.

What the care home could do better:

Three residents on first floor the commented that because of the lack of staff, it takes a long time for the staff to answer calls when they buzz for help. One residents stated that she had lost count of the number of times that staff would tell her that they are busy with another resident and never to come back again. In discussions with the staff and one of the nurses, it was stated that there are some care staff on the first floor who have refused to assist the nurse on duty when asked by the nurse to assist them with a personal or nursing care task. Complaints records should be properly dated to indicate the precise date on which the complaints are received. Two examples were seen stated merely the dates July 08 and August 08. Some of the care plans do not provide details to staff on how to deal with specifically identified care needs. Statements about care are very general and do not provide the necessary information to enable staff to know exactly what and how care is to be provided for the individual.The arrangements for assisting the residents on the dementia unit with their meals should be reviewed to make sure that domestic tasks do not take preference over assistance with meals for those residents who require it. For example, it was noticed that a considerable amount of time was spent by one of the two carers on that unit serving the meals from the small kitchen and rinsing dishes and cutleries when there were residents who were waiting to be assisted with their lunch. The provider should consider the current arrangements for office space, which is shared by the registered manager and the administration officer. The current arrangements do not offer complete privacy for discussing matters relating to the residents. For example, on the day of the inspection, the discussions between the manager and the visiting district nurse could be over heard in the reception area. There were also a lot of disruptions in the office from staff and visitors who were in the office, making communication difficult. The home should review the practice of wearing plastic glove when serving meals and assisting residents with their meals. This is institutional in look and compromises the dignity of the residents. The laundry shute on the first floor must be lock at all times when it is not in use. At the time of the inspection, this was left wide open and the key was left in the door. This seriously compromises the safety of the residents. Supervision notes show that the staff who undertake supervision with the care staff and nurses would need appropriate training in order to do this properly. Some supervision notes were only part completed. Some had not been dated and others were only about "review job description" and "review training needs". The quality of the supervision notes were poor.

CARE HOMES FOR OLDER PEOPLE Willowdene Care Home Lizard Lane Sedgefield Stockton On Tees TS21 3ET Lead Inspector Sam Doku Unannounced Inspection 5th February 2009 10:00 X10015.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 Willowdene Care Home DS0000059169.V373608.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. 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. Willowdene Care Home DS0000059169.V373608.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Willowdene Care Home Address Lizard Lane Sedgefield Stockton On Tees TS21 3ET 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) 01740 623644 01740 623645 willowdene@gmail.co.uk Maria Mallaband Care Homes Ltd Mrs Lynne Margaret Smith Care Home 48 Category(ies) of Dementia (12), Old age, not falling within any registration, with number other category (36) of places Willowdene Care Home DS0000059169.V373608.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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 36 (Nursing) Dementia, Code DE - maximum number of places 12 (personal care only) The maximum number of service users who can be accommodated is: 48 6th February 2007 2. Date of last inspection Brief Description of the Service: Willowdene provides residential care services for up to 36 persons in the category of OP (older persons) and for up to 12 persons in the category of DE(E) (Dementia Elderly) residing in the Maple Suite. The home is also registered to provide nursing care for people. The nursing care unit is based on the first floor of the building. The Home is a modern two story building with the benefit of a lift between the floors along with a single floor annex known as the Maple Suite. The home is situated on the B 1278, about half way between Sedgefield and Fishburn, and lies within its own grounds. Although situated in a rather isolated position, with no shops or other amenities close to the home, there are frequent buses to local villages and major towns and cities in the area (eg Durham, Sunderland) with a bus stop immediately outside the home. The scale of charges for the residents is between £417.00 and £549.00 per week. Willowdene Care Home DS0000059169.V373608.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating of this service is 1 Star. This means the people who use the service experience adequate quality outcomes. The inspection was unannounced and commenced on 5 February and completed on 9 February 2009. Before the visit the inspector looked at: Information we have received since the last inspection visit on 30 January 2008. How the service dealt with any complaints and concerns since the last inspection. Any changes to how the home is run. The providers view of how well they care for people, as highlighted in the details provided in the Annual Quality Assurance Assessment (AQAA). The views of the people who use the service through talking to them. During the visit the inspector did the following: Talked to the people who use the service, the acting manager and the care staff. Looked at information about the people who use the service and how well their needs are met. Looked at other records which must be kept. Checked that staff have the knowledge, skills and training to meet the needs of the people they care for. Looked around the home to make sure it is safe and secure. Checked what improvements have been made since the last inspection. The inspector told the manager what he found. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations- but only when it is considered that people who use the services are not being put Willowdene Care Home DS0000059169.V373608.R01.S.doc Version 5.2 Page 6 at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the service does well: What has improved since the last inspection? What they could do better: Three residents on first floor the commented that because of the lack of staff, it takes a long time for the staff to answer calls when they buzz for help. One residents stated that she had lost count of the number of times that staff would tell her that they are busy with another resident and never to come back again. In discussions with the staff and one of the nurses, it was stated that there are some care staff on the first floor who have refused to assist the nurse on duty when asked by the nurse to assist them with a personal or nursing care task. Complaints records should be properly dated to indicate the precise date on which the complaints are received. Two examples were seen stated merely the dates July 08 and August 08. Some of the care plans do not provide details to staff on how to deal with specifically identified care needs. Statements about care are very general and do not provide the necessary information to enable staff to know exactly what and how care is to be provided for the individual. Willowdene Care Home DS0000059169.V373608.R01.S.doc Version 5.2 Page 7 The arrangements for assisting the residents on the dementia unit with their meals should be reviewed to make sure that domestic tasks do not take preference over assistance with meals for those residents who require it. For example, it was noticed that a considerable amount of time was spent by one of the two carers on that unit serving the meals from the small kitchen and rinsing dishes and cutleries when there were residents who were waiting to be assisted with their lunch. The provider should consider the current arrangements for office space, which is shared by the registered manager and the administration officer. The current arrangements do not offer complete privacy for discussing matters relating to the residents. For example, on the day of the inspection, the discussions between the manager and the visiting district nurse could be over heard in the reception area. There were also a lot of disruptions in the office from staff and visitors who were in the office, making communication difficult. The home should review the practice of wearing plastic glove when serving meals and assisting residents with their meals. This is institutional in look and compromises the dignity of the residents. The laundry shute on the first floor must be lock at all times when it is not in use. At the time of the inspection, this was left wide open and the key was left in the door. This seriously compromises the safety of the residents. Supervision notes show that the staff who undertake supervision with the care staff and nurses would need appropriate training in order to do this properly. Some supervision notes were only part completed. Some had not been dated and others were only about “review job description” and “review training needs”. The quality of the supervision notes were poor. 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. Willowdene Care Home DS0000059169.V373608.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Willowdene Care Home DS0000059169.V373608.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4, 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service user guide and other information leaflets are freely available in the home for residents and prospective residents. Furthermore, there is a thorough assessment of needs before admission is arranged. This ensures that prospective residents have all the necessary information available to them to help them to make informed decisions about whether to move into the home. EVIDENCE: Six residents’ files were examined as part of the case tracking and these contained pre-admission assessments carried out by the home and also by the social worker or nurse assessor. The manager stated that where social services or the local health authority is making a referral for someone to receive care at Willowdene, it is the home’s policy that the home receives a copy of the full assessment as part of the admissions procedure. This allows the home to make sure that they have the necessary skills and facilities to meet the personal and Willowdene Care Home DS0000059169.V373608.R01.S.doc Version 5.2 Page 10 healthcare needs of the person. The social work and the home’s own assessments are then used to prepare the initial care plans for the person so that all staff would know what care and support the person needs when they arrive in the home. The inspector specifically spoke to three residents about their experience of the pre-admissions assessments. They all confirmed that they were visited in their homes or on a hospital ward by someone from the home and they were asked various questions about their health and the kind of help that they need. Residents and relatives confirmed that the staff supplied them with good information about the home when they were looking for a place. Information about the home is also available in the reception area for residents and visitors to see. Most of the information is relevant and up to date. A number of staff were spoken with about the way admissions take place in the home. Staff described the process including the opportunity for prospective residents come and visit the home and to find out more about the home before making up their minds about coming to live at Willowdene. Staff gave examples of specific residents who visited and even had lunch with other residents on the day of their first visit to the home. What the staff said supports the residents’ version of the admission process. The home does not provide an Intermediate Care service. Willowdene Care Home DS0000059169.V373608.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. On the whole, the residents receive care that meets their personal and healthcare needs. However, the reported negative attitudes of some staff and their refusal to look after nursing residents potentially undermine the welfare of the residents in their care. The home has good procedures in place for administration and safe handling of medication. This promotes the residents’ health and welfare. On the whole, the residents are treated with dignity and their right to privacy is upheld. Willowdene Care Home DS0000059169.V373608.R01.S.doc Version 5.2 Page 12 EVIDENCE: Residents confirmed that they have access to healthcare facilities including GP support and other healthcare professionals. Residents gave examples of how the nursing staff regularly arrange for their GPs to visit them. The residents files provide details of the healthcare support that each individual resident gets. The care notes show entries of visits to or from healthcare professionals. There were serious concerns raised by care staff and nurses about the attitude of some care staff who have refused to be involved in the care of residents with nursing care needs. For example, specific situation were described in which it was alleged that some care staff refused to assist a nurse with nursing tasks with the words “it’s your client, you get on with it”. The inspector was informed that this happens on both day shifts and on night shifts. One nurse indicated that this has been brought to the attention of the manager and senior staff at headquarters but nothing positive seems to have been done about it. However, in discussions with the manager and a senior officer from the company, the both indicated that they are aware of the problems and are addressing them. Staff stated that one nurse had resigned her position and left as a result of some care staff refusing to look after nursing residents. Another nurse indicated that she would soon be leaving her position to seek alternative employment somewhere else as a result of the attitude of some care staff. Three service users spoke about the delays for staff to answer buzzers. Residents said that it takes unusually long time for staff to answer the buzzers when they use it to summon help. They said, very often the care staff would say that they are busy with other residents and often forget to come back to them. One resident commented that on a number of occasions they were very close to being incontinent due to the delays in care staff answering their buzzer. The home has detailed written policies on the storage and administration of medicines. The manager confirmed that the nursing staff and senior care staff who are responsible for the administration of medicines have received up to date training on safe handling of medicines. A random check of the medicines administration system was undertaken by the inspector. There were no discrepancies noted, and the administration sheets have been signed and dated as required. Willowdene Care Home DS0000059169.V373608.R01.S.doc Version 5.2 Page 13 The interaction between staff and the residents was good. Staff showed respect to the residents and this was commented on by a number of residents. Relatives and residents confirmed that the staff treat people with respect and dignity. The staff were polite, courteous, friendly and professional in the way they related to the residents. There was a lot of exchange of polite and tasteful jokes and banter between staff and residents. This created a happy and friendly atmosphere in the home. Willowdene Care Home DS0000059169.V373608.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides meaningful and fulfilling activities, which enhance the wellbeing of the residents. The residents are provided good variety of wholesome and nutritious meals, which promotes their health and wellbeing. EVIDENCE: The activities coordinator provided good information about the activities that the residents get involved in. Forthcoming activities are placed on the notice board in the reception area for all residents and relatives to see. She also keeps a record of the activities that the residents participate in. Some of the activities include art and craft, watching video, card games, board games, outings, and quiz games. At the time of the inspection, the activities coordinator was involving residents on the first floor in gentle exercises and the residents later commented that she often organises such activities for them and commented that they enjoy taking part in these recreational activities. Willowdene Care Home DS0000059169.V373608.R01.S.doc Version 5.2 Page 15 The care plans that were viewed contained information about the social and recreational care needs through the social history section of the plans. However, the information in the files is not always supported by social care plans to reflect people’s with the recreational and religious needs. The manager indicated these aspects of the care plans are being improved to help staff to meet all aspects of the residents’ needs. The residents who were spoken with stated that they are able to make choices and make independent decisions about their care and the way they wish to be looked after. Residents described how they are able to do the things they like to do with the support of the staff. However, two people indicated that because of staff shortages, sometimes they are not able to fully exercise choices. One such example was when a request for a bath had to be postponed because the staff did not have the time to help them with their bath. The sign-in book shows that relatives regularly visit the home and spend time with the relatives. One relative calls at the home everyday at lunch time to assist her relative with her lunch and to spend time with her. Other relatives who were spoken with said they visit regularly to make sure that their relatives continue to maintain contacts with their family members. Examination of past menus show that the home provides choice of menu for the residents. The cook talked about making suitable arrangements to make sure that the residents received home-made and nutritious diet. The residents confirmed that the meals are always nice and there is always plenty for them to eat. Willowdene Care Home DS0000059169.V373608.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives have information about how to make a complaint and are confident that any concerns raised would be acted on by the home, thus promoting their right to express their views about the service. Staff are aware of safeguarding adults procedures and have received suitable training which help to safeguard the safety and welfare of the residents. EVIDENCE: The home has a complaints procedure and a copy of this is posted in the reception area for residents and visitors to see. A summary of the procedure is included in the service user guide. Details in the complaint book show that the home takes complaints seriously. The record shows the details of the complaints and details of the outcomes of any investigations that have been undertaken. However, in two cases, the complaints record did not show the precise date when the complaint was received. The record merely shows the month and the year when the complaint was received. A number of residents and relatives were spoken with about the homes complaints procedure. Residents said they are aware of the procedure and feel confident about raising any concerns with the manager if they were unhappy about anything. One resident told the inspector how she and her family used Willowdene Care Home DS0000059169.V373608.R01.S.doc Version 5.2 Page 17 the complaints procedure when they were unhappy about something. She indicated that her concerns were addressed satisfactorily and she was happy with the way the manager handled her concerns. Staff have had training in safeguarding adults. The training record shows that a large number of the staff have received training in safeguarding. Staff who were spoken with were familiar with the homes policy on safeguarding vulnerable people. The home has good system in place for holding the residents monies on their behalf. The system is robust and secure. A random check was carried out on three residents finances and no discrepancies were found. All transactions made on behalf of the residents have been accounted for and receipts have been kept as proof of purchase or transactions. Willowdene Care Home DS0000059169.V373608.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 23, 25. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides safe, secure, clean, warm and pleasant environment for the residents to live in thus promoting their welfare. EVIDENCE: The home is clean and maintained to a good standard. Residents and staff complimented the domestic staff for their hard work in maintaining the home in such an orderly, clean and hygienic condition. The bedrooms that were visited were clean and personalised, reflecting individual tastes and preferences. Residents have been encouraged to furnish their rooms with personal items making it homely and comfortable for them. The rooms are warm, homely and comfortable. All radiators have protective covering and window have restrictors on to ensure that windows can only open so far to ensure safety of the residents. Willowdene Care Home DS0000059169.V373608.R01.S.doc Version 5.2 Page 19 The corridors are wide enough to allow people with walking aids to move around freely. There are sufficient communal lounges and other spaces in the home for the residents to choose from. These areas are appropriately furnished and decorated for the residents to use. The conservatory was found to be cold but the manager indicated that the heating could be boosted up if any residents wanted to go in there. There are detailed written policies covering all aspects of the running of the home. These include policies on infection control policies. Staff have had training in infection control and records show that the home has adhered to infection control procedures. There are anti-bacterial hand wash dispensers in bathrooms and toilets. The standard of cleanliness in the kitchen was good and the kitchen staff have maintained good standard of cleanliness and hygiene. Willowdene Care Home DS0000059169.V373608.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staffing numbers and skills mix are satisfactory but the reported failure by some staff to be involved in the care of nursing residents seriously compromises the welfare of the residents. The home adheres to good recruitment practices, which helps to safeguards the welfare of the residents. EVIDENCE: The staff rotas were examined and the home appears to employ sufficient number of staff to meet the needs of the residents. However, staff expressed concerns that the staffing levels on the nursing floor are never sufficient to meet the needs of the residents. Staff said that because of the lack of sufficient staffing on the first floor, the arrangements for breakfast have been moved to 09:00 to allow the staff sufficient time to get the residents ready for their breakfast. However, the manager refuted this and said that the residents on the first floor were consulted and they decided to have the breakfast time moved to the later time of 09:00. Willowdene Care Home DS0000059169.V373608.R01.S.doc Version 5.2 Page 21 Staff also commented that very often the staffing levels are further reduced when a resident has to attend a hospital appointment. The manager stated that when more than one residents is scheduled to attend a hospital appointment, then arrangements would be made for extra care staff to be available to allow this to happen. On the day of the inspection, two residents were attending hospital appointment and an extra staff member was bought in to accompany the residents to hospital. The staff were very consistent with the issue of staffing, stating that with two care staff and one nurse on the first floor, if one carer had to attend hospital appointment with a resident, that leaves just one carer and a nurse on that floor and this can be difficult for the staff to provide the appropriate support that the residents on the first floor require. The views of the staff about the staffing levels are re-enforced by a number of anonymous calls made to the Commission in the past twelve months. All the three calls were about lack of adequate staffing on the first floor unit. In all these cases the manager informed the Commission that the correct number of staff are available to meet the needs of the residents. This remains an unresolved issue for the staff who are work on daily basis with the residents are saying that the staffing levels are not adequate to meet the needs of the residents. The provider should take appropriate action to review the staff levels and to satisfy themselves that the current staffing levels are meeting the needs of the residents. The staff have had appropriate training to equip them for their roles. The manager confirmed that the staff have received training in moving and handling, first aid, protection of vulnerable adults, fire safety, food hygiene and health and safety training. These were confirmed in the AQAA that the manager sent to the Commission and also by the staff training log. Five staff files were examined to check on the recruitment process by the manager. The files show that the home has been following the company’s policy on recruitment. All the files contain completed job applications, copy of job description, appropriate references, evidence of CRB checks and record of training. Willowdene Care Home DS0000059169.V373608.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has suitable arrangements in place to provide supervision for the staff but the quality of the supervision notes are poor and therefore there is no indication how difficult staffing issues are being addressed with the individuals staff concerned, which potentially compromises the welfare of the residents. The safety and welfare of residents are protected by the regular servicing of equipments and safety arrangements that are in place. However, the lack of clear instructions to staff on the safety measures relating to the “laundry shute” seriously compromises the safety and welfare of the residents. Willowdene Care Home DS0000059169.V373608.R01.S.doc Version 5.2 Page 23 EVIDENCE: The registered manager has long experience of managing a residential care home. Staff, residents and relatives commented positively on her ability as a manager. Most staff stated that she is approachable and supportive of them and also of the residents. Some staff expressed concern about the lack of firm action by the registered manager to address the issue relating to care staff who refuse to provide care for residents who are receiving nursing care. The staff feel that this situation should never have been allowed to continue as all care staff were employed to provide care for people who need it. One staff member indicated the registered manager would not take any firm action unless she has been provided with the names of the care staff who continue to refuse to work with residents that require nursing care. The inspector examined the personal allowance records and receipts of transaction. This showed that there is a good system in place and that the residents’ monies are safe and properly accounted for. Receipts are kept for all the transactions made on the residents behalf. The accounts are regularly audited. There are suitable arrangements for staff to receive one-to-one supervision from the manager and senior staff but the supervision notes show that the staff who undertake supervision with the care staff and nurses would need appropriate training in order to do this properly. Some supervision notes were only part completed. Some had not been dated and others were only about “review job description” and “review training needs”. The quality of the supervision notes were generally poor and the senior staff who are responsible for them should be provided with the necessary training to enable them to undertake this role more effectively. The company has detailed written Health and Safety policies and these are used by the manager and senior staff references documents. These cover policy areas such as fire prevention and Care of Substances Hazardous to Health (COSHH). There is evidence that staff adhere to the policies as set by the company. Staff have received training in fire safety, COSHH, first aid, food hygiene and infection control. Servicing and maintenance records show that all portable appliances have been tested. A record is maintained of regular water temperature. Regular servicing of fire equipment, passenger lift, bath lifts and hoists, gas and electrical appliances have been carried out by the contracted companies. All the servicing records that were examined were up to date. Willowdene Care Home DS0000059169.V373608.R01.S.doc Version 5.2 Page 24 Records examined indicate that fire precautions relating to weekly fire alarm testing and record of inspection takes place. There are records in the home indicating fire drills and fire instructions with staff. The manager confirmed that all staff have received up to date fire safety training. Willowdene Care Home DS0000059169.V373608.R01.S.doc Version 5.2 Page 25 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X 3 3 X 4 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 2 X 3 1 X 3 Willowdene Care Home DS0000059169.V373608.R01.S.doc Version 5.2 Page 26 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15(1) Requirement The residents care plans must provide sufficient information to about on how specific care needs are to be met so that all staff can provide consistent care for the residents. The provider must provide guidelines, setting out the role and duties as carer staff so that they are aware of their job roles including their role to provide care for residents who require nursing care. Health and safety measures relating to the laundry shute on the first floor must be put in place to safeguard the safety and wellbeing of the residents. Timescale for action 30/04/09 2 OP27 12(1)(a) 30/04/09 3 OP38 12(1)(a) 30/03/09 Willowdene Care Home DS0000059169.V373608.R01.S.doc Version 5.2 Page 27 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard OP12 OP15 OP24 OP36 Good Practice Recommendations The manager should review the practice by staff of wearing plastic gloves when serving and assisting residents with their meals and drinks. The home should review the arrangements for serving meals for the residents on the dementia care unit so that residents are assisted promptly with their meals. The home’s policy on answering buzzers from residents should re-enforced to make sure that staff respond promptly to buzzers for assistance from residents. Staff should receive regular supervision from senior staff who have been trained to undertake duties, making sure that the supervision sessions are properly documented, dated and signed. Willowdene Care Home DS0000059169.V373608.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Willowdene Care Home DS0000059169.V373608.R01.S.doc Version 5.2 Page 29 - 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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