Inspection on 18/09/08 for Willows Edge

This inspection was carried out on 18th September 2008.

CSCI found this care home to be providing an Excellent 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.

Other inspections for this house

Willows Edge 12/09/06

Willows Edge 07/11/05

Willows Edge 06/06/05

Willows Edge 13/12/04

Willows Edge 19/07/04

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Willows Edge Willows Edge Hutton Close Shaw Newbury Berkshire RG14 1HJ     The quality rating for this care home is:   three star excellent 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: Kerry Kingston     Date: 1 8 0 9 2 0 0 8 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. the things that people have said are important to them: They reflect 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 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Willows Edge Willows Edge Hutton Close Shaw Newbury Berkshire RG14 1HJ 01635 45252 Telephone number: Fax number: Email address: Provider web address: prolfe@westberks.gov.uk Name of registered provider(s): Name of registered manager (if applicable): Type of registration: Number of places registered: West Berkshire Council Mrs Patricia Rose Rolfe care home 36 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: 0 Over 65 36 Date of last inspection Brief description of the care home Willows Edge is owned and operated by West Berkshire Council. The home is located in Shaw, near Newbury, and provides specialist residential care for elderly persons with a diagnosis of dementia. Accommodation is on three floors with access via a lift. Thirtyfive single bedrooms are used for long-stay care and one single bedroom is available for respite care. The fees are six hundred and fifty pounds per week. Care Homes for Older People Page 4 of 26 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: three star excellent 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: This is a report for the key inspection of the service, which included a routine unannounced site visit. This took place between the hours of 10.00 am and 4.30pm on the 18th September 2008. The last key inspection on this service was completed on the 12th September 2006. The fees are, currently £650 per week, with additional charges for personal needs such as hairdressing. The information was collected from the Annual Quality Assurance Assessment, a document sent to the service by the Commission for Social care Inspection and completed by the manager of the service. Care Homes for Older People Page 5 of 26 Discussions with two staff members, the Registered Manager and three residents took place. Some people who use the service have limited communication ability, therefore observation was also used as a source of information throughout the visit. A tour of the home and reviewing residents’ and other records were also used to collect information on the day of the visit. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line – 0870 240 7535. Care Homes for Older People Page 7 of 26 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 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has comprehensive assessments for each individual to ensure that it can meet their needs. They regularly check that they can continue to meet peoples needs. Evidence: The assessments for five people, who were admitted during 2008, were seen. People have several different forms of assessment, one comprehensive assessment of needs is completed by the care manager, this includes all the individuals needs and there is a section where the service user is asked their views. Several other forms of assessments are completed by home staff and/or other professionals, such as mobility assistance assessment, mental capacity assessment and the assessment for abilities within a residential home. The assessments include all the necessary information to enable staff to care for the Care Homes for Older People Page 9 of 26 individual in the way that they want and need. The care plan is developed from the assessments and is reviewed regularly. The first review, notes if the person has settled into the home and if the home is able to meet all their needs. The assessments and care plans are reviewed monthly for all the people who use the service. Care Homes for Older People Page 10 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has detailed individual care plans which include personal, social and health care needs. Peoples needs as identified in the care plans are fully met. People are treated with respect and dignity and medication is safely administered. Evidence: Seven care plans were seen, they are highly individualised and ensure staff can meet peoples equality and diversity needs. For example one person has a health condition which means that he/she has very special needs. These needs are properly noted and the whole staff team, with the assistance of outside professionals, work together to ensure they are met. Someone who has had recent falls and is currently risk assessed as needing an electronic mat to alert staff when they get out of bed (assistive technology) is being further risk assessed to establish whether further assistive technology should be used to enhance safety whilst raising privacy and dignity issues for the individual, who tries to retain as much Independence as they are able. All the Care Homes for Older People Page 11 of 26 care plans are completed to a good standard and cover the necessary areas such as a personal profile, communication, Health and well being, mobility, personal hygiene, eating and drinking, cultural , emotional, recreational, leisure. They also include a daily task plan and a night care task plan. Individuals have detailed Health care plans which include specialised diets, weight record charts, safe handling plans, medication records and any skin viability issues. The manager reviews weight records regularly and makes comments and/referrals, as necessary to ensure any weight fluctuations are investigated. Records showed that people see the primary and/or specialised Health care professionals as necessary. People keep their own G.P as far as possible, as the home has many local residents, it also has the support of three G.P surgeries and work closely with the Community mental health team who work with the specialist psycho geriatrician. The home has the assistance of a community psychiatric nurse as necessary. A relative on a survey commented that staff did not accompany people to hospital, the manager confirmed that this is usually the case but families are advised as soon as possible if a relative has been taken to the hospital and the home keep up-to-date with peoples progress and condition. The home has a robust medication policy and work closely with the pharmacist, they use the Boots, Monitored Dosage system. There has been one medication error in the past year (confirmed by the manager). Only those staff trained to administer medication do so. The Home has plenty of suitable storage which has been moved from the ground floor to the first floor to improve security. Any medication used to help people to control their behaviour is prescribed by the psycho geriatrician after discussion with all parties concerned. All the people who live in the home have some medication, the home is well organised to ensure everyone receives their medication at the right time , for example those who have morning and lunchtime medication are prioritised so that there is the right gap between doses. The home has correct procedures, recording and storage for any controlled medication. The Pharmacist visits regularly and the manager advised that all the recommendations made at that visit are completed. The medication recording sheets seen on the day of inspection were correct. There was a discussion about the development of guidelines for people who are prescribed medication to be used as necessary for pain or behaviour, especially if they are unable to verbally communicate clearly. People spoken to felt happy and said staff are good , it is a nice place to live. Staff were observed treating people with sensitivity and respect. Their opinions were being sought and things were being explained to them carefully. The manager is aware that there are some areas of staffs behaviour with regard to showing kindness and care (such as the way that they comfort people physically), Care Homes for Older People Page 12 of 26 which need some discussion and thought. Staff members were seen to be interacting positively and respectfully with the people who live in the home. Care Homes for Older People Page 13 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home make sure that people have an interesting and rewarding lifestyle, remain part of the community and keep in contact with families and friends. The people who use the service are offered varied and nutritional food and mealtimes are a pleasant social occasion. Evidence: Daily activities are recorded on individuals and the activity organisors file. There are communal activities displayed on the notice boards and there is evidence that the coordinator does some one to one work with individuals who prefer not to or find it difficult to join in. People choose when to go to bed and when to get up and what activities they want to undertake during the day, care plans include peoples social and leisure needs, any cultural needs and likes and dislikes with regard to activities. People participate in activities such as singing for the brain, which is led by someone from the Alzheimers Society, PAT dogs, games, residents meetings and quizzes. People also note what outings they would be interested in and what activities they Care Homes for Older People Page 14 of 26 would like to do. The co-ordinator attempts to organise things people have asked for. One person said, we have lots to do and one survey said that the co-ordinator is wonderful. The home has focused on improving the garden area so that people can use it safely and it can form part of their daily activities, for example they have new garden furniture, grown herbs and some vegetables over the summer period. There are further plans to improve and use the outside areas. The visitors book showed that the home receives many visitors and there were many families and friends visiting the home on the day of the visit. Peoples contact with families friends is noted on their care plans, including any specific instructions or choices made by individuals. The home is an integral part of the local community with local schools and religious ministers visiting and people being able to visit the community. People are encouraged to make as many choices as possible for as long as possible. Residents meetings are held to try to ascertain peoples views and staff were seen to be giving people as much choice as possible. Meals are provided by an outside catering firm, the chef works very closely with the manager and attends training courses with staff if thought to appropriate such as dementia. There are always two choices on the menu and people can choose to have three cooked meals a day. The meals are very good quality and varied. Staff offer alternative food to people if they are not eating what they have chosen for instance a staff member was observed giving someone a special food, because they would not eat anything else. Sandwiches were offered as were extra helpings. Staff eat meals with residents whilst they are helping them with their food, this establishes a very relaxed, social and pleasant atmosphere. Staff were observed to be interacting positively with people throughout the meal and ensured it was a pleasant, experience for all. Weight records are checked by the manager and any fluctuations of weight investigated. Two people said the food is very good, you can have what you like. Care Homes for Older People Page 15 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home listens to peoples complaints and does something about them. People are kept safe from all forms of abuse or poor care practice. Evidence: The home has a robust complaints policy and staff have a guide to dealing with complaints. The service has a complaints manager in head office who visits the home regularly and advises on any complaints issues, as necessary. The home have had four complaints in the last year but none involved standards of care or any issues about the home. Complaints are carefully recorded in detail and up-dates are added to the complaint paperwork as things change or are resolved. The home has received seven compliments from people thanking them for the care they gave or are giving to relatives. There have been no safeguarding issues/concerns about the home but the service has made two referrals to the Protection of Vulnerable Adults Co-ordinator to ensure the financial safety of people who are resident in the home. Two people spoken to said that they feel very safe. One relative said I am absolutely confident my relative is safe, they let me know immediately if there are any problems or concerns. Staff were able to clearly describe what action they would take if they had any concerns Care Homes for Older People Page 16 of 26 about the well being of a person who uses the service. Staff are trained in Protection of Vulnerable Adults issues and this is considered by the home to be a core training course, that is, completed as soon as possible after a staff member has been appointed. The Commission has received no information with regard to complaints or safeguarding issues about this service. The home does not use physical restraint and there are guidelines for staff if people display any difficult behaviours. The home do not deal with peoples benefits or overall finances, they keep some personal allowance cash so that people have some money available if they go out or wish to purchase something. The financial cash records and recordings kept by the home were accurate but it was discussed that it would be good practice to keep individual receipts for hairdressing,chiropody and any purchases if people are unable to sign for receipt of the cash. Care Homes for Older People Page 17 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with a pleasant, homely environment to live in, which meets their diverse needs. The home is developing its garden and other areas to ensure that it offers a stimulating and enjoyable experience for the people who live there. Evidence: The home is well presented and has a very homely feel, the communal rooms have various types of seating to meet peoples different needs and preferences. Peoples art and craft work is displayed as are photographs of events and outings and orientation displays such as a where we come from map. The home is spacious having large communal areas and smaller areas where people can have some privacy or quiet time. Peoples private space is personalised, to their taste and preferences. Specialised equipment is provided, throughout the building, according to peoples individual and group needs. The home has numerous bathing and toiletting facilities, that are fitted with diverse equipment to ensure people can have a full choice of how they wish to bathe, for instance shower, assisted bath or ordinary bath with appropriate safety equipment. Some of the bathrooms are in need of decoration with one toilet requiring a new Care Homes for Older People Page 18 of 26 cistern, however they appear to be safe and functional. The manager confirmed that the safety work that was required at the last inspection (exposed pipework and flooring problems) has been completed. The garden space has been developed so people use it more. It has a circular path that people can walk round, new garden seating , a water feature, a herb garden and a few vegetables. There are plans for further development to add interest to the garden to give people an additional stimulating space in their home. The home has a large well equipped laundry and there were no complaints about clothing care noted by the home,although one survey mentioned that some of a relatives clothing had been spoiled. Special equipment and/or assistive technology is used as necessary, throughout the home, after the appropriate assessments and consideration of risks. The home was found to be very clean and smelt extremely fresh and pleasant. Care Homes for Older People Page 19 of 26 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. The home has good staffing ratios so that they can meet the diverse needs of the people who use the service. The staff team are well trained and qualified to ensure that they are able to offer the best possible care. Evidence: The home has a total of 37 care staff, there are a minimum of five , but usually six care staff per shift with the manager and an activity co-ordinator working days during the week, there are three waking night staff. The home has ancillary staff to support the care staff. There are currently two vacancies and any shortfall in staffing is covered by bank workers, agencies or staff doing overtime. The manager is trying to build up bank staff numbers so that she is confident it is people who know the residents who are working with them. Agency staff are usually people who have worked in the home before and they always work with the regular staff. The staff records for the two newest staff were seen, the local authority have made an agreement with the Commission that parts of the staff records will be kept at their head office. It was discussed that a record of the information held at head office should be kept on the premises. The manager confirmed that she had seen all the Care Homes for Older People Page 20 of 26 necessary information prior to employing staff such as references, CRB checks and medical checks. The home follows the robust recruitment policy and keeps records of interview questions and the interview assessment. A senior care officer is responsible for the training programme and keeps detailed records of training completed by staff. They showed that staff have completed the basic training courses and these are up-dated at the correct intervals, the home include protection of vulnerable adults and dementia training as standard courses. Ancillary staff are included on training programmes, as is the chef, when appropriate. Staff spoken to confirmed that they had good opportunities to participate in vocational and professional training and a new member of staff was able to describe training already completed in her first month and planned training in the next few months. Approximately 75 of the staff team have N.V.Q 2 or above. Staff were observed using skill when caring for the people who live there and those spoken to demonstrated knowledge and understanding of their role and the residents needs. A relative of a person who uses the service said staff are brilliant, youd have to go along way to find better staff. Care Homes for Older People Page 21 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is very well managed , in the best interests of the people who live there. The home continues to improve the lifestyle of the people who live there. People are kept as safe as possible by adherence to Health and Safety procedures. Evidence: The manager has been in post since October 2005, she has a Registered Managers Award and many years of management experience in residential care. The manager is supported by a deputy and a senior support team, lines of accountability are clear and she is aware of all her responsibilities and duties. Care Homes for Older People Page 22 of 26 The home has a well developed Quality assurance system which includes regular visits by a senior manager (regulation 26 visits), annual surveys and questionnaires sent out to families, people who use the service and other professionals. The results from these surveys are collated by head office and results in a report that is discussed in a team meeting at which and action plan is developed to ensure the home moves forward. Developments in the home such as more community presence and a better use of the garden, show that the home continue to try to improve the lifestyle of the people who live there. The home does not deal with peoples benefits or overall finances but ensures it safely handles the small amounts of personal allowance monies that it holds, on their behalf. A sample of Health and Safety records were seen, these showed that all Health and Safety maintenance checks are completed at the correct intervals. The provider holds a regular Health and Safety meeting which is attended by managers or their representatives to discuss any Health and Safety issues that arise.. All the work recommended to be done by the fire department and included in the requirement made at the last inspection has been completed and the home is to have a fireproof lift installed, which is able to accommodate a bed , to assist staff, in the unlikely event of an evacuation being necessary. The manager is aware that the current fire evacuation procedures will need to be amended to ensure staff are clear about what they should do in event of a fire. Incident and accident reports are kept on individuals files and are logged by the provider, comments are made action is taken to minimise recurrence or future risk, as appropriate. Care Homes for Older People Page 23 of 26 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 24 of 26 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 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 14 9 To develop guidelines for staff when giving medication prescribed by the Doctor, to be taken as required, so that all staff know when it is best to give it. Care Homes for Older People Page 25 of 26 Helpline: 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 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 © (2008) 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 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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