Inspection on 18/10/05 for Willows Nursing Home, Blacon

This inspection was carried out on 18th October 2005.

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

Willows Nursing Home, Blacon 29/05/09

Willows Nursing Home, Blacon 01/05/07

Willows Nursing Home, Blacon 14/04/05

Willows Nursing Home, Blacon 08/12/04

Willows Nursing Home, Blacon 07/06/04

Willows Nursing Home, Blacon 12/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Willows Nursing Home, Blacon Treborth Road Blacon Chester Cheshire CH1 5RP Lead Inspector Wendy Smith Announced Inspection 18th October 2005 09:00 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 Willows Nursing Home, Blacon DS0000018789.V260662.R01.S.doc Version 5.0 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. Willows Nursing Home, Blacon DS0000018789.V260662.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Willows Nursing Home, Blacon Address Treborth Road Blacon Chester Cheshire CH1 5RP 01244 374023 01244 379228 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) Mr Mohammed Hussain Mrs Anwar Hussain, Mr Naveed Hussain Mrs Vivienne Haynes Care Home 73 Category(ies) of Dementia (5), Dementia - over 65 years of age registration, with number (50), Old age, not falling within any other of places category (23) Willows Nursing Home, Blacon DS0000018789.V260662.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a mximum of 73 service users to include: * 50 persons in the DE(E) dementia over 65 years of age, category. * Within the 50, a maximum of 5 persons in the DE, dementia under 65 years of age category. * 23 persons in the OP, older persons, category. Bedroom numbers 8, 27, 64 and 65 only may be used to accommodate two persons The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Staffing must be provided to meet the dependency needs of the service users at all times and comply with any guidance which may be issued through the Commission for Social Care Inspection. 14th April 2005 2. 3. 4. Date of last inspection Brief Description of the Service: Willows Nursing Home is a single storey building situated in the Blacon district of Chester. The home is conveniently situated for local shops and other communal facilities in Blacon, and there is regular public transport into Chester city centre. The home provides nursing care for 23 older people whose needs are due to physical frailty, and fifty people who have dementia. The home is part of a small group of homes owned by the registered providers. The home has 65 single bedrooms, 26 of which have en-suite facilities, and four bedrooms which may be shared by two people. An extension to the home was completed in 2004 and work is ongoing to improve facilities in the original part of the building. Extensive work has been carried out to landscape the grounds of the home. All rooms and areas, including the gardens, are spacious and are accessible to wheelchair users. Willows Nursing Home, Blacon DS0000018789.V260662.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection visit took place over a period of six hours. It was carried out by two inspectors as part of the Commission for Social Care Inspection’s statutory inspection programme. 68 residents were accommodated at the home, of whom 47 were living on the dementia care unit, and 21 on the elderly frail unit. The inspection was carried out using a process of cross referencing the documentation of identified service users following discussion with them, and following the delivery of care and support to them. Staff records, health and safety records, complaints records and arrangements for handling residents’ personal money were inspected. A tour of the building, including all communal areas and a number of bedrooms, was completed. Time was spent in discussion with the home manager and with one of the proprietors. A number of residents and members of staff were spoken with during the course of the inspection. Comments cards were received from four relatives and from two professional visitors and these contained wholly positive comments. Some of the information contained in the report was taken from the pre-inspection questionnaire that had been completed by the manager. What the service does well: Willows Nursing Home provides a safe and well-maintained environment for residents. There has been continuous improvement of the environment over recent years and a programme of further refurbishment is in place. The home is a single storey building and is well equipped to meet the needs of service users. There is a good choice of lounges for the residents of the dementia care unit, and there are safe open spaces both inside and outdoors for residents who like to walk around. Residents health needs are met to a good standard, and they are supported to maintain high standards of personal appearance and hygiene. Residents’ relatives are kept well informed and are involved in their care. Visitors are made welcome and a visitors’ room is available where relatives may stay overnight. A good variety of food is provided, including cooked breakfast every day. Willows Nursing Home, Blacon DS0000018789.V260662.R01.S.doc Version 5.0 Page 6 There is a stable staff group who have a positive attitude towards the residents and training is provided for staff. The home has the Investors in People award. The home is well managed by a competent and experienced manager. Regular health and safety checks are carried out and recorded by the manager. There is a good standard of record keeping. 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. Willows Nursing Home, Blacon DS0000018789.V260662.R01.S.doc Version 5.0 Page 7 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 Willows Nursing Home, Blacon DS0000018789.V260662.R01.S.doc Version 5.0 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3; standard 6 is not applicable. The home has a Statement of Purpose and a Service User Guide that give information to residents and prospective residents. Residents are assessed before admission to ensure that the home will be able to meet their needs. EVIDENCE: Following the last inspection, the home’s Statement of Purpose was updated to inform the reader that the home provides transitional care. The Statement of Purpose and Service User Guide are available in the entrance area of the home and a copy of the Service User Guide is provided on request to residents and their relatives. Care plans relating to recently admitted residents contained evidence that a full assessment of each person had been carried out prior to admission. There was no evidence to suggest that any residents had been admitted inappropriately. Willows Nursing Home, Blacon DS0000018789.V260662.R01.S.doc Version 5.0 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 and 9. Each resident has a care plan and the care plans looked at were completed to a good standard. Residents’ health care needs are fully met. Medicines are generally well managed but there were some errors in the medicine records on the dementia care unit. EVIDENCE: A sample of care plans was inspected on the dementia care unit. The care plans contained detailed information about the needs of the residents and how these needs were to be met. The care plans had been reviewed regularly. The care plan relating to one particular resident showed how his mental and physical condition had improved significantly since admission to the home. The standard of the care plans had improved since the last inspection. Willows Nursing Home, Blacon DS0000018789.V260662.R01.S.doc Version 5.0 Page 10 On the elderly frail unit one resident was very ill and was being cared for in bed. One of the senior care staff described the care that this resident was receiving and her medication records showed that she was receiving appropriate pain relief. One resident has a serious pressure sore that is being treated with input from the district nursing service and the tissue viability specialist nurse. The nurse visiting on the day of this inspection told the inspector that the care she saw at the home was excellent. A very experienced agency nurse, working on the dementia care unit, told the inspector that she found standards of care at this home were good. A comments card received from a relative stated: The standard of care, kindness and communication at the Willows nursing home is excellent. I have been very impressed by the care and compassion shown by all members of the staff to the residents and their relatives at all times. A comments card received from a health care professional said: When placements are made I am always confident that patients’ needs are met and that I receive up to date relevant information from well-informed staff. A card received at the home from the family of a resident who died recently read: It is due to the dedication and caring nature of the staff that he settled in his new home very quickly and was cared for extremely well. Residents have a choice of 12 GP surgeries in Chester. Residents looked smart and well-groomed. Ladies were wearing stockings or tights and appropriate footwear, that were all in good condition. Some of the ladies wore jewellery. This demonstrated the care that had been taken by the staff assisting them to dress in the morning. Medicines are administered using the Boots monitored dosage system. Repeat prescriptions are ordered monthly by the two care managers. A contract is in place for the disposal of unused medicines. On the elderly frail unit, storage of medicines was good and there was no old stock. The medicine room door is connected to the alarm system. There were no missed signatures on the administration records. Three residents were prescribed medication to be given ‘as required for agitation’. For one of these residents a care plan detailed when this should be given, but for the other two residents there was no guidance for staff as to when to give the medicine. Willows Nursing Home, Blacon DS0000018789.V260662.R01.S.doc Version 5.0 Page 11 On the dementia care unit there were a number of missed signatures on medicine administration records and on two occasions medicines were recorded as having been given but were still in the blister pack. Some eye drops had not been dated with the day of opening. These findings were discussed with the manager and it was agreed that monthly medicine audits should be implemented so that any such discrepancies would be brought to the attention of the manager and could be addressed. See recommendation Willows Nursing Home, Blacon DS0000018789.V260662.R01.S.doc Version 5.0 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 14. Consideration is given to residents’ social and emotional needs. Residents can exercise choice in their daily lives. EVIDENCE: The home has an activities organiser who works five afternoons a week. She provides a variety of social opportunities for residents in small or larger groups or on an individual basis. Care staff also spend social time with residents. The home has a sensory therapy room. Musical entertainment is provided by a professional entertainer every few weeks. Social events are organised for residents and their relatives including a fete held in July and a Christmas party currently being planned. Residents were seen to be free to move around within the home and gardens, and a good choice of sitting areas is available on the dementia care unit. Residents may also choose to stay in their own room. One resident uses an advocacy service. Willows Nursing Home, Blacon DS0000018789.V260662.R01.S.doc Version 5.0 Page 13 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16. Complaints are dealt with appropriately. EVIDENCE: The home has a complaints procedure that is displayed in the reception area and is included in the Service User Guide. In the last year one complaint had been recorded in the complaints book and details of the action taken were recorded. Willows Nursing Home, Blacon DS0000018789.V260662.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. The home is clean, safe and well maintained. EVIDENCE: A tour of the home showed that the programme of redecoration and refurbishment for the original part of the building was being followed, and that the extension completed in 2004 had been maintained in good order. A number of bedrooms had been redecorated and fitted with new furniture and furnishings. The main corridor on the elderly frail unit has been measured for a new carpet. There is a new carpet in the large dining room. Two lounges on the dementia care unit have been redecorated The gardens and grounds are kept tidy and provide safe and pleasant areas for residents to walk and sit in. Willows Nursing Home, Blacon DS0000018789.V260662.R01.S.doc Version 5.0 Page 15 The elderly frail unit has a large lounge and a conservatory. The conservatory was formerly used as a smoking area for residents but is no longer used for this purpose. It is also used as a ‘short cut’ between corridors. The inspectors discussed with the manager how this conservatory could be improved so as to provide an alternative comfortable sitting area for residents who may not want to be in the large lounge. All areas of the home were clean and odour free. Willows Nursing Home, Blacon DS0000018789.V260662.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Staff are provided in sufficient numbers and skill mix to meet the needs of residents. The home is working towards 50 of care staff having an NVQ qualification. Good recruitment practices are followed for the protection of residents. Staff receive training for the work they perform. EVIDENCE: The home employs 10 registered nurses, 25 care staff and 11 ancillary staff. Four experienced care staff have been appointed as care supervisors and take responsibility for the training and supervision of new care staff. Two of the care supervisors were spoken with during the inspection and both told the inspector how much they enjoy their work. The home has a part-time administrator, and another part-time administrator has been recruited to start in November. The elderly frail unit always has a registered nurse on duty with three care staff during the day and one at night. The dementia care unit always has two registered nurses on duty with six care staff in a morning, five in an afternoon and evening, and three at night. Care staff work in both parts of the home. These numbers are maintained with the use of agency staff. The home is usually able to have the same agency staff who know the home’s residents. Willows Nursing Home, Blacon DS0000018789.V260662.R01.S.doc Version 5.0 Page 17 One new registered general nurse has been recruited and one overseas nurse has completed her adaptation. There is continuing difficulty in recruiting and retaining registered mental nurses. Four care staff have an NVQ qualification. Nine of the care staff are working towards NVQ level 2, and the four care supervisors are working towards an NVQ assessors qualification. Staff files for two new members of staff were inspected and provided evidence that procedures were being followed. Each contained two written references, including one from the last employer, and a POVA check. Criminal Records Bureau disclosures had been applied for and one had been received. New staff have a booklet to record the training they receive. This includes induction and foundation training, which takes approximately six months to complete. There was evidence that staff had attended a number of training courses relevant to their work. Willows Nursing Home, Blacon DS0000018789.V260662.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 35, 37 and 38. The home is run in the best interests of the residents. Residents’ money is handled appropriately. There is a good standard of record keeping. Arrangements are in place to ensure the health and safety of staff and residents. EVIDENCE: The home has the Investors in People award and an annual training and development plan for all grades of staff is in place and was available for inspection. Staff meetings and staff supervision take place on a regular, planned basis. The last staff meeting was held in July and the minutes of the meeting were made available to the inspector. Willows Nursing Home, Blacon DS0000018789.V260662.R01.S.doc Version 5.0 Page 19 Resident/relative meetings are not held regularly, but can be called as needed. Social events are organised for residents and their relatives including a fete held in July and a Christmas party currently being planned. The manager said that she prefers one to one contact with families, and there was evidence in care plans that relatives are consulted and that care is discussed with them. Residents who are publicly funded have an annual review with their social worker and relatives are invited to attend the review. A satisfaction survey has not been carried out recently and the manager considered that the last survey did not provide any useful feedback. A Commission for Social Care Inspection comments card received from a relative stated: The standard of care, kindness and communication at the Willows nursing home is excellent. I have been very impressed by the care and compassion shown by all members of the staff to the residents and their relatives at all times. A comments card received from a health care professional said: When placements are made I am always confident that patients’ needs are met and that I receive up to date relevant information from well-informed staff. A card received at the home from the family of a resident who died recently read: It is due to the dedication and caring nature of the staff that he settled in his new home very quickly and was cared for extremely well. The home has a part-time administrator, and another part-time administrator has been recruited to start in November. The home does not deal with any residents’ finances except for small amounts of personal spending money. Two residents have appointeeship through the local authority and two have solicitors who take care of their finances. Personal money is requested for these residents as required. No residents currently control their own money but have relatives who assist them. Approximately half of the residents have personal money kept securely in the home’s safe. Receipts are given to relatives for money paid in. There is a small safe that can be used out of hours. Residents’ money is kept in separate envelopes; all transactions are recorded and double signed; receipts for all expenditure made on behalf of residents are filed. Residents are discouraged from keeping money in their bedrooms and relatives are advised to leave only small amounts of money with residents. Basic toiletries are supplied by home. Willows Nursing Home, Blacon DS0000018789.V260662.R01.S.doc Version 5.0 Page 20 The home’s policies and procedures have been reviewed in July 2005, and the standard of management records inspected was good. The manager provided details of the testing and servicing of all plant and equipment. The gas and central heating systems were booked for testing and servicing later in October 2005. Requirements made by the fire officer in September 2004, which were mostly regarding doors, have been complied with and were signed off by fire officer on 13/10/05. During the inspection it was noticed that, on the elderly frail unit, two bedroom doors were wedged open. Residents were in bed in these rooms, and the manager said that all staff are aware of which doors are open and that they must be closed if alarm sounds, and at night. The inspector suggested that ‘Fire Guard’ devices should be fitted to these doors, but the manager said that she had discussed this with the fire officer, who did not recommend such devices. There are no plans at present to fit bedroom doors with automatic closing devices due to cost, however these are in place on corridor doors. The manager is a fire trainer and fire lectures have been held in June and October 2005, with fire drills held in between. A weekly fire alarm test is recorded and monthly emergency lighting test. The home has two moving and handling trainers, and they keep training records and are aware when update training is due for each member of staff. The manager carries out a monthly health and safety audit, a monthly kitchen audit, and a monthly accident audit. Records of these were made available for inspection. Willows Nursing Home, Blacon DS0000018789.V260662.R01.S.doc Version 5.0 Page 21 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 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 x 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X 3 3 Willows Nursing Home, Blacon DS0000018789.V260662.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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. 1 Refer to Standard OP9 Good Practice Recommendations Medicine audits should be carried out regularly to identify where there are any errors and to address any shortfalls. Willows Nursing Home, Blacon DS0000018789.V260662.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: 0845 015 0120 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 Willows Nursing Home, Blacon DS0000018789.V260662.R01.S.doc Version 5.0 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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