Inspection on 08/12/08 for Willows Residential Home

This inspection was carried out on 8th December 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 Residential Home 04/01/07

Willows Residential Home 13/01/06

Willows Residential Home 26/05/05

Willows Residential Home 17/01/05

Willows Residential Home 29/09/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Willows Residential Home Corders Farm, Bury Road Lawshall Bury St Edmunds Suffolk IP29 4PJ     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: Claire Hutton     Date: 0 8 1 2 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 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Willows Residential Home Corders Farm, Bury Road Lawshall Bury St Edmunds Suffolk IP29 4PJ 01284830665 01284830892 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Margaret Holt Type of registration: Number of places registered: Extrafriend Limited care home 25 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: 1 The home may accommodate persons of either sex, over the age of 65 years, who require care by reason of old age (not to exceed 25 persons) Date of last inspection Brief description of the care home The Willows is a large detached building set it its own grounds in the village of Lawshall, a rural location, approximately eight miles south of Bury St Edmunds. The property, originally a farm, was extended during 2004 to provide additional bedroom and communal facilities. As a result the number of registered beds at Willows increased from seventeen to twenty-five. Apart from one larger shared bedroom on the first floor, the remaining bedrooms were singly occupied, and all bedrooms in the home had en-suite facilities. The accommodation, located on two floors, includes a shaft lift, and a staircase, connecting the two floor levels. The home is set in pleasant gardens, which include patio seating areas, lawns, flowerbeds, and a pond. There is off road carCare Homes for Older People Page 4 of 28 Over 65 25 0 Brief description of the care home parking at the front of the home. Current weekly fees for this home range from £450.00 to £550.00. Care Homes for Older People Page 5 of 28 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 was a key inspection, which focused on the core standards relating to care homes for older people. The inspection was unannounced on a weekday, which lasted 7 hours. This report has been written using accumulated evidence gathered before and during the inspection, including information obtained from 10 Have Your Say surveys. Comments from these surveys are used in this report. The Annual Quality Assurance Assessment (AQAA), issued by the Commission for Social Care Inspection (CSCI) was returned completed by the manager. This self-assessment gives providers the opportunity to inform the CSCI about their service and how well they are performing. We (CSCI) also assessed the outcomes for the people living at the home against the Key Lines of Regulatory Assessment (KLORA). Care Homes for Older People Page 6 of 28 A tour of the premises was made and a number of records were inspected, relating to people using the service, staff, training, the duty roster, medication and health and safety. Time was spent talking with people who live in the home and 3 members of staff. Their comments are included in this report. The manager of the home was available during this inspection and fully contributed to the inspection process. We also had the opportunity to meet one of the owners/directors who spoke about future plans and developments of the service. What the care home does well: What has improved since the last inspection? What they could do better: We are confident that the management of this service will address matters we raised during inspection. One of these was to ensure 2 staff signed in controlled medication Care Homes for Older People Page 8 of 28 when it arrived at the home, as this would clarify that delivery was correct and ensure records started off correctly, thereby protecting residents and staff. We have also made a requirement that the manager review the fire risk assessment in place to ensure this is as comprehensive as possible and thereby protecting all in the home as far as is possible. 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 9 of 28 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 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Willows ensured that information was available about the service and clearly related to cost and contracts agreed. An assessment was routinely completed before moving in and formed the basis of care planning to ensure the service could meet individual needs. Trial periods were in place and followed up with a review. Evidence: Whilst at the service we asked if the Statement of Purpose and Service Users Guide was available. The manager was able to show that these were available to anyone who requested them. The service users guide set out the current fees for 2008 and also clearly stated what was included in the price and what was not included. Two things that were not included were hairdressing fees and chiropodist fees and the current 2008 price of these was listed. From three records we examined we found that contracts were in place and had been agreed by the appropriate parties. Therefore, people can be assured that they will know the cost of the services provided. The 6 Care Homes for Older People Page 11 of 28 Evidence: surveys from residents returned all said that they recieved enough information about the home. All comments made were positive. One person said Excellent brochure was provided and a very informative interview. In terms of an assessment before a resident moved into the service we were able to request three current residents records at random and found that a detailed preadmission assessment had been completed by the manager. This formed the basis of the care plan developed by the home. The manager explained to us that prospective residents and their families could come and visit and spend time at the home. On the day of our visit a relative was visiting the home to decide whether it was suitable for a family member. The home had been generous and had transported this relative to and from the home. The home has also supplied a checklist of questions to ask when visiting a care home to see if it is suitable. This is available to all on the website created about the service by the home. The manager explained to us that once a new resident moved into the home there is a trial period and after approximately 6 weeks a review would be held to decide if this was an appropriate permanent placement. We looked at three different records and found that a review had been held in each case and had included the individual resident and their family. The manager stated that this period could be extended as the home would not like anyone to commit to a contract that they were not totally happy with. Care Homes for Older People Page 12 of 28 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. People who use this service will find they have a comprehensive care plan in place that is using current good practice guidance and that they are regularly reviewed with the individual. Dignity and privacy is observed in this home. People are protected by the homes policies and procedures for dealing with medication. Evidence: Since our last visit to this service there has been new care plans developed. We examined three different care plans for residents who were new to the service and had higher dependency needs. We found that the care plans gave good clear information to care staff on how best to support individuals. The care plans were divided into different sections such as hygiene, dressing, elimination, eating and drinking, communication, mobility, safety, recreation, sexuality and sleeping. Daily care notes had been kept by care staff and were good factual care notes of the support given to individuals. There was also a record of bathing and hair washing. There was also evidence that once a month the care plan were evaluated and changes made where needed. Staff spoken with spoke highly of the new care plans and felt the care they gave was of good Care Homes for Older People Page 13 of 28 Evidence: quality. All comments around care and support were positive. One survey said Excellent care and support is always given. Medical support is obtained quickly when needed. In care plans there was also evidence of risk assessments. The two main risk assessment completed related to manual handling and falls prevention. The manual handling risk assessment had been well completed and had evidence of regular review and clearly gave instruction to staff on transfers, walking, toileting, bathing and getting into a car. The Willows had positively embraced the new information available around falls prevention. We spoke with staff who had a good understanding and some of which had attended training on falls prevention and others who had completed the champions course. There was a folder available that contained information that had details from the training courses. Staff had access to this and had used this information in individual care plans and had developed risk assessments and strategies in falls prevention. Linked to this was the Health on Tap. This was a joint working project with Anglia Water to ensure that residents were kept hydrated. The manager explained that she had close links with West Suffolk Hospital and the falls prevention team and they had already seen improvements in terms of less falls and injuries sustained by the resident group. In relation to access to health care on the day of our inspection we saw the district nurses visiting and a GP visiting. In care plans examined we saw evidence of all professional health care visit recorded. We noted in one case following a recorded accident that the appropriate health care had been sought. Residents spoken with said that they had a choice to remain with their own registered GP and had only need ask and a doctor would be called. Our observations of staff interactions and what resident told us leads us to believe that residents are treated with respect and their right to privacy is upheld. Medication within the home was generally well-managed. We were fortunate to observe staff administering medication at the lunchtime period and the delivery and return of medication from the pharmacist. We observed the staff were confident and competent and completed all paperwork appropriately. However, we examined the control medication records and discussed with the manager the reasons to ensure that 2 staff sign for control drugs arrival in the home. The manager agreed to ensure that this would happen in future. Residents spoken with said that the staff were extremely kind and always brought their medication when they needed it. We found that care plans contained information on funeral arrangements. Also on the day of inspection two care staff attended the funeral of a resident. The order of service with a photograph of the resident when younger was brought back to share with the Care Homes for Older People Page 14 of 28 Evidence: residents and staff. Care Homes for Older People Page 15 of 28 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 Willows provides an excellent range of social activities and ensures that residents health and well-being is maintained through the provision of good quality catering. Evidence: The Willows has a history of providing daily activities and recreational interests for residents. During our visit this time we found that this good standard of activities had continued. Whilst speaking to residents, staff and looking at notice boards we found that the home had involvement with the local community. This included the green light trust that had developed golden wood opposite the home and residents were able to visit the wood in good weather. Two local schools were also involved with the home and visited from time to time. This included them singing carols and providing tree decorations made by the children. We were told of about how residents and staff had enjoyed an open day at the Willows in the summer. This had involved a brass band, large games and hiring a marquee. There are two staff who are generally responsible for organising entertainment within the home. Not only do they provide daily entertainment such as keep fit sessions and general knowledge quizzes they also brought in entertainment. A theatre group of six Care Homes for Older People Page 16 of 28 Evidence: people that were singing and dancing to entertain the residents had visited the home. On the 29th of December a local musician who played the ukelele and guitar was due to visit the home to entertain the residents. The arrangements for Christmas were well under way and a cheese and wine party was planned for third of January 2009. Residents confirmed that there was plenty of activities and interests to meet their needs. Whilst we were at the home we were able to discreetly observe the lunchtime meal. The dining room is nicely laid out with table settings condiments and napkins. Each resident was offered a choice of drink. Lunchtime was a social affair that was unhurried and enjoyed by most if not all the residents group. One resident told us that they liked the menu set out on a large chalkboard in the dining room. We were able to see from the chalk board the todays lunch was sweet and sour pork served with three different vegetables and mashed potato. There was an alternative served to those who did not like sweet and sour pork. There was a lot a social chatter at the dining table however when the meal was served there was silence whilst the residents ate and enjoyed their main course and over the choice of dessert the chatting and socialising resumed. The staff went to great lengths to ensure that each person had a meal of their liking. Great care was also taken on the quality and style of presentation of the food. One relative told us My relative has a diabetic diet and a special menu. There are a good range of menus during the week. Care Homes for Older People Page 17 of 28 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. People who use this service can be assured that the Willows will take concerns and complaints seriously and take action to put things right. This home safeguards people from abuse and is aware of action they must take following any allegation. Evidence: The self-assessment completed by the manager told us that there was a robust clear complaints procedure in place with a log of complaints and the action taken. That the staff are trained to recognise and report worries and concerns. That the home had a whistle blowing policy. And that policies and procedure relating to safeguarding were clearly adhered to. On inspection we found that this was the case. The complaints procedure for anyone to use was clearly displayed. We examined the log of complaints and found that the service had listened to two complaints that had been made in the last 12 months. We found that these had both been responded to within 28 days and that action had been taken to the satisfaction of the complainant and to prevent a potential re-occurrence. When we spoke with residents they were quite certain that they did not have any concerns or needed to make any complaints but felt that they could talk to the manager if they needed to. The manager told us that she had received information and was booking places for Care Homes for Older People Page 18 of 28 Evidence: staff on training that related to the Mental Capacity Act. We also suggested to the manager that she should access specific training on abuse awareness. Staff spoken with had said this element of training had been covered on their induction training and had formed part of their NVQ training. Staff were also aware of the whistle blowing procedure. The manager knew of the local reporting procedure with regard to any allegations of abuse and had access to policies and procedures. Records examined showed that no staff were employed to work at this home before thorough checks around their suitability had been completed. This included a criminal records bureau check. Care Homes for Older People Page 19 of 28 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 living at The Willows can expect to live in a clean, comfortable and wellmaintained environment that meets their needs. Evidence: A tour of the communal areas and several bedrooms was undertaken, all were found to be clean and tidy and hygienic throughout. Some bedrooms had residents own furniture in and one of the rooms was unoccupied. All furnishings provided were of good quality. Bedrooms had personal possessions such as photographs, pictures and books. All bedrooms are en-suite. Accommodation is on two floors with access via a passenger lift. Willows is well decorated and maintained to a good standard. The communal lounge is large and spacious with a view of the well-kept garden. A sensory garden had been developed. The dining room is spacious and residents sit with groups of two to six people. The laundry room was well equipped with two washing machines and a dryer. And a sluice machine for cleaning commode pans. The self-assessment told us that the home uses universal precautions to minimise the spread of infection. Alcohol rub is avaiable upon entry to the home. Care Homes for Older People Page 20 of 28 Evidence: There were a number of specialist beds in place for use by residents and the home had installed a quality specialist bath. Main corridors/hallways were wheel chair accessible and had grab rails. Wheel chairs were stored tidily under a cupboard. All fire exits were clearly marked and designated. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People at this home can expect to be supported by sufficient staff that are well recruited and trained to meet their needs. Evidence: The self-assessment told us that the service complies to recruitment in line with national minimum standards. Also that there is a small staff turnover and that they never used agency. From examination of recruitment records we agree that staff are well recruited in line with regulation and that only suitable people work at the home. Staff spoke with said that the staff group is very stable and that any staff sickness or annual leave is covered from within the existing staff group. Residents confirmed that the staffing levels were good and that they did not have to wait for assistance. The self-assessment also told us that 50 of staff have achieved NVQ. 18 staff have infection control training. That 13 staff have received training in malnutrition and assisting residents to eat. And that four catering staff have received training in food hygiene and that nine care staff have received training in food hygiene. We spoke to 3 staff and all 3 said they had a NVQ qualification and that good training was on offer at this home. Staff also confirmed that they had received training on medication, manual handling and 1st aid. One staff member talked enthusiastically about their involvement with the falls prevention developments at the home. One staff member said I have no Care Homes for Older People Page 22 of 28 Evidence: concerns I love my job. The 4 staff surveys returned by staff were very positive about the home and how it was ran. One person wrote my induction was carried out brilliantly. I had no previous experience but after induction felt confident and able to do my job well. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Willows is run and managed appropriately with residents views being sought regularly. Majority of health and safety practices were good, but a potential risk can be addressed through reviewing the fire risk assessment. Evidence: The Willows is managed by a suitably qualified and experienced manager. The current manager was pleased to have completed the registered managers award in 2007. Staff and residents spoken with praised the managers friendly approach in her management of the home. They also said she was efficient and approachable. There were regular visits made by the owners to the home which support the internal quality assurance process. The reports form the visits had been routinely forwarded to CSCI, but now were available for inspection at the home. During our visit we had the opportunity to meet an owner/director of the organisation who was conducting one of his regular unannounced visits to the home to talk to staff and residents. The manager Care Homes for Older People Page 24 of 28 Evidence: was spoken with and confirmed that the service had continued with undertaking customer satisfaction audits. We were able to view the last one completed in June 2008. This had an action plan attached and was due to be repeated soon. The service does not manage any financial affairs on behalf of service users. It does however keep small amounts of cash for individuals. These monies were kept secure and a ledger was kept of every transaction with receipts so that money could be audited if required. The self-assessment confirmed positive outcomes in relation to health and safety matters and we sampled some areas. Hot water for bathing was delivered at a safe temperature. The premises electrical wiring certificate had been redone on 05/11/08. We looked at the current fire risk assessment in place. This was dated 2006 and we could not find evidence of recent review. We could not find evidence of information that related to evacuation procedures. We did find evidence of weekly fire alarm testing. Fire alarm services had visited on 29/07/08 and serviced the systems. There was also evidence of fire drills. The lack of review and developments is currently putting residents and staff a potential risk and this was fed back to the manager who agreed to address our concern. Care Homes for Older People Page 25 of 28 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 26 of 28 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 1 38 13 The fire risk assessment 09/02/2009 must be regularly reviewed and should contain information about evacuation procedures, the equipment provided and staff trained to use this equipment whilst following these procedures. This will further protect the residents and staff in the event of a fire. 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 Care Homes for Older People Page 27 of 28 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. 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