Inspection on 15/06/05 for Wilnecote Rest Home

This inspection was carried out on 15th June 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

Wilnecote Rest Home 30/04/07

Wilnecote Rest Home 06/09/06

Wilnecote Rest Home 25/10/05

Wilnecote Rest Home 06/12/04

Wilnecote Rest Home 01/06/04

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

CARE HOMES FOR OLDER PEOPLE Wilnecote Manor Farm Hockley Road Tamworth, Staffordshire B77 5EA Lead Inspector Wendy Grainger Announced Wed 15 June 2005 09.00am 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 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. Wilnecote E09 E51 S40806 Wilnecote V226854 150605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Wilnecote Address Manor Farm Hockley Road Wilnecote Tamworth Staffordshire, B77 5EA 01827 262582 01827 261569 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Dr Rais Ahmed Rajput Mrs Nichola Thomas Care Home 15 15 Category(ies) of DE(E) registration, with number of places Wilnecote E09 E51 S40806 Wilnecote V226854 150605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: N/A Date of last inspection 23 February 2005 Brief Description of the Service: Located off a busy main road Wilnecote is set in a quiet road within walking distance of a small selection of shops. The home was registered in December 2002 and provided accommodation for fifteen older people suffering with a dementia. With the exception of two bedrooms on the first floor all the bedrooms were on the ground floor. If necessary the first floor could be accessed via the shaft lift or main stairs. No en-suite facilities were provided, bathing and toilets were located on the first and ground floor. There was very limited parking facilities in the front courtyard to the home a larger parking area is located a t the rear of the home. The area at the side of the home at this time was unsuitable for the service users to use. The provider had plans to redesign this area. One large lounge and a quiet lounge were available to all the service users and or their families. The dining room was located off the main lounge. there are plans to increase the registered numbers of residents with the inclusion of a building in the grounds interlinked main home. this wil increse the number to 23 residents in total Wilnecote E09 E51 S40806 Wilnecote V226854 150605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. At the time of this inspection there were thirteen residents at Wilnecote, this included one person on respite stay for two weeks. The inspector found the residents well presented and continuing their daily routine of wandering freely around the corridors, sitting with a newspaper and interacting with the staff on duty. The care manager and cook provided the inspector with the relevant documents to complete the inspection including a Pre Inspection Questionnaire. A tour of the home was conducted, parts were sampled and where necessary commented about in this report. The inspection was based on the National Minimum Standards and evidence gathered. The Commission had received some comment cards from relatives. During the inspection the staff sat with the residents that had the ability to provide an opinion. From the five relatives cards two made extra comments that they felt the staff were approachable and sure they would respond in the event of any concerns. One verbal comment was “the staff were brilliant always friendly” One family expressed that their father had improved physically and mentally since his admission. The staff were always friendly and greeted them with a smile. The four residents cards had no extra comments but that they were satisfied with the home and staff. They did not wish to be involved with the homes decision making in the home. Bedrooms were located on two floors accessed via the lift and the stairs. There was a safety feature on the lift when it is on the ground floor. A key had to be used to open the door. This prevented any of the wandering people from using the lift accidentally. One resident used the lift independently from his room on the first floor. Two of the bedrooms had a malodour, despite regular carpet shampooing. The majority of the “Flotex” carpeting was beyond cleaning, and while not damaged in any way the carpets were badly stained with age and wear. These will need to be replaced in the very near future. The large lounge looks out onto the small courtyard; a number of the panes in the windows are to be replaced due to the seal being compromised. This will take place after/before the new extension has been completed. A number of the curtains in the bedrooms; while new clean and well pressed lacked a homely touch with limited hooks and fittings to hold them in an attractive manner. Residents were catered for via three meals daily; catering commenced at 8am until 3pm. Wilnecote E09 E51 S40806 Wilnecote V226854 150605 Stage 4.doc Version 1.30 Page 6 Housekeeping was at this time, on a part time basis three times each week. This will need to be increased when the home is extended. Staffing levels for the residents present was satisfactory. The dependency levels of the residents had decreased since the previous inspection. Residents were coming into the lounge ready for breakfast upon the arrival of the inspector. Each one was asked their preference. One person chose a bacon sandwich, which was promptly cooked, for her by the cook on duty. What the service does well: What has improved since the last inspection? The requirements made on the previous inspection had been addressed. The provider had purchased an industrial tumble dryer. New bedding, towels, flannels had been purchased. A new large fridge had been purchased. Wilnecote E09 E51 S40806 Wilnecote V226854 150605 Stage 4.doc Version 1.30 Page 7 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. Wilnecote E09 E51 S40806 Wilnecote V226854 150605 Stage 4.doc Version 1.30 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Wilnecote E09 E51 S40806 Wilnecote V226854 150605 Stage 4.doc Version 1.30 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 5 The home provided the essential information to assess the potential of the home and the facilities provided. EVIDENCE: The Statement of Purpose was displayed in the front entrance hall, a service users guide was made available to residents and families, in general they were not located in the bedrooms due to the mentally frail condition of the residents. Assessments continued to be undertaken prior to admission taking place. The home had a policy for prospective residents to view the home. Families were welcome to call at any time. A month’s trial period was normal practice. During the inspection the care manager was asked to re-assess a resident in hospital. Wilnecote E09 E51 S40806 Wilnecote V226854 150605 Stage 4.doc Version 1.30 Page 10 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 standard(s) 7,8,9,10,11, The health needs of the residents were well met with contact records being maintained. The format of the proposed care plan should ensure that needs and plan of action would be clearly identified and actioned by all the staff. EVIDENCE: The personal needs of individuals were recorded. A new format was to be explored; and was shown to the inspector. There was room to include, and expand on the areas discussed. The plans failed to identify the plan of action to be taken. This could easily be resolved. Two care plans were tracked; the personal needs and daily routine were observed. Photographs of the residents were in place. Arrangements were in place for the residents to receive the services of the District Nurse, one resident was visited irregularly, she is waiting for chiropody from the National Health Service, and the District Nurse had referred her twice without a response. The family requested this service and not private, hence the wait. Wilnecote E09 E51 S40806 Wilnecote V226854 150605 Stage 4.doc Version 1.30 Page 11 Nine of the staff had received medication training; this was on one day courses based on different kinds on medicines. The home’s residents were prescribed a limited amount of medication; very limited psychotropic drugs. No resident manages, controls or administers their medication. The staff were excellent with the residents very aware of their needs and responding to the routines of the day in a sensitive manner; nothing seemed to be too much trouble for the staff to deal with. Relatives during the admission process are requested for information in respect of funeral details. Not all the families provided information. Wilnecote E09 E51 S40806 Wilnecote V226854 150605 Stage 4.doc Version 1.30 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 standard(s) 12,13,15 The routine of daily life was at a pace to suit the residents; their social expectations could be seen as somewhat limited. The menus in general provided a selection of food, but would benefit from a total review of the alternatives, which were not always balanced. EVIDENCE: The social routine for the residents was somewhat limited and repetitive, the record evidenced that the majority of the activities were in the form of a sing song. An occasional entertainer was arranged; some manicures were recorded. Personal spiritual needs were met by individuals own minister calling. The Catholic priest tends to talk to all the residents socially. The home operated free style visiting for relatives this was evidenced on this and other inspections to the home. The menus remain an item of discussion; they offer a variety of food over a four-week period. There was a need to review the alternatives and to assist the residents to make a positive choice on a daily basis. Two residents had a softer diet and were assisted when dining. The inspector commented on the brown mass in a dish, which was a resident’s meal. While it was all consumed the presentation was not acceptable. The required temperatures were satisfactory. Wilnecote E09 E51 S40806 Wilnecote V226854 150605 Stage 4.doc Version 1.30 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 standard(s) 16 18 The home had a satisfactory complaints process in place. EVIDENCE: There had been two complaints brought to the attention of the Commission via the staff. One had been investigated by the provider, the second one by the Commission. The first one had been withdrawn; the second complaint was found inconclusive. The home displays a complaints procedure, comments from relatives in respect of the comment cards received identified that they were aware of whom to speak too. Further awareness in respect of working with Vulnerable Adults was part of the supervision process and within the induction. Wilnecote E09 E51 S40806 Wilnecote V226854 150605 Stage 4.doc Version 1.30 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 standard(s) 19,20,21,23,24,25,26. The environment while maintained hazard free needs to be reviewed to provide a more homely establishment. There had been limited change in the decoration or furnishings for some time. EVIDENCE: Externally at the rear the home was unsafe for residents, having a gravel finish. This was to be landscaped as part of the condition for registration when the extension is completed. Internally the staff maintained a hazard free environment. The majority of the “Flotex” carpeting were beyond cleaning, and while not damaged in any way the carpets were badly stained with age and wear. These will need to be replaced in the very near future. Wilnecote E09 E51 S40806 Wilnecote V226854 150605 Stage 4.doc Version 1.30 Page 15 The large lounge looks out onto the small courtyard; a number of the panes in the windows are to be replaced due to the seal being compromised. This will take place after/before the new extension has been completed. A number of the curtains in the bedrooms; while new, clean and well pressed lacked a homely touch with limited hooks and fittings to hold them in an attractive manner. Bedrooms sampled were suited for the taste of the residents; personal items were displayed. Advice was given as to providing some form of enclosed bag to contain the protective gloves left in the open box in the bathrooms. Recently the staff received a one day course for the control of infection, it was recommended that they management considered a more formal style of training in the form of distance learning course. Wilnecote E09 E51 S40806 Wilnecote V226854 150605 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30 With limited turnover in the staffing levels the residents received continuous support from experienced staff. With more formal training in some areas this will further enhance their knowledge. Residents were protected by the policies and procedures when employing new staff. EVIDENCE: The residents were cared for by staff with knowledge of their needs, the age and gender range of the staff was mixed. Residents were heard to respond positively to the male person undertaking the cleaning today. The management had an on going advert in the local press for staff at the time of this inspection staff were being interviewed in view of the extension being completed. Evidence was seen of the application form filled in by three applicants. Residents were protected by the procedures and practices of checking all the requirements prior to employment. The manager maintained training records, which were made available to the inspector. The mandatory training was current with the exception of two new staff being involved in a hands on fire drill. There was a recommendation to firm up the Health & Safety training with a formal course. Staff were expected and records confirmed they watched a video. Wilnecote E09 E51 S40806 Wilnecote V226854 150605 Stage 4.doc Version 1.30 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 32 33 35 36 37 38. The registered manager ensures, so far as reasonably practicable, the health, safety and welfare of the residents and the staff. The manager operated an open and inclusive home for staff and residents. Records demonstrated that the home seeks the views of other people. Staff supervision had been developed with records maintained. EVIDENCE: The registered care manager had been accepted on the Registered Managers Award at Stephensons College; funded by and agreed by another professional agency the National Occupational Standards Awards in Care. Mrs Thomas had a number of qualifications, which were relevant for the care of vulnerable people. Wilnecote E09 E51 S40806 Wilnecote V226854 150605 Stage 4.doc Version 1.30 Page 18 The home appeared to be operating in a satisfactory manner. Staff on duty confirmed supervision and that they were well supported by the management. The document used for supervision was a little restrictive; a suggestion was made to include another question in respect of if the staff had any issue that may affect their work. Surveys from other agencies and relatives were evidenced as part of the quality audit. There was a record of the audit of the home. Mrs Thomas was to commence an audit of the standards. Maintenance records were examined. It was evidenced that fire alarms were tested weekly, and all other aspects were addressed through tests and instructions including fire drills. The information contained in the Pre Inspection Questionnaire corresponded to the records provided. Wilnecote E09 E51 S40806 Wilnecote V226854 150605 Stage 4.doc Version 1.30 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 x 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 2 COMPLAINTS AND PROTECTION 2 3 3 x 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 N/A 3 3 3 3 Wilnecote E09 E51 S40806 Wilnecote V226854 150605 Stage 4.doc Version 1.30 Page 20 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 19 Regulation 16 (c ) Requirement Timescale for action 20 7 05 and on going 2. 12 16 (n) the registered person shall provide in rooms occupied by residents furnishings including carpets curtains suitable to the needs of the individual resident the registered person shall 20 6 05 consult residents about a and on programme of activities arranged going by or on behalf of the care home RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard 7 15 38 Good Practice Recommendations to review in full the care plan and risk assessment to include a more informative action plan to be taken following a risk being identified. to review in total the menus, to provide a more balanced suitable alternative and to offer the residents a more positive choice. to provide more formal training for the staff, considering distance learning courses. Wilnecote E09 E51 S40806 Wilnecote V226854 150605 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Stafford - Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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. 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