Inspection on 25/10/05 for Wilnecote Rest Home

This inspection was carried out on 25th 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Wilnecote Rest Home 30/04/07

Wilnecote Rest Home 06/09/06

Wilnecote Rest Home 15/06/05

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 Rest Home Manor Farm Hockley Road Wilnecote Tamworth Staffordshire B77 5EA Lead Inspector Mrs Wendy Grainger Unannounced Inspection 25 October 2005 10.00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Wilnecote Rest Home DS0000040806.V259591.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. Wilnecote Rest Home DS0000040806.V259591.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Wilnecote Rest Home Address Manor Farm Hockley Road Wilnecote Tamworth Staffordshire B77 5EA 01827 262582 01827 261569 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) Dr Rais Ahmed Rajput Mrs Nichola Jayne Thomas Care Home 15 Category(ies) of Dementia - over 65 years of age (15) registration, with number of places Wilnecote Rest Home DS0000040806.V259591.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th June 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 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 at 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 number of residents with the inclusion of a building in the grounds interlinked to the main home. This will increase the number to 23 residents in total. Wilnecote Rest Home DS0000040806.V259591.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was undertaken on the 25 October 2005. The residents, staff and deputy manager assisted with the information provided and included in the report. The registered care manager was in the building involved with her tutor for the Registered Managers Award NVQ Level IV and intermittently made contributions to the inspection. Feedback was given at the end of the inspection to the management. At the time of this inspection there were thirteen residents at Wilnecote. The majority of the residents were comfortable in the lounge, two ladies preferred to wander around the home, the staff monitored their routine. Included in the inspection was a sample tour of the home, following the last inspection the inspector was disappointed to observed limited action to address the curtains in seven of the sampled bedrooms. While clean and pressed they required more hooks and fittings to secure them. The carpets remained the same; the provider told the inspector that they had been cleaned by a commercial firm, but remained stained with age and wear. Future plans following the completion of the extension will include the carpets being replaced. There was a malodour near to the quiet lounge; bathrooms and toilets were located through the home. The recently provided infection control training session appears not to have been fully understood by certain staff not on duty at this time; this was evidenced in toilets, where toilet rolls and resident’s continence equipment were left exposed. This was discussed with the provider and care manager at the time and at feed back. The inspector spent time with residents; two in particular gave the staff a “good report” of their care and how they liked the home and staff. These residents sat with the inspector when their care plans was being examined and contributed to the plan where information had not been completed. Residents were observed to enjoy the lunch, which was well presented and of ample portions; homemade rhubarb crumble was served after the savoury mince. The previous report recommended a review of the menus to provide a more balanced suitable alternative. The inspector had conflicting information re the review and no evidence of the changes could be located. The previous inspection identified limited activities provided to meet the interests and hobbies of the residents. While constructive activities were not always possible for some residents, four residents told the inspector that they Wilnecote Rest Home DS0000040806.V259591.R01.S.doc Version 5.0 Page 6 would welcome entertainment/music from outside. There was no evidence of any activity that had taken place the programme could not be located. There had been some input to the training programme, which continued with one-day sessions and not at this time the distance learning sets as recommended. Arrangements were in place for the continued care of the residents, from other agencies as was evidenced in the care plans. The dependency levels of the residents had again decreased; the staffing levels at the time of this inspection appeared adequate to meet the individual’s needs. The inspector was impressed with the staff on duty and their commitment and approach to the residents and their needs. Risk assessments and care plan information were part of the inspection and discussion with the deputy care manager and staff. What the service does well: What has improved since the last inspection? What they could do better: The requirements of the previous inspection should have been addressed, especially the bedroom curtains, which was within the managers remit. Wilnecote Rest Home DS0000040806.V259591.R01.S.doc Version 5.0 Page 7 Infection control in the two toilets near the office was poor with continence equipment and toilet rolls left exposed. The sluice was left unsecured, a minimum of three residents wander along the corridors therefore the bolt should be engaged at all times. The boiler room should have been locked; this oversight was due to one of the workmen storing a special saw over the weekend. Residents with dementia and that wander should have been considered and the room secured. This report identified three requirements; two from the previous report are transferred to this report. Four recommendations will be identified. 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 Rest Home DS0000040806.V259591.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Wilnecote Rest Home DS0000040806.V259591.R01.S.doc Version 5.0 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 the following standard(s): 1,3 5 Standard six was not relevant to this home. Access to the applicable information was available for the prospective resident and or relative to make an informed choice of placement from the documents provided. EVIDENCE: The Statement of Purpose remained the same with the relevant information provided for any person enquiring about a placement. The management continued to assess individual’s needs prior to admission. This was evidenced in the care plans folders. An open invitation was offered to visit the home prior to admission. Wilnecote Rest Home DS0000040806.V259591.R01.S.doc Version 5.0 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 the following standard(s): 7,8,9,10 Arrangements were in place for the continued care for the personal and physical needs of individuals. The care plans and risk assessments should be more informative and reflect the individuals needs fully. The present format was not comprehensive enough, they needed to be wide ranging. The manager needed to monitor the records for the administration of medication; the system in operation was satisfactory. EVIDENCE: Two of the care plans were sampled the ones chosen were the two most recently admitted residents. The plans were in a modular form, while the personal needs were recognised the action plan was limited in some areas. There was no evidence of a resident being involved in their care plan. While the inspector recognised the homes registration, during the inspection the two residents whose plans were being reviewed came to the table and discussed their life style and needs. One of the residents had realised her plan was part of the inspection and became involved. Wilnecote Rest Home DS0000040806.V259591.R01.S.doc Version 5.0 Page 11 Information was gathered from both of the residents that was not included in the care plans. Risk assessments needed to be more detailed and informative. This was discussed and advice given as how to move them forward. Arrangements were in place for the continued care of individuals. Where appropriate supportive equipment had been provided. The registered care manager was to commence a distance learning course for the Safe Keeping and Handling of Medication in November 2005, the Deputy and then the staff will also complete this course. One day’s medication had not been signed for as evidenced in the records. No resident had the ability to self administer his or her medication. The inspector was impressed with the staff on duty during the morning when the majority of the inspection took place. They responded to the needs of individuals while recognising their of lifestyle to wander the corridors. The staff were also fully aware of the other residents needs and addressed them appropriately. Wilnecote Rest Home DS0000040806.V259591.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): 12,13,15 The social life of the residents was somewhat limited to in house, there was no evidence of any activities taking place, and this observation was incorporated in the previous inspection report. Links with families and relatives were encouraged and maintained. The recommended review of the menus had not been actioned, there was no written evidence of the planned alternatives to be offered. It is important that all the staff were aware of the dietary needs of the residents to ensure the appropriate food was served. EVIDENCE: The limited social/interest/hobbies of the residents remained unchanged. The registered care manager could not locate the activity programme, which the inspector was told was in the building. While speaking with the residents four of them were enthusiastic about someone coming into entertain them. Three of the residents had daily visits from their relatives, they were welcomed and assisted in giving any treats of food they had brought in. Wilnecote Rest Home DS0000040806.V259591.R01.S.doc Version 5.0 Page 13 Following the last inspection the menus were to be reviewed to provide more positive alternatives. The inspector received conflicting information from the cook and care manager. There was no written evidence provided to confirm the review. Identified with one of the new resident’s was that she did not like sausage; she had been served them, and was unaware that she had an option. It was agreed with the cook that when sausage was on the menu the resident would be served her favourite chicken. This information was on the care plan but had not been identified by the staff. Leading the inspector to express to the management that all the staff should have an awareness of the care plans and to ensure they are put into practice. Wilnecote Rest Home DS0000040806.V259591.R01.S.doc Version 5.0 Page 14 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): 16,18. The homes complaint process remained unchanged it was displayed within the relevant documents and within the home. Residents were protected from any form of abuse via the training programme internally and externally EVIDENCE: There had been no complaints raised by relatives to the registered care manager or Commission. Residents were protected by the committed staff group who benefited from the home induction and external NVQ Level II & III in Care Wilnecote Rest Home DS0000040806.V259591.R01.S.doc Version 5.0 Page 15 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 20 23 24 25 26. There had been no change in the environment since the previous inspection. The home had areas that needed attention especially the fittings in the bedrooms to maintain a homely environment. Any identified malodours should be monitored and addressed. EVIDENCE: Located in a quiet road, near to a small amount of shops the home is undergoing an extension to increase the number of places to twenty-three. Internally the home was hazard free, where residents can wander freely. The carpets remained in need of replacement. The provider told the inspector that he had had the carpets cleaned by a specialist since the previous inspection. Unfortunately the carpets are aged and stained, the first impression of visitors would be the carpets. Wilnecote Rest Home DS0000040806.V259591.R01.S.doc Version 5.0 Page 16 There was a malodour identified outside the small lounge, this needed to be monitored and addressed. The curtains referred to in the previous report remained unchanged the inspector identified seven bedrooms where a little thought and extra hooks and fittings would provide a more attractive environment. This concern and advice was fed back to the provider. The staff had received a one day training course for the control of infection. This appeared to have made little impact on certain staff that had placed a number of unprotected toilet rolls, and a large number of resident pads in the toilets. Apart from an individuals dignity being compromised the pads may have been contaminated. This was brought to the providers and managers attention. The sample of bedrooms identified that resident’s relatives were encouraged to bring in personal possessions. Wilnecote Rest Home DS0000040806.V259591.R01.S.doc Version 5.0 Page 17 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 30 Arrangements were in place for the residents to receive continued care from the committed staff. The staffing levels were adequate to meet the needs of the present resident group. Staff via the in house and external training were competent to do their jobs. EVIDENCE: Wilnecote did not experience a large turnover in staff. The present staff were experienced and competent to do their jobs. Staff were aware of their roles and responsibility. The registered care manager was aware of the need to have in place all the required checks prior to employment. Mandatory training was evidenced from the records provided for the inspector. Wilnecote Rest Home DS0000040806.V259591.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): 31,32,36,38 The home was run for the benefit of the residents. Staff and management so far as reasonably practicable ensured that the home was a safe and secure. It is important that the testing of the fire system was completed weekly and recorded. It is important that each of the resident’s information was current and available EVIDENCE: The home was operated by the registered care manager, supported by her deputy and other staff to ensure that the residents were well protected from harm as far as practicable. Wilnecote Rest Home DS0000040806.V259591.R01.S.doc Version 5.0 Page 19 There was a calm relaxed atmosphere within the home the interaction between the residents and the staff was warm and positive. Residents shared time with the inspector who was grateful for their time and comments. At the time of the inspection the registered care manager was spending the day with her tutor for the Registered Manager Award NVQ Level IV. The manager up dates her own knowledge with in house mandatory training. Records identified that for two weeks the fire system had not been tested; it is important that when the person responsible was not available then someone else should be delegated to carry out the testing. Evidenced in the residents records were that identification i.e. photographs were not available on all the records. It is important that the manager reviews Schedule 2 of the National Minimum Standards. To be fair the care manager had requested a disposable camera four times evidenced from the shopping list, the provider had not made this available. Wilnecote Rest Home DS0000040806.V259591.R01.S.doc Version 5.0 Page 20 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 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 3 X X 2 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 3 3 X N/A X X X 2 Wilnecote Rest Home DS0000040806.V259591.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? yes 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 OP19 Regulation 16 (c ) Requirement Timescale for action 01/12/05 2. OP12 16 (n) 3 OP38 13 3 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 11/11/05 consult residents about a programme of activities arranged by or on behalf of the care home The registered person shall make 31/10/05 suitable arrangements to prevent infection, toxic conditions and the spread of infection at 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. Refer to Standard OP7 OP15 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 DS0000040806.V259591.R01.S.doc Version 5.0 Page 22 Wilnecote Rest Home 3. 4 OP9 OP38 suitable alternative and to offer the residents a more positive choice. The registered person shall ensure that medication is signed immediately after it is given. There is a need to monitor the recording of the weekly testing of the fire system Wilnecote Rest Home DS0000040806.V259591.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Stafford Office 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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