Inspection on 13/06/06 for Wilton Lodge

This inspection was carried out on 13th June 2006.

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

Wilton Lodge 27/04/09

Wilton Lodge 22/05/08

Wilton Lodge 05/02/08

Wilton Lodge 23/08/07

Wilton Lodge 31/10/05

Wilton Lodge 24/06/05

Wilton Lodge 21/12/04

Wilton Lodge 29/06/04

Wilton Lodge 29/01/03

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

CARE HOMES FOR OLDER PEOPLE Wilton Lodge 55 Wilton Road Bexhill-on-sea East Sussex TN40 1HX Lead Inspector Mike Flint Unannounced Inspection 13 June 2006 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 Wilton Lodge DS0000021290.V291752.R01.S.doc Version 5.1 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. Wilton Lodge DS0000021290.V291752.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Wilton Lodge Address 55 Wilton Road Bexhill-on-sea East Sussex TN40 1HX 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) 01424 216250 01435 874819 Angel Healthcare Limited Vacant Care Home 12 Category(ies) of Dementia (12) registration, with number of places Wilton Lodge DS0000021290.V291752.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. That the maximum number of service users to be accommodated is twelve (12). That service users accommodated will be aged 65 years, or over on admission. That service users accommodated will have a dementia type illness. That a maximum of two (2) service users between the ages of 55 and 65 years, who would otherwise fall within the main category, may be accommodated at Wilton Lodge at any one time. The home is not registered to accommodate service users with primary symptoms of drug or alcohol abuse, or acquired brain injury. 31st October 2005 5. Date of last inspection Brief Description of the Service: Wilton Lodge is a Victorian terraced property set close to the seafront and town centre in Bexhill-on-Sea. There are bus routes and a mainline railway station, within a short distance. The home, one of four care homes owned by Angel Healthcare Limited, is registered to provide residential and social care for twelve older people with dementia type illnesses. Accommodation is provided on three floors. Stair lifts are fitted, providing assisted access to rooms on the first and second floors. There is a staff sleep-in room on the fourth floor that doubles as the managers office. At the rear of the premises is a small, private courtyard for use by residents. Wilton Lodge DS0000021290.V291752.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced ‘key’ inspection took place over five hours, during a day in mid June late, when there were eleven residents, one of which was in hospital. During the morning shift there were three carers on duty, reducing to two in the afternoon. (A key inspection is carried out from time to time on all care services, registered with the Commission for Social Care Inspection, for the purpose of determining overall performance ratings). Also on duty was the acting manager, who assisted with the inspection; each of the duty care assistants was spoken with individually; the Inspector also spoke with a visiting Community Healthcare worker. Communication with residents was limited due to their varying degrees of dementia. In regard to this inspection, comment cards had been completed and returned by eight visitors to the home, including relatives on behalf of residents. The Inspector had contact with a Social Services manager and a senior practitioner, with knowledge of the residents at Wilton Lodge. These views together with the views of staff, both verbal and written, are reflected in this report. The current weekly fee level is in the range of £409.10 to £525.00. What the service does well: What has improved since the last inspection? Following concerns that were raised at the time of the previous inspection about the recording of medicines administered, the acting manager is now monitoring these procedures and staff responsible have undertaken training in this area of their work, to promote residents’ health. Records show that training for staff in other ‘safe working practices’ has also taken place and is on-going for newly appointed staff, supporting residents’ well being. Since the last inspection a new assistant manager has been appointed, who is introducing a revised format for the residents’ care plans to provide improved Wilton Lodge DS0000021290.V291752.R01.S.doc Version 5.1 Page 6 access to information about individual care needs and how these are to be met by the staff. The required 1:1 staff supervision is now taking place for which records are being kept. Staff commented that problems they raised are being acted on more quickly now and that communications with management have improved. And, most importantly, that, where necessary, medical interventions and, or re-assessments are being arranged more promptly than previously. A new, replacement stair lift has been installed to the first floor and the stair carpet replaced also. A wash hand-basin has been provided for staff undertaking tasks in the basement laundry; this being a requirement in respect of hygiene and infection control. What they could do better: At the time of this inspection there were no staff undertaking training in the National Vocational Qualification awards for care staff, which omission will necessarily affect the quality of care provided. A relative had noted this and commented that ‘there seems to be not many (staff) with the necessary training’. Staff said that the training they received was inadequate, in particular that dealing with dementia, challenging behaviour and ‘moving and handling’, including use of equipment. Another commented that communication was sometimes problematic, where there was insufficient information about a resident, or where staff were being employed, whose first language was not English. No ancillary workers are employed at Wilton Lodge to undertake the cooking, cleaning and laundry tasks; instead, care staff hours are taken up in this way. During this inspection visit it appeared that these staffing arrangements detract from the care that residents would otherwise receive i.e. in terms of both the 1:1 personal supervision that one of the current residents requires and the outings/ activities that may otherwise take place. A staff commented that the employment of a cleaner would benefit the home e.g. improving cleanliness in the home and enabling staff to provide improved levels of care for those residents with greater needs. One relative expressed disappointment in that the only time her father got out was when the family visited, having been previously assured that ‘he would be taken out (by staff at the home) on a regular basis’; whilst another comment made by a relative read as follows, ‘I feel carers should be carers and not cleaners. Sometimes they are cleaning when they should be caring’. Comments made by a visitor to the home indicated that, when the acting manager was not there, or was working in the office, which is currently on the third-floor, certain care staff would tend to congregate in the kitchen. Furthermore, that by having an office on the ground floor, this would contribute towards a more hands-on management presence, in the supervision of staff and the care of residents. Wilton Lodge DS0000021290.V291752.R01.S.doc Version 5.1 Page 7 The Inspector thanks the acting manager, the staff and residents for their participation, co-operation and hospitality shown during the course of the inspection. Thanks also to those others, who have submitted their written comments, or who have been contacted for their comments, as part of this Key inspection of Wilton Lodge. 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. Wilton Lodge DS0000021290.V291752.R01.S.doc Version 5.1 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 Wilton Lodge DS0000021290.V291752.R01.S.doc Version 5.1 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 and 6 Quality in this outcome area is adequate; the home has produced the required documents that provide information about the home to assist potential service users, their relatives and other interested parties, however those available were not up to date. As it is presently set up, the home has difficulty in meeting the needs of some residents with deteriorating conditions, due to staffing arrangements and the physical environment. These judgements have been made using available evidence, including a visit to the service. EVIDENCE: Although the home’s Statement of Purpose and the Service User Guide provide detailed information about the home and the facilities and services it provides, the documents available at the time of the inspection were out of date and in need of revising in order to provide accurate information to interested parties. Wilton Lodge DS0000021290.V291752.R01.S.doc Version 5.1 Page 10 Following information that had been passed to Social Services, concerning three of the current residents who are suffering from deteriorating conditions, a re-assessment of their needs has been arranged. On the day of the inspection one resident was requiring continuous monitoring, due to the risk of falls, where there had been ten (10) incidents previously recorded in the accident book; another resident, who is unable to weight-bear, is being considered for nursing care; the third was admitted to hospital following alleged eating difficulties. During the inspection, the Inspector was concerned to note that of the three carers rostered on duty, two appeared to spend much of their morning on domestic tasks i.e. cooking and cleaning. This being the case, there are insufficient dedicated care hours, currently employed at Wilton Lodge, when compared with the recommended care staffing levels as per the National Residential Forum. The Inspector recommends that a cleaner be employed to free up those care hours, enabling improvements in the quality of care that may thereby be provided. The home does not admit persons requiring intermediate care, or those referred as emergency admissions. A relative commented that ‘there were two visits (to the home)’, prior to agreeing to a trial period. She had found this helpful. Another commented ‘(I) was told that staff was able to meet (his/ her) means (needs) but there seems to be not many with the necessary training’. Wilton Lodge DS0000021290.V291752.R01.S.doc Version 5.1 Page 11 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 and 10 Quality in this outcome area is adequate; care-planning documentation provides sufficient information for staff to ensure continuity of care, though not all these records were up to date. The administration of medicines in the home has improved, better to promote residents’ good health. Residents’ dignity is compromised through the lack of privacy when bathing. These judgements have been made using available evidence, including a visit to the service. EVIDENCE: An examination of residents’ care plans showed a variety of formats are in use; the Inspector was told that the assistant manager is in the process of updating these documents and there was evidence of a newly introduced system of recording in place, though nothing to show that residents’ care needs, and how these are to be met, were being reviewed at least monthly, as is required. However, the recording of the daily notes was up to date for all residents. Wilton Lodge DS0000021290.V291752.R01.S.doc Version 5.1 Page 12 In speaking with a visiting Community Healthcare worker, it was apparent that the home receives good support and regular input from the local Health services; the acting manager was able to confirm this. Since it was made a requirement, at the time of the last inspection, there has been a noticeable improvement in the standard of recording, including the administration of medicines, which the acting manager now regularly monitors. However, one relative suggested that staff should have ‘more medical knowledge’, following an incident when the resident was still taking ‘medication that should have been stopped’. During the last inspection it was noted also that it was not possible for the bathroom door to be closed i.e. in respect of residents’ privacy and dignity, when bathing. The acting manager suggested that this could be remedied by fitting a smaller radiator, which could be carried out by the employed maintenance workers, with the owner’s instruction. Wilton Lodge DS0000021290.V291752.R01.S.doc Version 5.1 Page 13 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, 14 and 15 Quality in this outcome area is adequate; daily communal activities, providing social opportunities for those living in the home, appeared to be lacking, though there was evidence of regular visits to the home by entertainers and therapists. Wilton Lodge welcomes visits from relatives and friends, which contributes significantly to the enjoyment and emotional well-being of residents. These judgements have been made using available evidence, including a visit to the service. EVIDENCE: During the morning of the inspection the regular hairdresser was attending to the majority of residents, who pay for this service; one of the residents was taken for an outing to the nearby seafront by a duty carer; the remainder were unoccupied. One of the residents spoken with told the Inspector that she preferred spending time in her own room, as there was no one who she could have a conversation with. This posed a potential risk of isolation and associated deterioration in mental health condition. Wilton Lodge DS0000021290.V291752.R01.S.doc Version 5.1 Page 14 An activities book is maintained by staff, who were observed encouraging residents’ interests; a duty staff spoke enthusiastically about this but added that the time available for activities was restricted by the time taken up with domestic duties. A musical theatre company are engaged on a monthly basis; the acting manager confirmed that this was popular and that most residents joined in; there were colourful photographs pinned up of a recent party, staged at the home by this company. Residents, who wish, may pay for aromatherapy, or reflexology sessions that are then arranged. The Inspector was told that most of the residents are able to enjoy and benefit from the social contact they have with relatives visiting. In talking with staff, the Inspector suggested some alternative provision could be arranged for the two residents, who have no visitors e.g. a befriender, or advocate. Residents, who were asked, said that they enjoyed their meals. A two-week menu plan showed a varied and wholesome diet is provided; staff said that there are always alternative choices at the main, midday meal for residents. A menu board was on display to inform residents and staff. One of the duty staff commented on the lack of variety that residents had for their supper meal. When the Inspector asked about this, the acting manager said that the menu plan for lunch and supper was intended as a guide only for staff but they could prepare what residents said they wanted. A visitor commented ‘I believe my.. (resident’s name)… eats when hungry and enjoys (the) food’. Wilton Lodge DS0000021290.V291752.R01.S.doc Version 5.1 Page 15 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 and 18 Quality in this outcome area is good; the acting manager handles complaints and matters of concern objectively, reassuring those involved that they are being listened to and that appropriate action will be taken. Most staff have received training in the protection of vulnerable adults, providing an insight and understanding of issues relating to adult abuse. These judgements have been made using available evidence including a visit to the service. EVIDENCE: The acting manager produced a complaints book that included records of recent complaints and actions that had been taken as a result. Following a complaint from a neighbour, concerning noisy disturbances, the Inspector recommended some improvement in the way that complaints are reported i.e. in cases where the Social Services, or the Commission for Social Care are to be informed and/ or involved. The acting manager has produced a staff-training matrix that readily identifies staff, who have completed the various mandatory courses; the Inspector suggested that it would be helpful to record dates that the training took place also. This record showed that most staff have received training in the protection of vulnerable adults/adult abuse, since the last inspection. Wilton Lodge DS0000021290.V291752.R01.S.doc Version 5.1 Page 16 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 Quality in this outcome area is adequate; a clean and homely environment is maintained for the comfort and well being of residents. However, the premises are unsuited to the present usage, as a care home for elderly confused, there being a lack of sufficient space, where residents may wander in safety. The absence of an accessible communal garden area is likely to have an adverse impact on the quality of life for those residents, who cannot go outside independently e.g. into the home’s rear courtyard, or for walks around the local community. These judgements have been made using available evidence including a visit to the service. EVIDENCE: The home is one of four, owned by the organisation, and is satisfactorily maintained by an employed father-and-son maintenance team. A new, replacement stair lift has been fitted to the first floor landing, since the last inspection. The original, worn stair carpet has necessarily been replaced also. Wilton Lodge DS0000021290.V291752.R01.S.doc Version 5.1 Page 17 Although the home does not have a garden, there is a rear courtyard area, where potted plants and garden furniture have been provided for the use and enjoyment residents, in particular those few, who are able to access this area safely on their own. However, as there is no level access between any of the communal areas, the home is not suitable for wheelchair users, or those with restricted mobility; also there is a flight of steps, leading from the road up to the front entrance at Wilton Lodge. The current resident group includes several who have limited mobility and one wheelchair user. All residents require to be escorted by a carer, or family member, when going out into the community. The Inspector was told that, whenever possible, staff take one, or two residents out each day to the seafront, or shops, in favourable weather for fresh air and community contact. Following the comments made by relatives and given the limited amount of communal space within the home, the Inspector is of the view that more time should be prioritised for this activity. During a physical inspection, the home appeared clean and tidy; there were odours in two of the residents’ private rooms, where carpets needed to be cleaned. When questioned, care staff confirmed that they would clean carpets, whenever necessary. The Inspector recommends that this task would be more appropriately undertaken by a contract cleaner. Records showed that most staff have received training in infection control and were therefore aware of the need for protective gloves and aprons, when attending to residents’ personal care. A wash hand-basin has been fitted in the basement laundry and the system for laundering residents’ clothes appeared to be satisfactory. Wilton Lodge DS0000021290.V291752.R01.S.doc Version 5.1 Page 18 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 Quality in this outcome area is adequate; however, taking into account the domestic duties carried out by care staff, the actual care hours in the home do not meet the levels, recommended by the National Residential Forum, in care homes for those suffering from dementia-type illnesses; the current arrangements appear to impact adversely on the quality of care that may otherwise be provided. The current absence of the recommended training for staff i.e. the NVQ in Care awards, will inevitably also impact on the quality of care that residents are entitled to receive. Some shortfalls in the home’s recruitment procedures mean that there is a potential risk to residents from the home employing persons unsuited to this work. These judgements have been made using available evidence including a visit to the service. EVIDENCE: A relative commented ‘my father’s needs are nearly always dealt with, depending on which staff are working’. The Inspector established that on a daily basis, during part of the mornings, two of the three duty care staff are otherwise occupied on cleaning and cooking tasks. The employment of a cleaner is recommended, enabling the home to achieve advancements in the overall quality of service provided by meeting the guidance on staffing, issued Wilton Lodge DS0000021290.V291752.R01.S.doc Version 5.1 Page 19 by the National Residential Forum. However, a comment made by a visitor suggested that there is a tendency for staff to congregate at times in the kitchen i.e. instead of attending to residents’ needs. The Inspector is of the view that the day-to-day supervision of staff would be better facilitated if the manager’s office were to be sited on the ground floor. The acting manager has devised a helpful spreadsheet that clearly shows the significant amount of recent staff training that has taken place, though actual dates were not included. However, the Inspector noted at the time of the inspection that there was no staff currently working towards the National Vocational Qualification awards in Care. Three out of the thirteen staff have received this training, against the National Training Organisation’s workforce training target of 50 trained staff. Nevertheless, the staff spoken with on the day of the inspection presented as competent, when carrying out their duties. In reviewing recruitment practices, the Inspector noted that there were completed Police/ CRB check for all but one of the employed care staff; when this was queried, the acting manager said that this person had been away on maternity leave and the application returned, not having been followed through. In another staff file there was evidence from the applicant’s referees of poor performance in their previous employment; in one instance an applicant had declined to give the most recent employer as a referee. These matters had not been followed-up by the acting manager, as they should have been, prior to making an offer of employment. A comment made by a visiting relative indicated that staff are responsive to queries, ‘most of the time’ but that ‘some staff do not speak English so it’s hard sometimes to understand (them)’. The acting manager confirmed that some agency staff had been employed recently, whose first language was not English. Wilton Lodge DS0000021290.V291752.R01.S.doc Version 5.1 Page 20 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, 33, 35 and 38 Quality in this outcome area is adequate; however, the current, overall management of the home does not meet the Standard, which necessarily impacts on the quality outcomes for this service. Although the acting manager has introduced improvements, the home must now have a ‘hands-on’ manager who is qualified and registered, if it is to achieve the required Standards. The home has a welcoming, relaxed and friendly atmosphere that contributes positively to the sense of well-being for the majority of this group of mentally and physically frail older people. The staff are adequately supervised and say that they feel supported by the acting manager, which contributes favourably to overall team efforts. Although, by having the office on the third floor of the building, this necessarily places limitations on the manager’s contact with staff and residents. These judgements have been made using available evidence including a visit to the service. Wilton Lodge DS0000021290.V291752.R01.S.doc Version 5.1 Page 21 EVIDENCE: Although experienced and appearing competent in the day-to-day running of the home the acting manager has failed to complete the required management training. It is unacceptable that the home continues without a registered manager after two years, since the registered owner relinquished this post at Wilton Lodge. The acting manager, together with staff, has worked to improve the quality of life for the residents and the formerly low occupancy levels have increased; the home now employs more staff hours, as a result. A new assistant manager has been appointed which is having a beneficial affect on record keeping. Feedback is actively sought from relatives and visitors to the home, who say they are made to feel welcome. As an additional quality assurance measure, the Inspector recommends a development plan be produced reflecting the aims of the home and actions planned to be taken in securing positive outcomes for residents. Each of the residents has a relative, or representative acting for them; the acting manager said that some small personal requisites are purchased for residents from time to time and that receipts are kept with a written record of any such transactions. Records show that staff supervisions are taking place and that most staff have completed, or are receiving training in safe working practices. However, it was noted that the required Gas and Electrical Safety certificates were not available at the time of the inspection. In conclusion, the Inspector recommends that by adapting one of the groundfloor rooms to office accommodation, the overall operation of the home would benefit from a considerably improved level of management contact with both staff and residents i.e. as opposed to working in isolation in the third floor, manager’s office-cum-staff sleep-in room. Wilton Lodge DS0000021290.V291752.R01.S.doc Version 5.1 Page 22 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 2 X 3 2 X 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 2 Wilton Lodge DS0000021290.V291752.R01.S.doc Version 5.1 Page 23 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. 01 Standard OP1 Regulation 4(1), 5(1) Requirement That the home has a Statement of Purpose and Service User Guide that is up to date and provides accurate information about the home and the service it provides. That residents’ care plans are consistently recorded and reviewed at least once a month to reflect changing needs. That the bathroom door can close fully and is lockable. (Previous timescale not met) That the routines of daily living and activities be further developed to suit residents’ preferences and capacities e.g. outings and walks into the community. That at all times suitably qualified and experienced persons are working in the home, in the capacity of carers, appropriate for the safety and well being of residents. Timescale for action 01/08/06 02 OP7 15(2)(b) 01/08/06 03 OP10 12(4)(a) 01/08/06 04 OP12 16(2) 01/08/06 05 OP27 18(1)(a) 01/08/06 Wilton Lodge DS0000021290.V291752.R01.S.doc Version 5.1 Page 24 06 OP28 18(1)(c, i) That the required target ratio of 50 care staff trained, or in training to the required NVQ standard is achieved. (Previous timescale not met) That a more robust recruitment process is put in place, including a personal career history, or CV as part of the application form, a reference from the most recent employer, that questionable references are followed up and that satisfactory Police/ CRB checks are in place for all care staff employed at the home. That the home has a registered manager, who has the required qualifications i.e. NVQ at level 4 in Management, or equivalent, together with the Registered Managers Award. (Previous timescale not met) That the appropriate certificates are obtained in respect of Gas Installation and Electrical Wiring. 01/12/06 07 OP29 19(1) 01/08/06 08 OP31 8(1) & 9(2b,i) 01/12/06 09 OP38 13(4) 01/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 01 Refer to Standard OP16 Good Practice Recommendations That improved reporting mechanisms are introduced in cases where external agencies are to be informed, or involved in handling matters of complaint. That a cleaner is employed, who may also carry out carpet cleaning and laundry tasks, to ensure that consistently satisfactory standards of cleanliness and hygiene are DS0000021290.V291752.R01.S.doc Version 5.1 Page 25 02 OP26 Wilton Lodge maintained, also to free up care hours in meeting the levels agreed by the National Residential Forum. 03 OP31 That the manager’s office base be suitably sited on the ground floor of the building, where there may be regular contact with residents and staff, indicative of a more ‘hands-on’ approach. That there is a development plan for the home, based on a systematic cycle of planning-action-review, reflecting the aims and outcomes for residents. 04 OP33 Wilton Lodge DS0000021290.V291752.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Wilton Lodge DS0000021290.V291752.R01.S.doc Version 5.1 Page 27 - 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. 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