Inspection on 14/02/06 for Wilton Lodge

This inspection was carried out on 14th February 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 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

Wilton Lodge 13/06/08

Wilton Lodge 21/06/07

Wilton Lodge 08/09/05

Wilton Lodge 03/02/05

Wilton Lodge 07/09/04

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

CARE HOMES FOR OLDER PEOPLE Wilton Lodge 402 Holderness Road Hull East Yorkshire HU9 3DW Lead Inspector George Skinn Unannounced Inspection 14th February 2006 09:30 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 DS0000000876.V262182.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 DS0000000876.V262182.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Wilton Lodge Address 402 Holderness Road Hull East Yorkshire HU9 3DW 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) 01482 788033 01482 788120 Humberside Independent Care Association Position Vacant Care Home 48 Category(ies) of Dementia - over 65 years of age (48), Old age, registration, with number not falling within any other category (48) of places Wilton Lodge DS0000000876.V262182.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th September 2005 Brief Description of the Service: Wilton Lodge provides personal care and accommodation for a maximum of 48 older people some of who may have memory impairment. It is owned By Humberside Independent Care Association Ltd (HICA) which is a not for profit organisation.The home is located on Holderness Road, which is to the Eastern side of the city of Hull. The homes location provides service users with easy access to a variety of shops, pubs, public transport etc. The home was rebuilt in 1999 and is a two-storey building with access to the upper floor via a passenger lift. All of the homes bedrooms are single with 42 having en-suite. A number of these single rooms do have a lockable interconnecting door which means couples are able to share a bedroom whilst using the other as a lounge area. The homes theme of decoration reflects its location with old photographs of East Hull and memorabilia from Hull Kingston Rovers. Central to the home is a garden and courtyard area with patio tables and chairs; all service users are able to access these areas safely.The home was designed so as to take full advantage of the bustling community life; lounge areas are located in such a position to ensure service users feel part of the community. Wilton Lodge DS0000000876.V262182.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection which was undertaken over 7 hours. The residents were spoken with the environment was looked at and records were examined. What the service does well: What has improved since the last inspection? Much has improved since the last inspection with the home addressing all those requirements set positively and promptly. The residents spoke positively about the home and the conduct of the staff; they said that their individual needs are now respected and their choices are maintained. The home has improved the records which are kept on each residents and these are now much more informative and detailed so the staff can meet the residents’ needs more effectively. Staff are now working 12 hour shift patterns, they commented on these being a positive move enabling them to give a more consistent service to the Wilton Lodge DS0000000876.V262182.R01.S.doc Version 5.1 Page 6 residents thus ensuring continuity. The home only use agency staff in extreme circumstances this is again to ensure continuity for the residents. 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. Wilton Lodge DS0000000876.V262182.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Wilton Lodge DS0000000876.V262182.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 All residents are assessed prior to moving into the home EVIDENCE: Those files inspected contained evidence which indicated that the residents needs are assessed prior to moving into the home, these files were better organised and easier to access than during the last inspection. Staff spoken with confirmed that the files were more accessible and understood whose responsibility it is to maintain them. The resident commented on the staff being more committed and that they are now meeting their needs better. Wilton Lodge DS0000000876.V262182.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Residents’ personal health needs are being appropriately met. The residents are protected by the homes policies and procedures for handing medication and their privacy and dignity is maintained. EVIDENCE: Those files inspected contained adequate information to enable the care staff to meet the needs of the residents; it is obvious that a lot of work has gone into updating and improving the residents’ files. This will benefit the residents in that the staff find the new formats easier to work with and more accessible. The files were well organised and the daily recording gives an indication that the needs of the residents were being met. There is a detailed medication policy in the home about the handling of medication. Records of medication received into the home are well maintained along with their administration and disposal. The home does not routinely facilitate self-medication. Those residents whom wish to self medicate would be enabled in this process, subject to an assessment and agreement. Wilton Lodge DS0000000876.V262182.R01.S.doc Version 5.1 Page 10 Appropriate storage facilities for controlled medication are available. Some medication is stored in a fridge; the temperature of this is monitored and recorded on a daily basis. Senior staff that have been trained and assessed as competent administer medication in the home and sample signatures are retained. The health of residents on medication is monitored and recorded in case files regular medication reviews takes place with the GP. The organisation has developed a medication-training package, which has extend to a formal assessment process based on competency and understanding. The maintenance of resident’s privacy and dignity forms part of the staff induction programme. Residents spoken to confirmed that privacy and dignity is respected whilst personal tasks are being undertaken, assistance is always available but where possible independence is enabled. Medical examinations/ treatment are conducted in the privacy of the residents’ own room. The preferred form of address is recorded on all case files. Residents are informed in the statement of purpose about their rights to have a private phone fitted in their bedroom. Residents can use the homes payphone to make and receive calls. Wilton Lodge DS0000000876.V262182.R01.S.doc Version 5.1 Page 11 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 The residents are now being provided with opportunities for stimulation, and are enabled to lead a life style of their choosing. EVIDENCE: Staff provide a variety of choice and flexibility in the daily lives of the residents, with care being given to ensure that it reflects the wishes of the resident. . Leisure and social activities are arranged both in house and within the local community. Notices of forthcoming social events are displayed around the home, a designated activities co-ordinator is employed at the home and she undertakes one to one activities and group activities as appropriate for the residents. Residents interests are recorded in their individual care plans. Through discussion with residents it was evident they choose when to get up, go to bed, spend time in company, time alone etc. Whilst mealtimes are set residents are able to make choices about where they wish to eat and there is some flexibility around the timing and what they would like to eat. Wilton Lodge DS0000000876.V262182.R01.S.doc Version 5.1 Page 12 Residents are able to receive visitors at all reasonable times. The statement of purpose states that residents are able to choose whom they see and don’t see. No restrictions are placed on visiting. Relatives spoken to commented that they were made to feel welcome by staff and frequently joined in the main meal. Relatives were of the opinion that sufficient and varied social activities were organised. Wilton Lodge DS0000000876.V262182.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Both relatives and resident knew whom to complaint to and had confidence that their complaints would be taken seriously. The residents are protected from abuse. EVIDENCE: A complaints procedure is available which encourages residents and relatives to express their dissatisfaction without fear of repercussion. This procedure includes contact details for CSCI. Complaints are seen as an opportunity to improve the service as a whole or more specifically for an individual. Residents and relatives all said they felt the management style of the home encouraged them to speak out and they were satisfied that they would be listened to and issues acted on, they would not hesitate in bringing such matters to the staffs attention. Residents are protected from abuse with robust procedures in place for responding to any suspicion. All staff receive formal training on abuse and the protection of vulnerable adults, and the home act swiftly and appropriately to ensure the safety of the residents. Wilton Lodge DS0000000876.V262182.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Residents live in a home which is well maintained and repairs are made as required. EVIDENCE: The home was purpose built and is accessible, safe and well maintained. The maintenance of the building is audited by the home manager as well as the company bank to ensure environmental standards do not deteriorate. Redecoration is ongoing and subject to individual choice. Garden areas are available and used by residents. The building complies with the requirements of the local fire and environmental health department. CCTV cameras are not used. The premises were clean and hygienic with systems in place to reduce the risk of odours. It is the organisation policy that where minor odours are identified as a problem that cannot be rectified by cleaning then new carpets are purchased. The location of laundry facilities is suitable and ensures that dirty laundry is not carried through food storage, preparation or dinning areas. Wilton Lodge DS0000000876.V262182.R01.S.doc Version 5.1 Page 15 Policies and procedures for the control of infection are in place along with the provision of protective clothing. The homes laundry is fitted with industrial washers and driers. There is separate hand washing facilities in the laundry room. The covering on the laundry room floor is impermeable and easily cleaned. Wilton Lodge DS0000000876.V262182.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 & 30 The number and skill mix of the staff meet the needs of the residents. The staff receive adequate training and have access to the HICA training plan. EVIDENCE: The National Care Standards Commission have been advised that recommended guidance should only be applied to new registrations. For homes registered prior to April 1st 2002 staffing levels must at least meet the minimum requirements of the previous regulatory authority. At the time of this inspection staffing numbers were found to meet those previous requirements. The home retains a copy of duty rosters. All staff employed by the home to care for residents are aged over 18 years and those staff left in charge are at least 21 years old. Dedicated domestic staff are employed in sufficient numbers to ensure the home is maintained in a clean and hygienic state. The staff are well equipped to undertake their duties as the company provide a comprehensive training diary. Mandatory training is provided and routinely updated as required. The process of planned supervision and development interviews identifies any areas of specialist training which the staff feel they need and this is provided as far as possible. Wilton Lodge DS0000000876.V262182.R01.S.doc Version 5.1 Page 17 The company has a detailed induction program which meets National Training Organisations (NTO) standards and incorporates all mandatory training this is done in a weeks block training. From staff files seen it is evident that induction is a formal process, which is allocated the appropriate amount of time and attention. The company operates a thorough training programme, which equips staff for their role and ensures they are able to meet the changing needs of residents. In addition the manager undertakes an audit of residents’ needs and compares this against the skills of the staff, the purpose of this is to establish if there is any shortfall in training need. Staff training is based on individual supervision; the amount of training provided was seen to exceed the three days required per year. Those staff spoken to during the inspection were knowledgeable about their role and the varying aspects of caring. The home do need, however, to ensure that 50 of the care staff are trained to NVQ level 2. Wilton Lodge DS0000000876.V262182.R01.S.doc Version 5.1 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, 33, 35 & 38 The resident live in a home which is well managed, and run in their best interest. EVIDENCE: The home does not currently have a registered manager the acting manager has submitted an application to the CSCI. The home has a quality assurance system in place, which seeks the views of all stakeholders. Residents confirmed that they are regularly consulted via questionnaires. The quality audit tool focuses monthly on areas such as the environment, complaints, individual care, etc. The company produces an annual development plan which looks at the organisation as a whole as well as each individual home. Wilton Lodge DS0000000876.V262182.R01.S.doc Version 5.1 Page 19 Residents who are able to manage their own finances are encouraged to do so; this was confirmed during the inspector’s discussions with them. For those who are not as able, finances are managed in varying degrees dependant on individual abilities and wishes. This has resulted in a number of residents taking care of their own personal allowance whilst others ask the home to keep monies in safekeeping. The home maintains a rigorous system for the safekeeping of monies, with individual details and receipts of any monies spent on their behalf. Hard copies of this account are printed off on a daily basis. This account, whilst being rigorous, does fall into the realms of a communal non-interest account, which is in conflict with the regulations. However, from discussions with residents and having read information provided to them, it is apparent that any decision to utilise this system has been made by the resident or their representative and is based on individual choice often for convenience. On the basis of these findings this system has been accepted. The home has a detailed Health and Safety policy. Safe working practices are maintained by the provision of training to staff in the form of moving and handling, basic food hygiene, first aid at work, basic first aid, infection control and fire safety. Systems are in place to ensure that all the homes equipment and building maintenance is up to date. Hazard notifications are circulated to the home manager, action taken and then retained for staff to see. Hot water is regulated to control the risks of Legionella along with the risk of scalding. Wilton Lodge DS0000000876.V262182.R01.S.doc Version 5.1 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 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x 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 3 28 2 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Wilton Lodge DS0000000876.V262182.R01.S.doc Version 5.1 Page 21 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP28 Good Practice Recommendations 50 of the care should be trained to NVQ level 2. Wilton Lodge DS0000000876.V262182.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 DS0000000876.V262182.R01.S.doc Version 5.1 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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