Inspection on 19/10/07 for Wilton Lodge

This inspection was carried out on 19th October 2007.

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 27/11/06

Wilton Lodge 11/05/06

Wilton Lodge 24/04/06

Wilton Lodge 17/01/06

Wilton Lodge 31/08/05

Wilton Lodge 11/12/04

Wilton Lodge 30/07/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Wilton Lodge 77-79 London Road Shenley Hertfordshire WD7 9BW Lead Inspector Sheila Knopp Key Unannounced Inspection 19th October & 2nd November 2007 09:25 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 DS0000019621.V349254.R01.S.doc Version 5.2 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 DS0000019621.V349254.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wilton Lodge Address 77-79 London Road Shenley Hertfordshire WD7 9BW 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) 01923 854623 01923 850019 Wilton House Limited Mrs Ruta Starkute-Nahani Care Home 36 Category(ies) of Dementia - over 65 years of age (36), Old age, registration, with number not falling within any other category (36) of places Wilton Lodge DS0000019621.V349254.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd August 2007 Brief Description of the Service: Wilton Lodge is a care home providing personal care and accommodation for 36 older people who may also have dementia. It is owned by Wilton House Limited, which is a private company. The home was opened in 1990 and consists of a purpose built two-storey building. It is adjacent to Wilton House Nursing Home, but the two homes operate independently. Wilton Lodge is in the village of Shenley, approximately 1½ miles from Radlett. It is within walking distance of local shops, and several pubs and churches are close by. All the homes bedrooms are for single occupancy and have en-suite facilities. A passenger lift provides access to the first floor. Each floor has a lounge and dining area. Residents are able to sit in the front garden, which has a covered seating area and is enclosed by a low wall. There is level access to the front entrance from the main road but access from the car park at the back of the building is via a steep flight of stairs. Details of the latest CSCI inspection report are available in the home and copies can be obtained from the manager. The current fees for the service range from £546 - £596 per week. Variable charges are made per bed depending on funding arrangements with the local authorities concerned. Wilton Lodge DS0000019621.V349254.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The information in this report is based on an unannounced visit to the service by two inspectors, one whom was a pharmacy inspector. A further follow up visit was arranged to review records. Information from two unannounced random inspections carried out during May and August has also been reviewed. The focus of the May inspection was to follow up immediate health & safety requirements made following the key inspection on 24th April 2007. These requirements had been met. A statutory Enforcement Notice served on the Company required them to take action in relation to admission procedures, care planning and risk assessments. We were satisfied that staff responded appropriately to changes in resident behaviour that indicated risk assessments needed to be reviewed but have not been able to fully explore the admission process for new residents as there have been no recent admissions. The August inspection focussed on the experience of people who have dementia. This demonstrated to us that the company had reviewed their training and care planning procedures to reflect a more person centred approach to dementia care in line with current thinking. We have also received completed survey forms from 10 residents who were helped by the home’s activities organiser to complete them where assistance was required. This is the first year care providers have been required to complete an annual quality assurance assessment (AQAA) of their service. We have reviewed this together with the information services are legally required to give us in relation to accidents and incidents. Where information has remained the same, this has been brought forward into this inspection report. Overall this was a positive inspection. The strong leadership of the Director who acts as the Responsible Individual for the company and Registered Manager mean that better systems have been put in place to support the future development of this service and positive outcomes for the people who live there. The judgements in this report acknowledge this but reflect our need to see that consistent standards are maintained over a period of time. What the service does well: Residents receive a good standard of personal care and receive support from the General Practitioner and Community Nurses who visit the home. Wilton Lodge DS0000019621.V349254.R01.S.doc Version 5.2 Page 6 Residents have their own room, which they can make their own by adding personal possessions. Some take up the option of having their own key. The home has been found to be fresh and clean on recent visits. The home has a very good activity organiser and now that more attention is being paid to promoting best practice in relation to caring for people with dementia this area is developing well. Clear procedures are available for staff on the safe use and handling of medicines, which will protect residents from harm. We have not received any complaints about this service between our key inspections. What has improved since the last inspection? The information available to people enquiring about the service provided at Wilton Lodge has been updated to provide clearer information about what people can expect particularly in relation to dementia care. People living at Wilton Lodge can now expect to have their needs, preferences and ability to maintain their independence assessed in more detail to provide a more individual approach to their care. With the support of an external training provider staff have been involved in a review of how people with dementia are being supported. This has led to improved recording of the action staff take in response to changes and how the strengths and abilities of each individual are supported to maintain independence and promote a sense of well being. The skills and understanding of staff in promoting the well being of residents has improved now that more in-depth and interactive training is being provided, rather than a reliance on the use of videos. A positive step has been the inclusion of accredited dementia care training at varying levels. Staff now have access to the Medical Health Regulation Agency (MHRA) reports, which enables them to protect residents by checking the safety of equipment they are using against any known alerts. More emphasis is being placed on identifying any restrictions placed upon people because of their ability or inability to use the keypad door systems, which are used to protect people. The decoration of rooms, repair of damaged furniture and replacing carpets, curtains and bedspreads has improved the environment for residents. Wilton Lodge DS0000019621.V349254.R01.S.doc Version 5.2 Page 7 The registered manager is well organised and has put clear systems in place to audit the quality of the service provided to residents and monitor health & safety standards. 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. The summary of this inspection report can be made available in other formats on request. Wilton Lodge DS0000019621.V349254.R01.S.doc Version 5.2 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 DS0000019621.V349254.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1 & 3 (standard 6 does not apply to this service) People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The revised admission procedures tell us how people will be assessed before they come to stay at Wilton Lodge and the expectation placed on staff to identify any needs or risks and how they will be managed. However, as there have been no recent admissions we have not been able to see how this is working. EVIDENCE: The information available to people looking to move into Wilton Lodge has been updated to reflect changes within the company and their approach to dementia care. This is so people have clearer information on which to base their decision No new residents have been admitted since a Statutory Enforcement Notice related to the admission assessment procedure and risk assessments was Wilton Lodge DS0000019621.V349254.R01.S.doc Version 5.2 Page 10 served. Therefore we have not been able to verify the new procedures put in place to improve the quality of the admission assessment process and identification of risks. We have been able to confirm that where risks for existing residents have changed appropriate action has been taken to provide additional monitoring, involve support agencies and reflect the actions required by staff in the plan of care. Wilton Lodge DS0000019621.V349254.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 & 10 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Our recent visits have demonstrated that with more intensive training and support, staff are demonstrating a clearer understanding of providing person centred care. However, we now need to see that these standards are maintained over time and do not decline in response to changes in the staff team. The continued health of residents is supported by good working relationships with the General Practitioner and Community Nurses who visit Wilton Lodge. Our inspecting pharmacist found that clear procedures are available for staff regarding the safe use and handling of medicines, which will protect residents from harm. Staff do not get clear, written information regarding, when medicines prescribed as ‘when required’ should be given particularly, in relation to those which affect behaviour, so staff are consistent in their approach and know when to try an alternative approach first. Wilton Lodge DS0000019621.V349254.R01.S.doc Version 5.2 Page 12 EVIDENCE: Our observation of people with dementia found that there was good interaction between staff and residents at all times. Staff were respectful and worked at a relaxed pace, acknowledging each person and offering choices. The care plans for the people observed were reviewed and found to contain the information staff require to respond to their individual needs. Residents receive good attention to their personal care and hygiene. A community nurse we spoke to had not visited the home for some time but felt there was a good atmosphere, staff were helpful and residents were receiving the personal care they needed. No residents were reported to have pressure sores. Equipment to maintain the comfort and mobility of residents is provided by the community nursing service. The weight of residents is monitored and individuals referred to their GP if problems arise. Food supplements are available to support people if they are not eating well. Storage facilities provided for medicines are satisfactory and secure. Temperatures of medicines storage areas are monitored and recorded regularly to ensure the quality of medicines used for the treatment of residents. Clear records are kept when medicines are received into the home and when they are disposed of. Although there were some minor deficiencies in the records kept of when medicines are given to residents, there is a good audit trail to account for all medicines in use. Such an audit has identified the apparent loss of some medication, which was reported to the Commission and investigated under the Hertfordshire Safeguarding Adult policy. The conclusion of the multi-disciplinary strategy meeting was that the home had taken appropriate action when the loss was discovered and residents were not affected. When medicines are administered on a variable dose basis, e.g. ‘one or two tablets’, the records do not clearly indicate the doses given. When medicines are prescribed for use on a “when required” basis, there is a need for clear guidance for staff on the circumstances these are used and a clear indication of what they are required for. This will protect residents from harm and prevent misuse of medication. Our further visit on 1st November identified that the manager was addressing this with the GP who visits the residents and senior staff. Therefore a requirement has not been made at this time and a further review will be carried out at the next inspection. The registered manager reported the medicines policy has recently been reviewed to reflect current guidance. Wilton Lodge DS0000019621.V349254.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 & 15 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There are opportunities for the people who live at Wilton Lodge to go out or take part in planned activities and social events arranged in the home. The residents say they enjoy the choice of meals they are offered and receive sensitive assistance if they need help at meal times. Residents are given support to maintain the religious and cultural aspects of their lives, which are important to them. EVIDENCE: Residents we spoke to enjoy going out. They visit the local shops and country park café. Egg and chips is a favourite of one person who goes out. A range of activities and visiting entertainers take place in the home and books, videos, games and reminiscence items to pick up and look at are available. Tactile pictures have been placed on the corridor walls to provide a point of interest to people walking about. The use of signs and familiar pictures on bedroom doors helps people to recognise where they want to be. Wilton Lodge DS0000019621.V349254.R01.S.doc Version 5.2 Page 14 Our observation of staff providing support to people with dementia identified the following good practice. Staff were sensitively assisting people at lunchtime, taking their time and speaking to people throughout the meal telling them what each mouthful of food was. When drinks were offered people were shown the range of juices available so they could make a choice from what they had seen. The residents were bright and alert and involved in the activities and interaction that was taking place. A positive development has been the training arranged for the activity organiser which will help to develop ideas further particularly in relation to supporting people with dementia. Examples of the attention given by staff and the chef to meeting the cultural needs of individuals can be seen. Church services are held for those wishing to attend. It is positive to note that accredited distance learning training supported by the National Association of providers of Activities for Older People has been arranged for the activities organiser. Wilton Lodge DS0000019621.V349254.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 & 18 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There are informal and formal systems in place for people to use if they have any concerns. The registered manager has demonstrated a commitment to reporting incidents appropriately and working with the other authorities involved to achieve positive outcomes for the people who live at Wilton Lodge. EVIDENCE: No complaints or concerns about the service provided at Wilton Lodge have been raised with us since the key inspection in April. The registered manager reported they had not received any complaints during this time. Their records show that five compliments had been received since March. As well as day-today contact with residents and relatives the manager arranges regular meetings for people to give their views. Quality assurance survey forms are also sent out. As in previous years it is the registered managers intention to provide a summary of the responses and any action taken to residents and their relatives to keep them informed. The manager provides an individual response to relatives raising any issues on the survey forms. The outcome of a recent strategy meeting, which looked at an incident reported by the manager concerning missing medication, concluded that the Wilton Lodge DS0000019621.V349254.R01.S.doc Version 5.2 Page 16 manager had taken all the appropriate steps required to report and investigate the incident and protect residents from harm. Further safeguarding meetings during the period between key inspections concerned the behaviour of a resident who posed a risk to themselves and other residents. The community mental health team were involved and the individual admitted to hospital for further assessment. The care records of people identified through the incident reports sent to us by the manager as required by legislation have been reviewed as part of recent inspections. In each case risk assessments have been updated to protect the individual concerned and there has been good liaison with the other health and social care professionals involved. Steps have been taken to reflect in each person’s plan of care the restrictions that may be imposed on individual residents, by the keys pads fitted to internal and external doors within the home. This is to ensure there is a clear record of the decisions reached in respect of residents who may lack capacity and these decisions can be kept under review by the individual’s social worker or representative. It was reported that Mental Capacity Act training is being arranged for staff. Staff receive training in protecting people from harm and treating them with respect and dignity. All interaction observed was sensitive and appropriate. Wilton Lodge DS0000019621.V349254.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 & 26 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are able to maintain their autonomy and independence by adding personal possessions to their rooms and having their own door key. A programme of decoration, upgrading of furniture and fittings and replacement of carpets and soft furnishings is currently taking place to improve the quality of the environment for the people who live at Wilton Lodge. The current bathroom décor, equipment and ensuite facilities provide an institutional environment and are not always accessible to service users. There are suitable arrangements in place to protect residents from infection by appropriate laundering of clothing, managing and maintaining a clean fresh environment and responding to any illnesses, which may occur. Wilton Lodge DS0000019621.V349254.R01.S.doc Version 5.2 Page 18 EVIDENCE: Resident’s rooms are nicely personalised and the recent decoration has brightened the home up. The manager reported residents have been involved in choosing colour schemes and new curtains and bedspreads. Staff were assisting residents who wished to use the garden. Residents able to use the keypad alarm system can go out as they wish. The bathing and en-suite arrangements have not been upgraded since the home opened in 1990. With the increasing dependency of people moving into the home the en-suite baths are no longer used. The communal bathrooms have a very institutional feel and the baths have become stained. These areas would benefit from a complete review of moving and handling equipment, aids and adaptations to see if more modern equipment is available or residents would benefit from access to suitable showers as well as baths. These points have been discussed with the lead director who reports these areas will be reviewed. Following concerns raised at the last key inspection a review of the cleaning schedules and products used has taken place. Chemicals are kept securely to prevent accidents and information and training has been made available to staff on their use. This information has also been translated into Polish so that Polish-speaking staff understand their responsibilities. Non-refillable liquid soap dispensers have been provided as these are less likely to be contaminated. The manager has also been on training organised by the local Health Protection Unit (HPU) and guidance is available on monitoring any symptoms, which may indicate there is an infection. The manager has introduced an outbreak log as required, to alert staff to any emerging problems and liaises with the HPU if advice is needed. There is a small laundry in the basement. On this occasion the laundry was well managed and the fire exits in this area were clear. Wilton Lodge DS0000019621.V349254.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 & 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staff are currently provided in sufficient numbers to meet the needs of the people currently living at Wilton Lodge and support the running of the home. There are training systems in place to support staff through their induction and on to national Vocational Qualifications (NVQ) in care so they acquire the skills needed to support the residents. New staff are checked for their suitability to work with vulnerable people before they are employed. EVIDENCE: The senior staff team is relatively stable which has enabled the manager to take many of the recent changes forward. Care and domestic staff are mostly recruited from abroad with a high proportion of staff currently from Poland. New staff receive induction training and move on to complete further training in care at NVQ level 2. Language courses are arranged for those who need further support with their English. The staff are caring and supportive towards the residents but some do not stay long in their jobs, which means the skill mix, experience and language competency of staff is reduced when new staff arrive to take their place. Five (33 ) of the total care staff team (15) have Wilton Lodge DS0000019621.V349254.R01.S.doc Version 5.2 Page 20 changed since August. Staff turnover has in the past affected the quality of the service provided to the people who live at Wilton Lodge. There have been improvements in the quality of staff training provided since the company engaged the services of an external training provider. The manager is also able to translate for staff and ensure they have achieved an acceptable level of understanding. The senior care staff have all achieved an NVQ level 2 in care. The recruitment records of three new staff were reviewed. The overseas recruitment agency provides translations of documents in other languages and police checks from the country of origin are available. It is good practice for the translator to sign and date the translated documents as proof of their validity. The manager completes a checklist to make sure she has received all the information required by legislation before appointing staff. Telephone interviews are carried out before staff arrive in the home to check on their experience, language skills and attitude. New staff have to complete a satisfactory probationary period. Details of the employment checks carried out by agencies supplying staff to the home together with details of their training and a photograph for identification purposes are available to check on the competency of staff. Wilton Lodge DS0000019621.V349254.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35 & 38 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Since the April inspection the registered manager has demonstrated she has the skills and experience to make the changes required to improve the quality of the service provided to the people who live at Wilton Lodge. There is a secure system in place, which enables the people who live at Wilton Lodge to deposit small amounts of money for day-to-day use. Clear systems have been put in place to show that the safety of residents and staff are supported by training and regular maintenance and checks on the health & safety systems within the home. Wilton Lodge DS0000019621.V349254.R01.S.doc Version 5.2 Page 22 EVIDENCE: The manger and deputy manager both have the Registered Managers Award (RMA), which is the national qualification standard set for managers of care services. The manager has responded promptly to requirements made by us and taken a positive approach to improving standards. She returned the completed Annual Quality Assurance Assessment on time and identified areas for further development. We can see through the approach of the lead director and her reports to the board of directors that there is a commitment to taking a more robust approach to providing the in-depth training staff require and reviewing how the service works in line with best practice. The manager is also expected to report on the conduct of the home at regular board meetings. As well as day-to-day contact with the manager residents and relatives are able to give their views on the running of the service through quality assurance questionnaires and three monthly meetings. The manager plans to provide residents and relatives with a summary of the feedback from the questionnaires but we also saw individual letters to relatives where specific issues had been raised. There are secure systems in place for residents to deposit small amounts of money for day-to-day use in the office. Records and receipts for money deposited or taken out are kept and we were able to reconcile the records with the amount held. The manager reported that all residents are in receipt of their personal allowance and no one within the company acts as an appointee in respect of any individual’s finances. There is an up to date insurance certificate in place. The manager has records of her regular checks on the quality of the service provided and health and safety checks that cover hot water temperatures and the safety of window restrictors. Information is now available from the MHRA to alert staff to any problems with equipment they may be using. Risk assessments are now in place where residents are using equipment such as electrically operated beds or recliner chairs, to show they are being used appropriately and checked regularly. In response to a health & safety inspection by the local Environmental Health department protective fencing has been fixed to external railings to reduce the risk of accidental falls from height. Wilton Lodge DS0000019621.V349254.R01.S.doc Version 5.2 Page 23 A recent inspection by the local Fire Safety service did not require a follow up visit and the manager reported the procedural issues had been addressed. The record and management systems are well organised. We were able to see that the regular servicing required for the gas, fire, electrical, water, lift and hoist safety systems in the home were up to date. Records of the individual health & safety training staff have received were available. Putting together a computer matrix of all the training carried out would enable the manager to identify any gaps more easily and assist with future planning. The manager and staff would benefit greatly from having access to a computer as most of the information from professional agencies, including CSCI, is now cascaded via the Internet directly to the service. The company are relying on the good will of staff to use their home computers and there was evidence that staff are coming up with good initiatives or using the Internet to search for ideas on their home computers. Wilton Lodge DS0000019621.V349254.R01.S.doc Version 5.2 Page 24 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 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 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 3 28 3 29 3 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 DS0000019621.V349254.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No 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 OP38 Good Practice Recommendations Providing the manager with access to a computer and Internet link is recommended: To access professional information and guidance. To support administrative functions and putting a training matrix in place to provide an overview of the training provided, identify any gaps and plan future requirements. Wilton Lodge DS0000019621.V349254.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 DS0000019621.V349254.R01.S.doc Version 5.2 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. 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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