Inspection on 24/06/05 for Wilton Lodge

This inspection was carried out on 24th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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 13/06/06

Wilton Lodge 31/10/05

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 24 June 2005 10:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Wilton Lodge H59-H10 S21290 Wilton Lodge V223572 280605 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Wilton Lodge Address 55 Wilton Road Bexhill-on-Sea East Sussex TN40 1HX 01424 216250 01435 874819 None Angel Healthcare Limited Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Miss Jenny May Miles Care Home 12 Category(ies) of Dementia (DE), 12. registration, with number of places Wilton Lodge H59-H10 S21290 Wilton Lodge V223572 280605 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the maximum number of service users to be accommodated is (12). 2. That service users accommodated will be aged 65 years, or over on admission. 3. That service users accommodated will have a dementia type illness. 4. That a maximum of two (2) service users between the ages of 55 and 65 years, who woulde otherwise fall within the main category, may be accommodated at Wilton Lodge at any one time. 5. The home is not registered to accommodate service users with primary symptoms of drug or alcohol abuse, or acquired brain injury. Date of last inspection 21 December 2004 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 Wilton Lodge 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 manager’s office. At the rear of the premises is a small, private courtyard for use by residents. (* Since this inspection visit there has been a change to the company name, which at the time of publication is Angel Healthcare) Wilton Lodge H59-H10 S21290 Wilton Lodge V223572 280605 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This routine unannounced inspection was carried out over four and a half hours during a day in June, when there were eight (8) residents; the recently appointed deputy manager assisted throughout the visit. During the inspection, the Inspector toured the premises and spoke with duty staff, a visitor to the home and the residents, with whom he had lunch. Three other residents were spoken with individually, though communication was limited, due to their mental confusion. A selection of the home’s records was also inspected, including care plans, daily logs and record of medicines administered. Shortly after the inspection, the home owner was spoken with also. What the service does well: What has improved since the last inspection? There has been a marked improvement in the continuity of day-to-day management supervision within the home, since the appointment of an acting manager. Staff said that they felt included in decision-making and that staff meetings were held. Communication within the home appeared to be good. Self-monitoring is taking place, through monthly checks, undertaken by the owner’s representative. A senior manager for the company, Wilton Lodge Limited, has been appointed in order to assist the owner and provide additional support to the four home’s managers. Wilton Lodge H59-H10 S21290 Wilton Lodge V223572 280605 Stage 4.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Wilton Lodge H59-H10 S21290 Wilton Lodge V223572 280605 Stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection Wilton Lodge H59-H10 S21290 Wilton Lodge V223572 280605 Stage 4.doc Version 1.20 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 standard(s) 3, 4, 5, 6 The home has procedures in place to ensure that the needs of those admitted can be met. EVIDENCE: Prospective residents are assessed prior to admission to the home to determine whether they would be appropriately placed there. Additionally, Social Services/ Healthcare assessments are available for all those who are funded. From discussions with the acting manager and staff, it was clear that they had the knowledge, skills and experience necessary to deliver the care services that the home is registered to provide. Potential service users and/ or their relatives are encouraged to visit the home prior to admission, whenever this is possible. Trial periods may vary though it is usually for one month. The home does not provide dedicated facilities, or the services required for intermediate care. Wilton Lodge H59-H10 S21290 Wilton Lodge V223572 280605 Stage 4.doc Version 1.20 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 standard(s) 7, 8, 9, 10, 11 The staff have a good understanding of the residents’ support needs. This is evident from the positive relationships, which have been formed between staff and residents. EVIDENCE: Suitable arrangements are in place for meeting the health and personal care needs of the residents, who suffer with dementia-type illnesses, including Alzhiemer’s also those with additional mental health problems. However, it is recommended that care planning documentation and risk assessments be updated for all residents and presented in a more readily accessible format. From observing personal interactions, the Inspector felt that staff respected residents’ privacy and dignity. However, a visiting relative said that residents’ personal laundry did not always find its way back to the right owner. Residents’ wishes concerning terminal care and arrangements after death, where this is known, are recorded on their care plans. Staff have received training in the safe handling of medicines. The records inspected were up to date and accurate. No service users have responsibility for their own medicines. Wilton Lodge H59-H10 S21290 Wilton Lodge V223572 280605 Stage 4.doc Version 1.20 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15 The home provides a relaxed and supportive environment that is beneficial to the residents’ wellbeing. An increase in activities would enhance the quality of life that residents experience. Family visits are encouraged for the enjoyment of residents and in support of their emotional needs. EVIDENCE: Activities in the home take place during the afternoons, when duty staff are available to organise these; the daily cleaning and catering tasks are carried out in the mornings by the care staff. A resident commented that they would like to be taken out for walks more often. The owner said that there was no reason why this could not happen in the mornings, when the acting manager was there to provide additional cover. Monthly reminiscence, arts and crafts sessions and drama group activities took place. Staff said that residents have complete freedom of movement around the home; those who wish can access the rear courtyard, where garden furniture is provided for the enjoyment of residents in fine weather. The Inspector was told that visitors to the home are welcomed. Residents are encouraged to make choices, wherever possible and may bring personal items into the home on admission e.g. furniture, pictures and ornaments. Wilton Lodge H59-H10 S21290 Wilton Lodge V223572 280605 Stage 4.doc Version 1.20 Page 11 On the day of the inspection the meal served was hot, nourishing and attractively presented. Staff were on hand to provide discrete assistance to residents, as required. One resident commented that they were not always informed of what was to be served; staff said that this information was usually available a week in advance and that a menu board was to be displayed in future. The Inspector noted that alternative mealtime choices are offered, even though all the main dishes are prepared off-site. Wilton Lodge H59-H10 S21290 Wilton Lodge V223572 280605 Stage 4.doc Version 1.20 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 17, 18 The owner, or acting manager handle complaints and matters of concern objectively, reassuring those involved that they are being listened to and that appropriate action will be taken. EVIDENCE: Details of how to make a complaint are made available to residents, their relatives and other visitors to the home. Records are kept of any complaints made. A resident spoken with said the staff and the acting manager were approachable. There are policies and procedures in place relating to adult protection and managing challenging behaviour. Staff receive training in these areas of their work. The home ensures that residents’ legal rights are protected i.e. that all have either a next-of-kin, or an appointee to manage their affairs. Residents are included on the electoral register; postal voting forms are available for those who wish to take part in local, or general elections. Wilton Lodge H59-H10 S21290 Wilton Lodge V223572 280605 Stage 4.doc Version 1.20 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 22, 26 The home provides a comfortable and homely environment that is suitable in meeting residents’ individual and collective needs. Partially restricted access, results in the home being less suitable for those with poor mobility. EVIDENCE: The home is well maintained by the company’s maintenance staff and the standard of décor is good. A programme of replacing furnishings in residents’ rooms and communal areas is in process. The home is kept very clean by the care staff and free from offensive odours. There is a policy on infection control and staff have received training on this subject. The laundry does not have the required hand washbasin fitted; a quotation for this work has been obtained. The owner accepts that the facilities and physical environment are not best suited for service users with poor mobility. This information is to be included in the home’s Statement of Purpose and Service Users Guide. Some adaptations have been carried out though it is recommended that the premises be professionally assessed i.e. by a physiotherapist, or occupational therapist, in respect of the current residents’ presenting needs. Wilton Lodge H59-H10 S21290 Wilton Lodge V223572 280605 Stage 4.doc Version 1.20 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29, 30 Staff have a good understanding of the residents’ support needs, evident from the positive relationships, which have been formed between staff and residents, observed during the inspection. When occupancy levels increase, additional staff hours will enable the home to achieve advancements in the overall quality of service provided. EVIDENCE: Minimum care staffing arrangements include two duty carers, throughout the day, with one waking and one sleep-in night staff. The acting manager is employed to work a five-day week, sharing on-call duties with the deputy manager. Staff vacancies mean that afternoon staff are currently covering some relief sleep-in duties. Ancillary workers are not employed at this time for cooking, cleaning, or laundry. The owner confirmed that an additional full-time carer is to be employed, when occupancy levels justify this. Staff were able to confirm that there had been recent training opportunities in safe working practices. All staff appointments are subject to satisfactory CRB checks being carried out. Wilton Lodge H59-H10 S21290 Wilton Lodge V223572 280605 Stage 4.doc Version 1.20 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 37, 38 Wilton Lodge is satisfactorily managed on a day-to-day basis by the acting manager and senior staff, with support from the company’s Director, ensuring the health, safety and welfare of residents as far as reasonably practicable. EVIDENCE: The acting manager has yet to complete the required training in management. Staff appeared committed in their work and said they felt supported by the acting manager. A satisfactory quality of care is provided. The Company carries out and records self-monitoring visits to a suitable standard. Records seen during the course of the inspection appeared to be satisfactorily maintained, though it was noted that several of the entries were undated in care planning documentation. Additional to the NVQ training available to staff, training in fire safety, food hygiene, first aid, infection control and safe handling has been provided during the last 12 months. Wilton Lodge H59-H10 S21290 Wilton Lodge V223572 280605 Stage 4.doc Version 1.20 Page 16 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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 x 2 x x x 2 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 2 x 3 x x x 3 3 Wilton Lodge H59-H10 S21290 Wilton Lodge V223572 280605 Stage 4.doc Version 1.20 Page 17 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard 26 22 Regulation 23(2)(j) 16(2c) Requirement Timescale for action 01.09.05. That a hand washing facility is provided in the laundry. That assessments are carried out On-going by a suitably qualified person i.e. physiotherapist, or OT, to ensure that the needs of those residents with restricted mobility are addressed and that subsequent recommendations for disability equipment, or environmental adaptations are carried out. That the home’s manager receives the required training and achieves NVQ level 4 in Management, or equivalent, together with the Registered Managers Award. 2005 3. 4. 31 9(2b,i) 5. 6. Wilton Lodge H59-H10 S21290 Wilton Lodge V223572 280605 Stage 4.doc Version 1.20 Page 18 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard 07 10 15 27 37 Good Practice Recommendations That the content of service users’ care plans is revised to ensure that the current information, concerning care needs and how these are to be met, is readily accessible to staff. That the staff responsible ensure that residents personal laundry is always correctly distributed after washing/ cleaning. That residents are always advised of the menu of the day beforehand. That staffing levels are kept under review and are appropriate to the assessed needs of the residents, including activity and social and community contact. That all written entries made on the required individual records and home records are dated and signed. Wilton Lodge H59-H10 S21290 Wilton Lodge V223572 280605 Stage 4.doc Version 1.20 Page 19 Commission for Social Care Inspection 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 H59-H10 S21290 Wilton Lodge V223572 280605 Stage 4.doc Version 1.20 Page 20 - 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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