Inspection on 31/08/05 for Wilton Lodge

This inspection was carried out on 31st August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 19/10/07

Wilton Lodge 27/11/06

Wilton Lodge 11/05/06

Wilton Lodge 24/04/06

Wilton Lodge 17/01/06

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 Claire Farrier Unannounced 31 August 2005 9:00 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 I52 s19621 wilton lodge v243152 020805 stage 4 310805.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Wilton Lodge Address 77-79 London Road Shenley Hertfordshire WD7 9BW 01923 854623 01923 850019 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) Wilton House Limited Miss E L Pead Care Home 36 Category(ies) of OP Old Age - 36 registration, with number DE(E) Dementia over 65 - 36 of places Wilton Lodge I52 s19621 wilton lodge v243152 020805 stage 4 310805.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: There are no additional conditions of registration. Date of last inspection 11 December 2004 Brief Description of the Service: Wilton Lodge is a care home providing personal care and accommodation for thirty-six 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. The home is located in the village of Shenley, approximately 1.5 miles from Radlett. It is within walking distance of local shops, and several pubs and churches are close by. All the home’s bedrooms are single and all have en-suite facilities. The first floor is accessed by a passenger lift. A sun lounge forms part of the home’s entrance. There is an enclosed front garden with a lawn and seats that is well maintained and easily accessible. A car park is available at the back of the building. Wilton Lodge I52 s19621 wilton lodge v243152 020805 stage 4 310805.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first unannounced inspection of the inspection year and took place over one day, starting at 9.00am. Two inspectors visited the home, and the majority of time was spent observing and talking to residents and staff. Some time was also spent looking at records and care plans, and the results of the inspection were discussed with the manager and the company’s Operational Director. Thirteen residents, two members of staff and one visiting relative were spoken to during the inspection. The residents and relative praised the quality of care provided by the home, and were complementary of the staff. This was generally a positive inspection, and the majority of the standards were met or partially met. All the requirements made in the last inspection report were met. New requirements were made concerning moving and handling procedures, risk assessments, activities and the storage of personal information. The manager is leaving the home, and all the residents and staff spoken to said that they will miss her. What the service does well: All the residents who took part in the inspection said that they are happy in the home and that the staff provide a good quality of care. Several said that the staff are very good and kind, and that they come when they are needed, and one said that she feels safe in the home. The care staff spoken to were enthusiastic about their work, and said that they have a good level of training and support to enable them to meet the needs of the residents, including training in dementia care The staff were observed to have a good relationship with the residents and to treat them with courtesy and respect. The home provides a good quality of food, with a choice of nutritious meals that reflects the likes and dislikes of the residents. Most of the residents spoken to praised the food and especially the roast dinners. Care plans have a format that provides clear and easily accessible information on all the residents’ needs, although in one case the care plan was not up to date. Wilton Lodge I52 s19621 wilton lodge v243152 020805 stage 4 310805.doc Version 1.40 Page 6 What has improved since the last inspection? 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 I52 s19621 wilton lodge v243152 020805 stage 4 310805.doc Version 1.40 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 I52 s19621 wilton lodge v243152 020805 stage 4 310805.doc Version 1.40 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 and 4 A comprehensive assessment of the needs of the residents was seen to be in place, and appropriate risk assessments are carried out to ensure that the residents live in a safe environment. The home has sufficient information on residents’ needs and access to appropriate services to enable the needs to be met. EVIDENCE: Care records of residents were inspected and there was evidence of a preadmission assessment of needs being carried out in each case. The assessment includes full details of the person, and brief comments on the personal care and health care needs. One example seen stated “does need a bit of help” for personal care, and then specified that assistance is needed with washing, bathing, dressing and toileting, and that the person has a poor appetite. Seen alone the assessment does not provide full details of the person’s needs, but the care plan is written giving very full details. In the example given above, the care plan provides full procedures for the assistance needed with personal care, and information and procedures for monitoring their nutritional needs. Wilton Lodge I52 s19621 wilton lodge v243152 020805 stage 4 310805.doc Version 1.40 Page 9 The home receives a copy of the pre-admission assessment of needs of prospective residents for those who are funded by the Social Services and discharge letters from hospital, where applicable. The home is registered for dementia care, and it has recently been awarded accreditation for dementia care by Hertfordshire County Council (HCC). Training is provided for all the care staff in dementia care. The deputy manager is currently completing a distance learning course in positive dementia care, and eight or nine of the care staff have also started this course. The first floor has keypads to open the doors to the stairs for the safety of the residents. There are also some aids to orientation, such as red door frames for the bathrooms and toilets and pictorial signs on the doors. The service could be further improved by provision of activities specifically for people with dementia (see Standard 12). All the residents spoken to, and a visiting relative, are very happy with the care provided by the home, and feel that home meets their needs. One resident was admitted to the home with an assessment of double incontinence and demanding behaviour. The care plan shows that the person is no longer incontinent, and the demanding behaviour is addressed by talking to the person and providing reassurance. Few incidents of the previous behaviours have been recorded since the person moved into the home. Wilton Lodge I52 s19621 wilton lodge v243152 020805 stage 4 310805.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10 The individual needs of residents are clearly set out in care plans to ensure that all their needs are identified and can be met, although not all care plans are up to date. The home monitors and addresses all the residents’ health needs, and has good procedures for the administration of medication. Residents said that staff treat them with respect, and, with one exception, the policies and practice in the home also promote privacy and dignity for the residents. EVIDENCE: Detailed case tracking was carried out through the files of four residents. They contain clear and easily accessible information on the resident’s health and personal care needs, with comprehensive procedures for meeting the needs. The individual care plan needs are reviewed every month, and each person’s assessment and care needs are reviewed every month. Some care plans, however, have not been updated to reflect the changing needs of the residents. Staff were observed manually lifting one resident, and not using the equipment specified in the care plan. It was reported that the care plan is out of date. The resident now needs a hoist for transfers, but the home does not have a suitable hoist (see Standard 38). The care staff complete a daily record with comments that are relevant to the person’s care plan needs. Wilton Lodge I52 s19621 wilton lodge v243152 020805 stage 4 310805.doc Version 1.40 Page 11 Appropriate risk assessments are in place for each resident. A falls risk assessment, moving and handling assessment and pressure area assessment are in place for each resident, and these are reviewed every month. Each resident also has a risk assessment for medication, which shows the risks of staff administering their medication. Individual risk assessments include smoking, bedroom flooring, use of alcohol and confusion. In some care plans risk assessments were seen dated 2003, with no evidence of a review since then. The care plans contain good information on the residents’ health care needs, with appropriate monitoring of specific health concerns and recording of all contacts with medical practitioners. The monthly review addresses each resident’s emotional and mental health with an assessment of the person’s well-being and ill-being. The indications of well-being include communication, showing pleasure and a sense of purpose, and for ill-being, depression, aggression, discomfort and withdrawal. Residents are weighed every month, and any concerns with their weight are acted on. Food intake charts were seen for two residents with a concern about low weight, to record all the food that they eat and ensure that they have adequate nutrition. All falls in the home are monitored, with a monthly record of where and when the fall occurred, any pattern noticed and any action that should be taken. The home is actively seeking advice on the management of falls from the PCT (primary care trust) falls advisory service, but this is currently not available in the area. A visiting relative said that her mother has falls, but the home manages them very well. The home ensures that residents are not at undue risk during very hot weather. The NHS guidance on supporting vulnerable people during a heatwave is in the home. This inspection took place on a hot day. Jugs of cold drinks were provided in each resident’s room, and the staff were seen to replace and replenish these during the morning. Several residents were sitting in the garden, in the shade and all wearing hats. The home is situated so that the sun does not shine directly into the bedrooms for most of the day. One resident said that when it is hot she closes her curtains. Medication is stored on a separate trolley on each floor. Regular medication is supplied in individual monitored dosage blister packs. PRN (when required) medications are stored in a separate container for each resident. The home has good procedures for the administration and recording of medication. The deputy manager carries out a full audit of medication every week, and this was observed during the inspection. She checks that all packages of PRN medication are dated, and that the amount of medication tallies with the record. Wilton Lodge I52 s19621 wilton lodge v243152 020805 stage 4 310805.doc Version 1.40 Page 12 All the residents said that the staff are kind and friendly. They treat them with respect and provide a good quality of care. The care plans record whether each person likes to have their bedroom door open or closed, and several residents choose to lock their door when they are not there. Food intake charts for two residents were seen in the ground floor dining room. They were openly on display, so that anyone entering the room could see personal information about the residents. The charts need to be easily available for staff so that they can be completed at mealtimes. However they must be kept out of sight in order to protect the residents’ privacy. Wilton Lodge I52 s19621 wilton lodge v243152 020805 stage 4 310805.doc Version 1.40 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 standard(s) 12, 13, 14 and 15 Maintaining contact with families and friends is promoted by staff in accordance with the residents’ wishes. Wholesome and varied meals are provided within the home presenting a well-balanced nutritious diet for the residents. Residents maintain their independence by making choices about the food and how they spend their days, but there is a lack of activities in the home due to the absence of the activities co-ordinator. EVIDENCE: The activities co-ordinator is currently on maternity leave, and her absence was evident in the home. Several residents said that there are no activities for them, and a visiting relative said that the only fault with the home is the lack of activities. It was reported that staff try to take residents out for a walk or to sit in the garden or to visit the pub across the road when possible. An entertainer visited the home the previous week, and some residents had a meal at the pub, some played cards, and the hairdresser visits regularly. The residents are asked to take part, but often do not wish to. The care plans include a daily evaluation sheet for activities, and these were seen to be completed for each resident until 11th August, with the activities that they took part in and comments on their participation. The manager is attempting to recruit a temporary activities co-ordinator, but has so far had no success. The home is registered for dementia care (see Standard 4), but there is no evidence of specific activities for people with dementia. Wilton Lodge I52 s19621 wilton lodge v243152 020805 stage 4 310805.doc Version 1.40 Page 14 Families and friends are welcomed into the home, and family members are consulted about the resident’s care. The home promotes the residents’ autonomy, and all the bedrooms seen contained evidence of the resident’s own furniture and decorations. The care plans include resident’s choice forms, that record each resident’s preferred rising and retiring time, whether they like a bath or a shower, their choice of clothing and favourite meals and pastimes. Several residents stated that they would like to have a shower, but there are no showers in the home (See Standard 21). Most of the residents said that the food provided is good, and that they have a choice of what they wish to eat. Two commented that the roast dinners are particularly good, and one resident, a Yorkshire man, praised the chef’s Yorkshire pudding. One resident was not happy with the choice of meals, although she admitted that she is a fussy eater. The chef uses fresh ingredients to prepare the meals, and he talks to the residents every day about their meals. Wilton Lodge I52 s19621 wilton lodge v243152 020805 stage 4 310805.doc Version 1.40 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 standard(s) 16 and 18 The home has a comprehensive complaints procedure in place, and residents and their relatives are confident that any complaints will be properly investigated. All staff have appropriate training on prevention of abuse, and robust polices and procedures are in place to ensure that the residents are protected. EVIDENCE: The home has a satisfactory complaints procedure in place. Residents and their relatives are encouraged to make their concerns and complaints known. All complaints made to the home are recorded, and recent recorded complaints concerned the lack of an activity co-ordinator (see Standard 12). The records showed that complaints are responded to appropriately. In one case a meeting was arranged with the resident’s social worker, where all the issues of concern were discussed to the satisfaction of the complainant. Most of the staff spoken to were aware of the home’s procedures for prevention of abuse and of the whistle blowing policy, and training is currently taking place for all the staff in the home. Wilton Lodge I52 s19621 wilton lodge v243152 020805 stage 4 310805.doc Version 1.40 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 standard(s) 19, 21 and 26 The home and gardens are well maintained and provide a comfortable and attractive environment for the residents. Individual and communal facilities are generally appropriate for the residents’ needs, but there is no shower available for the residents. The provisions of the home ensure that the residents are able to maximise their independence and live in a safe and comfortable environment. EVIDENCE: No changes have been made to the fabric of the home since the last inspection. Wilton Lodge is a purpose built two storey building, situated close the centre of the Shenley. The decorations and furnishings in the home are domestic in style, and provide a homely and comfortable environment. There is a garden at the front of the house that is accessible for all residents, and several residents were observed enjoying the sunshine there during the inspection. The home is well decorated and the fabric of the building appears to be well maintained. Wilton Lodge I52 s19621 wilton lodge v243152 020805 stage 4 310805.doc Version 1.40 Page 17 The home has sufficient bathrooms for the residents. Some bedrooms have ensuite facilities, although the baths in en-suite bathrooms are unsuitable for most residents, who need assistance to have a bath. One resident said that she would prefer a shower, and that she may be able to use a walk in shower without assistance from the staff, which would improve her independence. It was reported that staff have also requested a walk in shower to enable them to provide a better quality of care for the residents. The Operational Director of Wilton House Ltd was in the home during the inspection, and she responded that the provision of a shower will be considered by the company. The home appeared to be clean throughout, and there were no offensive odours. Appropriate procedures are in place for the control of hygiene. Wilton Lodge I52 s19621 wilton lodge v243152 020805 stage 4 310805.doc Version 1.40 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 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 and 30 Staff numbers in the home are sufficient to ensure that all the residents’ needs are met, and staff receive appropriate training. Good recruitment procedures and staff training make sure that, as far as possible, the residents are supported and protected in the home. EVIDENCE: The home has a good level of staffing, with five care assistants and a duty officer on each shift during the morning, four during the afternoon and three waking night staff. The home practices a thorough recruitment procedure, including obtaining CRB (Criminal Record Bureau) and POVA (protection of vulnerable adults) disclosures before new staff start to work in the home. Most of the care staff are recruited from Poland, but the files seen showed that sufficient information, including references, are provided in English. CRB (Criminal Record Bureau) and POVA (Protection of Vulnerable Adults) checks are carried out before they start work, when they have been allocated a NI number. An agency is used to recruit the care workers in Poland, and they are interviewed by phone. However the Operational Director intends to go to Poland in the future to carry out interviews in person. Wilton House Ltd provides accommodation for overseas workers. Wilton Lodge I52 s19621 wilton lodge v243152 020805 stage 4 310805.doc Version 1.40 Page 19 All the staff spoken to said that they take part in regular training. There is a thorough induction programme, and updates in training. Notices were seen of training courses taking place in September on health and safety, customer care, infection control, fire safety and protection of vulnerable adults. The deputy manager has completed a course in dementia care, and she and several other staff are now taking a distance learning course in positive dementia care. All the members of the care staff and domestic staff spoken to during the inspection were enthusiastic about their work in the home, and several said that they like the residents, and that they feel well supported. The residents feel confidence in their abilities and several said that the staff are very good and very kind. Wilton Lodge I52 s19621 wilton lodge v243152 020805 stage 4 310805.doc Version 1.40 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 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) 33 and 38 The home actively seeks the views of the residents and other involved people in order to ensure that a good quality of care is provided. Adequate records are maintained for the effective management of the home and monitoring of heath and safety procedures. The practices in some areas must be tightened up to ensure that there is no risk to the health and safety of the residents. EVIDENCE: The home has a sound quality assurance system in place that meets the needs of the service. Questionnaires are sent to the residents and their families twice a year, with each resident and family being surveyed once a year. The manager goes through the questionnaires when they are returned and takes up any issues raised with the individual concerned. A summary of the results of the questionnaires is kept in the file, but it contains personal details of the residents, and so is not suitable for providing feedback to the residents and relatives on the outcome of the consultation process. It was suggested that a report should be provided for the residents and relatives with a summary of the concerns raised and any actions taken. Wilton Lodge I52 s19621 wilton lodge v243152 020805 stage 4 310805.doc Version 1.40 Page 21 This will give feedback to them on the actions taken following their comments, and provide validation of their active involvement in the life of the home. This should also be sent to CSCI. There are regular residents meetings in the home. The proprietor makes monthly visits to the home to monitor the quality of care provided. The home maintains appropriate records for the health and safety of the residents and staff in the home, and staff follow the home’s policies and procedures. All the staff have training in moving and handling, fire safety, food hygiene and infection control as part of their induction. Two health and safety concerns were noticed during the inspection. 1. The staff were observed manually lifting a resident from her recliner chair in the lounge into her wheelchair, although her care plan specified the use of moving and handling equipment (see Standard 7). It was reported that the resident’s needs have changed, and she now requires a hoist for transfers. However there is no suitable hoist available on the first floor, and her room is not large enough for the use of a hoist. A new moving and handling assessment must be carried out, and suitable equipment must be provided for transfers, in order to safeguard both the resident and the staff from the risk of injury. 2. Hot food trolleys are used to take meals from the kitchen to the dining rooms. These are stored outside the kitchen, close to one resident’s bedroom. There is a notice on the wall by the food trolleys, with a risk assessment and warning of the danger of the hot surfaces of the food trolleys. However there is no assessment for the risk to the resident of the nearby bedroom if she should touch a trolley as she is entering or leaving her room. It was reported that the risk is minimal as the resident is unable to walk out of her room unaided. However, there is a risk to her, and a risk assessment must be implemented. Wilton Lodge I52 s19621 wilton lodge v243152 020805 stage 4 310805.doc Version 1.40 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 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 x N/A 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 3 x 2 x x x x 3 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 x 3 x x 2 x x x x 2 Wilton Lodge I52 s19621 wilton lodge v243152 020805 stage 4 310805.doc Version 1.40 Page 23 No 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. Standard 7 Regulation 15(2)(b) & (c) Requirement The care plan for one resident contained inaccurate and out of date information on moving and handling procedures. Care plans and risk assessments must be updated to provide up to date and accurate information on the residents needs, and to ensure that both the resident and staff are safeguarded from the risk of injury. Food intake charts for residents were openly on view. All personal information must be stored securely in order to protect the privacy of the residents. There is currently no programme of activities in the home. The manager must ensure that residents are provided with opportunities to take part in their choice of activities, with special consideration for specific activities for people with dementia. A resident was observed being manually lifted from her chair to a wheelchair. A moving and handling assessment must be carried out, Timescale for action 31 October 2005 2. 10 12(4)(a) 31 October 2005 3. 12 16(2)(n) 30 November 2005 4. 38 13(4) 31 October 2005 Wilton Lodge I52 s19621 wilton lodge v243152 020805 stage 4 310805.doc Version 1.40 Page 24 5. 38 13(4) and suitable equipment must be provided for transfers, in order to safeguard both the resident and the staff from the risk of injury. Hot food trolleys are stored close to one residents bedroom. A risk assessment must be implemented to ensure that there is no risk to the resident frorm the hot surfaces of the food trolleys. 31 October 2005 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 7 Good Practice Recommendations Good risk assessments are in place for each resident, but some have not been reviewed or updated since 2003. Risk assessments should be reviewed and updated on a regular basis, and at least annually, to ensure that they continue to meet the needs of the resident. The home has sufficient bathrooms, but no shower. Consideration should be given to providing a walk-in shower in the home to meet the needs of the residents and to enable some to gain more independence in their personal care. It is recommended that a summary of the bi-annual surveys of the residents and their relatives should be provided for the residents and their families. The report should also be sent to CSCI. 2. 21 3. 33 Wilton Lodge I52 s19621 wilton lodge v243152 020805 stage 4 310805.doc Version 1.40 Page 25 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City AL7 3BQ 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 I52 s19621 wilton lodge v243152 020805 stage 4 310805.doc Version 1.40 Page 26 - 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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