Inspection on 31/10/05 for Wilton Lodge

This inspection was carried out on 31st October 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 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 24/06/05

Wilton Lodge 21/12/04

Wilton Lodge 29/06/04

Wilton Lodge 29/01/03

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

CARE HOMES FOR OLDER PEOPLE Wilton Lodge 55 Wilton Road Bexhill-on-sea East Sussex TN40 1HX Lead Inspector James Houston Unannounced Inspection 31st October 2005 8:45 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Wilton Lodge DS0000021290.V259967.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Wilton Lodge DS0000021290.V259967.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Wilton Lodge Address 55 Wilton Road Bexhill-on-sea East Sussex TN40 1HX Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01424 216250 01435 874819 Angel Healthcare Limited Vacant Care Home 12 Category(ies) of Dementia (12) registration, with number of places Wilton Lodge DS0000021290.V259967.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. That the maximum number of service users to be accommodated is twelve (12). That service users accommodated will be aged 65 years, or over on admission. That service users accommodated will have a dementia type illness. That a maximum of two (2) service users between the ages of 55 and 65 years, who would otherwise fall within the main category, may be accommodated at Wilton Lodge at any one time. The home is not registered to accommodate service users with primary symptoms of drug or alcohol abuse, or acquired brain injury. 24th June 2005 5. Date of last inspection Brief Description of the Service: Wilton Lodge is a Victorian terraced property set close to the seafront and town centre in Bexhill-on-Sea. There are bus routes and a mainline railway station, within a short distance. The home, one of four care homes owned by 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 managers 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 DS0000021290.V259967.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place during the morning and early afternoon of the thirty-first of October 2005. Before the inspection papers held by the Commission of Social Care inspection were read and those standards to be assessed prepared. The inspection in the home took 5.6 hours. A tour was made of the premises. A variety of records including three care plans and policies and procedures were read. The inspector met with all the residents and spoke with three of them. The inspector also spoke with two staff and the acting manager and a visiting health staff member. After the inspection two relatives were spoken to. There were 11 residents in the home on the day of the inspection. What the service does well: 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 DS0000021290.V259967.R01.S.doc Version 5.0 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Wilton Lodge DS0000021290.V259967.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 and 6. The home offers full information to prospective residents and their representatives. EVIDENCE: The home has produced a satisfactory Statement of Purpose/Service Users Guide. These are periodically reviewed. Residents are provided with a copy of the terms and conditions of residence, and a copy is retained in the home. The home does not provide intermediate care. Wilton Lodge DS0000021290.V259967.R01.S.doc Version 5.0 Page 8 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10. Care plans need more regular review. Residents’ health care needs are met. Medication administration records need attention. A bathroom and toilet door should be attended to give privacy and dignity to residents. EVIDENCE: Three care plans were inspected. Plans contained a detailed initial assessment. A relative said that they had been involved in completing this. Plans had a monthly review but these had not been completed on a monthly basis not for the last three months. Plans had a risk assessment. A daily update is written and these were found to be up to date and well written. Records inspected showed that residents’ health needs are well met. Staff said that gentle exercises are offered. Residents are monitored for pressure sores, and the acting manager said that the home has close links with the incontinence advisers. A visiting health care staff member said that the home gives good attention to the health care needs of its residents. A resident confirmed this. It is recommended that regular weighing of residents be resumed. Wilton Lodge DS0000021290.V259967.R01.S.doc Version 5.0 Page 9 No residents currently self medicate. Medications are held securely. The record of drugs administered was not fully kept and a requirement has been made. Staff said that they have had relevant training. A pharmacist visits four times a year to assess the system. The door to the home’s main bathroom, which is said to be in daily use, cannot close because a radiator guard impedes it. In addition the door has not got a locking mechanism. This door and the door of a toilet nearby have a small hole in them from the removal of a lock. These matters should be addressed. Wilton Lodge DS0000021290.V259967.R01.S.doc Version 5.0 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 the following standard(s): 13 and 15. Visitors are made welcome. Mealtimes offer variety and interest to residents. EVIDENCE: Staff said that visitors are made welcome and offered a cup of tea. Relatives said that they are always made welcome. The home keeps careful records of food served and alternatives offered. A relative said that staff are aware of residents’ likes and dislikes. The main meals continue to be cooked elsewhere and heated up in the home. The meal served during the inspection looked appetising and was in ample portions. Staff said that they have time to offer discreet assistance to residents who need it, and observation confirmed this. Special diets are catered for as needed. A recommendation had been made at the last inspection that residents are informed beforehand what the main meal is to be. Staff said that they tell residents if asked, and the establishment supplying the meals sends a laminated sheet with the meal for the day set out on it. The menu displayed was some days old and so the recommendation has been repeated. Wilton Lodge DS0000021290.V259967.R01.S.doc Version 5.0 Page 11 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. The home has suitable arrangements to deal with complaints made to it. The home’s procedures and processes are designed to protect residents in the event of any abuse or allegations of abuse. Some new staff need training on adult protection and challenging behaviour. EVIDENCE: The home has a suitable complaints procedure. Relatives said that they are aware of it and would be happy to raise issues. Records inspected showed that the home has received has received no complaints since the last inspection, and none have been received by the Commission for Social Care inspection. The home has a suitable adult protection and whistle-blowing policy. Records inspected showed that some new staff need suitable training in adult protection and challenging behaviour. Staff said that they are aware of the home’s policies on receiving gifts and gratuities. Wilton Lodge DS0000021290.V259967.R01.S.doc Version 5.0 Page 12 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,21,23,24 and 26. The home is well maintained and affords accommodation to a high standard. A hand washing facility in the laundry is still required. EVIDENCE: The home is well maintained by the company’s maintenance staff and the standard of décor is good. Staff said that they enter items in the maintenance book and this was made available for inspection. Minor items requiring attention were noted during the inspection. An environmental health officer visited recently and the acting manager said that his one recommendation is being actioned. The home has sufficient toilets and baths to meet the needs of residents and most single rooms are en suite. Wilton Lodge DS0000021290.V259967.R01.S.doc Version 5.0 Page 13 Since the last inspection the home called in a physiotherapist to assess the needs of one resident and the acting manager said that advice would be sought in respect of other residents as needed. The home is not easily suited to residents with poor mobility and it is recommended that the Statement of Purpose be reviewed to reflect this. The home has three single bedrooms smaller than the size set out in the National Minimum Standards, and this is set out in the Statement of Purpose. There are two double rooms, one in single occupation and one with two residents. Their dimensions are set out in the home’s Statement of Purpose. Residents’ rooms are well presented with furniture of good quality and good fittings. A resident said that they had chosen not to have a key to their room. The home has a suitably equipped laundry. However the requirement made at the last inspection that a hand-washing facility be installed has not been met and has therefore been repeated. A resident said that their own clothes are retuned to them in very good condition. The home was clean and tidy throughout, and there are no odours. Wilton Lodge DS0000021290.V259967.R01.S.doc Version 5.0 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 28. A competent staff team meets residents’ needs, but staffing levels should be kept under review. Levels of qualification (NVQ in Care) amongst care staff need addressing. EVIDENCE: A staffing rota was available for inspection. The acting manager added staff roles to it during the inspection. Residents and relatives said that they find the staff helpful. Since the last inspection the staffing level has been increased to three care staff in the morning from two, with, as before, being on duty in the afternoon and two on duty at night (one awake and one asleep)-the number of residents has risen from seven to eleven. On the day of the inspection there were only two staff for part of the morning due to an unexpected staff absence. An assistant manager had just been appointed to the home but has since resigned. The manager currently shares on call duties with the provider, but it had been hoped that the assistant manager would assist. Staffing levels should be kept under review. One staff member holds NVQ level 3 in care and another staff member holds level 2, and another is doing level 2. The recommended staff ratio of 50 of staff holding this level of qualification is not currently met. Wilton Lodge DS0000021290.V259967.R01.S.doc Version 5.0 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,35 and 36. Current management of the home is not adequate. A registered manager is needed. The home has a warm ethos. Regular supervision for care staff should be provided. EVIDENCE: The home has an acting manager and an application from the provider is needed in respect of a registered manager. The acting manager has a suitable job description, and has undertaken suitable training to update her knowledge and skills. She has been undertaking her registered managers award and hopes to complete this by early 2006. Staff on duty said that they had not attended staff meetings. The acting manager said that meetings take place from time to time but minutes had not been circulated. Residents, relatives and staff said that they find the acting manager and friendly and helpful. Residents’ meetings are not held, but staff were observed to spend time with residents and involve them. Wilton Lodge DS0000021290.V259967.R01.S.doc Version 5.0 Page 16 The home does not currently hold valuables or monies on behalf of residents but the facility to do so exists. Staff have not received supervision since the last inspection. Records inspected showed that this is to be reinstated. It is recommended that care staff should receive supervision at least six times a year. The acting manager said that she has had training in supervision. Wilton Lodge DS0000021290.V259967.R01.S.doc Version 5.0 Page 17 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 3 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 3 3 3 X X 2 STAFFING Standard No Score 27 3 28 2 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 X 3 3 1 X X Wilton Lodge DS0000021290.V259967.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard OP9 OP10 Regulation 17(1)(a) &Sch 3(i) 12(4)(a) Requirement Record fully medicines administered to residents. Ensure that the bathroom door can close fully and is lockable. Fill the hole in this door and in the adjacent toilet door. Provide new staff with training in adult protection and challenging behaviour. That a hand washing facility is provided in the laundry. (Previous timescale of 01/09/05 not met). That the homes manager receives the required training and achieves NVQ level 4 in Management, or equivalent, together with the Registered Managers Award. (Previous timescale had not expired). Provide formal supervision for staff. Timescale for action 31/10/05 30/11/05 3 4 OP18 OP26 18(c)(i) 23(2)(j) 31/01/06 31/01/06 5 OP31 9(2b,i) 31/12/05 6 OP36 18(2) 31/12/05 Wilton Lodge DS0000021290.V259967.R01.S.doc Version 5.0 Page 19 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 6 Refer to Standard OP7 OP15 OP24 OP27 OP32 OP36 Good Practice Recommendations Update plans of care monthly. Advise residents of the menu of the day beforehand. Attend to minor physical items identified at inspection. That staffing levels are kept under review and are appropriate to the assessed needs of the residents. 50 of care staff achieve NVQ level 2 in care by 2005. Care staff receive formal recorded supervision at least six times per year. Wilton Lodge DS0000021290.V259967.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Wilton Lodge DS0000021290.V259967.R01.S.doc Version 5.0 Page 21 - 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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