Inspection on 12/07/07 for Wilton Manor Nursing Centre

This inspection was carried out on 12th July 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 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 Manor Nursing Centre 15/06/06

Wilton Manor Nursing Centre 03/02/06

Wilton Manor Nursing Centre 23/02/05

Wilton Manor Nursing Centre 20/07/04

Wilton Manor Nursing Centre 17/02/04

Similar services:

21 High Street

Vale House

Chestnut Walk

The Old Vicarage

Cherwood House Care Centre

Ashley House

Ascot Nursing Home

Fountain View

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

CARE HOMES FOR OLDER PEOPLE Wilton Manor Nursing Centre Wilton Avenue Southampton Hampshire SO15 2HA Lead Inspector Anita Tengnah Unannounced Inspection 12th July 2007 09:15 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 Manor Nursing Centre DS0000011455.V339062.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 Manor Nursing Centre DS0000011455.V339062.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wilton Manor Nursing Centre Address Wilton Avenue Southampton Hampshire SO15 2HA 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) 02380 230555 02380 632076 welhamsa@bupa.com www.bupa.co.uk BUPA Care Homes (ANS Homes) Limited Ms Sara Jane Welham Care Home 69 Category(ies) of Dementia (13), Dementia - over 65 years of age registration, with number (69), Mental disorder, excluding learning of places disability or dementia (13), Mental Disorder, excluding learning disability or dementia - over 65 years of age (69) Wilton Manor Nursing Centre DS0000011455.V339062.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ ies of service only: Care home with nursing only - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following Categories: Dementia (DE) Mental disorder, excluding learning disability or dementia (MD) 2. The maximum number of service users to be accommodated is 69. Date of last inspection 15th June 2006 Brief Description of the Service: Wilton Manor is a care home providing care for 69 older persons in need of nursing care. The home is registered to provide care for older people with mental diseases associated with old age and those with a mental disorder, excluding learning disabilities. BUPA care owns the service. The home is located in the city centre of Southampton and is close to all the local amenities. The home was purpose built on three floors, and provides a modern environment with single occupancy accommodation, all of which have en-suite facilities. There is a well- maintained garden at the front of the building. The current fee charged is £775-£905 Wilton Manor Nursing Centre DS0000011455.V339062.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit was undertaken as part of the inspection process on the 12th of July 2007. As part of case tracking 7 staff and 4 service users views were sought and care records were looked at. Information gained from the Annual Quality Assurance Assessment (AQAA) was used and included in this report, as was information gathered by the commission since the last inspection to contribute in assessing judgements in this report. The commission received 17 comment cards from the service users and their relatives. The information gathered and relatives and service users spoken with indicated that the home provides a reliable and consistent service. Care practices observed at the time of the visit showed that the staff and the service users had developed good relationships and care was provided in a respectful manner. Positive comments were received from the service users who were able to contribute about the care that they are receiving at the home. What the service does well: The home has an assessment process in place and takes into account the needs of both potential and existing service users to ensure that the home can meet their needs. The home has continued to develop the activity programmes to the satisfaction of the service users. The service users are provided with a warm, homely accommodation with evidence of ongoing refurbishment. The care plans and records of care given ensured that residents received the support and help they required. This included the service users/ family wishes when death occurs. The management system and procedures in the home worked well. The service has dedicated staff that are skilled and knowledgeable about the care needs of older people and regular training was available to them. Wilton Manor Nursing Centre DS0000011455.V339062.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Wilton Manor Nursing Centre DS0000011455.V339062.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Wilton Manor Nursing Centre DS0000011455.V339062.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 3,6 The admission process is well managed and ensures that the prospective service users’ needs are appropriately assessed prior to admission. The home does not provide intermediate care. EVIDENCE: A sample of two newly admitted service users records was looked at as part of this visit. The manager or senior nurse undertook an assessment of the service users prior to admission. Records contained details of health care needs and identified risks such as falls and mobility. Staff must ensure that these assessments are signed and dated and would help in identifying reviews as needed. Wilton Manor Nursing Centre DS0000011455.V339062.R01.S.doc Version 5.2 Page 9 Comments cards received indicated that the home provided the service users with appropriate information in written forms and the opportunity to visit the service. Information received and discussion with staff showed that the family visited, as the service users were unable to do so due to their physical and mental frailties. The manager confirmed that the service does not provide intermediate care. Wilton Manor Nursing Centre DS0000011455.V339062.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care plans are detailed and staff have information about the support that the service users required. Further development of the communication needs and life history would further enhance the care. The healthcare access for the service users is well managed. The medication management is good and appropriate records maintained. The service users are treated with respect and their dignity maintained. EVIDENCE: Wilton Manor Nursing Centre DS0000011455.V339062.R01.S.doc Version 5.2 Page 11 A sample of five care plans was looked at as part of this visit. The care plans were detailed and included risk assessments for falls, moving and handling, use of bedrails, nutrition and pressure areas assessments. The care plans seen contained details of personal care, moving and handling requirements, and continence management. The fall care plan seen was formulated following a risk assessment, bedrails assessments and consent from the next of kin and contained details such as hip protectors. The care plans are reviewed monthly and there was some evidence of the service users relatives’ involvement in this process. Comment cards response to the question “Do you receive care and support you need” 4 said always and 5 said usually and 3 sometimes. Comments included “as a regular visitor it seems so” and “everything works well for our relative and for us the family”. The other comments were that due to changes of staff and the perceived lack of continuity mouth care was neglected and glasses not cleaned. Another comment was that the family are not involved in the care planning of her relative. Two of the relatives spoken with said that they would speak to the staff and did so when they visited. The care plan for a service user with a learning disability seen did not contain any information about her communication needs. This was brought to the attention of two staff members who reported that they thought that there had been something put in place. However this plan was not available in her care plan seen and need to be rectified. Development of personal life history/ profile would further enhance the information about the service users and reflect a common approach to person centred care planning in meeting all the needs of the service users. Involvement of the service users relatives/ advocates should be further developed in order to ensure that all care needs have been identified and their wishes respected. This is echoed in comments received for x2 relatives. All the service users are registered with a local surgery and the manager reported that there is good support and link with the community trust and the community psychiatric team. Comments received indicated that “support from the GP and physiotherapist is superb”. The GPS visit the home three times a week and available at other times as required. Comment cards responses to “Do you receive the medical support you need”. Sixteen of them said always and one said usually. The home was using the Measured Dosage System (MDS) and medication was ordered on a monthly basis. The Medication Administration Record was looked at on the first floor. Records of medication administered were recorded accurately. All medication on that floor was maintained securely. The staff reported that there was no service user receiving any controlled drug at the time of the visit. There was good practice procedure noted where two staff signed the MAR sheets for medication that were transcribed. Staff reported that some medications are dispensed for two months and a printed MAR sheet Wilton Manor Nursing Centre DS0000011455.V339062.R01.S.doc Version 5.2 Page 12 is not always available to them from the chemist and would be rectified with the pharmacist. Staff must ensure that all prescribed medication has the name of the service users clearly marked on the bottle/ package including administration instruction. A bottle of aperients was found with no label and staff said that this would be discarded. Five of the service users and three relatives spoken with were all very complimentary of the care provided by the home. They stated that staff were very helpful and were treated with respect. Staff were observed to knock prior to entering the service users’ rooms. A service user commented that ”the staff are very kind” and “ I like it here Comments cards indicated a high degree of satisfaction about the care and included comments such as “the staff are helpful and very caring”. All the rooms are single occupancy and two relatives said that the service users privacy and dignity are “always” respected when receiving care. Comments received and observation on the day showed that the staff had developed good relationships with the service users and treated them with respect. Wilton Manor Nursing Centre DS0000011455.V339062.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 12,13,14,15 The activity programme is varied and further development would be beneficial in particular at weekends. Service users say that their autonomy and choices are respected. The home’s open visiting policy encourages and supports the service users in maintaining contact with their family and friends. The home provides the service users with varied meals and choices are available. EVIDENCE: The home has a planned activity that was displayed in the entrance hall. There are three activity coordinators who all work during the week and no planned activity is available at the weekends. Activities are organised either in small groups or one to one. None of the service users spoken with were able to Wilton Manor Nursing Centre DS0000011455.V339062.R01.S.doc Version 5.2 Page 14 comment about the activities. Some records of activities were available and the senior activity coordinator discussed that the way that activities are delivered was being further developed and recording of activities will be as part of care planning. The home had a room on the ground floor that had been fully refurbished and designated as an activity room. This was well equipped and also fitted as a hairdressing salon for the service users. One of the staff who works two days a week and undertakes only activities was passionate about his job and talked about his role. The inspector observed good interaction with the service users and he had good knowledge of the needs of the clients group accommodated. The relatives were complimentary about his care and said, “he is very good and communicates well with them”. When asked “Are activities arranged by the home that you can take part in”, the comment cards from the relatives indicated that 8 of them said always, 4 usually, 2 said sometimes and 1 said never. A relative commented, “residents with dementia and sensory loss seem to preclude joining in”. Other comments were “there is a time table and “there appear to be very few activities and I have never seen on the floor entertainment”. The overall comment was that activities could be further developed and particularly at weekends for the people who are unable to take part or make choices due to their mental incapacity. The home has an open visiting policy and this was evidenced by the entries in the visitor’s book that the home maintains. Three relative spoken with said that there was no restriction on visiting. Another relative said that he visited at least three times a week and “this is never a problem”. Staff and relatives said that they are able to entertain their visitors in their rooms or in different areas in the home as they wished. The manager reported that the Anglican and Baptist ministers visited the home on a regular basis and undertook a service at the home. The priest was also available at request. The mobile library visit has been suspended die to a lack of interest and the manager said that she would be keeping this under review. The home has a planned menu in place that the manager reported is rotated on a four weekly basis. The service users were observed taking their meals at lunchtime in the communal dining room. Meals appeared well-presented, appetising and included pureed meals. Service users said that the meals were good. Comment cards and relatives spoken with indicated that meals were to their satisfaction. Comments included “ the food is very good and always looks nice “. Wilton Manor Nursing Centre DS0000011455.V339062.R01.S.doc Version 5.2 Page 15 Comment cards responses to “Do you like the meals at the home”. Eight said usually, two said sometimes and four said always. Other comments included “unfortunately my wife can only eat puree but the meal looks appetising”. One said the meal “usually unappetising and only sandwiches of limited fillings for tea instead of light plated meals and soup”. This was brought to the attention of the manager who confirmed that light cooked meals and soups are all available at teatime. Staff were observed to offer support with meals in a sensitive manner and meals were not rushed. The service user was informed about what the lunchtime meal was and supported him to eat. During the morning a staff member was observed serving hot drinks at coffee time. The service users were offered tea and given a couple of biscuits. No choice was offered to the service users regarding drinks or the type of biscuits that they would prefer. This was discussed with the manager who said that the staff knew what the service users have. As part of meeting needs the service users should be offered choices and staff should develop ways in helping them make these choices. It was noted that at lunchtime a carer had the main course and a hot pudding on the tray; she was helping a service user with her meal in her room. This was brought to the attention of the manager and would be addressed to ensure that hot meals are served appropriately. Another service user who was in a wheelchair had a towel on the floor and a senior staff said that this was to protect the floor as she spilt her food. This was discussed with the manager as the service user was trying to get out of her chair and the towel posed a risk of her slipping on it. This also did not promote the dignity of the service user as the wooden floor could be easily cleaned. Wilton Manor Nursing Centre DS0000011455.V339062.R01.S.doc Version 5.2 Page 16 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 16,18 The complaint management is good and relatives are confident that their complaints would be listened to. Staff have good understanding of adult protection and ongoing training ensures that the service users are protected EVIDENCE: The home has a complaint procedure in place and two service users and three relatives spoken with stated that they would approach the staff if they had any concerns. A complaint log was available and record indicated that there has been no complaint since the last visit. The complaint procedure was displayed in the reception area and suggestion box/ comment cards were in place for the relatives and visitors. The home has a copy of the Hampshire County Council ‘Protection of Vulnerable Adults’ policy and procedure and it’s own policy and procedure reflects the guidelines from Hampshire County council’s own policy. Staff spoken with had good knowledge of what constituted abuse and said that they would not hesitate to report any allegation to the manager. Training in the prevention of abuse was available to the staff and also formed part of the Wilton Manor Nursing Centre DS0000011455.V339062.R01.S.doc Version 5.2 Page 17 induction process. There has been no allegation of abuse reported to the commission since the last visit. Wilton Manor Nursing Centre DS0000011455.V339062.R01.S.doc Version 5.2 Page 18 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 19,26 The accommodation is homely and overall well maintained. The communal bathrooms and shower rooms are in need of attention and should be made good. The lack of garden access for the service users remains unresolved. The infection control procedures are adequate. EVIDENCE: A tour of the building was undertaken as part of the visit. Accommodation is provided in a well- maintained, spacious and homely environment with a good Wilton Manor Nursing Centre DS0000011455.V339062.R01.S.doc Version 5.2 Page 19 complement of communal areas for the service users. Adaptation and equipment were available to maintain and support the service users in maintaining their independence. The se All the bedrooms seen were personalised and the service users were complimentary about their rooms. The furnishing was of good quality and appropriate to meet the needs of the service users. The décor within the home had evidence of on-going maintenance and improvements. Recent refurbishment included new chairs for the communal lounges, ground floor bathroom, and some bedroom carpets. The carpet in the communal lounge was planned for renewal this month. Comments cards received about the environment included “the home is clean “ to “standard of cleanliness has deteriorated in past 6 months” and “carpets mucky and furnishing poor”. It was noted that one of the communal shower room was in a poor state of repair, with lack of ventilation and smelt of damp. The communal bathrooms had a number of equipment stored including hoists, slings and walking frames. This was brought to the attention of the manager and staff must ensure that the communal bathrooms are free from hazard and maintained as a homely environment. The shower room as identified at the time of the visit must be renovated in order to provide the service users with a clean and safe bathing facility. During a tour of the first floor it was observed that all the communal toilets, bathrooms and shower rooms were locked. This was discussed with the manager and rectified at the tome. The manager is aware that the service users must have access to the communal facilities at the home and any restriction must be within a risk assessment framework. Access to the dining room is also restricted with key pads and the manager reported that this was only in use whilst the dining room was set up at mealtimes and the service users have free access at other times. During the last visit in June 06 the inspectors discussed garden access for the service users where an area to the front of the property was currently unused and could with a little work provide a secure area where residents could wander unaccompanied. This remains an area that needs to be developed in order that the service users can have access to safely. The manager reported that the garden area to the side of the building that could be accessible from the activity room was looked into and that it would require some work’ as there was a drainage problem. This as suggested during the last visit would enable people on the ground floor to access an external garden, as and when they desired, as well as promoting for those participating in activities within the lounge the freedom to walk outside if they wished. Wilton Manor Nursing Centre DS0000011455.V339062.R01.S.doc Version 5.2 Page 20 The home has an internal laundry and staff reported that al the service users’ laundry is undertaken internally. The laundry room was well equipped with washing machines that had sluicing facilities and dryers. The staff had information on infection control procedures and equipment such as gloves and aprons were available. Comments cards received raised some issues about the service users “ Clothes go missing and other peoples clothing in relative room.” This included 2 new pairs of slippers where only one side of each could be found. A random sample of the service users’ clothing seen indicated that some were labelled but this did not apply to all the clothes. The manager said that relatives are advised to mark the clothing on admission. The shower room and some of the communal bathrooms had bins with no lids. One of these bins contained incontinent pads that had been discarded in the shower room. This was brought to the attention of the manager and removed. A review of bins for the disposal of incontinent pads must be in place and staff must ensure that infection control practices do not put the service users at risk. Wilton Manor Nursing Centre DS0000011455.V339062.R01.S.doc Version 5.2 Page 21 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 27,28,29,30 The staffing numbers are adequate to meet the present needs of the service users. The home has a good induction system in place to support the staff. The number of staff with NVQ training remains low. The recruitment process is good. All checks are undertaken prior to employment to ensure the safety of the service users. There is an ongoing training programme in place to ensure that staff are supported in their work. EVIDENCE: The home has a duty roster for nurses and carers and a separate roster for ancillary workers. The home is run as three floors and a sample of the staff roster seen indicated that there are 1 trained staff and 2 carers on the early shifts, and 1 trained staff and 2 carers on the late shifts on each floor except for the second floor where there are 1 trained staff and 3 carers. The night Wilton Manor Nursing Centre DS0000011455.V339062.R01.S.doc Version 5.2 Page 22 staff included 1 trained staff and 2 carers on each of the floors. Staff spoken with confirmed that they felt that there were adequate staff to meet the service users’ needs. During the weekdays the activity coordinators supported the staff. The staff reported that the trained staff and senior carers usually remained on the same floor, however the carers were rotated and frequently worked on different floors. Observations on the day indicated that staff were available to meet people’s care and social needs, including mealtime activity. Service users spoken with said, ”the staff are very good and lovely”. Comments received were “Staff friendly and caring”. Other comment from relatives and those spoken with indicated that “changes of staff who are rotated on 3 floors causes lack of continuity in personal care such as oral care neglected, spectacles not cleaned.” Other comments were” lack of staff especially at weekends” and “few staff at meal times to assist with meals.” Information received from the AQAA showed that home has 27 permanent carers and 9 have completed the National Vocational Qualification (NVQ) and 5 other carers were undertaking the course at present. The service has 9 “bank” staff who worked when needed and none of them had NVQ training. Overall the home had 18 of staff who had completed NVQ training. The manager is aware that continuous development in NVQ training for staff is needed in order to meet the 50 target for NVQ qualified staff. The home has a recruitment procedure and the manager interviewed all the applicants. A sample of newly recruited staff seen indicated that the home had a good recruitment process that staff followed. Checks were undertaken and references secured prior to employment. There is a detailed corporate induction programme for staff that included understanding dementia pack for the staff via distant learning course. The home has a good training programme in place to ensure that all staff have mandatory training in health and safety. The manager kept a training matrix to help monitor training achieved and needs. The staff reported that they felt supported in their works and that the on going training programme training and internal trainers made accessing training easy. Wilton Manor Nursing Centre DS0000011455.V339062.R01.S.doc Version 5.2 Page 23 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 31,33,35, 36,38 The home has a manager who demonstrated clear lines of accountability for the service. The financial interests of the service users are safeguarded through good accounting. The process of seeking the service users’ views is well managed and ensures that the home is run in their best interests. The structured supervision programme for staff is not fully implemented. There is a satisfactory procedure in place to ensure the health and safety of the service users are promoted. Wilton Manor Nursing Centre DS0000011455.V339062.R01.S.doc Version 5.2 Page 24 EVIDENCE: The home has a registered manager who is also a registered nurse with a number of years experience in the care of the elderly. The manager has an open and inclusive management style and demonstrated clear lines of accountability within the home. She undertook regular updates to maintain her skills and to upkeep her nursing registration. Mrs Whelan is planning to start her Registered Manager’s Award in July 2007. The staff and relatives spoken with said that the manager is supportive and available to them when needed. Two relatives stated that they would “be happy to raise any concerns with her. It was evident from interaction observed that the staff and the service users had developed good relationships with each other. Comments from service users included “the staff are very kind and attentive”. A relative said, “the staff are helpful.” A sample of the personal allowance as managed by the home was looked at. The administrator explained that all the service users’ personal allowances were kept in a residents’ account. Receipts and invoices were maintained of all transactions undertaken on behalf of the service users. The administrator reported that the company has just changed the bank and was unsure how the interests accrued would be shared between the service users. Previous account help in the residents’ names did not yield any interest. The service has an internal auditing programme in place. The service users views are sought as part of an ongoing process and service users’ meetings are held at regular intervals. One of the relative said that he attended these meetings and would raise an area of concern at the next meeting. Comment/ suggestion cards are available in the main reception area and confidentiality assured. Other auditing included pressure ulcers monitoring. Last visit report indicated that there was no structured supervision programme in place. The manager reported that a staff appraisal has been recently completed and a supervision programme has been set up. The process includes senior staff members have been allocated a number of carers that they would supervise including 1:1. This has not commenced but planned to start soon. Records of these meetings would be maintained in staff files. Information received indicated that there are regular reviews of policies and procedures to ensure that they meet current legislation/ guidelines. There is an Wilton Manor Nursing Centre DS0000011455.V339062.R01.S.doc Version 5.2 Page 25 ongoing programme for the servicing of fire equipment, hoists, wheelchairs, lift and emergency lighting. All substances that are hazardous to health (COSHH) were kept locked away safely. Wilton Manor Nursing Centre DS0000011455.V339062.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 3 Wilton Manor Nursing Centre DS0000011455.V339062.R01.S.doc Version 5.2 Page 27 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 Standard OP19 Regulation 23(1) Requirement Timescale for action 30/10/07 2. OP36 The communal shower room must be renovated to provide a safe and clean environment for the people using the service. Regulation The management must ensure 19 staff receive appropriate formal supervision and records of these are maintained. This is a repeated requirement with timescale of 10/08/06 not met. 30/08/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP28 Good Practice Recommendations The home/management should take steps to ensure that the 50 target of staff possessing and NVQ 2 is achieved and maintained. Wilton Manor Nursing Centre DS0000011455.V339062.R01.S.doc Version 5.2 Page 28 Wilton Manor Nursing Centre DS0000011455.V339062.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Manor Nursing Centre DS0000011455.V339062.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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