Inspection on 05/09/07 for Wimbledon Beaumont

This inspection was carried out on 5th September 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Similar services:

Ashlong House

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

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

CARE HOMES FOR OLDER PEOPLE Wimbledon Beaumont 35 Arterberry Road Wimbledon London SW20 8AG Lead Inspector Liz O`Reilly Unannounced Inspection 5th September 2007 10:30 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 Wimbledon Beaumont DS0000069471.V350027.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. Wimbledon Beaumont DS0000069471.V350027.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wimbledon Beaumont Address 35 Arterberry Road Wimbledon London SW20 8AG 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) 020 8944 8299 020 8879 7399 Barchester Healthcare Homes Ltd Mrs Rosetta Worgan Care Home 49 Category(ies) of Dementia - over 65 years of age (43), Old age, registration, with number not falling within any other category (43), of places Physical disability (43) Wimbledon Beaumont DS0000069471.V350027.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. For the admission of one specified male resident aged under 60 years for respite care on a periodic basis. 14th February 2006 Date of last inspection Brief Description of the Service: The Wimbledon Beaumont is situated in a residential area of Wimbledon, close to public transport. The home provides nursing care for up to forty-nine residents who may have dementia. Accommodation is provided over three floors. All rooms are single apart from one shared room. All rooms have en suite facilities. Each floor has its own lounge and there is an accessible garden for residents. Dining facilities are situated on the ground floor. A variety of activities are offered including outings and shopping trips in the home’s minibus. Information about the home is available in the Statement of Purpose and Service User Guide. Fees for this service start at £1000 per week. Wimbledon Beaumont DS0000069471.V350027.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over one and a half days by two inspectors. We had the opportunity to speak with six people who use the service one visitor and a number of staff members. We examined a sample of the records held in the home. Additional time was given following the inspection to allow for the return of questionnaires sent to staff and people who use the service. The home has provided an Annual Quality Assurance Assessment – Self Assessment form to the CSCI. Information received from all of the above sources as well as observations made by the inspectors has been used to come to the judgements made in this report. What the service does well: What has improved since the last inspection? Improvements have been made in the outside areas of the home. The garden has been redesigned and replanted. New patio areas are available. The dining room is now open for lunch and evening meals. Staff have made some progress on increasing the social information on care plans which will assist in providing more person centred care. Wimbledon Beaumont DS0000069471.V350027.R01.S.doc Version 5.2 Page 6 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. Wimbledon Beaumont DS0000069471.V350027.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 Wimbledon Beaumont DS0000069471.V350027.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): 1 & 3People who use this service receive good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Pre admission assessments are carried out to make sure that staff have the right skills and abilities to meet individual needs. Care must be taken by staff to use these pre admission assessments appropriately. Prospective residents are provided with good information on what they can expect from the home before they move in. EVIDENCE: People who use this service told us that they were provided with good information on what they could expect from the service. The home has a statement of purpose and service user guide which sets out aims and objectives. A brochure and information pack are available. An assessment of each persons’ needs is carried out before they move into the home. This assists in making sure that the home can meet individual needs and that staff are provided with information about the person before the day of admission, Wimbledon Beaumont DS0000069471.V350027.R01.S.doc Version 5.2 Page 9 The pre admission assessments should be used to set up an initial care plan. However we found that information from the assessments was not always brought forward to the care plan or not always brought forward accurately. Examples of this included the admission assessment stating a person could speaks clearly and was able to make their wishes known but the care plan stated this person was unable to communicate. The assessment also noted that this person was suffering from hearing loss but the care plan stated that hearing was good. If the assessments are to inform the care provided from the time the person moves into the home these issues need to be addressed. Should the needs of a person change between the assessment being completed and admission this should be recorded. Wimbledon Beaumont DS0000069471.V350027.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): 7, 8, 9 & 10 People who use this service receive adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Each individual has a care plan which includes basic information for the delivery of care but the plan is not detailed or person centred. The quality of care planning is variable and information is not always recorded consistently nor does it reflect good practice. The health care needs of individuals are met. Medication is well managed. EVIDENCE: Each person is provided with a care plan. We found evidence that staff were making improvements in including some of the social and emotional needs of the person as well as their physical needs. However the quality and quantity of information available was variable in the sample of care plans examined. In some instances staff have clearly taken time to gain information about the person which could enable them to provide more person centred care. Staff had taken note of recent bereavements and recognised the need for sensitive support. They had also noted that one person did not like being alone and given instructions that staff needed to spend time talking with the person. Wimbledon Beaumont DS0000069471.V350027.R01.S.doc Version 5.2 Page 11 In other instances there was little information on why the person had been admitted to the home, the social preferences of individuals and minimum life history. Overall the physical needs of individuals were well documented. However in one instance it was not clear if the person was experiencing pain. On one document it was noted that the person was not experiencing pain while in another document it indicated they were having some pain. Staff must take care particularly in relation to pain that they are addressing and assessing the needs of the person accurately. Staff clearly take care to meet the health care needs of individuals. Referrals are made to other health care professionals such as wound care advisors, dieticians and GPs if needed. People who use this service can access dental, optical and chiropody services within the home or use community services. Medication was found to be well managed, stored and administered in a safe manner. Individuals told us that they felt they received the medical support they needed and most felt satisfied with the care provided. The issue of transport to hospital appointments was raised with the inspectors. We were told that the present firm used was at times unreliable. This is an issue that should be investigated by the manager. One person told us that they needed their spectacles at all times but that staff often removed them when they were assisting them which meant that they could not see what was happening. Staff should be reminded that any aids should not be removed unless absolutely necessary and for the minimum amount of time so as not to further disable people. Staff must take care that the information they record in the care planning and other documentation is accurate and in line with current good practice. We noted that in one instance the records showed that a person was unable to communicate. When the inspector met with this person it was clear that they were able to communicate their needs. In another instance staff had recorded that the person “can’t make a simple decision for herself”. This statement was made as this person is living with dementia. This suggests to the inspectors that staff have a poor understanding of dementia care. These issues need to be addressed through staff training and access to up to date information on communicating with people with disabilities and working with people living with dementia. Wimbledon Beaumont DS0000069471.V350027.R01.S.doc Version 5.2 Page 12 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): 12, 13, 14 & 15 People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. People who use this service are offered a good variety of social activities including events outside the home. The religious needs of individuals are recorded and met. The food provided is varied, with a good selection to choose from and is well presented. The preferences, religious and cultural dietary needs of individuals are met. Staff work towards making mealtimes a pleasurable social event. EVIDENCE: We found a good range of activities on offer in the home with very regular trips out to places of interest. A full time Activity Organiser is employed who provides a weekly activity programme, a copy of which is provided for each person and on display in the entrance of the home. The activities programme for the week of our first visit included:-Reflexology, keep fit, cribbage, dominoes, a film, shopping at tesco, beautician, bingo, what the papers say, pub lunch, yoga/keep fit and a tasting quiz. Several trips were seen to be arranged each month and have included:- pub lunches, Richmond Park, a garden centre, the River Thames, a mystery tour. Wimbledon Beaumont DS0000069471.V350027.R01.S.doc Version 5.2 Page 13 weekly shopping at Tesco, Denbies Vineyard, Syon Park, pick your own farm, and Hampton Court. The majority of feedback on the activities was positive. People pick and choose activities according to their individual interests. However two people we met with, who spent most of their time in their rooms, were less satisfied. One person said they were often bored and another said they would very much like to spend more time sitting in the garden. We noted that the self assessment carried out by the manager and the action plan from the home’s own quality monitoring indicated that staff should spend more time with individuals to gain a better understanding of their background and lifestyle and that care staff should become more involved in activities. These actions should improve the situation for those residents who prefer not to join in group activities. Consideration should be given to expanding the keyworker role in providing a more person centred approach. Care is clearly taken by the staff to offer a good variety of food with a relaxed atmosphere at meal times. The menu is varied and includes seasonal products. Feedback on the food provided was good. People told us that they enjoyed the meals, liked the new lay out of the dining rooms and felt there was always a good choice. We were told that food is available at any time during the day or night if people are hungry between meals. However we were also told by people who use the service that this was unlikely as they could have three courses at each main meal of the day. The food seen was very well presented and offered a good variety. Special diets for medical or cultural needs can be catered for. People told us they enjoyed the mealtimes. Feedback suggested that people were supported to maintain contact with family and friends. Visitors felt staff made them welcome in the home. The management are aware that there have been problems at times with the speed at which the telephone or front door has been answered particularly in the evenings and action has been taken to address these issues. Wimbledon Beaumont DS0000069471.V350027.R01.S.doc Version 5.2 Page 14 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): 16 & 18 People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. People who use the service are aware of the complaints procedure and who to speak to if they have any concerns. Safeguarding adults training is regularly arranged and procedures are in place for the reporting or investigation of allegations. The training on safeguarding adults should be provided to all staff working in the home to ensure that they can recognise and report any concerns. EVIDENCE: A clear complaints procedure is in place and people we had contact with were aware of who to contact if they have a problem or complaint. We are aware of two complaints received by the home over the last twelve months. The manager has carried out investigations into the issues raised and responded appropriately. Staff are open to listening to and learning from any complaints or concerns raised. All complaints are well recorded. At the time of these visits not all staff had been provided with training on safeguarding adults. However the deputy manager informed us that training had been arranged for the following day and twenty two staff would be attending these sessions. The manager should ensure that all staff including ancillary staff are provided with training on safeguarding adults. There are clear procedures to be followed should there be an allegation or suspicion of abusive behaviour. Wimbledon Beaumont DS0000069471.V350027.R01.S.doc Version 5.2 Page 15 Wimbledon Beaumont DS0000069471.V350027.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 24 & 26 People who use this service receive good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. The individual and shared areas are furnished and decorated to a high standard. The organisation works to improve the environment with a rolling programme of redecoration. People who use the service are encouraged to personalise their bedrooms. The home is well lit, clean, tidy and smells fresh. EVIDENCE: Generally the home is decorated and furnished to a high standard. The building is well maintained. Each person is provided with their own room with en suite facilities. People who live here are encouraged to bring to the home their own items or furniture and belongings. This enables individuals to make the room “their own” and gives a personalised appearance to bedrooms. Wimbledon Beaumont DS0000069471.V350027.R01.S.doc Version 5.2 Page 17 There is a large garden are which has recently been redesigned. New patio areas provide different outdoor seating areas. All of the outside areas were seen to be very well maintained. The changes made to the garden and patio areas have improved the facilities for people who use this service. The majority of the home was found to be clean and tidy except for the bathroom and toilet in the corridor on the first floor. These areas are not decorated or maintained to the same high standard as the rest of the home. We were informed that plans were in place for the bathrooms to be refurbished. Consideration should be given to making bathrooms and toilets less clinical in appearance. A bath mat in the first floor bathroom was found to be mouldy on the underside and this was removed at the time of our visit. Comments from one survey also noted that bathrooms and toilets were not always fresh and clean. All other comments on cleanliness were positive. Wimbledon Beaumont DS0000069471.V350027.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use this service receive good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. There are consistently enough staff available to meet the needs of people using the service. Good opportunities are available for staff training. Further training on dementia care and communication needs to be carried out. Care is taken to safeguard people who use the service through the staff recruitment checks. EVIDENCE: There are sufficient staff on duty both day and night to meet the needs of individuals who live at the home. Staff records showed that care is taken to carry out the required checks on staff before they start working in the home. The training records and feedback from individual staff showed that there are good opportunities for training. As noted previously all staff need to be provided with on going training at a level appropriate to their role in dementia care and communication. Regular staff meetings are held to keep all staff up to date with general issues. Wimbledon Beaumont DS0000069471.V350027.R01.S.doc Version 5.2 Page 19 Staff told us that they felt well informed through meetings, that they were provided with good information on any changes in the needs of individuals they were supporting and that they had all taken part in induction training. People who use the service told us staff were “very polite”, “patient” and “helpful”. Wimbledon Beaumont DS0000069471.V350027.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 People who use this service receive good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. The home has good systems in place to monitor the quality of the service which includes consulting with people who use the service. Staff take care to protect the health and safety of all those who live in, work and visit the home. The staff supervision system could be improved. EVIDENCE: The manager is in the process of being registered by the CSCI. We were unable to meet with the manager during this inspection. Staff and people who use the service said that the manager makes sure that any problems are dealt with as soon as possible and that they can meet with the manager privately if they wish. Wimbledon Beaumont DS0000069471.V350027.R01.S.doc Version 5.2 Page 21 We found good records were maintained for money deposited with the home by people who use the service. A separate account is held for each person and regular statements are provided. Staff feedback on supervision was mixed, some people felt they were well supported and others felt less so. The way in which supervision is carried out suggested to the inspectors that this was a form of clinical supervision. Staff are not allocated a particular supervisor and the records do not show what has been discussed or agreed at supervision sessions. Each member of staff is provided with an appraisal once a year which includes setting goals for the following year There is a well developed quality monitoring and quality assurance programme. As part of this questionnaires, asking their opinions on the home, are sent to people who use the service and their visitors. The responses are collated and an action plan is prepared to address any issues raised. At the last survey issues were raised about access to the home by visitors, the quality and comfort of the bedrooms, social activities and delays sometimes experienced in answering the telephone. We could see that more trips had been provided in response to the survey, and that letters had been sent to residents, relatives and regular visitors to the home. Additional hours had been allocated to allow for the reception to be staffed more often. In addition to the annual surveys regular residents meetings are held at which people can be consulted on the day to day running of the home and any changes. Records showed that staff make regular checks on the home to ensure the health and safety of people who use the service, staff and visitors. Staff are provided with regular training on moving and handling, health and safety, fire and food safety. Weekly checks are carried out on the fire alarm system with regular professional maintenance checks. Staff keep a record of hot water temperatures before anyone is supported to have a bath or shower to reduce the risk of injury. Wimbledon Beaumont DS0000069471.V350027.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X 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 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 3 Wimbledon Beaumont DS0000069471.V350027.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 Requirement In order to make sure that people are provided with the appropriate care staff must ensure that information on the care plan is up to date, accurate and in line with good practice. Information from the pre admission assessment must be used to compile an initial care plan. To maintain the dignity of people who use the service staff must ensure that they do not remove any aids from individuals. If it is absolutely necessary to remove an aid this must be returned to the person as soon as possible. In order to provide informed up to date care for people who use this service all staff must be provided with training on communicating with people with disabilities. All staff must be provided with on going training, appropriate to their role, on dementia care. Timescale for action 05/12/07 2 OP10 12(4) 05/11/07 3 OP30 18 05/12/07 Wimbledon Beaumont DS0000069471.V350027.R01.S.doc Version 5.2 Page 24 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 OP12 Good Practice Recommendations Consideration should be given to staff working with the activities officer to provide more person centred care to individuals who do not wish to join more organised activities. All staff who work in the home should be provided with training on safeguarding adults. When refurbishing bathrooms and toilets consideration should be given to making these areas appear less clinical. The present arrangements for staff supervision should be reviewed. 2. 3 4 OP16 OP19 OP36 Wimbledon Beaumont DS0000069471.V350027.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection West London Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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 Wimbledon Beaumont DS0000069471.V350027.R01.S.doc Version 5.2 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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