Inspection on 17/10/07 for Wimborne Care Home

This inspection was carried out on 17th October 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

Wimborne Care Home 08/06/09

Similar services:

St Vincents

The Cotswold Home

Winton House

Newbeech House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Wimborne Care Home Selsmore Road Hayling Island Hampshire PO11 9JZ Lead Inspector Ian Craig Unannounced Inspection 17th October 2007 10:15 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 Wimborne Care Home DS0000069917.V347193.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. Wimborne Care Home DS0000069917.V347193.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wimborne Care Home Address Selsmore Road Hayling Island Hampshire PO11 9JZ 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) 0207 3522224 Barchester Healthcare Sally Ann Flanagan Care Home 52 Category(ies) of Dementia - over 65 years of age (0), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (0), Old age, not falling within any other category (0) Wimborne Care Home DS0000069917.V347193.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 only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - OP Dementia old age - DE(E) Mental disorder, excluding learning disability or dementia, old age MD(E). The maximum number of service users to be accommodated is 52. 2. Date of last inspection N/a Brief Description of the Service: Wimborne Care home is run by Barchester Healthcare and can accommodate up to 52 older persons. It has been registered as a care home under the ownership of Barchester Healthcare since 19th April 2007. Prior to that time it was under private ownership. The building is on one storey and is surrounded by well-maintained gardens with courtyards, seating and car parking. One person occupies each bedroom, but there is provision for three of the bedrooms to accommodate two people. Each bedroom has an en suite bathroom with a toilet and wash hand basin. The home is close to Hayling Island seafront and promenade and there are nearby shops. Activities are provided for the residents on a regular basis. Care staff are provided over a 24-hour period with five staff on duty form 8am to 2pm and 4 staff at remaining times. In addition to this, the home has catering and cleaning staff. There is an activities coordinator employed for 24 hours per week. Wimborne Care Home DS0000069917.V347193.R01.S.doc Version 5.2 Page 5 The home’s weekly fees range from £439.00 to £680.00. Wimborne Care Home DS0000069917.V347193.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The inspection consisted of a tour of the home, examination of records, policies and procedures, documents and residents’ records. Staff were observed working with the residents and 3 care staff and one member of the management team were spoken to about their work. Two residents were interviewed in private and several other residents were spoken to. Survey forms were sent to a number of residents, relatives and professionals. Ten of these forms were returned and information contained in them has been used in this report. The home also completed an Annual Quality Assurance Assessment, which has also been used for completing this report. What the service does well: The home’s environment and decoration is of a very good standard. Communal areas are pleasantly decorated with pictures, ornaments and floral displays. The gardens are well maintained with patio courtyards for residents and visitors to sit in. Residents’ rooms are personalised with their own belongings and many residents have their own telephone. Residents and relatives report that the care needs of the residents are met. Residents are clean and well presented and were observed laughing and chatting whilst having a glass of sherry or juice before the midday meal. Care plans give details of how care needs are to be met. Medication procedures are of a good standard. The home employs an activities coordinator who provides and facilitates activities and outings for the residents. These include games, competitions and outings. Staff are motivated in their work and have a good knowledge of each person’s needs. Wimborne Care Home DS0000069917.V347193.R01.S.doc Version 5.2 Page 7 Many positive comments were made by the relatives and residents about the service provided by the home and include the following: • “Very friendly and caring staff who communicate well with the residents.” • “Friendliness and courtesy are shown to the residents, catering for different needs….my relative is very happy there.” • “Since Barchester took over ownership of Wimborne, they are arranging outings to places of interest for the residents which many of them look forward to.” • “The home makes my mother/father feel liked and well cared for.” A professional stated that the home always respects the residents’ privacy and dignity and that it is always a happy and well managed care home.” What has improved since the last inspection? What they could do better: Whilst staff sate that they have access to training this could be checked against training records. Regular staff supervision has not been taking place. Procedures for recruiting new staff need to be improved as records showed that one person had started work before a Criminal Record Bureau (CRB) or Protection of Vulnerable Adults (POVA) first check had been obtained. For another person, recruitment records did not show that the required checks had been completed. One resident and one relative reported that some staff could be abrupt in their manner when interacting with the residents. Wimborne Care Home DS0000069917.V347193.R01.S.doc Version 5.2 Page 8 Residents’ dental care needs could be more effectively monitored. 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. Wimborne Care Home DS0000069917.V347193.R01.S.doc Version 5.2 Page 9 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 Wimborne Care Home DS0000069917.V347193.R01.S.doc Version 5.2 Page 10 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): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each person referred to the home for possible admission has his or her needs assessed to ensure that the home is able to meet their needs. EVIDENCE: The home uses a form called, Admission Form to assess and record potential resident’s needs. Records and discussions with staff confirm that when someone is referred to the home for possible admission that an assessment is completed by the home Wimborne Care Home DS0000069917.V347193.R01.S.doc Version 5.2 Page 11 to determine if the person’s needs can be met. Residents’ records contain details obtained from recent hospital placements. Wimborne Care Home DS0000069917.V347193.R01.S.doc Version 5.2 Page 12 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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ personal and health care needs are met. Residents’ privacy and dignity is promoted although there is scope for improving the attitude of some staff when interacting with residents. EVIDENCE: Care plans were examined for 4 residents. These contain assessments of need and care plans showing how those needs are to be met by staff. Risk assessments are completed for the likelihood of falls and other areas where risk is highlighted. Care plans include details of moving and handling needs of the individual residents. Wimborne Care Home DS0000069917.V347193.R01.S.doc Version 5.2 Page 13 Records show that the choice of each person is given consideration. For instance, the preferred time that the resident likes to go to bed and get up is recorded. Residents confirmed that they are able to retire to bed and get up when they wish. Discussion with the residents and feedback from surveys confirm that the residents and their relatives consider that personal and health care needs are met. Residents look well cared for. There is written evidence of health care needs being met with records to show that weight is monitored and that the home liaises with resident’s general practitioners, that eyesight checks take place and that the advice of the community nursing team is obtained. Dental needs are not routinely checked and are described by staff as being arranged by relatives or when required. The inspector recommended the use of a monitoring format for dental checks to help ensure that residents receive regular checks and treatment. Medication procedures were checked. Staff receive training in medication procedures. Records confirm that staff sign a record each time medication is administered to a resident. Records show that controlled medication is handled and administered in accordance with pharmaceutical guidelines. A staff member was observed carrying out specialist medication procedures for checking blood sugar levels. The staff member demonstrated a comprehensive knowledge of the resident’s needs, that the procedures are supported by training from the district nursing service and are recorded in the care plan. Comments from residents, relatives and other persons described the staff, and the home’s practices, as respecting the residents’ privacy and dignity. One relative stated, “Friendliness and courtesy are shown to the residents when catering for their different needs.” There were, however, 2 exceptions to this: one resident described that the staff are varied in their manner shown to the residents, and a relative stated that some staff speak harshly to the residents and that dignity is not always given when providing care. Residents’ rooms have a lock and they can choose to have door key if they wish. Several of the residents have a key to their room. A telephone is available for residents to use and a number of residents have a telephone n their bedroom. Wimborne Care Home DS0000069917.V347193.R01.S.doc Version 5.2 Page 14 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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The provision of activities for residents has been improved and there is now a schedule of events so that residents benefit from stimulation and meaningful activities A nutritious diet is provided. EVIDENCE: The home has recently employed an activities coordinator for 24 hours per week with the sole brief of providing activities for the residents. At the time of the inspection the activities coordinator was engaged with 2 residents planting pansies in pots that they had painted. Also at the time of the inspection, several residents were joining in with gentle exercise to music in the lounge. Wimborne Care Home DS0000069917.V347193.R01.S.doc Version 5.2 Page 15 An activities programme is displayed in the home giving details of the week’s events. A relative commented that residents have opportunities to visit local attractions. Several residents are attending a night out at a local pub. Staff reported that the improvement in the activities has benefited residents’ mood and outlook. Residents were observed sitting in the communal areas, reading books and newspapers. Other residents preferred to sit in the rooms. One resident stated that he/she likes to join in with the quiz competitions and another resident stated that he/she had recently won a contest organised by the home’s owners. The daily preferences for each person are recorded and residents confirmed that they are able to spend their time as they wish. Visitors are welcome to the home and the residents are supported to visit local amenities. The serving of the midday meal was observed. Residents sat at dining tables set with napkins and a staff member took a trolley to each table to offer each person a drink of juice or sherry before the meal. Residents have a choice at each meal time. The midday meal looked appetising and consisted of lamb chops with a variety of vegetables. Residents can have breakfast in their bedrooms if they wish. Comments from residents and relatives about the food were mixed. Most stated that the food is of a good standard but one resident stated that he/she does not like the meals and a relative described the meals as “sometimes rather inappropriate.” The home engages residents in choosing carpets furnishings and decoration schemes for the home. One resident stated that he/she would like to be able to express his/her views more freely to the home’s representatives indicating that there is scope to further involve residents in decision making in the home. Wimborne Care Home DS0000069917.V347193.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): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home makes available its complaints procedure and acts upon any complaints received. Residents are protected from any possible abuse. EVIDENCE: Each person is supplied with a copy of the complaints procedure. Residents and relatives confirm that they know what to do if they have a complaint. The home’s own records show that there have been 3 complaints in the last year each of which was resolved within 28 days. Staff and training records confirm that staff receive training in adult protection procedures. There are also plans for staff to attend a training course in adult protection provided by the organisation’s regional trainer in November 2007. Wimborne Care Home DS0000069917.V347193.R01.S.doc Version 5.2 Page 17 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, 21, 22, 23, 24, 25 and 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home’s physical environment is clean, well maintained and provides a range of facilities so that residents’ needs are met and their dignity is promoted. EVIDENCE: Each resident has a single bedroom with an en suite bathroom, which has a toilet and wash hand basin. There are several bedrooms which can be used as double rooms, for instance for a married couple. Bedrooms were found to be clean and well maintained. A number of rooms have a patio door, which opens Wimborne Care Home DS0000069917.V347193.R01.S.doc Version 5.2 Page 18 onto the home’s gardens. The home is one level, which helps those with mobility problems. The home is surrounded by well-maintained and attractive gardens, including paved courtyards with tables and chairs for the residents and their visitors. The home employs a staff member with responsibility for maintaining the grounds. At the time of the visit he was placing newly planted hanging baskets in the courtyard areas. Residents were observed using both the conservatories and lounges for either relaxing, reading chatting or for organised activities. Communal areas are decorated with pictures, wall hangings, ornaments, flora displays and indoor plants. All areas of the home were found to be clean and free from any unpleasant odours. The home has a laundry and residents’ clothes are organised so that they do not go astray when washed. Wimborne Care Home DS0000069917.V347193.R01.S.doc Version 5.2 Page 19 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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home deploys sufficient staff to meet the residents’ needs. Staff are motivated and knowledgeable although training records are not well organised. Staff recruitment procedures do not always protect the residents. EVIDENCE: The home provides 5 care staff from 8am to 2pm each day followed by 4 care staff from 2pm to 8pm. The home’s manager is additional to the care staff hours. Four ‘waking’ night staff are on duty each night. Staff employed in other capacities are as follows: • 2 cooks and a kitchen assistant • 6 domestic staff • 2 maintenance staff • 1 administrator Wimborne Care Home DS0000069917.V347193.R01.S.doc Version 5.2 Page 20 • Activities coordinator for 24 hours per week Staff, residents and relatives felt that the staffing levels are sufficient for the needs of the residents with the exception of one relative who stated that more staff are needed. Staff are generally described as helpful, polite, professional, kind and friendly. There are 2 exceptions to this, which are detailed in the Health and Personal Care section of this report. The inspector spoke with 4 staff and the administrator each of whom showed a motivation to their work, as well as thorough knowledge of the resident’s needs and the home’s procedures. Staff have access to various training courses including adult protection, medication procedures, moving and handling, fire safety, care plan recording and NVQ in care. 48 of the staff have NVQ level 2 or above, and a further 6 staff are currently studying for the qualification. The home does not have a training programme and staff training records are in the process of being transferred to a new system and so were not readily available. Newly appointed staff have a set induction programme, which is recorded. Staff reported that formal supervision sessions have not taken place for the last six months, but are due to recommence shortly. It was also reported that staff ‘handover’ meetings take place each day but that staff meetings have not been held. Recruitment procedures were examined for 5 recently appointed staff. These show that references and checks such as a criminal record bureau (CRB) and protection of vulnerable (POVA) are obtained before the person starts work. There were 2 exceptions to this where one staff member had started work one month before a CRB and POVA check had been obtained. For another staff member, there was no record that a POVA ‘first’ check had been obtained before the person started work. The inspector was assured this had taken place and that the record is held centrally by Barchester Care. Wimborne Care Home DS0000069917.V347193.R01.S.doc Version 5.2 Page 21 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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. With the exception of staff recruitment and supervision the home is well managed and run in the interests of the residents. The welfare and safety of the staff and the residents is promoted. EVIDENCE: Wimborne Care Home DS0000069917.V347193.R01.S.doc Version 5.2 Page 22 At the time of the inspection the home’s management was in period of change with the existing registered manager being replaced by a new incoming manager the following week. Staff described the current manager and the deputy manager as supportive. Feedback from residents and their relatives, as well as from the staff, is that the home’s new owners are making improvements to the service. One resident, however, expressed the view that the home is not as well run as it was under the previous ownership. The home’s system of quality assurance was checked. Audits take place of the following: activities for residents, medication procedures, health and safety, infection control, records, personal care and professional practice. It was understood that residents and relatives have been given surveys by the home to comment on their view of the service provided. There was no evidence of the results of these surveys being incorporated into the home’s audit and plans for the future. An annual development plan was not available. The home’s system of quality assurance needs to be developed further to include an annual development plan. The home does not handle, or hold for safekeeping, any resident’s finances or valuables. Appliances and equipment are serviced and checked by suitably qualified persons. The fire logbook shows that the fire safety equipment is regularly tested. Records also show that staff receive instruction in fire safety and that fire drills take place. Staff are trained in first aid, moving and handling, food hygiene and infection control. Measures are taken to protect residents from hot radiators by covers and from hot bath water by the use of thermostatic controls on the taps. Wimborne Care Home DS0000069917.V347193.R01.S.doc Version 5.2 Page 23 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 X 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 4 3 3 3 3 4 3 3 STAFFING Standard No Score 27 3 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 2 X 3 Wimborne Care Home DS0000069917.V347193.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? N/a 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 OP29 Regulation 19 Schedule 2 Requirement Staff must not commence work in the home until a CRB is applied for and a POVA ‘first’ check obtained. Records must be available to show that the above checks have been completed. 2 OP36 18(2) Staff must be appropriately supervised by the provision of regular formal supervision. 17/12/07 Timescale for action 17/11/07 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 OP8 Good Practice Recommendations Individual resident’s dental needs and check ups should be recorded and monitored. Wimborne Care Home DS0000069917.V347193.R01.S.doc Version 5.2 Page 25 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 Wimborne Care Home DS0000069917.V347193.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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!