Inspection on 23/01/07 for Winash Rest Home

This inspection was carried out on 23rd January 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:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Winash Rest Home 9 Albert Road Clevedon North Somerset BS21 7RP Lead Inspector Barbara Ludlow Unannounced Inspection 23rd January 2007 10:20 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 Winash Rest Home DS0000069260.V332531.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. Winash Rest Home DS0000069260.V332531.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Winash Rest Home Address 9 Albert Road Clevedon North Somerset BS21 7RP 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) 01275 873129 01275 879362 heatherhouse87@hotmail.co.uk Mrs Heather Jane House Mrs Heather Jane House Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places Winash Rest Home DS0000069260.V332531.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 06.01.06 Brief Description of the Service: Winash is a privately owned residential care home in Clevedon for older people. It is a well established home (1973 by Mr and Mrs Wood) and many residents having lived locally have chosen to move into the home. The home is formed by two joined Victorian houses that have been extended (2002) and upgraded over the years. It is situated close to local shops and amenities in the older part of Clevedon at Six ways. The home is owned and has been managed by Mrs Heather House (daughter of Mr and Mrs Wood) since 1996. Winash Rest Home DS0000069260.V332531.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The outcome of this inspection was excellent. This unannounced key inspection was undertaken by B Ludlow for CSCI. The inspection commenced on 23/01/07, Mrs House was not on duty. A mutually convenient arrangement was made to complete the visit with Mrs House present and to give feedback on 26/01/07. Service user and staff questionnaires were distributed on 26/01/07. The inspection was closed on 9/02/07 to allow sufficient time for the responses to be returned to CSCI. Thirty-one service users were in residence and one person was in hospital. The homes deputy was in charge on day one and time was taken to support the inspection process. There was also three care staff on duty, three domestic staff including the housekeeper and the two cooks. The hairdresser was on the premises in the morning and the afternoon activity was playing cards, namely whist. Time was spent with the service users in the communal lounge / dining room in the morning and to observe lunch in the dining room and activities in the afternoon. A tour of the premises was made and bedrooms were sampled. Care plans were sampled. Day two. Mrs House was on duty; access was given to personnel files and contracts. These were sampled along with staff induction and supervision. Thank you cards and letters were seen from service users, families and staff. Medications management was checked and staff were seen briefly going about their work. The afternoon activity was music and singing with two outside entertainers, the chairs in the dining room had been arranged like a theatre and the service users had song sheets and were joining in the singing. Feedback was given to Mrs House. Winash Rest Home DS0000069260.V332531.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? One bedroom had en suite facilities fitted. The home now has 23 of its 32 single bedrooms with en suite facilities. Staff have attended a wide range of relevant training. Specialist training has included topics such as therapeutic activities and dementia, palliative care and understanding bereavement. Winash Rest Home DS0000069260.V332531.R01.S.doc Version 5.2 Page 7 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. Winash Rest Home DS0000069260.V332531.R01.S.doc Version 5.2 Page 8 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 Winash Rest Home DS0000069260.V332531.R01.S.doc Version 5.2 Page 9 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): 1,2,3,4,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A good level of information is available about the home and is given out when enquiries are made to Winash. Visits are welcomed. Contracts are issued and are clear about the terms and conditions of residence and the cost of care. Pre admission assessments are made to ensure care needs can be met. EVIDENCE: A good level of information is available about the care home. There is a statement of purpose and a brochure available. Each service user has a service user guide in their bedroom to refer to after admission to the home. Service users spoken with described visiting the home with their family to look around. They had been given brochures and information. Two people asked Winash Rest Home DS0000069260.V332531.R01.S.doc Version 5.2 Page 10 stated that they had not been disappointed with their choice and one said it ‘met their expectations.’ Written feedback to CSCI from five service users confirmed that all were given a contract. One person commented that the information was very clearly presented. The information gathered describes a home that is well regarded locally and the service users asked knew of the home before coming in. The care plans seen as part of the case tracking, demonstrated pre admission assessment by the manager or one of her two deputy managers. The administration office based files for service users were sampled, contracts were seen, these were clear and the first four weeks is considered the trial period. Winash Rest Home DS0000069260.V332531.R01.S.doc Version 5.2 Page 11 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 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. All service users have care plans that are detailed and are kept up to date. Staff treat all service users with respect and in a dignified manner at all times. Independence and well-being are promoted through good attention to care practices. EVIDENCE: Care plans were examined for five service users. There was good evidence of pre admission assessment and personal information, which included a photograph and a description. Relevant professional contacts and family contacts were recorded. Previous medical history and current health information was recorded. Observations including weight are monitored. Health promotion interventions Winash Rest Home DS0000069260.V332531.R01.S.doc Version 5.2 Page 12 from the community health care professionals was seen e.g. Flu vaccination recorded as given. Visits by health care professionals are recorded. Visits from professionals allied to health care such as the optician, chiropodist and physiotherapist were recorded. One Service user reported going out for speech therapy. Regular monthly reviews are made, but not all were signed by the service user, this is recommended. Accident reports are stored in the individuals care plan file. Records are made for service users who have mobility aids such as powered scooters; identification is also given to service users who go out from the premises, this will assist any emergency intervention when away from the home. The care plans are supported with a kardex system of record keeping. This is used for daily information relevant for good communication at to staff handover. Medication administration records were examined and were found to be well managed. The home’s deputy responsible for the incoming medication checks had this in progress at the inspection. All medications are checked against the pharmacy lists and are signed for. All returns are logged and signed for. The Medication Administration Records ( MAR’s) were seen and all were complete. Prescription skin creams are labelled with an ‘opened on’ and ‘discard by date’, this is good practice. Controlled drugs storage and record keeping was seen and the stock was checked, this balanced and was correct. Staff were observed to be polite and respectful in all their dealings with service users. The service users who are more independent have clear guidance in their care plans for the level of assistance required. An example being independent bathing where the preparation required is recorded and the risk assessment and rationale are identified. Winash Rest Home DS0000069260.V332531.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): 12,13,14,15, Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. C EVIDENCE: Time was spent with service users in the communal areas of the home and in private in their rooms. Service users spoke very positively about how they spend their time each day. Service users expressed their contentment with spending time in their rooms listening to the radio or watching television or reading the daily paper. One person asked about their morning routine said they wake about 10am, have a cup of tea and read the paper before having assistance with washing and dressing. Social care is valued and supported as an important part of life at Winash. The home has three part time staff dedicated to maintaining an activities programme throughout the week. On the first day of the inspection the hairdresser was visiting during the morning and a game of whist and a craft session was held in the afternoon. On Winash Rest Home DS0000069260.V332531.R01.S.doc Version 5.2 Page 14 the second day the home had visiting musical entertainers. The event was well supported and the seating in the conservatory was organised theatre like in rows. Song sheets were provided and most service users joined the singing. The home is close to local shops and service users, who are able, go out. Two service users spoken with had been out shopping just the day before. Those who have and can safely use their battery-powered scooters park them at the front of the home and go out as they wish. One service user has a bus pass and catches the bus just outside the home to visit the shops in the town centre. Visitors are welcome and are invited to special events. Mrs House reported that at Christmas the staff and service users performed a pantomime and a buffet was prepared, families were invited and seventy people attended the function. On Christmas day some service users went out for lunch and one family came to he home for lunch. Meal times start with breakfasts served from eight o clock. Lunch was observed served in the conservatory / dining room. The tables were nicely presented with serviettes, water jugs and glasses, condiments and flower arrangements. Staff wore checked aprons to serve the food, the meal was served hot and the staff pleasantly and very politely managed the mealtime. The food looked appetising, chicken pie with broccoli and swede was the main menu, the vegetarian option was pasta. The alternative vegetable options, gravy and sauces were served separately. Dessert was fruit salad and cream. Service users asked all said they enjoyed the food, the written responses confirmed that three people always like the food, one usually does and one does sometimes. Drinks were served morning and afternoon. Cakes are served with the afternoon tea. The kitchen was clean and well organised, all record keeping was up to date. A recent Environmental Health Inspection had been satisfactory. Winash Rest Home DS0000069260.V332531.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a complaints policy and complaints are investigated. Staff have received training about abuse and the protection of the vulnerable people in their care. All staff have been Criminal Record Bureau checked as part of the recruitment procedure. EVIDENCE: The home had received two complaints, these related to environmental work and were logged and explanations were given by the homes manager. Staff recruitment and training files were examined: Seventeen staff attended abuse awareness training in 2006. All CRB checks held were examined; all staff employed at the home had satisfactory Enhanced CRB checks on file. Staff spoken with understood their role in protecting vulnerable adults in the care from abuse. The written feedback from five service users indicated that they all know how to make a complaint and know who to speak with if unhappy. The complaints procedure is contained in the Service user Guide in each bedroom. Winash Rest Home DS0000069260.V332531.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): 19,20,21,22,23,24,25,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained, clean and tidy. The premises have been adapted for elderly care. Communal space is comfortable and bedrooms can be personalised. EVIDENCE: This home was not purpose built but has been adapted over the years to provide good accommodation for service users with personal care needs. A tour of the premises was made and all areas were clean and hygienic. Service users seen in their rooms were very satisfied with their accommodation. Bedrooms have been personalised with pictures and photographs. Winash Rest Home DS0000069260.V332531.R01.S.doc Version 5.2 Page 17 Freestanding heaters have been provided to supplement the heating if required. A risk assessment for their use is held in the health and safety file and in the care plan folder for each floor indicating who has one. The communal areas have level access and are comfortable, nicely decorated and well furnished. The dining room / conservatory was fully utilised during the inspection visits. The kitchen is adjacent and there is a serving hatch for use at meal times. The main lounge looks out over the front of the property and is a large comfortable room. Bedrooms vary in size and one more has been updated to provide an en- suite facility, this means that 23 now have en suite facilities, out of the total of 32 bedrooms. All bedrooms have level access except bedroom 3 this has a small (three) flight of stairs leading to it. There are assisted bathing and shower facilities; one refurbished facility has both a shower and bath. The front of the home has a small garden and sloping level access. The rear garden has some seating and directly overlooks tennis courts and other gardens. Winash Rest Home DS0000069260.V332531.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 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has a dedicated staff team. Staff are well trained. Care is delivered to a high standard by these competent staff. The home has policies and procedures in place to protect service users from harm. Recruitment was satisfactory. EVIDENCE: Staff at the home work hard to deliver a professional caring service. Staff know the service users well and care is delivered to meet their needs as individuals. The home runs with a sufficient staff number to meet the needs of service users. No complaints or concerns were raised about the care delivery or the response to the call bell if rung. Key workers are appointed for service users and one person was asked about this, they knew who had been allocated to them and was pleased with this system. Staff are well regarded by service users and their families. Comment included that ‘staff are very nice’ and ‘very patient’. Winash Rest Home DS0000069260.V332531.R01.S.doc Version 5.2 Page 19 Staff recruitment for three new starters was examined and CRB checks were seen for all staff employed at the home. Induction records, records of supervision and training opportunities were reviewed for three staff who were part of the case tracking methodology used at this inspection. Induction included the protection of vulnerable adults. Supervision was recorded and included an annual appraisal. Training opportunities for staff included leadership skills, dementia care training and NVQ placement. Staff were observed to have a handover period between shifts to ensure the continuity of care. There are policies and procedures in place to guide and inform staff and to keep the service users in a safe environment and in safe hands. Very positive feedback was received at CSCI from seven members of staff. One commented that the home offered them ‘a lot of training opportunities’. None of the respondents felt that they have ever had to deal with any situations for which they felt unprepared for or not trained for. Winash Rest Home DS0000069260.V332531.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): 31,32,33,34,35,36,37,38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Mrs House provides an excellent level of support and open management at the home. Services users best interests are at the heart of the homes caring philosophy. Staff are supervised and supported in their work. The home is well maintained and safely managed. EVIDENCE: Mrs House is an experienced registered manager. The home is well run and has two deputy managers and an administrator. Very positive feedback was received from seven members of staff. One commented that Mrs House is an ‘understanding manager’. Winash Rest Home DS0000069260.V332531.R01.S.doc Version 5.2 Page 21 Twenty one staff have attended first aid training. Fourteen first aid training places are available for staff in February. Manual handling training and mandatory fire training was confirmed as current in the staff files sampled at this inspection. The written feedback from care staff working both day and night shifts positively confirmed that this training had been given. Laminated COSHH guidance is made available for cleaning and kitchen staff. Mrs House has undertaken some quality assurance questionnaires, a good response was received, the surveys asked about the meals and activities. Residents meetings are held three monthly. The results of the questionnaires and feedback from service users will be used to inform service improvements. Maintenance records were examined: Hoist servicing had been carried out in November 2006. Gas boiler and gas tumble dryer were serviced in January 2007. The passenger lift has an annual service under contract and has a monthly visit; this was last recorded in December 2006. All Portable Electrical Appliance Testing (PAT) was carried out in August 2006. The home has a contract for any minor electrical work. The mains electrical check is due in 2007. The fire records were checked and the alarm must be checked weekly, the contractor had checked this in December 2006. Emergency lights had an in house monthly check and had an annual service. Fire extinguishers were serviced in June 2006 and have a monthly service. Winash Rest Home DS0000069260.V332531.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 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 4 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 3 3 3 3 3 2 Winash Rest Home DS0000069260.V332531.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. Standard Regulation Requirement Timescale for action 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 OP38 Good Practice Recommendations The fire alarm should be tested each week in line with the guidance recommended by the fire brigade, ‘Fire safety, An employers guide’ Winash Rest Home DS0000069260.V332531.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Winash Rest Home DS0000069260.V332531.R01.S.doc Version 5.2 Page 25 - 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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