Inspection on 23/12/05 for Windsor Residential Care Home

This inspection was carried out on 23rd December 2005.

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

The inspector found no outstanding requirements from the previous inspection report, but made 11 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Windsor Residential Care Home 23/05/08

Windsor Residential Care Home 30/05/07

Windsor Residential Care Home 05/09/06

Windsor Residential Care Home 06/05/05

Windsor Residential Care Home 16/08/04

Windsor Residential Care Home 16/04/04

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Southfields

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Lyncol House

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

CARE HOME ADULTS 18-65 Windsor Residential Care Home 18-20 St Mildreds Road Westgate-on-sea Kent CT8 8RE Lead Inspector Brenda Pears Announced Inspection 23rd November 2005 09:30 Windsor Residential Care Home DS0000023628.V270755.R01.S.doc Version 5.0 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 Windsor Residential Care Home DS0000023628.V270755.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. 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. Windsor Residential Care Home DS0000023628.V270755.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Windsor Residential Care Home Address 18-20 St Mildreds Road Westgate-on-sea Kent CT8 8RE 01843 836055 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) Parkcare Homes Limited Carole Saunders Care Home 17 Category(ies) of Learning disability (17) registration, with number of places Windsor Residential Care Home DS0000023628.V270755.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th May 2005 Brief Description of the Service: Windsor Residential Care Home is registered to provide residential care for up to 17 adults with learning disabilities. At present there is no identified upper age limit. The Home is owned by a large company and has a Manager who is responsible for the day-to -day running of the establishment. Windsor is situated in a residential area of Westgate, which is adjacent to the seaside town of Margate. The Home, which has a small front garden, is within walking distance of most local amenities, including the seafront and local shops. There is limited off road parking but there is on road parking to the front of the property. There are staff on duty 24 hours a day including staff on wake duty at night. The health care needs of the residents are met by the local primary health care team. Windsor Residential Care Home DS0000023628.V270755.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection and the inspection consisted of speaking with the manager, staff and service users. The methods of inspecting the home included checking records, tracking service user care plans, observations and a tour of the building. The focus of this inspection was on monitoring the requirements and recommendations from the last inspection, the core standards and the quality of life for service users in the home. As part of the pre-inspection process, residents and relatives were consulted for their views of the home. The service users and families returned their comment cards, providing valuable feedback about the home, which helped in the planning of this inspection. Although the building is in need of attention and repair, the home was found to be clean, odour free and welcoming with a relaxed atmosphere that is created by the current staff group. The main building was warm and service users appeared comfortable and those spoken to at this time stated they are happy. Staff were seen to be undertaking their duties with due consideration for independence and choice. All service users were aware of the announced inspection and were happy to allow access into their rooms and sit and discuss their day with the inspector, providing valuable information to support the outcomes of this report. What the service does well: Staff provide a homely and relaxed atmosphere and also support service users in the home to undertake activities and routines that are chosen by each individual. Staff encourage and support service users to undertake daily living skills. Some service users were enjoying baking cakes at this time and everyone was eager to talk about what had been made and how the cakes were to be completed. Service users were fully included in the inspection process and in all discussions that were undertaken around the home. The Home has good links with the local community and college, where a number of the people attend weekly. Windsor Residential Care Home DS0000023628.V270755.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Medication must be dispensed with 2 members of staff to fully comply with requirements and ensure full safety of both staff and service users at all times. Any adjustment in medication must be fully documented and supported by the signatures of 2 members of staff. While reviewing care plans, attention must be paid to the communication needs of each service user. This is the first piece of information any person requires to enable contact with service users and must be clearly presented on all care plans. The ongoing redecoration and refurbishment programme needs to continue before the shabby interior and exterior of the home is in a more acceptable state of repair. This is necessary for the home to be more inviting and comfortable but more importantly, to provide an acceptable environment in which to live. Windsor Residential Care Home DS0000023628.V270755.R01.S.doc Version 5.0 Page 7 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. Windsor Residential Care Home DS0000023628.V270755.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Windsor Residential Care Home DS0000023628.V270755.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2&3 Assessments of service user needs and care plans continue to be improved by being reviewed and re-written, all files have not yet been completed. EVIDENCE: Staff are working hard to ensure all care plans and assessments are current and complete to support the care being delivered. Some files have not yet been touched and an audit must be carried out to ensure every file is a useful working document that clearly presents the support required to deliver care in the appropriate manner. Attention must be paid to the communication needs of each service user as this is the first piece of information any person requires to support all contact with service users and must be clearly identified on all care plans. Windsor Residential Care Home DS0000023628.V270755.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 10 Service users who were able, stated they are given choices and make decisions about how they spend each day. Care plans are being reviewed and appropriate information is being included, however, the individual communication needs of each person must be clearly and easily identified. While records are stored in the office area, this room is not always locked when unattended. EVIDENCE: Staff are working hard to ensure all care plans and assessments are current and complete to support the care being delivered. Some files have not yet been touched and an audit must be carried out to ensure every file is a useful working document that clearly presents the supports required to deliver care in the appropriate manner. Attention must be paid to the communication needs of each service user as this is the very first piece of information any person Windsor Residential Care Home DS0000023628.V270755.R01.S.doc Version 5.0 Page 11 requires to support all contact with service users and must be clearly identified on all care plans. The staff on duty at this time were observed to be interacting with the service users and indicated that they consider choice, dignity and independence. Files are retained in the office area, but during this inspection this area was left unattended and unlocked. The manager arranged for a key-pad to be fitted to this area during this inspection. Windsor Residential Care Home DS0000023628.V270755.R01.S.doc Version 5.0 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14, 15 & 17 Service users have appropriate relationships. The meal being cooked looked appealing but the dining area is currently unacceptable. Food temperatures must be tested and recorded. EVIDENCE: Questionnaires received prior to this inspection confirm that family and visitors are always welcomed in the home and all appropriate relationships are supported. While the food being prepared looked and smelt appetising, the dining area is in a totally unacceptable condition. This has been identified at previous inspections and was discussed again at this time. The manager stated this area is to be renovated but not until the new conservatory area is added onto the building. During this time, even a quick covering of bright paint would lift Windsor Residential Care Home DS0000023628.V270755.R01.S.doc Version 5.0 Page 13 the dismal atmosphere in this room and provide a brighter, lighter environment in which to eat. Food temperatures are currently not tested when food is served. The manager stated this would be undertaken and temperatures recorded. A variety of activities are enjoyed by service users and these consist of exercise twice weekly, weekly aromatherapy sessions, music, cooking in the kitchen allocated for service users, art sessions, swimming, day centre and using local amenities. Windsor Residential Care Home DS0000023628.V270755.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 Full support is given to all service users regarding medication but the storage area must be secured when not in use, 2 staff must administer all medication and 2 signatures must be recorded for all alterations of medication. EVIDENCE: Currently one member of staff administers medication directly to service users from the storage area. A requirement for two staff to administer medication is implemented in this report to ensure the full safety of service users during this procedure and to guard against distractions causing medication errors and any adverse incident that may require staff attention. Medication records were clearly and fully completed and storage was orderly and in the main, appropriate. However, the area where medication is stored is used during the day by staff, but this area was not being locked when staff were elsewhere in the building. During this inspection the manager arranged for a key-pad to be installed to ensure this area is secure when unattended. Windsor Residential Care Home DS0000023628.V270755.R01.S.doc Version 5.0 Page 15 Windsor Residential Care Home DS0000023628.V270755.R01.S.doc Version 5.0 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Although not directly inspected at this time, two service users who were able did state they are well cared for and feel safe, this was also confirmed on the questionnaires received prior to this inspection. Two previous complaints have been appropriately handled by the home, following the complaints procedure and with a satisfactory outcome for the complainants. EVIDENCE: Windsor Residential Care Home DS0000023628.V270755.R01.S.doc Version 5.0 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 28 & 30 The home was found to be clean and the atmosphere was relaxed and friendly. As stated in the previous unannounced inspection report, many areas are in need of renovation, redecorating and require new furnishings The lounge area has been totally renovated and now provides a clean, bright and comfortable area. New windows have been installed and the home is now much warmer and brighter. EVIDENCE: The service users bedrooms were clean, odour-free and benefiting from new windows that have recently been installed. Many of the bedrooms are in need of redecoration and refurbishment, this has been discussed by the organisation and a programme is in place to upgrade the building both inside and out and timescales have also been developed. Windsor Residential Care Home DS0000023628.V270755.R01.S.doc Version 5.0 Page 18 The lounge has been completely renovated and now provides a bright, modern and comfortable area for service users to enjoy. An ongoing programme of works is in place to address all areas of the home. Windsor Residential Care Home DS0000023628.V270755.R01.S.doc Version 5.0 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34 & 35 Training has been reviewed and the manager will ensure all staff undertake appropriate training and that refresher courses are updated. EVIDENCE: Staff on duty at this inspection demonstrated a committed attitude to the welfare of service users, while supporting choice and independence. Questionnaires received prior to this inspection stated service users feel cared for, safe and personal privacy is respected. The recruitment procedures are in line with the required guidelines and regulations. The staff training programme has been reviewed and training courses that have been booked include the use of Maketon, autism and epilepsy, first aid, moving and handling, plus NVQ levels 2 and 3 have also commenced. Staff are therefore being given the specific knowledge required to support individual service users in the home and continued refresher training will further develop the staff group. Windsor Residential Care Home DS0000023628.V270755.R01.S.doc Version 5.0 Page 20 A key worker system is in place and this role is clearly defined and written in detail to explain the expectations of each key worker. A checklist is in place with all key worker responsibilities to remind staff and also to ensure these are regularly undertaken. Windsor Residential Care Home DS0000023628.V270755.R01.S.doc Version 5.0 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38 & 42 An open and inclusive management style was evidenced during this inspection. The health, welfare and safety of service users are considered by staff, but this needs to be reflected fully in all care plans and recordings. EVIDENCE: Staff and management interacted in an inclusive manner, creating a relaxed and welcoming environment in the home. Questionnaires received prior to this inspection from healthcare professionals, confirm that visitors are welcomed into the home and that observations to date confirm that staff provide a satisfactory level of care. All appropriate health care support is accessed and policies and procedures are regularly reviewed. Windsor Residential Care Home DS0000023628.V270755.R01.S.doc Version 5.0 Page 22 Discussions, observations and questionnaires all confirm that staff consider independence, choice and privacy of service users. The fire safety officer is to look at all fire installations to ensure ongoing work being undertaken in the home does not compromise safety in any way. While, in the main, the safety of service users is considered by staff, details in care plans and attention to procedures regarding medication will strengthen the support currently being given to service users. The ongoing programme of renovation and redecoration plus brighter lighting, will improve the fabric of the building and provide a far more acceptable environment for service users and for staff to deliver care and to ensure the full support and well being of those living in the home. Windsor Residential Care Home DS0000023628.V270755.R01.S.doc Version 5.0 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 2 2 X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 X X 2 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X 2 X 2 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X X X 3 2 x CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Windsor Residential Care Home Score X X 2 x Standard No 37 38 39 40 41 42 43 Score 3 3 X X X 2 X DS0000023628.V270755.R01.S.doc Version 5.0 Page 24 Are there any outstanding requirements from the last inspection? 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 YA6YA3YA2 Regulation 12,13,14 Requirement Timescale for action 31/01/06 2. YA6YA3YA2 3. 4. 5 YA10 YA17 YA20 6 7 YA20 YA20 The Home must fully complete the assessment of service users needs and aspirations to ensure appropriate support is given at all times.. 12,13,14 All care plans must contain full information regarding the communication needs of each service user 10,12,17,20 All confidential information to be stored appropriately at all times. 12,13 A sampling of food temperatures to be taken and recorded 12,13,23 That the dispensing of medication is in line with guidelines set by the Royal Pharmaceutical Society 23 The area in which medication is stored to be secured when unattended. 12,13,23 All adjustments to medication to be supported by 2 staff signatures at all times. 31/01/06 31/12/05 31/01/06 31/12/05 31/12/05 31/12/05 Windsor Residential Care Home DS0000023628.V270755.R01.S.doc Version 5.0 Page 25 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 28 & 30 Good Practice Recommendations The refurbishment programme to be continued until the environment meets an acceptable standard and provides a comfortable home to live in. That training is fully completed by all staff and is then regularly updated. 2 35,42 Windsor Residential Care Home DS0000023628.V270755.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Windsor Residential Care Home DS0000023628.V270755.R01.S.doc Version 5.0 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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