Inspection on 26/02/07 for Windward Nursing Home

This inspection was carried out on 26th February 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

Windward Nursing Home 07/03/06

Windward Nursing Home 22/09/05

Windward Nursing Home 15/03/05

Windward Nursing Home 09/09/04

Windward Nursing Home 11/03/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Windward Nursing Home Dartmouth Road Stoke Fleming Dartmouth Devon TQ6 0QS Lead Inspector Mandy Norton Unannounced Inspection 26th February 2007 10:00 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 Windward Nursing Home DS0000028776.V314677.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. Windward Nursing Home DS0000028776.V314677.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Windward Nursing Home Address Dartmouth Road Stoke Fleming Dartmouth Devon TQ6 0QS 01803 770789 01803 770827 windwardnh@btconnect.com 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) Mr Robert Henry Gunn Sally Marguerite Moyse Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (3), Physical disability (25) of places Windward Nursing Home DS0000028776.V314677.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th March 2006 Brief Description of the Service: Windward is located on the outskirts of the village of Stoke Fleming 2 miles from Dartmouth. There are several country lanes leading from the home, which can provide wheel chair walks for Service Users and their relatives. The home has a driveway leading to parking for several cars. The home is registered to provide care to Service Users requiring nursing (maximum of 25) or personal care (maximum 3) of either gender and over the age of 65. The home is on 2 levels with a passenger lift to the first floor. Some rooms have wheel chair accessible en-suite facilities. All rooms have a nurse call bell and television point. There are 2 lounges both on the ground floor one of which has access to the patio and benefits from countryside and sea views. Some of the Service Users rooms have the benefit of these views also. There is a variety of equipment to support physically disabled Service Users needs and specialist equipment is available following an assessment of need. There is an assisted Parker bath; two assisted shower rooms are also available on the ground floor. A registered nurse is on duty at all times supported by a team of Health care assistants, administration, catering, domestic and maintenance staff. The fees charged range from £550 to £650 (October 2006). People requiring ‘continuing care’ have their fees negotiated by the placing authority on an individual basis. ’The latest inspection report is displayed in the entrance foyer and the manager was advised that the Statement of Purpose should be updated to include information about where people can access the latest report if they do not have access to the internet. The contracts issued include name and date of admission and who pays the fee, how the fee is broken down and the total fee, plus the homes terms and conditions of residency. Windward Nursing Home DS0000028776.V314677.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place from 11.10 am until 4.10 pm and was conducted with the manager. A tour of the home was carried out. The report contains views from the completed staff surveys returned (13) reflected throughout, information taken from the completed pre inspection questionnaire and views of Service Users spoken on the day of the inspection. Service Users seen were not always able to fully express themselves or comment on the care they received. What the service does well: What has improved since the last inspection? Windward Nursing Home DS0000028776.V314677.R01.S.doc Version 5.2 Page 6 There were no recommendations or requirements made following the last inspection. The manager and staff always strive to ensure the Service Users needs are met and that people are treated as individuals with dignity and respect. 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. Windward Nursing Home DS0000028776.V314677.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 Windward Nursing Home DS0000028776.V314677.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, 2 & 3 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who use this service or are prospective Service Users have good information about the home in order to make an informed decision about whether the service is right for them. The personalised needs assessment means that people’s diverse needs are identified and planned for before they move to the home. This home does not provide intermediate care. EVIDENCE: Windward Nursing Home DS0000028776.V314677.R01.S.doc Version 5.2 Page 9 The pre admission documentation file was examined during the inspection. It included information about prospective Service Users assessed needs, equipment required, medications, next of kin and general information about the person. A brochure that includes the up to date Statement of Purpose is given or sent to every person wishing to move into the home. The information is easy to read but includes all of the information that is useful to somebody when they move into the home. The manager said that if a prospective Service User is local to the area she herself or one of the other senior trained nurses goes to visit the person in their current setting to make an assessment. The manager said the person or their relative are welcome to visit the home prior to moving in. Windward Nursing Home DS0000028776.V314677.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 & 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager promotes and maintains Service Users health and ensures access to health care services to meet assessed needs. The homes medication systems protect the welfare of residents. Service Users are treated with respect and their right to privacy is upheld. EVIDENCE: Three (3) care plans were examined; in all of those seen there were assessments which provided information about skin integrity, moving and handling, safety - including risk of falls, use of bed rails risk assessments and nutritional screening. The information generates the plans of care, which Windward Nursing Home DS0000028776.V314677.R01.S.doc Version 5.2 Page 11 provide the basis for the care to be delivered. The care plans were clear and easy to understand and had been regularly reviewed. In some cases it was evident that the plans had been created and reviewed with input from the residents and/or their representatives. They are kept in the Service Users rooms so that they can be used and completed whilst dealing with a Service User. Records are maintained for all visits to the home by social or health care professionals, all residents are registered with a GP. Records in the communication book, diary and care plans detailed outpatient appointments and GP visits showing that health resources are enabled to use health resources. The medication system is well managed; some of the controlled drug stock was checked against records and found to be correct. The manager said stock is checked weekly and ordered monthly as often as possible. Disposal of unused/ out of date medication is safe, well recorded and removed by a licensed contractor. Staff were overheard knocking on doors prior to entering rooms of Service Users. Appropriate interactions between staff and Service Users was heard during the inspection. The activity co-ordinator was seen interacting with Service Users in a dignified and appropriate manner during a quiz she was doing with a umber of Service Users. Windward Nursing Home DS0000028776.V314677.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 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Effort is made by the home to provide an activities programme and social interaction/stimulation for Service Users. Service Users are able to maintain contact with family and friends and exercise choice and control over their lives. Service Users receive a wholesome appealing diet and are not rushed encouraging the mealtime to be a social event. EVIDENCE: The activity co-ordinator was conducting a quiz with some of the Service Users during the inspection. A tour of the home showed some Service Users in their rooms watching appropriate TV programmes, reading newspapers and Windward Nursing Home DS0000028776.V314677.R01.S.doc Version 5.2 Page 13 magazines and chatting with visitors. Others were in one of the 2 lounges watching TV or taking part in the quiz. The menus (provided with the pre inspection questionnaire ) are on a rolling 4 week system . The manager said that fresh fruit is provided and Service Users are asked on the day of the meal what they would like to eat. Alternatives are always available. Specialist diets are catered for. Information about the Service Users requiring these was available in the kitchen for the catering staff to refer to. Service Users can eat in their rooms or in the lounge, there is no separate dining room. Catering staff spoken to were approachable and work well in a small kitchen. An environmental health office inspection took place on 21.12.06 – no recommendations were made. It stated that the recently introduced ‘Safer Food Better Business’ documentation is in use. Windward Nursing Home DS0000028776.V314677.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users and their relatives/friends know how to make a formal complaint. People are safe living in this home. EVIDENCE: The complaints procedure was seen displayed within the home and is in the Statement of Purpose, given to all Service Users and /or their representatives prior to admission. The manager says she carries out a daily ‘round’ at different times of the day and Service Users will often talk to her about any concerns at this time. She also works nights as part of internal rotation of staff, enabling her to talk to staff and Service Users at all times. She said she has an open door policy for Service Users, visitors and staff to approach her and discuss any issues. The pre inspection questionnaire states that there have no complaints or adult protection referrals since the last inspection. Windward Nursing Home DS0000028776.V314677.R01.S.doc Version 5.2 Page 15 Twelve (12) of the thirteen (13) completed staff surveys indicated they were aware of adult protection procedures (one did not complete that section of the survey). All of the care staff that completed surveys indicated that they have enough support to carry out their job, have regular meetings and supervision sessions and are never asked to work outside their area of expertise. Windward Nursing Home DS0000028776.V314677.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, 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 safe and well maintained and clean and hygienic ensuring the Service Users live in a satisfactory environment. EVIDENCE: A tour of the home showed that Service Users rooms contain personal items including furniture, ornaments and pictures. The home appeared well equipped to meet the needs of Service Users identified with moving and handling risks and disabilities that affect their capability to bathe (hoists, stand aids, a shower and assisted bath). Specialist Windward Nursing Home DS0000028776.V314677.R01.S.doc Version 5.2 Page 17 mattresses and adjustable beds were seen in place for those Service Users requiring them. There is call bell system throughout the home, Service Users seen in their rooms all had the bell placed within their reach. There were a variety of toilet facilities for use by Service Users throughout the home. There is a shaft lift and a sluice. Outdoor space consists of a patio leading from the dining room (there is a ramped access). The area has good views of the local countryside and the sea. There are 2 lounges on the ground floor, 1 has a television. Both lounges were tastefully decorated and looked comfortable. Service Users were seen being assisted from wheelchairs to sit in comfortable chairs in the lounge. Visitors were seen with their relatives in the lounge and in the privacy of their own rooms. Hand washing facilities were seen throughout the home, as were protective gloves and aprons. The laundry has one industrial washing machine, with a disinfecting sluice cycle and a large tumble dryer. The laundry assistant and the manager said that this was sufficient for the washing the home produces. They said that the night staff do put washing on if they have time, the laundry is not near to Service Users rooms. The kitchen appeared well equipped although small but they manage to provide meals for the number of Service Users living in the home. Windward Nursing Home DS0000028776.V314677.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 good. This judgement has been made using available evidence including a visit to this service. There are sufficient numbers of staff with appropriate skills and knowledge to meet the needs of Service Users in this home. The homes recruitment procedures protect Service Users from being placed at risk of harm or abuse EVIDENCE: Duty rotas supplied with the pre inspection questionnaire indicate that the manager works full time and is included in the internal rotation system used by the home. There are usually 4 – 5 carers and at least 2 trained nurses during the day and 1 trained nurse and 2 carers overnight. There were 18 Service Users in the home on the day of the inspection. The home also admits people with ‘continuing care ‘ needs and works well with other professionals using the Liverpool Care Pathway (a plan that provides guidance on different aspects of palliative care required, irrespective of Windward Nursing Home DS0000028776.V314677.R01.S.doc Version 5.2 Page 19 diagnosis, including comfort measures, psychological, spiritual and family support: more information can be found on www.mariecurie.org.uk). The pre inspection questionnaire states that there are 7 Registered Nurses (RGN’s) employed in the home, they are assisted by 17 care assistants, 10 of whom have achieved a National Vocational Qualification (NVQ), level 2 or above, in care. Three more are undertaking an NVQ in care. There are also 6 ancillary staff (catering, laundry, domestic, activities and maintenance) employed in the home. The 2006 training record, provided with the pre inspection questionnaire, had information about individual training provided, including: fire safety training, first aid, manual handling, skin and pressure area care, nutrition assessment, and Liverpool Care Pathway. The inspector looked at three (3) staff files – they all contained 2 written references, interview records, proof of Criminal Records Bureaux (CRB) checks and identity information. Service Users and relatives spoken to said that the staff are wonderful and the care is excellent Windward Nursing Home DS0000028776.V314677.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 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed by an experienced Registered Nurse. There is a formal quality assurance system in place. Personal money held in the home on behalf of Service Users is managed appropriately. The registered provider shows a responsible attitude toward promoting and protecting the health, safety and welfare of Service Users and staff. Windward Nursing Home DS0000028776.V314677.R01.S.doc Version 5.2 Page 21 EVIDENCE: The manager of this home is a 1st level registered nurse who has achieved a Registered Managers Award and is currently studying for a City & Guilds 7302 in teaching. The deputy manager has also achieved the Registered Managers Award and another of the trained nurses is about to start the course. The manager has managed the home for many years and is well respected by the provider and local health care professionals. The group has its own complaints process, robust recruitment procedures and numerous training opportunities. A formal quality assurance system is in use in the home and results are displayed in the entrance foyer. The manager has an open door policy for staff and visitors to bring any issues or concerns to her. Safety notices were displayed throughout the home including action to be taken in case of fire. The completed pre inspection questionnaire indicates that all equipment is regularly maintained and tested. Portable electrical testing (PAT) stickers were seen on electrical equipment throughout the home. The fire and accident book were examined and found to be completed as required. The inspector was shown he records and storage of personal money held in the home on behalf of Service Users. Best practice systems are in place for the protection of both residents and staff, all receipts are stored for auditing purposes and the money is stored securely. Windward Nursing Home DS0000028776.V314677.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 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 3 3 X 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Windward Nursing Home DS0000028776.V314677.R01.S.doc Version 5.2 Page 23 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. 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. Refer to Standard Good Practice Recommendations Windward Nursing Home DS0000028776.V314677.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Windward Nursing Home DS0000028776.V314677.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. 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!