Inspection on 14/06/05 for Windy Ridge Nursing Home

This inspection was carried out on 14th June 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Windy Ridge Nursing Home 13/03/08

Windy Ridge Nursing Home 27/09/07

Windy Ridge Nursing Home 13/03/07

Windy Ridge Nursing Home 18/10/05

Windy Ridge Nursing Home 22/12/04

Windy Ridge Nursing Home 02/08/04

Windy Ridge Nursing Home 10/02/04

Windy Ridge Nursing Home 25/06/03

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

CARE HOMES FOR OLDER PEOPLE Windy Ridge 32 Barton Lane, Barton On Sea, New Milton, Hampshire Lead Inspector Gina Pickering Unannounced 14/6/05 10:00am 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 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. ` H54 S11456 Windy Ridge V232465 140605.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Windy Ridge Nursing Home Address 32 Barton Lane, Barton On Sea, New Milton, Hampshire, BH25 7PN Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01425 610529 01590 644678 MNS Care PLC CRH 21 Category(ies) of DE- Dementia: 4 registration, with number DE(E)- Dementia: 21 of places ` H54 S11456 Windy Ridge V232465 140605.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1- The number of persons for whom accomodation and nursing care may be provided for any one time is 21. 2- A maximum of 4 service users may be accomodated at any one tme in the DE category. 3- Service users in the DE category must be 60 and 64 years of age. Date of last inspection 22/12/2004 Brief Description of the Service: Windy Ridge is a 21 bedded care home offering nursing care for service users suffering from dementia illnesses. The home is situated in a quiet residential area of Barton on Sea. The registered provider of the home is MNS Care PLC who own several care homes throughout the country. The manager has been in post since September 2004 and is in the process of being registered by the Commission for Social Care Inspection. ` H54 S11456 Windy Ridge V232465 140605.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced lasting seven hours on 14/06/05. The inspector spoke to nine service users, eight members of staff, two visitors and the manager. It was noticed during the inspection that the atmosphere at the home had improved since the previous inspection with staff and service users being very welcoming and friendly. There was noticed improved interaction between staff and service users. The two relatives that the inspector spoke with stated that they were satisfied with the level of care and support given to their relative in the home and the support given to themselves. What the service does well: What has improved since the last inspection? All communal space is now accessible with the temperature in the conservatory having been addressed. Service users are cared for by a work force that is receiving training programme thus ensuring all needs are met. The atmosphere in the home is welcoming and friendly suggesting an improvement in the morale of the staff group. ` H54 S11456 Windy Ridge V232465 140605.doc Version 1.30 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. ` H54 S11456 Windy Ridge V232465 140605.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection ` H54 S11456 Windy Ridge V232465 140605.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2 & 3 Prospective service users and their representatives are unable to make a fully informed decision regarding the suitability of the home due to the absence of a Statement of Purpose. Service users and their representatives are not fully aware of the details of their terms and conditions. The home is unable to make a fully informed decision regarding the suitability of the service user for the home due to a pre admission assessment process that is lacking in detail. EVIDENCE: There was no Statement of Purpose in the home at the time of the inspection. The manager informed the inspector that she had been requesting statement of purpose from the provider but was now aware that she would have to produce a statement of purpose accurately reflecting the service provided at the home herself. Review of the service user guide available in each service users bedroom indicated that service users views regarding the care home are still not included within in this document. ` H54 S11456 Windy Ridge V232465 140605.doc Version 1.30 Page 9 All service users have a statement of terms and conditions of residency at the home. This includes the rights and obligations of both the service provider and the service user and a breakdown of the fees payable and by whom they are payable. However out of five statements of terms and conditions sampled, only one was signed by a representative of the service user. The service user, or if this is not possible their representative, must sign the statement of terms and conditions of residency at the home. All prospective service users receive an assessment of their needs prior to the decision being made as to whether the home will be able to meet their needs. The documentation used at the present time does not allow for a comprehensive assessment of the prospective service user’s physical, emotional and social needs. The pre admission assessment process must be revised to produce a comprehensive assessment of all needs of the person. Discussions with relatives evidenced that two members of staff visit the service user to assess their needs prior to admission to the home. ` H54 S11456 Windy Ridge V232465 140605.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 9 & 10 The medication at the home is well managed promoting good health for the service users. The manner and approach of staff at the home allow service users to feel that their respect and dignity is being upheld. EVIDENCE: Robust medication polices and procedures supported by guidance from the Royal Pharmaceutical Society are in place that covers the storage and administration of medications. Inspection of medications administration records, medication storage areas, and a record of medications returned to pharmacy suggest that the policies and procedures are adhered to. It was noted that the home possessed a medication reference book that was several years old. It is recommended that the home obtain a recent copy of this book. The inspector observed throughout the inspection care staff and ancillary staff addressing the service users at the home with friendly dignity and respect. Staff in the conservatory area were interacting with the service users producing an informal friendly chatty atmosphere. Conversations with service users and relatives indicated that service users rights and individualities are ` H54 S11456 Windy Ridge V232465 140605.doc Version 1.30 Page 11 accounted and respected by all staff at the home. All service users appeared smartly dressed and well cared for, again suggesting that care staff strive to maintain dignity of the service users. ` H54 S11456 Windy Ridge V232465 140605.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13 & 14 The home management enables service users to retain contact with family and friends. The ethos and philosophy of the home creates an environment in which service users are able to exercise choice and control within their daily life. EVIDENCE: Despite written information indicating that visitors to the home are preferred in the afternoon discussion with the manager stated that the home operates a policy whereby visitors are welcome to the home at any time. It is recommended that the written details reflect the present practice of open visiting. Visitors, who the inspector spoke with, confirmed that they are able to visit at any time of the day. Discussion with the manager and staff members’ indicated that the home has an ethos of enabling service users to exercise choice regarding their daily life. Discussions with visitors confirmed that their relative is able to exercise choice regarding daily life and that their decisions and outlook on life are respected. The inspector observed service users making the decision whether to join in with communal activities or enjoy their own company in the privacy of their bedrooms. An advocacy charter is available in each service users guide but at the time of the inspection no advocacy details were available in the home ` H54 S11456 Windy Ridge V232465 140605.doc Version 1.30 Page 13 should they be required by a service user. It is recommended that a list of advocacy services be available within the home. ` H54 S11456 Windy Ridge V232465 140605.doc Version 1.30 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 Service users are protected from abuse by staff who have a clear understanding of the issues surrounding the protection of vulnerable adults. EVIDENCE: Polices and procedures are set in place with regard to the protection of vulnerable adults. Records indicate that all staff members have received training with regard to this subject; this was confirmed in conversations with staff members. Staff that the inspector spoke to were able to describe the correct process to be taken should an incident of abuse be suspected. The manager had recently invoked the adult protection procedure in the correct manner thus protecting service users at the home. ` H54 S11456 Windy Ridge V232465 140605.doc Version 1.30 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 & 20 Service users generally, live in a safe and comfortable environment though some are unable to access all areas independently due to the heavy nature of the fire doors. The conservatory offers a comfortable and pleasant environment for service users to utilise. EVIDENCE: A tour of the home evidenced that service users live in a generally well maintained home. Service users are able to access the home by the provision of ramps at all exit points. The décor of the home was of a homely fashion with some areas having had murals painted on them by the activity organiser enhancing the cheerfulness of the home. Service users are able to access the garden area of the home, which is secured with the use of locked gates. A requirement had been made after the last inspection regarding the heavy fire doors situated throughout the home. These are very heavy to open resulting in service users that are unable to open them not being able to access all areas of the home independently. It was noted during the inspection process that this issue had not been addressed despite the manager having raised the issue ` H54 S11456 Windy Ridge V232465 140605.doc Version 1.30 Page 16 with the registered provider. A further requirement will be made regarding this. The requirement made after the last inspection regarding the excessive temperature in the dining area has been addressed. The temperature was of a comfortable level during the inspection. However the staff at the home continue to monitor the temperature in the conservatory to ensure the wellbeing of the service users. ` H54 S11456 Windy Ridge V232465 140605.doc Version 1.30 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 & 30 Service users needs can be met by the number of staff employed at the home. Service users health and well being are protected by the skills and training of the staff at the home. EVIDENCE: Inspection of the staff rota suggested that an appropriate number of staff are on duty each shift to enable the service users needs be met. Staff, service users and relatives that the inspector spoke with indicated that they felt there were enough staff on each shift to enable the needs of the service user be met. All service users were clean and tidy suggesting that sufficient numbers of staff are available to attend to al aspects of personal care. Since being in post the new manager has been addressing training issues. Training records indicate that all staff are receiving the mandatory training that includes fire safety, moving and handling, and the protection of the vulnerable adult. The manager places much emphasis on communication skills; this is reflected on the training records viewed and observation of staff interacting with service users. Staff are able to access other training that will give them the knowledge and skills to meet the needs of the service users. Discussions with staff suggest that they consider they receive appropriate training to enable them perform their jobs. conversations with relatives suggest that they believe the staff at the home have the skills to met the service users needs. ` H54 S11456 Windy Ridge V232465 140605.doc Version 1.30 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 36 & 38 Service users live in a home that is managed effectively within the constraints of imposed managerial hours. Service users, relatives and staff views are an integral part of the management of the home. Service users receive care from staff that are adequately supervised. The health and safety of service users is partially protected by the practices at the home. EVIDENCE: Leah Madechangu, the manager has been in post since September 2004 and is the process of being registered by CSCI. The Director of Care and the registered provider support her to do her job. However discussions that she held with the inspector revealed that she feels she is unable to fully meet the obligations as registered manager on the managerial hours that the registered ` H54 S11456 Windy Ridge V232465 140605.doc Version 1.30 Page 19 provider allows. This is an issue that she has raised with the provider and has yet to be resolved. The manager discussed with the inspector that she operates an open door policy by which staff, service users and relatives can speak with her regarding any concerns. This was evidenced during the inspection process as relatives, staff and a service user visited her in the office to discuss issues. Staff in conversation stated that they are able to approach the manager with any concerns that will be acted upon accordingly; this was mirrored in conversations with visitors. Service users are consulted regarding changes at the home in one to one discussions. Staff meetings are held. Documentation of these meetings evidenced that any changes in the management of the home are discussed with staff. A programme of formal supervision has been implemented meeting a requirement made at the previous inspection. Polices and procedures are in place relating to moving and handling, fire safety, first aid, food hygiene, and infection control. All staff at the home receive the required training with regard to fire safety. It was noted that all care staff receive training with regard to moving and handling, however ancillary staff that handle objects, such as the laundry staff and cleaning staff, have not received any training with regard to moving and handling. A requirement has bee made regarding this. Service certificates indicate that that all equipment, appliances and services are serviced at the recommended intervals. Three monthly health and safety audits ensure that all areas of the home are assessed for health and safety issues. Risk assessments are in a place for all job descriptions. A record of all accidents in the home is maintained; this is audited at monthly intervals with a view to highlighting trends. ` H54 S11456 Windy Ridge V232465 140605.doc Version 1.30 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 2 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 x COMPLAINTS AND PROTECTION 2 3 x x x x x x STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 3 3 x x x 3 x 2 ` H54 S11456 Windy Ridge V232465 140605.doc Version 1.30 Page 21 yes 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 OP1 Regulation 4(!c) Requirement A Statment of Purpose must be made available to all prospective service users and their represenatives. The registered person must make service users views of the service provided by the care home available in the service users guide. THIS REQUIREMENT IS REPEATED FROM 10/02/04 The registered person must ensure that the service user or their representative sign the terms and conditions of residency at the home. THIS REQUIRMENT IS REPEATED FROM 10/02/04 The registered person must perform an assesment of the ability of service users to open the internal fire doors throughout the home. appropriate action must be taken to ensure that all communal areas of the home are accessible to all service users. THIS REQUIRMENT IS REPEATED FROM 10/02/04 AND 02/08/04. The registered person must ensure that all staff at the home Timescale for action July 30th 2005 August 30th 2005 2. OP1 5 3. OP2 5 & 17 July 30th 2005 4. OP18 23(1a) July 30th 2005 5. OP38 12 July 30th 2005 Page 22 ` H54 S11456 Windy Ridge V232465 140605.doc Version 1.30 receive training with regard to moving and handling. 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. 2. 3. Refer to Standard OP14 OP13 OP31 Good Practice Recommendations It is recommended a list of advocacy services is made available within the home. It is recommended that the practice of open visitng is documented clearly in the service users guide and policies and procedures. it is recommended that an asessment is made regarding the management hours allocated to the manager and these are ammended accordingly to enable her to fulfil her role as manager of the home. ` H54 S11456 Windy Ridge V232465 140605.doc Version 1.30 Page 23 Commission for Social Care Inspection 4th Floor- Overline House Blechynden Terrace Southampton Hampshire 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 ` H54 S11456 Windy Ridge V232465 140605.doc Version 1.30 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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