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Inspection on 24/02/06 for Winifred Kettle Community Care Centre

Also see our care home review for Winifred Kettle Community Care Centre for more information

This inspection was carried out on 24th February 2006.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home has a group of staff that have worked at the home for a long time and residents liked the staff team. They were also happy with the way the staff cared for them, as they made sure they got the care that was needed. Residents described the staff as "very kind", "caring" and "lovely". The home has a good manager and staff team who know the needs of the people living at the home. Intermediate care` residents receive a good standard of care from staff so they get the help they need to be as independent as possible and return home. The care plans looked at were very detailed and gave people reading them a clear picture of what each person needs help with.

What has improved since the last inspection?

Good progress has been made by the manager to make sure that the things, which needed improving from the last inspection, have been done. Visits from health care workers such as doctors and district nurses are now recorded separately. This means people looking at records can see exactly when residents have been visited and any treatment they have received. More staff trained to help intermediate residents to return home have been employed.

CARE HOMES FOR OLDER PEOPLE Winifred Kettle Community Care Centre Winifred Kettle Community Care Centre Leigh Road Westhoughton Bolton Lancashire BL5 2NE Lead Inspector Kath Smethurst Unannounced Inspection 24th February 2006 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 Winifred Kettle Community Care Centre DS0000031365.V283264.R01.S.doc Version 5.1 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. Winifred Kettle Community Care Centre DS0000031365.V283264.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Winifred Kettle Community Care Centre Address Winifred Kettle Community Care Centre Leigh Road Westhoughton Bolton Lancashire BL5 2NE 01942 634566 01942 634564 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) Bolton Metropolitan Borough Council Ms Alison Irene Leaver Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places Winifred Kettle Community Care Centre DS0000031365.V283264.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. The Home is registered for a maximum of 23 service users, to include: Up to 23 service users in the category of OP (Older People) The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Staffing levels are to be calculated in accordance with the Residential Forum Staffing Guidance (Older People) by 1 April 2004. The service must, at all times, employ suitably qualified and experienced staff to meet the assessed needs of the service users. Within the maximum of 23 places, there is provision for up to 17 intermediate care places. 12th August 2005 Date of last inspection Brief Description of the Service: Winifred Kettle Community Care Centre provides personal (residential) care for older people. It is a local authority home, owned and run by Bolton Metropolitan Borough Council. The home is a detached, purpose built building, on two floors (with a lift). There are 23 places - 3 permanent, 3 respite and 17 intermediate care. The intermediate care places are provided on a specialised, rehabilitation basis as a joint arrangement with the health authority (PCT), with a length of stay up to 6 weeks. Care is provided to these 17 residents by an on-site team of nursing, physiotherapy, occupational therapy and care staff. Care staff looks after the 3 ‘permanent’ and 3 respite residents only. These six residents share one lounge/dining area and live on the ground floor (no more permanent residents are being accepted by the home). The 17 intermediate care residents live on the first floor and share 3 lounge/dining areas. All bedrooms are singles, with wash hand basins (no ensuite facilities are available). The home has an enclosed garden to the rear and car parking to the front and side. It is in a residential area of Westhoughton, with a bus stop directly outside and shops and local amenities nearby. The home is also a busy community centre for older people, with a separate day centre (Monday to Sunday) and evening groups taking place. Winifred Kettle Community Care Centre DS0000031365.V283264.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and started at 10.00 am. It took place over five and a half hours during the morning and afternoon. The inspector looked around some but not all of the home, checked care plans and some records. To get more information about the home the inspector spoke to 6 residents, two visitors, three care assistants, the manager and health authority (PCT) staff. What the service does well: What has improved since the last inspection? What they could do better: Written information about the home needs to be completed so residents have a full and accurate picture of the services provided. The home needs to continue to check if permanent, respite and intermediate care residents would like more activities to be provided. Winifred Kettle Community Care Centre DS0000031365.V283264.R01.S.doc Version 5.1 Page 6 While the décor in the home is good plans need to be made for some of the corridors and bedrooms to be redecorated as the wallpaper and paintwork is showing signs of wear and tear. 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. Winifred Kettle Community Care Centre DS0000031365.V283264.R01.S.doc Version 5.1 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 Winifred Kettle Community Care Centre DS0000031365.V283264.R01.S.doc Version 5.1 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 the following standard(s): 1,2 & 6 Residents admitted for intermediate care receive a high quality service, which meets their varied and specialised needs, ensuring their independence is maximised so they can return home. EVIDENCE: During the last inspection requirements were made in regard to updating and amending the written information contained in the statement of purpose and service user guide. Discussion with the manager indicated this was still in the process of being addressed. It is understood a draft of the final version of both documents have been forwarded to the CSCI (Regulatory Manager) and it is hoped both documents will be finalised in the near future. Given this has been a requirement for some time steps need to be taken to finalise the documents, so residents have full details of the service provided. To be followed up during the next inspection. Seventeen of the twenty-three places provided at the home are for intermediate care. Separate facilities for these seventeen residents are provided on the first floor. Winifred Kettle Community Care Centre DS0000031365.V283264.R01.S.doc Version 5.1 Page 9 Care staff employed by the home work with all twenty-three residents within a multi disciplinary. The team includes nursing, physiotherapy and occupational therapy staff. These staff provide a service to the seventeen intermediate care residents only. Since the last inspection two assistant practioners have been employed. These staff have undertaken foundation degree training, which allows them to undertake some nursing and therapy duties. The practioners also undertake out-reach work in the community visiting former intermediate care residents. The service also plans to employ an additional practitioner in the near future. Two hospital consultants are attached to the home and visit weekly. Specialised equipment is provided on an individual basis and is matched to the equipment residents will use when they return home. The intermediate care service is provided for a maximum of six weeks. Good practice was noted in that the home only accepts one admission a day, with new residents only being admitted within office hours Monday to Friday when PCT (Primary Care Trust) staff were available. On the day of the visit one intermediate care resident was admitted. Once she had had time to settle she was spoken with. She was able to confirm staff had made her very welcome and had informed her of what her therapy and care would involve over the coming weeks. Winifred Kettle Community Care Centre DS0000031365.V283264.R01.S.doc Version 5.1 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 the following standard(s): 7&8 Care plans were detailed, up to date and provide staff with the information they need when delivering care. Health care needs were well met with evidence of multi disciplinary working taking place. EVIDENCE: Five care plans were examined. (2 ‘permanent’ and 3 ‘intermediate care’). The permanent residents plans contained comprehensive information relating to residents personal, social and health care needs. Daily entries in care notes were completed in all the plans examined. The plans were easy to read and had been regularly reviewed. For example in one plan staff had identified that the resident’s nutrition was an area of concern. Staff were instructed to “Monitor diet and weight”. Examination of records demonstrated staff had followed this guidance as required and the resident in question was now gaining weight. The care plans examined contained some very good information in respect to residents past lives, needs, likes/dislikes and chosen lifestyle. For example one read, “Does not like physical contact” and “can make feelings known”. Winifred Kettle Community Care Centre DS0000031365.V283264.R01.S.doc Version 5.1 Page 11 With regard to intermediate care, after an initial local authority care plan was completed, all staff were now using the ‘skills plan’, which was the overall summary of the resident’s abilities and care needs produced by the PCT staff. A full range of detailed information was provided including assessments completed by the occupational therapist and physiotherapist, goals set and details of reviews and plans for discharge. Reviews take place weekly at a multi-disciplinary team meeting. Joint daily care notes completed by all PCT and local authority staff are due to be introduced. Review documents provided evidence that residents and their representatives are fully involved in their care. In respect to permanent residents there was evidence of regular health care checks. Individual care records inspected showed evidence of visits from General Practitioners, chiropodist and district nurses. The health care needs of intermediate care residents are well met, as previously mentioned they have access to the team of doctors, nurses, physiotherapist and occupational therapist attached to the home. Winifred Kettle Community Care Centre DS0000031365.V283264.R01.S.doc Version 5.1 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 the following standard(s): 12 & 14 The provision of social and recreational activities to each of the three groups of residents (‘permanent’, ‘respite’ and ‘intermediate care’) need to be kept under review, in order to ensure the social care needs of residents are not overlooked. Personal support is offered in such a way as to enable residents to exercise choice and control over their lives. EVIDENCE: During the last inspection a requirement was made in respect to the provision of social activities for permanent, respite and intermediate care residents. Discussion took place with the manager in regard to action taken to address this requirement. The manager indicated that activities were limited but this reflected resident’s preferences. In regard to permanent residents staff undertake one to one activities a few times a week. Records of these activities are now being maintained. In respect to social activities provided to respite and intermediate care the manager advised that when consulted they did not wish any extra activities to be provided. Respite and intermediate care residents who have been allocated a place at the day centre can continue to attend while resident in the home. Intermediate care residents spoken with indicated they were happy doing their rehabilitation exercises and seeing visitors. The manager advised residents Winifred Kettle Community Care Centre DS0000031365.V283264.R01.S.doc Version 5.1 Page 13 could attend the evening social (organised by outside groups) held in the home but none had done so as yet. The manager said that intermediate care residents had visitors most days, which along with their rehabilitation programmes meant their days were very full. As a result there was limited interest in any additional activities. Although feedback from residents indicates satisfaction with current arrangements this could change. Therefore the manager needs to keep under review the range and frequency of activities provided to ensure the needs and preferences of residents are met and not overlooked. On the day of the unannounced inspection, the routines of daily living were observed to be flexible. Permanent and intermediate care residents spoken with spoken with expressed satisfaction with care provided and organisation of life at the home. Relationships between staff and residents seemed warm, caring and friendly. Residents were treated with courtesy, and staff demonstrated an understanding of residents’ likes, dislikes and preferred routines. Observation of care practice and information in permanent residents care plans indicated are encouraged to make choices. For example in respect to where they spend their day, meals and social activities. For example one care plan instructed staff that X “Can make her needs known”. Evidence of personalisation was seen in permanent residents bedrooms where personal mementoes and photographs were on display. An essential feature of the care provided for intermediate care residents is to enable them to relearn daily living skills and return home. As part of that process residents take part in therapeutic activities. These activities are clearly indicated and agreed in individual care plans and treatment programmes. Winifred Kettle Community Care Centre DS0000031365.V283264.R01.S.doc Version 5.1 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 the following standard(s): Not assessed during this visit. EVIDENCE: Standards 16 and 18 were assessed during the last inspection and were found to be satisfactory. Winifred Kettle Community Care Centre DS0000031365.V283264.R01.S.doc Version 5.1 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 the following standard(s): 19 The home provides residents with an attractive, comfortable and homely place to live in. EVIDENCE: Winifred Kettle is well maintained both internally and externally. In the main standards are good but it was noted that the wallpaper and paintwork in corridors and some bedrooms is damaged and beginning to show signs of age. The manager advised she had already identified this as part of the future programme of renewal. However she does not have the final decision in this matter. Those staff responsible for allocating the budget for maintenance/redecoration need to ensure this work is planned for so standards in the home don’t fall below an acceptable standard. The Home is spacious with several lounge and dining areas. These areas are furnished with good quality items. Ornaments pictures and flowers enhance the homeliness of these areas. The garden areas are tidy, well maintained, safe, secure and accessible for residents. Residents and visitors spoken with made no adverse comments about environmental standards in the home. Winifred Kettle Community Care Centre DS0000031365.V283264.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 & 29 Staffing levels are satisfactory ensuring consistency of care for the residents living in the home. Recruitment policies and procedures are robust and staff delivering care have been appropriately vetted, so ensuring residents are protected. EVIDENCE: On the day of inspection sufficient staff were on duty to meet residents care needs. Staff spoken with indicated that currently staffing levels were sufficient to meet residents needs. During the visit staff were observed to respond speedily to requests for assistance made by residents and also spent time socialising with them. Residents spoken with said that staff looked after them well and were very complimentary about the care provided. For example one resident described staff as being “very kind”. It was evident from speaking with staff that they enjoyed working in the home. Staff said teamwork was “good”, that they “liked coming to work” and were “very happy” working at the home. Winifred Kettle Community Care Centre DS0000031365.V283264.R01.S.doc Version 5.1 Page 17 Staffing remained at 4 carers and a care supervisor in the morning, 3 carers and a care supervisor in the afternoon and evening and two waking care staff at night. The manager’s hours were supernumerary. The manager provides on call cover (with back up cover available from the other local authority homes’ managers). The rota provided written evidence that domestic and catering staff provide support seven days a week. Therefore care staff do not have to engage in domestic tasks, which would take them away from the direct care and supervision of residents. In addition to local authority staff PCT staff (nursing, physiotherapist, occupational therapist, assistant practitioners) provide a service to the seventeen intermediate care residents. Recruitment records are held in Bolton Social Services personnel department. Periodically inspectors from the CSCI examine the records held centrally. The records examined during the last visit demonstrated that thorough preemployment checks had been carried out. All contained 2 satisfactory references, completed application forms, Criminal Records Bureau Check, verification of identity, and a signed declaration of physical and mental fitness. Winifred Kettle Community Care Centre DS0000031365.V283264.R01.S.doc Version 5.1 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 The home is well managed and run efficiently providing a safe environment for people living there. EVIDENCE: The Manager is a qualified social worker (CSQW) and has extensive experience of running care homes for older people. She has also completed NVQ (National Vocational Qualification) level 4 registered managers award. Staff spoken to all indicated that the manager provides clear leadership and direction. The standard of record keeping in the home is of a good, further demonstrating staff are knowledgeable about their roles and responsibilities. There is a clear line of accountability in the home which both residents and staff are aware of. Residents who commented were all aware of whom to approach if they had a concern. Winifred Kettle Community Care Centre DS0000031365.V283264.R01.S.doc Version 5.1 Page 19 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 2 2 X X X 4 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X X X X STAFFING Standard No Score 27 3 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X X Winifred Kettle Community Care Centre DS0000031365.V283264.R01.S.doc Version 5.1 Page 20 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. 1 Standard OP2OP1 Regulation 4,5 Requirement Steps must be taken to ensure the draft copies of the statement of purpose and service user guide are finalised. Confirmation and finalised copies to be forwarded to the CSCI. To ensure (permanent, respite and intermediate care residents) social care needs are met the range and frequency must continue to be reviewed in consultation with residents and action taken if appropriate. Timescale for action 01/05/06 2. OP12 12,16, 18,24 01/05/06 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 Winifred Kettle Community Care Centre DS0000031365.V283264.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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 Winifred Kettle Community Care Centre DS0000031365.V283264.R01.S.doc Version 5.1 Page 22 - 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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