Inspection on 03/02/09 for Winifred Kettle Community Care Centre

This inspection was carried out on 3rd February 2009.

CSCI found this care home to be providing an Excellent service.

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

Winifred Kettle Community Care... 03/01/07

Winifred Kettle Community Care... 24/02/06

Winifred Kettle Community Care... 12/08/05

Winifred Kettle Community Care... 21/01/05

Winifred Kettle Community Care... 13/07/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Winifred Kettle Community Care Centre Winifred Kettle Community Care Centre Leigh Road Westhoughton Bolton Lancashire BL5 2NE     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Rukhsana Yates     Date: 0 3 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Winifred Kettle Community Care Centre Leigh Road Winifred Kettle Community Care Centre Westhoughton Bolton Lancashire BL5 2NE 01942634566 01942634564 alison.leaver@bolton.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Bolton Metropolitan Borough Council care home 23 Number of places (if applicable): Under 65 Over 65 23 old age, not falling within any other category Additional conditions: 0 Staffing levels are to be calculated in accordance with the Residential Forum Staffing Guidance (Older People) by 1 April 2004. 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 must, at all times, employ suitably qualified and experienced staff to meet the assessed needs of the service users. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Within the maximum of 23 places, there is provision for up to 17 intermediate care places. Date of last inspection Care Homes for Older People Page 4 of 25 Brief description of the care home Winifred Kettle Community Care Centre provides personal 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, the majority of which are used to provide 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 by an on-site team of nursing, physiotherapy, occupational therapy and care staff. Care staff support those in receipt of short term respite care. No long term admissions are accepted by the home. The intermediate care service users live on the first floor and share 3 lounge/dining areas. All bedrooms are single, with wash hand basins (no en-suite 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. A Service User Guide that describes the homes services is readily available in the home and the staff give other information about the home to new and prospective residents and their families verbally. A copy of the latest inspection report, the homes Statement of Purpose and a copy of the latest quality assurance survey are also displayed in the home. The intermediate care service is provided without charge whilst charges for other services range from #92:55 to #394:00 per week with these figures being subject to negotiation to allow for individual circumstances. Additional charges are made for hairdressing services. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection included a site visit and was unannounced. The last inspection on this service was completed on 3 January 2007. In January 2008, an Annual Service Review (ASR) was carried out. This involved the manager filling in an annual quality assurance assessment (AQAA), and people who use the service and staff completing surveys to tell us their views of the home. The outcomes for people using the service at that time were good, and showed us that people continued to be happy with the way they were supported. Prior to this inspection, we used surveys and asked the manager to complete an AQAA again. This gave the manager the opportunity to tell us what had changed or improved since the last inspection and ASR. The form was well completed and there were clear Care Homes for Older People Page 6 of 25 plans in place to further improve the service. The service was inspected against all of the key inspection standards at the site visit. This included observing care practices, talking with people who use the service, the manager and staff. A selection of records relating to care and safe working practices were also looked at. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are given useful information about the service, and are provided with the support they need to maximise their independence so that they can return to live at home. Evidence: The service provides a statement of purpose and service user guide to people admitted, and the manager has devised leaflets that are easy to read and understand so that people know about the facilities and services available to them during their stay. There are plans to provide this information in different formats to meet the specific needs people may have, such as large print or audio form. The service does not admit people for permanent care. Pre- admission assessments aim to ensure that people admitted may benefit from the intermediate (rehabilitative) Care Homes for Older People Page 10 of 25 Evidence: care or short term care services. The intermediate care service can accommodate up to 18 older people who need help to recover after they have been ill or had an accident, so that they can return to their homes and live independently. This service is jointly provided by Social Services staff employed at Winifred Kettle Community Care Centre, and by employees of the local Primary Care Trust. A specialist team of workers is available that includes physiotherapists, occupational therapists, nurses, therapy assistants, care staff, managerial and ancillary staff. A range of needs assessments are undertaken and programmes of care and support set up immediately following the persons admission to the service. The rehabilitation programme usually takes place over a six week period and includes regular reviews. People receiving this service were aware of the purpose of their stay at the home and knew of the programme of care in place to enable them to return home. One person said, All of them have been wonderful. Im feeling much steadier and I feel better about going home now. Another person admitted on the day of the inspection visit was seen to be welcomed by friendly and encouraging staff, and quickly felt at ease. Where possible, people are encouraged to visit the service before admission, although this is not possible for those admitted in an emergency or at very short notice. Some people admitted are familiar with the service, having attended the day centre or through a previous short stay. Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People feel that they receive a high quality of care and support that meets their range of needs and expectations, and benefits their health and wellbeing. Evidence: The care files seen contained a wide range of information that included comprehensive needs and risk assessments, care plans, specific skills and goals plans as appropriate to the individual, each designed to assist people in regaining their health and independence. The plans were reviewed frequently with the full involvement of the individual concerned, taking account of their wishes, perspective and particular concerns. Specific health care needs were assessed and recorded, including nutritional screening and pressure area care needs. The service was well resourced in terms of aids, adaptations and pressure relieving equipment, and there was evidence of improvements in health for people using the service. The daily care notes were completed in each persons file by each member of the multi-disciplinary team involved. This provided a clear and complete picture of the Care Homes for Older People Page 12 of 25 Evidence: persons ongoing support needs and progress. It was clear from the records, and from speaking with staff, that the team works well together to ensure an effective and well coordinated approach to care is achieved. This was further confirmed by people using the service who spoke highly of the staff team, praising their competence and attitude, and had confidence that their needs and wishes were well understood and met. One person said, They are all so kind and helpful. Its a lovely atmosphere; they like to get to know you and nothing is ever too much trouble. Another commented, I couldnt have come to a nicer place and I feel much better. Safe and effective arrangements were in place in respect of the management of medication. All medicines were administerd by trained staff in accordance with Bolton Councils comprehensive medication policy. A pharmacist visits weekly to provide support and guidance on the safe use of medication and information about drug alerts, and internal audits are carried out regularly, with the results of these recorded and acted on as necessary. One person described how she was being supported to selfmedicate in preparation for returning home, and this was seen to correspond with her written support plan. It was evident that the manager and staff treat people in a way that promotes dignity and respect, from observations of practice and comments made by people staying at or visiting the service. People were highly complimentary about how staff assisted them with personal care tasks and felt that their privacy and dignity were respected at all times. One comment was, they treat us all so well, they are very kind - cant praise them enough, every one of them. Staff members spoken with described a staff team that works well together, respects one anothers input and skills, and communicates well about the needs and wishes of people using the service, thereby ensuring that each persons particular needs are known and met. Surveys also showed that staff have access to up to date information about individual needs. Staff receive culltural awareness training, and the service has access to Bolton Councils translation and interpreter services in order to be in a position to meet the potentially diverse needs of people requesting care and support. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have choices that mean they are able to spend their time as they wish, have visitors when it suits them, and enjoy good, nutritional meals. Evidence: The day centre staff organise and run a varied programme of recreational and social activities for people receiving a service. In practice those people receiving intermediate care are largely occupied by the therapeutic nature of their care, and they said that they tended to mostly watch television, listen to music and read. They can if they wish join the day centre activities. A discussion took place with the manager about the potential benefits of better recording of social needs in order to enhance social care provision in accordance with known hobbies or preferences. The permanent residents at the home have lived there a long time and their needs are very well known to staff who spend time individually chatting with them. People interviewed, including staff, confirmed that visitors are welcome at any time, although preferably not at mealtimes. People could take visitors to their rooms to see them in private , or see them in the main lounge. They said that their visitors are made welcome and offered a drink. Care Homes for Older People Page 14 of 25 Evidence: People felt their routines were flexible and that they had choices as to where to spend their time, whether or not to take part in activities, what to wear, and times for rising and retiring. Staff were seen to treat residents in a dignified, respectful and courteous manner and assist in a friendly and caring way that put people at ease. A four weekly menu was seen that offered a choice of nourishing food, with the main meal served at lunchtime and a lighter meal at teatime. Warm food is always offered at mealtimes. Nutrtional screening is routinely carried out by nursing staff. The cook speaks to all residents at the time of their admission when she asks them about their food likes and dislikes, with this information being recorded and acted on. People spoken with praised the food served and also said that drinks and snacks were available at most times of the day. Meals were seen to be presented in an appealing manner with good portions provided, and sensitive, encouraging support offered as needed. Meals are eaten in a number of small dining rooms that are nicely furnished and provide a comfortable and homely setting for people to dine. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Procedures and training arrangements in place ensure that people using the service feel listened to, safe and protected. Evidence: The service has copies of the Bolton Social Services and Bolton NHS Primary Care Trust comments, compliment and complaints procedures that are available in leaflet form in the reception area. Further information about making complaints is also in the service user guide. The information states how a complaint can be made, who to, and that an initial and final response will be provided within a given time period. There is s system for documenting complaints. No complaints have been made to the service or to us since the last inspection. A safeguarding issue was dealt with appropriately by the manager. Discussions with people using the service showed that they would feel comfortable about raising concerns and they would talk to the staff or the manager if they had any concerns. Staff said they would inform the manager if any problems were highlighted to them that they could not resolve. There were written procedures covering adult protection, whistle blowing and financial matters, and a copy of the Bolton inter agency safeguarding policy and procedure was available . Records showed that the staff had been given training in safeguarding procedures. In Care Homes for Older People Page 16 of 25 Evidence: discussion the staff confirmed that they had received training and they were aware of the different sorts of abuse and they also understood what they should do if they suspected that someone was being mistreated. The manager has ensured that training has been extended to ancillary staff, recognising that every person working at the service has contact with potentially vulnerable people, and has a duty to protect them. Care Homes for Older People Page 17 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Winifred Kettle provides clean, safe, comfortable and homely surroundings for the people staying there. Evidence: The home is reasonably well maintained , bright and welcoming. Decoration, furnishing and lighting is domestic in style. There is good accessibility around the building with ramps, assisted baths and other equipment provided. Aids and adaptations are provided in bedrooms, bathrooms and toilets. There is an attractive garden area with level access and seating that is enjoyed by people in the summer months. The laundry is properly equipped and information regarding the control of infection is available. Standards of hygiene were seen to be high, with handwashing facilities in use throughout the building. The environment was clean and tidy throughout and was free from adverse odours, therefore providing a pleasant place to live. People spoken with were happy with the environment. One person said, I have no complaints, its clean and my bedroom is nice and comfortable. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are well cared for by sufficient numbers of staff that are safely recruited, properly trained and work positively together for the consistent benefit of those they support. Evidence: Rotas showed that there were sufficient numbers of staff, including health and care personnel, domestic and catering staff, to meet peoples needs, with an increase in staff numbers since the last inspection. It was clear from discussions with staff and people using the service that there is positive and constructive team work that has created a good atmosphere and commitment to providing an excellent quality of care. This has resulted in a low staff turnover, ensuring consistency of skilled care and support being provided. One staff member said, it is a good place to work; the manager listens to us, has regular meetings with us and will sort anything out if it is in her power. People using the service said that they could not praise the staff enough. Recruitment records are held in the HR department of the local authority. Periodically, inspectors examine the records held centrally. The records examined during the last visit demonstrated that thorough pre-employment checks had been carried out. All contained two satisfactory references, completed application forms, Criminal Records Bureau checks, verification of identity, and a signed declaration of physical and mental Care Homes for Older People Page 19 of 25 Evidence: fitness. Discussion with the staff and looking at records showed that there is a strong commitment to staff training. the staff gave examples of the wide range of training they had done. This included induction, NVQ (National Vocational Qualification) assessment, and managing medicines, safe moving and handling, fire safety, food hygiene and first aid. The provision of this training was confirmed by computerised staff records seen. 89 of the staff were either qualified to NVQ level 2 or above or in the process of completing an NVQ. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The way the service is managed ensures that people receive a high quality of care and support at all times. Evidence: The manager is a qualified social worker and has extensive experience of running care homes for older people. She has also completed the Registered Managers Award and NVQ4. It was apparent from discussions with people using the service, the staff and the manager, that the service is run well and in an open and inclusive way, with an emphasis on providing a good quality service and seeking continuous improvement. Comments reflected the view that the manager is fair-minded, approachable, competent and easy to get along with. With respect to quality assurance, feedback is sought from people using the service and their carers through the use of questionnaires, and verbally on a day to day basis. The results are brought together and analysed, and displayed in the home in the form Care Homes for Older People Page 21 of 25 Evidence: of a report with good points noted and action being taken to deal with any issues raised. The report for January 2009 showed a high level of positive responses and satisfaction with the support and services provided. Comments referred to the happy atmosphere, and the excellent meals. One person said they liked The care and consideration from the staff from the highest to the lowest. the way the staff are always there for you, listening to you and making sure that you have all you need. Another said I had the best care I needed at the time of my illness - thank you to you all. The home holds money for a number of people for safekeeping. This system was checked with the details found to be properly written down and with the correct amounts of money kept. Secure storage was available for the safekeeping of money and valuable items. Information obtained from the AQAA and from random checking of service records showed that the homes equipment is properly maintained and regularly services. Records and discussions also showed that the necessary training had been provided so that staff could work safely. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 12 Information about recreational need and interests should be consistently recorded and shared so that individuals preferences are familiar to all staff. Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 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!