Inspection on 03/11/05 for Winslow Court

This inspection was carried out on 3rd November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Winslow Court 23/10/08

Winslow Court 31/10/07

Winslow Court 18/09/06

Winslow Court 27/01/06

Winslow Court 30/10/04

Winslow Court 17/06/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Winslow Court Winslow Rowden Bromyard Herefordshire HR7 4LS Lead Inspector Jean Littler Announced Inspection 3rd November 2005 02:30 Winslow Court DS0000024749.V264522.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Winslow Court DS0000024749.V264522.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Winslow Court DS0000024749.V264522.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Winslow Court Address Winslow Rowden Bromyard Herefordshire HR7 4LS 01885 488096 01885 483361 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) Winslow Court Limited Mr Donald Ellsmore Care Home 24 Category(ies) of Learning disability (24) registration, with number of places Winslow Court DS0000024749.V264522.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residents may also have a physical disability or mental disorder associated with their learning disability. 30th October 2004 Date of last inspection Brief Description of the Service: Winslow Court is a residential centre for twenty-four adults with severe learning disabilities and complex behaviour patterns that can challenge staff. It is purpose built and divided into four units, each of which accommodates six service users. The units are based around a central courtyard. There are communal facilities on site including a computer room, art and music provision and a leisure complex that includes a spa pool. The grounds extend to twentysix acres and there is also a school on the site that is run by the same organisation. Winslow Court DS0000024749.V264522.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This routine announced inspection was carried out on a weekday between 2.30 and 6pm. The main focus of the visit was to review the catering arrangements as two residents’ relatives had recently raised concerns about the quality of the food. One unit was focused on during the inspection as a sample. A resident who had recently moved into this unit spent some time with the inspector and assisted with a tour of her area of the Home. She also came with the inspector and her unit manager to view the new leisure complex that had recently been opened and was being used by the Home and the school. The unit manager and the registered manager assisted with the inspection process. The providers monthly visit reports that are sent to the Commission, and other communication with the Home since the last inspection were considered as part of the inspection process. What the service does well: What has improved since the last inspection? Care documentation is now being updated as each residents’ needs change rather than only at the six monthly reviews. The use of bedrails for two residents has been professionally assessed to ensure they are needed and are appropriately fitted to reduce the risk of any injuries. A new purpose built leisure complex with spa pool has been opened and residents are beginning to use this facility. The house has been made more homely and new furniture has been provided in some areas. Winslow Court DS0000024749.V264522.R01.S.doc Version 5.0 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. Winslow Court DS0000024749.V264522.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Winslow Court DS0000024749.V264522.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3. Comprehensive assessments had been carried out prior to recent new residents being admitted on a trial basis. The Home’s policy for formally reviewing how new placements were progressing had not being consistently followed. EVIDENCE: Two residents had recently moved into the one unit that was inspected. The unit manager explained to the inspector how the assessments and transitions had been arranged. One of the new residents had been a pupil at the school that is on the same site and the providers were already aware of her needs. Staff had visited the school to get to know her and her care plan information had been transferred across to the Home. The other new resident had moved from a school elsewhere. Following the initial assessment process, which was carried out by the registered manager, the unit manager spent time with the resident at her school on several occasions and liaised closely with her family. Both placements were progressing well and appropriate arrangements were in place to meet their needs. The site nurse takes on the responsible for completing the health care plans. These had not yet been returned to the unit to form part of the overall care plan. Ideally these should be in place prior to any new placement being confirmed as permanent to provide evidence that the service can meet all the resident’s assessed health needs. Winslow Court DS0000024749.V264522.R01.S.doc Version 5.0 Page 9 The four week transitional review meeting, that should take place in line with the Home’s admission policies, had not been held for one new resident. The unit manager had been making efforts to arrange the next stage, which is a three month review meeting to confirm the placement. This was proving difficult to book as those involved from external agencies had limited availability. The manager should consider setting these dates when the placement is first agreed. Winslow Court DS0000024749.V264522.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6. Appropriate care planning systems were in place to ensure staff had the relevant information to meet the residents’ needs. EVIDENCE: The manager reported that care plans were being updated more frequently as changes occur. Care arrangements are formally reviewed at six monthly review meetings. The daily care records sampled were detailed and provided information that allowed the resident’s wellbeing and quality of life to be monitored. The care plan sampled showed that the risk assessments had been completed regarding the new residents known behaviour patterns and clear intervention strategies had been developed. Guidance to staff could be further improved if it specifically related to the physical intervention techniques taught to staff e.g. level one or two restraint. Clear incident reports were being completed whenever a resident became distressed or needed any form of physical intervention. One resident became distressed during the inspection. Staff were seen to react very quickly and calmly while following the agreed intervention procedure. This resulted in the resident calming down quickly in his bedroom while being supported by one worker. Winslow Court DS0000024749.V264522.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 13, 14, 15, 17. Great efforts were being made to support residents to maintain contact with their families. Residents were being regularly provided with appropriate and therapeutic activities and outings to help their personal development. The catering arrangements were not consistently providing residents with quality meals in appropriate quantities. EVIDENCE: Each resident has a personalised activity plan that focused on their individual assessed needs. It is positive that progress has already been made with one new resident who had successfully coped with visiting the local shops. This was viewed as a breakthrough and a positive indicator for the future. Two activity/art therapists are employed and links are in place with local further education colleges. One of the new residents assisted in showing the inspector around the newly built leisure building with spa pool that is being made available to pupils of the school and the residents of the Home. One resident had been on a helicopter ride the previous week and his keyworker was now considering plans for him to go on a holiday abroad next year. This presents many challenges and may not be possible, however it is Winslow Court DS0000024749.V264522.R01.S.doc Version 5.0 Page 12 positive that consideration was being given to new opportunities in full consultation with the resident’s relatives. Another resident had been supported by a member of staff to accompany his parents on a trip to India to visit relatives. One new resident showed the inspector her symbol communication system that she had been using while at school. A member of staff interacted well with her and took time to ensure she understood what was being communicated to her. The way meals are being provided has been changed. A catering company took over the catering arrangements and now provide meals for the school that is on the same site, and the main meals, at lunchtime, for the Care Home. Staff in the units have previously shopped with residents and prepared the breakfast and evening meals in the unit kitchenettes. The ingredients for breakfast and the evening meals are now being collected from the kitchen. Following initial concerns raised by the staff team each unit is being given £50 a week to buy sundry items for the evening meals and snacks such as herbs, biscuits and crisps. Staff have been raising concerns about the quality and quantity of the meals and ingredients being provided, and although the new arrangements have been in place for four months the same concerns continue to be raised. The manager openly acknowledged the problems and is taking steps to address them. A kitchen manager has been appointed by the catering company, and he is liaising closely with staff to resolve any problems as they arise. Quality monitoring forms have recently been introduced and staff are completing these after each meal. Weekly meetings are going to be held to resolve issues and monitor quality, and a catering committee has been set up that will meet monthly. New menus have been developed following the first of these meetings and these are due to be introduced shortly. An independent review of the nutritional value of these is going to be commissioned. The manager agreed to keep the Commission informed about any progress made in addressing the issues and agreed to develop an action plan with the providers in case these issues are not resolved in the next three months. It is acknowledged that it is difficult to formally consult the residents about the catering arrangements, however part of the monitoring should include information about which residents ate and seemed to enjoy each meal. As arrangements are reviewed consideration should be given to how the current arrangements fit in with the principles of ‘normal living’ and whether they provide the residents with their main meal at the most suitable time of day and give a genuine opportunity for them to choose the food they wish to eat that day. Winslow Court DS0000024749.V264522.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19. Suitable health care arrangements were in place to meet the residents’ assessed needs. EVIDENCE: The care plan sampled showed that detailed information had been obtained about the personal care and health needs of a new resident. Staff were being provided with training that related to her health conditions and appropriate links were in place with specialists. One resident was making good progress after major surgery last year and following specialist input he is no longer using a frame to walk. An outbreak of Chicken Pox in one unit was being appropriately managed. The doctor had visited and the nurse based on site had also given advice. Suitable infection control arrangements had been implemented e.g. laundry was being sealed and then washed separately. Staff working on that unit had been consulted to ensure they were happy to continue working in this area of the Home. The manager confirmed that bed rails were still only being used for two residents on the basis of a risk assessment and following consultation with appropriate professionals. Winslow Court DS0000024749.V264522.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. Complaints were being treated seriously and fully investigated. Robust arrangements were in place to protect residents from abuse. Concerns that had been raised had been taken seriously and reported to appropriate authorities. EVIDENCE: A complaints procedure is in place. Complaints have recently been made by two residents’ relatives about the quality of the meals provided to the residents. Meetings are being held with the complainants to inform them of how their concerns are being addressed. As detailed above similar concerns have been raised by care staff. A brief and clear ‘Abuse’ policy is in place. This makes clear reference to the local multi-agency procedure for dealing with ‘Vulnerable Adult’ concerns. A ‘Whistle Blowing’ policy is also in place that states staff will be protected if they report a concern. All staff are provided with training about abuse and their duty to protect vulnerable people. Adult protection issues that have occurred since the last inspection have been promptly reported to the relevant authorities and staff who reported their concerns have been supported. The management team has co-operated fully with multi-agency strategy meetings and internal disciplinary procedures have been appropriate instigated. Winslow Court DS0000024749.V264522.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24. The premises were being well maintained and were providing the residents with a safe, clean and comfortable Home. EVIDENCE: Repairs are reportedly being dealt with promptly and there is a continual cycle of redecoration and refurbishment. More major improvements are planned including a refit of the main catering kitchen and a new mains water supply is due to be connected to the laundry. The new detached leisure building has been formally opened. This provides a variety of facilities including a spa pool. The areas of the Home seen during this visit were clean, homely and well equipped. Efforts are continuing to make bathroom and toilet areas more attractive and to encourage residents to accept and look after normal household furniture. It was very positive that one resident had now accepted an armchair in his bedroom. Winslow Court DS0000024749.V264522.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 35, 36. Appropriate staffing levels were being maintained to meet the complex needs of the residents. Staff were being provided with the support and training programmes to equip them for their role. EVIDENCE: Appropriate staffing levels of at least four staff are being maintained on each unit. Recruitment efforts are continuing and some overseas staff are being recruited to help bolster numbers. It is predicted that by the end of November 05 the Home will be fully staffed. Over the last year efforts to improve staff retention have been successful and turnover is now at approximately 20 . Auxiliary domestic staff are employed for domestic, maintenance, and laundry services to assist the smooth running of the service. Staff training records indicated that 39 of the 59 staff employed at the Home have gained an NVQ award in Care. It is very positive that the target of having over 50 of staff qualified has been reached. Seven other staff are working towards an NVQ award. The Home has introducing the Learning Disability Award Framework as part of new staffs’ induction and foundation arrangements. Managers have also been pro-active in assisting the Hereford training consortium in launching LDAF training across the county in services for people with learning disabilities. Consideration is being given to the Home becoming a LDAF centre. The induction arrangements are due to be changed Winslow Court DS0000024749.V264522.R01.S.doc Version 5.0 Page 17 and new staff will spend their first ten days on a training programme that will cover all core training. The unit manager spoken with reported that staff were being well supported and appropriately trained. She felt that staffing levels were appropriate to meet the needs of the residents. Winslow Court DS0000024749.V264522.R01.S.doc Version 5.0 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37. The Home was being effectively managed and the residents’ needs were being prioritised. EVIDENCE: The management arrangements have changed since the last inspection. The providers have opened another small Care Home and the manager of Winslow Court has line management responsibility for this service in addition to his responsibilities for overseeing another established small Home. Because of these responsibilities the providers are considering if the role of registered manager should be transferred to the current assistant care manager. If this change is implemented then the role descriptions need to be reviewed prior to an application for registration being made to the Commission. A development plan had been circulated to unit managers and staff some weeks ago that indicated that the recommendations from the last inspection, and other developments were being promoted e.g. better activity planning during college holidays. Winslow Court DS0000024749.V264522.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 4 3 X x Standard No 22 23 Score 3 4 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X x LIFESTYLES Standard No Score 11 3 12 X 13 3 14 3 15 4 16 X 17 Standard No 31 32 33 34 35 36 Score X 4 4 X 4 x CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Winslow Court Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 X X X X X x DS0000024749.V264522.R01.S.doc Version 5.0 Page 20 NO 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. 1 Refer to Standard YA3 Good Practice Recommendations Ensure reviews are held for new residents in line with the Home’s admissions policy. The health care plan completed by the site nurse should be put in place as early as possible for new residents so it can be considered as part of the three monthly placement review. Review catering arrangements and ensure a quality meals service is consistently provided. 2 YA17 Winslow Court DS0000024749.V264522.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Hereford Office 178 Widemarsh St Hereford Herefordshire HR4 9HN 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 Winslow Court DS0000024749.V264522.R01.S.doc Version 5.0 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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