Inspection on 19/09/05 for Winslow House

This inspection was carried out on 19th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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 House 18/04/07

Winslow House 28/03/06

Winslow House 23/02/05

Winslow House 28/09/04

Winslow House 08/01/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Winslow House Springhill Nailsworth Gloucester GL51 9EY Lead Inspector Sharon Hayward-Wright Announced 19 September 2005 9:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Winslow House D51_D03_s44887_Winslow House_v243255_AI_190905_Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Winslow House Address Springhill Nailsworth Gloucestershire GL51 9EY 01453 832269 01453 836423 winslowhouse@invictawiz.co.uk Winslow House Ltd Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Jean Ellen Walker Care Home 35 Category(ies) of OP old age (35) registration, with number of places Winslow House D51_D03_s44887_Winslow House_v243255_AI_190905_Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 23/2/05 Brief Description of the Service: Winslow House is situated within walking distance of the town centre of Nailsworth. The home is large converted Victorian House that was extended approximately seven years ago. Service users are accommodated on the ground and first floor. The first floor is accessed by a shaft lift. The communal areas consist of a large lounge/dining room on the first floor with one lounge, a dining room and a large conservatory/dining room on the ground floor. The grounds are attractively laid out and well maintained. Winslow House D51_D03_s44887_Winslow House_v243255_AI_190905_Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over 6 hours on one day in September 2005 by two inspectors. Twelve service users were spoken with to gain their views on the home; the care of three service users was examined in detail and four staff members were also spoken to, as well as the Registered Manager and Registered Provider. Staff were observed going about their duties and interacting with each other and service users. The recommendations made at the last inspection were followed up and records relating to the homes’ Statement of Purpose, Service Users Guide, service users care, duty rotas, staff training, complaints, activities, personnel files, quality assurance and servicing of equipment were inspected and a tour of the home took place with a number of service users rooms inspected. What the service does well: There is a clear and consistent care planning system in place providing staff with the information needed to satisfactorily meet service users needs. The medication at this home is well managed promoting good health. The home provides a varied activities programme which service users can chose to participate in. The standard of the environment within this home is good providing service users with an attractive and homely place to live. The staff demonstrated good understanding of the service users support needs and service users felt they have developed positive relationships with the staff. The home has over the recommended 50 care staff trained to NVQ level 2 or equivalent. The systems for service user consultation in this home are good with a variety of evidence that indicates service users views are sought and on the whole acted upon. Winslow House D51_D03_s44887_Winslow House_v243255_AI_190905_Stage 4.doc Version 1.40 Page 6 The Registered Manager is supported well by her senior staff in providing clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibility. The health, safety and welfare of the service users and staff is protected and promoted. What has improved since the last inspection? 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 House D51_D03_s44887_Winslow House_v243255_AI_190905_Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Winslow House D51_D03_s44887_Winslow House_v243255_AI_190905_Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3 & 5 The homes Statement of Purpose and Service Users Guide provided service users and prospective service users with the detailed information they need in relation to the services offered and for proposed service users allows them to make an informed choice. Service users are not admitted to the home without the home obtaining information to ensure they can meet the needs of the service users. Prospective service users and their families/friends have the opportunity to visit the home prior to moving in. EVIDENCE: The Registered Manager said no amendments have been made to the Statement of Purpose and Service Users Guide. Copies of these guides were seen, at the main entrance to the home. The pre admission information of three recently admitted service users was examined, all had application forms completed and two had an assessment undertaken by the home. One of the service users who came from out of the area had information from their previous home and social services information. Winslow House D51_D03_s44887_Winslow House_v243255_AI_190905_Stage 4.doc Version 1.40 Page 9 The other service user who came from out of the area was admitted for respite care. One service user and a relative (on behalf of their service user) confirmed they had visited the home prior to making a decision about moving in. Winslow House D51_D03_s44887_Winslow House_v243255_AI_190905_Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 & 10 There is a clear and consistent care planning system in place providing staff with the information needed to satisfactorily meet service users needs. Service users with an assessed need have access to health professionals. The mediation in this home is well managed promoting good health. Service users are treated with respect and their privacy is upheld. EVIDENCE: Three service users had their care examined in detail. All had an assessment of their needs and from this care plans are devised and reviewed on a regular basis. This provided evidence that the service users were receiving the care relevant to their needs. Evidence of health professionals being accessed for service users with an assessed need was seen. Procedures for medication were inspected. Records were seen of medication received into the home, administered and returned to the local pharmacy. The Registered Manager said service users are able to self medicate following an assessment; at the time of the inspection no service users were selfmedicating. Winslow House D51_D03_s44887_Winslow House_v243255_AI_190905_Stage 4.doc Version 1.40 Page 11 The home does not have any service users taking controlled medication or Temazepam but have a register to maintain records for when needed. Evidence was seen of staff having undertaken an accredited medication course and the Registered Manager said staff are not allowed to give out medication until they have undertaken this training. Dates of opening were seen on medication that was not in a blister pack and the home has an up to date drug reference book. A list of staff initials and signatures was seen. The local chemist has recently undertaken an audit of the homes medication and the Registered Manager said this happens on a regular basis. The home’s policies and procedures were not examined. The medication is transported around the home in lockable trolleys Service users spoken with said the staff in the home maintain their privacy and dignity. Examples given were knocking on their doors prior to entering, addressing them by there preferred from of address and receiving their post unopened. Winslow House D51_D03_s44887_Winslow House_v243255_AI_190905_Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 ,14 The varied activities programme provided, offers service users the opportunity to satisfy their interests and needs. Links with the local community are encouraged and maintained and visiting to the home is flexible to meet the needs of service users families and friends. EVIDENCE: Service users and a relative spoken with confirmed that visiting is flexible. One service user was out at a day club that is run and managed locally, during the inspection. The home seems to have a large programme of activities for the service users, which is displayed on the wall on the ground floor lounge. Activities include: chocolate tasting, mobile library, local club, the vicar visits to give Holy Communion, painting, one carer was giving a seminar on her trip to South Africa, old films, bingo, quiz games, music and movement and raising money for charities via garden tea parties. All but one service user said they are able to exercise choice and control over their daily lives. This service user said they prefer to get up at 9am but they have to get up at 7.30am. Winslow House D51_D03_s44887_Winslow House_v243255_AI_190905_Stage 4.doc Version 1.40 Page 13 The service user said they have informed the staff of this request but nothing has happened. Where practical the home must ensure that service users have choice and control over their lives. The Registered Manager gave assurance that this is not the case and that service users do have a choice over what time they get up. However a small number of service users that are taking a certain type of medication have to sit up one-hour prior to breakfast. Service users personal possessions were seen in their rooms. Lunchtime was observed and staff offered discreet assistance. On the whole the feedback relating to meals was very good, but some service users felt the food was better on some days. Winslow House D51_D03_s44887_Winslow House_v243255_AI_190905_Stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 The home has a complaints procedure in place, however to date this has not been tested. Service users felt there concerns would be listened to. Policies and procedures are in place to protect service users from abuse. EVIDENCE: The home has not received any complaints. A copy of the homes complaints procedure is positioned near to the lounge and contains the required information in line with the Care Homes Regulations Service users spoken with said they could approach the management of the home if they had any concerns or complaints. The home has the appropriate polices in place as they use Croners. Staff are shown a video and set questions on vulnerable adults. Two staff spoken with confirmed they were aware of the procedure to be followed if an allegation of abuse is made. The home has a copy of the local adult protection guidelines for Gloucestershire. Winslow House D51_D03_s44887_Winslow House_v243255_AI_190905_Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 24 & 26 The standard of the environment is good providing service users with an attractive and homely place to live. EVIDENCE: The ground floor consists of en-suite bedrooms, which exceed the standard for useable size. The communal areas were located on the ground floor and consisted of a large dining room with a walk through lounge. The first floor is made up of en-suite bedrooms, which are of good sizes for each service user and a large living room with dining room space. The grounds are attractively laid out and well maintained. There are plans for landscaped gardens around the front of the house and the back of the building. There are elements of the building, which had to be in keeping with the structure as it as listed building and some of the garden and free space was enclosed from service users due to major work being conducted. Ongoing plans and improvement programmes for the outside grounds were being prepared with the view to carry out work in the very near future. Winslow House D51_D03_s44887_Winslow House_v243255_AI_190905_Stage 4.doc Version 1.40 Page 16 The environment on the whole is clean, safe, comfortable, bright, airy and provides sufficient suitable lighting, heat and ventilation and more importantly is hygienic and free from offensive smells. Furniture was intact with each service user having use of their TV equipment. Individual equipment was housed within each service users room to prevent cross contamination. A number of minor maintenance issues were identified and given to the Registered Provider to address, these are: • The bathroom on the ground floor had a hole in the door • The set of scales is in need of replacing • The linen cupboard has a large hole in the wall in the bottom left hand corner as it looks like it’s crumbling away. • Any visible pipes need guarding to prevent risks to service users. • Some of the service users rooms did not have toilet holders in place • The downstairs toilet needs a privacy lock and it was difficult to distinguish between the hot and cold taps. • The new bathroom and toilet (in which lights come on when the bathroom is being entered) requires a toilet holder and a privacy lock. • The ironing room had large hole going through from one wall into another and could do with a general paint and tidy up. • In the kitchen there was a panel in the bottom part of the door that was sharp and needs attention. • The large window in the small dining room needs painting and tidying up. Winslow House D51_D03_s44887_Winslow House_v243255_AI_190905_Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 & 30 Staff morale is high resulting in an enthusiastic workforce that works positively with service users to improve their whole quality of life. Service users are protected by the homes recruitment procedure. Staff are provided with training to assist them in meeting the needs of the service users. EVIDENCE: Duty rotas were seen as evidence of staffing levels. On an early shift the home has five care staff; on an afternoon shift there are three to four care staff and on nights there are two waking night staff. Either the Registered Manager or Deputy Manager work from 8am to 6pm and they are additional to the care staff. The home employs ancillary staff to cover cooking, domestic duties etc. The Registered Manager said that all the care staff are over the age of 18 years. Service users spoken with all praised the staff saying they are friendly and helpful and nothing is too much trouble for them. Agency staff are used to cover shifts when required. The home has 15 care staff with NVQ 2 or above, this equates to 57 exceeding the recommended 50 . Winslow House D51_D03_s44887_Winslow House_v243255_AI_190905_Stage 4.doc Version 1.40 Page 18 Personnel files of recently appointed staff were examined; of these, two needed photographs and proof of identity. The home also needs to find out where able the reasons for the member of staff leaving their last employment especially if from a care position. Evidence was seen on a new member of staff induction booklet of the name of their supervisor. The home provided proof that they offer ongoing training that includes first aid, fire, moving and handling and basic food and hygiene. Staff spoken with confirmed that training is provided and they were undertaking the NVQ 2 training. An induction booklet was seen as evidence of their induction programme and the Registered Manager said it is devised along the guidelines of the National Training Organisation. Winslow House D51_D03_s44887_Winslow House_v243255_AI_190905_Stage 4.doc Version 1.40 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 35 & 38 The Registered Manager is fit to be in charge of the home and able to discharge her responsibilities fully. The Registered Manager is well supported by her senior staff in providing clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities. The systems for service users consultation in this home are good with a range of evidence that indicates that service users views are both sought and on the whole acted upon. The health, safety and welfare of service users and staff is promoted and protected. Winslow House D51_D03_s44887_Winslow House_v243255_AI_190905_Stage 4.doc Version 1.40 Page 20 EVIDENCE: There have been no changes in the management of the home. Service users and staff felt that they could approach the Registered Manager if they had any concern or complaints. Evidence was seen of staff and service users meetings. The Registered Manager is supported well by the Deputy Manager and all staff showed awareness of their roles. Quality assurance systems are in place and the home completes an audit of its services. Questionnaires are sent out to new service users a few months after they have been at the home and other stakeholders in the community also receive one. Staff complete quality assurance sheets for service users and any issues identified are discussed at service users meetings. The Registered Manager said she and the other two Managers undertake care staff supervision; a schedule was seen on the wall in the office. The home plans to undertake supervision 6 times a year as recommended and appraisals once a year. Evidence was seen of servicing of equipment. The home has copies of the invoice of electrical work carried out but was not able to find the electric certificate. Checks on water temperatures were also examined. Risk assessments are in place for the environment and there is a health and safety policy. Winslow House D51_D03_s44887_Winslow House_v243255_AI_190905_Stage 4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 x COMPLAINTS AND PROTECTION 2 3 3 3 x 3 x 3 STAFFING Standard No Score 27 3 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x x 3 x 3 Winslow House D51_D03_s44887_Winslow House_v243255_AI_190905_Stage 4.doc Version 1.40 Page 22 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. 1. Standard 19 Regulation 23(2b) Requirement The Registered person must address the maintenance issues identified in the Environmental Standards. Since the introduction of the POVA scheme, and the amendments to the Care Home Regulations on the 26/7/04 for pre-employment checks on staff, the Home must obtain the following for all staff recruited since this date: 1) Proof of indentity to include a recent photograph. 2) Where a person has previously worked in a position which involved contact with children or vulnerable adults, written verification of the reason why the person ceased to work in their last position unless it is not reasonably practicable to obtain such verification.· Timescale for action 30/12/05 2. 29 7, 9, 19 & Scehdule 2 30/10/05 and ongoing 3. Winslow House D51_D03_s44887_Winslow House_v243255_AI_190905_Stage 4.doc Version 1.40 Page 23 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 Good Practice Recommendations Winslow House D51_D03_s44887_Winslow House_v243255_AI_190905_Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester GL3 4AB 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 House D51_D03_s44887_Winslow House_v243255_AI_190905_Stage 4.doc Version 1.40 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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