Inspection on 09/08/05 for Winterton House

This inspection was carried out on 9th August 2005.

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

Winterton House 28/10/08

Winterton House 08/01/08

Winterton House 18/09/06

Winterton House 24/01/06

Winterton House 17/02/05

Winterton House 17/08/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Winterton House 5 Epping New Road Buckhurst Hill Essex IG9 5JB Lead Inspector Sandra Parnell-Hopkinson Announced Inspection 09 August 2005 10:00 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. Winterton House G55_S0000025935_Winterton House_V240487_090805_Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Winterton House Address 5 Epping New Road, Buckhurst Hill, Essex IG9 5JB 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) 020 8504 1183 020 8559 0818 Ms Jaya Ramjibhai Hira Ms Jaya Ramjibhai Hira CRH Care Home 8 Category(ies) of OP Old age (8) registration, with number of places Winterton House G55_S0000025935_Winterton House_V240487_090805_Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 17 February 2005 Brief Description of the Service: Winterton House is a care home providing personal care and accommodation for eight older people. All bedrooms are single without en suite, but there are sufficient seperate toilets and bathrooms. Three bedrooms are situated on the ground floor and the remainder on the first floor. As the home does not have a pasenger lift any residents who are accommodated in an upstairs bedroom must be mobile and able to climb the stairs. The large detached house is situated in its own grounds with a large secluded garden. The home has its own transport (mini bus) and designated driver to take residents out. The proprietor is also the registered manager. She holds registered nursing qualifications in both general and mental health nursing. Winterton House G55_S0000025935_Winterton House_V240487_090805_Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was announced and undertaken by an Inspector from the Central Registration Team. The visit was to discuss the registered persons application for a major variation to enable the home to accommodate people living with dementia. The visit commenced at 10am and lasted two hours. Discussion took place with the manager and deputy manager. The Inspector made a tour of the home and spoke to several residents during the visit. What the service does well: 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. Winterton House G55_S0000025935_Winterton House_V240487_090805_Stage 4.doc Version 1.40 Page 6 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 Winterton House G55_S0000025935_Winterton House_V240487_090805_Stage 4.doc Version 1.40 Page 7 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) . None of the standards were looked at during this inspection as the visit was in relation to the application for a variation of registration to enable the home to accommodate people living with dementia. EVIDENCE: Winterton House G55_S0000025935_Winterton House_V240487_090805_Stage 4.doc Version 1.40 Page 8 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) . Standard 7 was looked at during this inspection in relation to the application for variation of registration to enable the home to accommodate people living with dementia. Residents health and personal care needs are set out in individual care plans, but more comprehensive care planning will be required to identify and meet the specialist dementia care needs of residents. EVIDENCE: The quality of care, which is experienced by someone with dementia, can be improved by the way staff use and understand care plans. A comprehensive care plan can only enhance the care experience of a resident living with dementia. Because the label of “dementia” tends to prompt very negative responses, care plans tend to be couched in terms of risk, dependency or disability. The assumption that people with dementia cannot do much leads to dependence on care staff to do tasks that they could actually be doing themselves. It is therefore, essential that comprehensive care plans be compiled, with the assistance of relatives and friends of the resident, to ensure that staff provide the correct level of care. Winterton House G55_S0000025935_Winterton House_V240487_090805_Stage 4.doc Version 1.40 Page 9 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) . Standards 12, and 15 were looked at during this inspection in relation to the application for variation to enable the home to accommodate people living with dementia. There is a varied programme of activities available. More consideration would need to be given to planning activities which are suitable for residents with specialist needs such as dementia to ensure that all residents have a sufficiently stimulating and varied choice of activities. EVIDENCE: There is a general programme of activities for the home, but more consideration would need to be given to the specialist needs of people living with dementia. For instance more individual activities focusing on the individual’s needs and cognitive functioning, and adapting activities to relate to the individual’s likes and dislikes, past and present. The meals in the home are well presented and there is always a choice of meal. Residents with dementia may benefit from the use of, for example picture menus, finger foods, small nutritious snacks and more flexible eating times to maintain independence, exercise choice around food and eating and still be provided with a health balanced diet. Winterton House G55_S0000025935_Winterton House_V240487_090805_Stage 4.doc Version 1.40 Page 10 One resident living in the home is of the Muslim faith and has very little contact with family and friends. She can communicate in English but fortunately the proprietor/ registered manager is able to communicate with this lady in her native language. Though the manager reports that this lady has settled well in the home, I would recommend that the manager discuss with her the possibility of visiting a mosque, where perhaps she could become involved in a women’s group. Or alternatively, someone from a local mosque could visit her at Winterton House. Winterton House G55_S0000025935_Winterton House_V240487_090805_Stage 4.doc Version 1.40 Page 11 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) . Standard 16 was looked at during this inspection in relation to the application for variation of registration to enable the home to accommodate people living with dementia. The manager and staff make every effort to sort out any problems or concerns and makes sure that residents and their relatives feel confident that their complaints and concerns are listened to and will be acted upon. However, the complaint policy and procedure will need to be produced in an additional format that is appropriate for people living with dementia. EVIDENCE: The home has a written complaints policy and procedure and records the nature of the complaint, details of investigation, any action taken and the outcome for the complainant. The complaints policy would need to be produced in an alternative format so that it is more appropriate and easily accessible and understood by people living with dementia. Winterton House G55_S0000025935_Winterton House_V240487_090805_Stage 4.doc Version 1.40 Page 12 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) . Standard 19 was looked at during this inspection in relation to the application for variation of registration to enable the home to accommodate people living with dementia. Generally the standard of the environment within the home provides residents with an attractive, safe and comfortable place in which to live. However, the environment would need to be improved to meet the specialist needs of people living with dementia. EVIDENCE: The standard of the décor, furnishings and fittings are generally being maintained to a good standard. Since the last inspection all communal areas of the home have been re-decorated and the kitchen has been completely refurbished. There is an ongoing programme of refurbishment and redecoration for the home. The kitchen is small and domestic in style and residents are currently encouraged to engage in food preparation and small domestic tasks, for example peeling vegetables or making a cup of tea, to enable them to retain a degree of independence whilst living in a care home. Winterton House G55_S0000025935_Winterton House_V240487_090805_Stage 4.doc Version 1.40 Page 13 As the ability of people with dementia to communicate with words decreases, the use of non-verbal cues and the environment is important in enabling them to cope better with daily life. The general environment will need to reflect good practice guidance on dementia care within care homes and a copy of the Commission’s “Dementia Care Within Care Homes Guidance” was given to the manager. Consideration will need to be given to utilising the existing design and layout of the home to meet the specialist needs of people living with dementia. For example, through the use of visual cues such as colour and signage. The rear garden must be tidied and debris removed. Brighter lighting must be provided in the corridors and more effective use of the dining room so that this could be used as a small lounge from time to time. The home must consult with the fire safety officer to discuss the following issues: • The two fire exits, which are currently not alarmed. • The rear garden to be made secure so that residents cannot wander into the front of the home and then into the main road. The securing of a fence on one side of the house and a gate at the other side. Full discussion must take place with the fire safety officer since the enclosure of the rear garden may affect fire evacuation. Winterton House G55_S0000025935_Winterton House_V240487_090805_Stage 4.doc Version 1.40 Page 14 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) . Standards 27 and 30 were looked at during this inspection in relation to the application for variation of registration to enable the home to accommodate people living with dementia. Current staffing levels are satisfactory and there are sufficient staff on duty to meet the individual assessed needs of the residents. However, night staffing arrangements will need to be reviewed if the variation for dementia is agreed. The care staff are not currently sufficiently trained or skilled to understand and effectively meet the needs of people living with dementia. EVIDENCE: If the variation for dementia is agreed the registered manager must review night staffing levels from one sleeping and one waking night staff, to two waking night staff. The registered manager holds a registered nursing qualification in mental health nursing and the deputy has undertaken adequate and appropriate training in dementia care. All other staff will need to undertake comprehensive training in caring for people living with dementia. It is recommended that at least a three-day course for care staff, and a one-day awareness course for other staff. Winterton House G55_S0000025935_Winterton House_V240487_090805_Stage 4.doc Version 1.40 Page 15 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) . Standards 31 and 32 were looked at during this inspection in relation to the application for variation of registration to enable the home to accommodate people living with dementia. The manager of the home is a well qualified and experienced person and residents benefit as the home is run in their best interests. EVIDENCE: The proprietor is also the registered manager. She is a registered nurse with qualifications in both general and mental health nursing. She has the relevant clinical and management qualifications and a good understanding of the care needs of people living with dementia. Winterton House G55_S0000025935_Winterton House_V240487_090805_Stage 4.doc Version 1.40 Page 16 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 x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 2 COMPLAINTS AND PROTECTION 2 x x x x x x x STAFFING Standard No Score 27 2 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x x 3 3 x x x x x x Winterton House G55_S0000025935_Winterton House_V240487_090805_Stage 4.doc Version 1.40 Page 17 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 Regulation Requirement It should be noted that this inspection was in relation to the application for variation of registration to enable the home to accommodate people living with dementia. Therefore all requirements made in this report need only apply, if the variation for dementia is agreed. More comprehensive care planing is required to ensure that staff identify and meet the specialist care needs of residents with dementia. The home must provide a more varied programme of activities for those residents with a specilialist need such as dementia. Menus must be provided in an appropriate format for people living with dementia. The complaints policy and procedure needs to be produced in an alternative format so that it is more appropriate, and easily accessible and understood by people living with dementia. The exisiting layout and design of the environment in the home must reflect good practice Timescale for action 2. 7 15 30/11/05 3. 12 16 30/11/05 4. 5. 15 16 12(3) & 16(2) (i) 22 30/11/05 30/11/05 6. 19 23 30/11/05 Winterton House G55_S0000025935_Winterton House_V240487_090805_Stage 4.doc Version 1.40 Page 18 7. 19 23 (4) 8. 9. 27 30 18 18 guidance on dementia care within care homes, to ensure that the specialist needs of people living with dementia are adequately met. The registered provider must consult with the fire safety officer to discuss the issues raised in this report relating to fire exits and fire evacuation. Night staffing levels must be reviewed. All staff staff working in the home must receive comprehensive and certificated training in caring for people living with dementia. 30/11/05 30/11/05 30/11/05 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 12 Good Practice Recommendations It is a recommendation that the manager discuss and make suitable arrangements, if requested to do so, for the resident of the Muslim faith to visit a mosque or make contact with a Muslim womens group in the local area. Winterton House G55_S0000025935_Winterton House_V240487_090805_Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Ferguson House 113 Cranbrook Road Ilford Essex IG1 4PU 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. 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