Inspection on 27/08/08 for Wintofts Residential Home

This inspection was carried out on 27th August 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Wintofts Residential Home 31/05/07

Wintofts Residential Home 29/11/06

Wintofts Residential Home 22/02/06

Wintofts Residential Home 27/09/05

Wintofts Residential Home 17/02/05

Wintofts Residential Home 12/08/04

Wintofts Residential Home 06/03/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

Abbey The

Grayling

Pennine Camphill

Snydale Care Home

Muston Road (70)

Extracts from inspection reports are licensed from CQC, this page was updated on 20/03/2009.

CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 Wintofts Residential Home Wintofts Farm Lendales Lane Pickering North Yorkshire YO18 8ED Lead Inspector Ray Burton Unannounced Inspection 27th August 2008 10:00 Wintofts Residential Home DS0000007831.V371800.R01.S.doc Version 5.2 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 Wintofts Residential Home DS0000007831.V371800.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People and 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. Wintofts Residential Home DS0000007831.V371800.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wintofts Residential Home Address Wintofts Farm Lendales Lane Pickering North Yorkshire YO18 8ED 01751 4752333 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) Mrs Sylvia Rosalind Robson Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (6), Old age, not falling within of places any other category (4) Wintofts Residential Home DS0000007831.V371800.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Service Users to include up to 6 LD, up to 6 LD (E) and up to 4 OP up to a maximum of 6 Service Users. The National Care Standards Commission must be consulted in advance of the admission of any new service user. No emergency placements may be accepted. No service user who is not independently mobile may be accommodated above ground floor level. 31st May 2007 Date of last inspection Brief Description of the Service: Wintofts Farm offers personal care and accommodation to a maximum of six people who can be accommodated by virtue of a learning disability or old age and infirmity. Communal and bedroom accommodation is provided in part of the adapted farm buildings. The registered provider and her family occupy other parts of the premises. The home is on two floors with bedrooms and facilities on both floors. Sitting and dining space is on the ground floor. The registered provider and her staff provide personal care, catering, laundry and domestic services. As the home’s location is secluded, being over two miles down a narrow lane, access to any outside facilities depend on the provision of private transport as there is no public service to and from the home. The registered provider has a motor vehicle for use by people living at the home. The home is owned and managed by Mrs Sylvia Robson. Information is given to new and existing service users to the home detailing the accommodation, facilities and services provided. The basic weekly fee quoted by the provider is £345.00 per week with additional charges for one to one support, private chiropody and hairdressing, some holidays, some transport costs and some toiletries. Wintofts Residential Home DS0000007831.V371800.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 0 star. This means the people who use this service experience poor quality outcomes. This is a report of an unannounced inspection covering all of the key standards of the National Minimum Standards for younger adults and older people. It commenced on 27th August and was completed on 11th September 2008. A second inspector accompanied the lead inspector for part of the inspection. What the service does well: What has improved since the last inspection? What they could do better: The management of the home is poor; this has resulted in a service that does not adequately meet the needs of the people living there. The environment is poor and the home is in need of major refurbishment to bring it up to an acceptable standard. General administration and record keeping, particularly in the area of care planning, must be improved so that the needs of people living in the home are properly assessed and suitable strategies put in place to ensure their safety and wellbeing. There is an over-use of convenience foods such as frozen ready meals; there is little evidence of fresh food being prepared or that people are offered a balanced and nutritious diet. Wintofts Residential Home DS0000007831.V371800.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Wintofts Residential Home DS0000007831.V371800.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Outcomes Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) Wintofts Residential Home DS0000007831.V371800.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 People who use this service experience good quality outcomes in this area. The homes assessment procedure ensured no one would be admitted to the home unless his/her needs could be met. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: There have not been any admissions to the home since the last inspection however the manager said that following receipt of a referral for admission she would visit the prospective resident in his/her own home or hospital so that an assessment could be carried out and to determine if the home would be able to meet the persons needs. If the referral were made by a social services Wintofts Residential Home DS0000007831.V371800.R01.S.doc Version 5.2 Page 9 department the application would be accompanied by an assessment from a care manager. Prior to admission the prospective resident would be invited to visit Wintofts either for a short visit or for a holiday. Following admission there would be a trial period during which time the new resident could decide if he/she wished to remain at the home. The home does not offer intermediate care therefore Standard 6 of the National Minimum Standards for Care Homes for Older People does not apply. Wintofts Residential Home DS0000007831.V371800.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14 and 33 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 People who use this service experience poor quality outcomes in this area. Care plans were poorly organised with little evidence of adequate assessments or reviews being conducted. Risk assessments were inadequate, out of date and did not show how identified risk would be managed. We have made this judgement using a range of evidence, including a visit to the service judgement has been made using available evidence including a visit to this service. Wintofts Residential Home DS0000007831.V371800.R01.S.doc Version 5.2 Page 11 EVIDENCE: The personal files belonging to the four people currently living in the home were examined. The files were poorly organised with little sense of order; documents were stored loosely making it difficult to locate information. Care plans were very basic with little background information or evidence that proper assessments of need had been carried out. There was no evidence that regular reviews were conducted by the home to identify changing needs and to monitor the progress of the people living there. The manager told the inspector of episodes of challenging behaviour, however these did not appear to be recorded nor were there clear instructions for staff to follow when such episodes occurred. The manager recognises the right of the people living in the home to take control of their lives and encourages them to make decisions and choices however there was no evidence that this was within the context of a proper assessment process. Some risk assessments had been conducted but these were by-and-large out of date and did not contain risk management strategies showing the action taken to eliminate or minimise identified risks, for example one service user is taken each morning into town and collected each evening; she also has regular holidays by herself in various parts of the country. It is of particular concern that the provider has given her a key to a partly furnished cottage in the town and that the service user spends substantial periods of time alone in this property. There is no evidence that personal or environmental risk assessments have been carried out or that risk management strategies have been developed to ensure the safety of the service user whilst taking part in these activities. Wintofts Residential Home DS0000007831.V371800.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. 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. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. 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. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. 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. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers Standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Wintofts Residential Home DS0000007831.V371800.R01.S.doc Version 5.2 Page 13 11, 12, 13, 14, 15, 16, 17 People who use this service experience poor quality outcomes in this area. Not all of the people living in the home are presented with opportunities to lead a full and stimulating life. There was little evidence that people living in the home were offered a balanced and nutritious diet. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: Conversation with the manager, a member of staff and examination of records revealed three of the four residents engage in regular and appropriate daytime activities either in-house or in the community e.g. shopping, visiting cafes, attending day care services, part-time voluntary work in a charity shop, church activities and day trips to places of local interest. It is of some concern however that the fourth person appears not to engage in activities either on a one to one basis with a member of staff or with the other people living in the home, but seems to spend most of her time sitting alone in her room. Members of staff who serve her meals and attend to her personal needs visit her but there is no evidence of interaction with the other residents living in the home or that she is involved in any form of meaningful activity. The manager stated that this person did not often leave the home, as she does not like travelling in the car. It is very important that all of the service users are involved at an appropriate level in the daily activities of the home, are presented with opportunities to mix with other people and are encouraged and supported to engage in suitable social activities. The manager must, as a matter of priority, encourage and enable the fourth resident to lead a more stimulating and fulfilling life. Conversation with the manager and examination of records showing what food people had eaten indicated an over-use of convenience foods such as frozen ready meals. The main meal each day appeared to be taken in cafes. There was little evidence of fresh food being prepared and individual and nutritional needs did not appear to be taken into consideration. Wintofts Residential Home DS0000007831.V371800.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) 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. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20, People using this service experience poor quality outcomes in this area. The home does not ensure that all of the people living in the home receive appropriate healthcare and personal support to ensure their safety and wellbeing. We have made this judgement using a range of evidence, including a visit to the service. Wintofts Residential Home DS0000007831.V371800.R01.S.doc Version 5.2 Page 15 EVIDENCE: Because of the haphazard way of filing information in service users files and the lack of adequate assessments it is difficult to ascertain from records if the healthcare needs of people living in the home are being fully met. Observation and conversation with the manager however indicated shortcomings in this area. When discussing the needs of one service user the manager said this person would not “allow anyone near her” as a result her finger and toenails had not been cut since her admission to the home; the manager also stated the doctor was not able to carry out a proper examination of the person. This person occupies a ground floor bedroom, which, because of the layout of the building, is separated from the rest of the home by the manager’s personal accommodation. In order to access the room the inspectors had to exit the building, walk around the outside and enter the bedroom via a patio door. As the occupant of the room is visually impaired and dependent on others to guide her to wherever she wishes to go there is a danger that she could become socially isolated. It was observed that she was wearing a torn dress and was sitting on a sagging chair with a cushion that was covered with a black bin liner. This is unacceptable practice; it is undignified and does not meet care needs. The manager must consult with a continence advisor to ensure this person receives appropriate advice and support. It is of the utmost importance that the manager ensures the social, emotional and physical needs of this person are fully met and that she consults with healthcare professionals so that proper medical treatment is obtained. Currently only one person living in the home requires assistance to take medication. Medicines are stored in a wall mounted metal cupboard that, although tiny, is adequate for the small amount of medication currently held. The manager stated she was the only member of staff to give out medication. One service user is responsible for handling her own medication. It is of some concern that risk assessments have not been conducted to ascertain the person’s competency to safely keep and administer her medication. It is also of concern that a record of the person’s medicines is not kept in the home and that the manager cannot, with any certainty, state what medicines have been prescribed, what medicines are stored in the home or if the medicines are actually being taken. The manager said she had not seen the medication but had been told by the person’s care manager what had been prescribed for the service user. When asked about storage facilities the inspectors were told the service user keeps the medication in her handbag; it is important that suitable and secure storage facilities are provided in service users bedrooms for those people wishing to look after their own medicines. Wintofts Residential Home DS0000007831.V371800.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16-18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are safeguarded. (OP NMS 35) The Commission considers Standards 22-23 (Adults 18-65) and Standards 16-18 and 35 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 People who use this service experience poor quality outcomes in this area. Complaints are not managed effectively. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: The home has policies and procedures informing the people living in the home how to complain if they are dissatisfied about the care they receive. Policies are also in place to safeguard residents and to protect them from abuse. Examination of a service users file revealed the service user had made two written complaints about a lack of hot water for bathing. When the inspectors tested the water temperature it was found to be insufficiently warm for bathing also the pressure was extremely low resulting in the water leaving the tap at a mere trickle. The manager said it took about twenty minutes to fill the bath It is of concern that this complaint was not dealt with effectively and that there is still an insufficient supply of hot water. Wintofts Residential Home DS0000007831.V371800.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 People who use this service experience poor quality outcomes in this area. The physical environment does not meet the needs of the people living in the home. We have made this judgement using a range of evidence, including a visit to the service. Wintofts Residential Home DS0000007831.V371800.R01.S.doc Version 5.2 Page 18 EVIDENCE: The accommodation for service users is provided on ground and first floor levels in parts of the farmhouse and adjoining adapted outbuildings. The manager and her husband occupy the remainder of the building. The layout of the building makes moving from one room to another difficult, as it is sometimes necessary to go outside to avoid passing through the owner’s private accommodation. To conduct the inspection the inspectors were, on several occasions, required to go outside and walk around the building to another entrance. During the inspection two service users accessed the lounge through a door leading directly into an adjoining barn. The barn has an uneven floor and is filled with old furniture, machinery as well as straw and the oil storage tank; when questioned about this the manager stated service users only used the barn as means of accessing the house if accompanied by a member of staff and only during bad weather when, she said, it was safer to use the barn as leaves made the pathways slippery. It was observed that the door was unlocked and people living in the home could easily have accessed the barn at any time (since the inspection the manager has told us the door has been permanently locked). A walk around the building revealed it to be free from unpleasant odours and reasonably well maintained although the home is in need of complete refurbishment to bring it up to an acceptable standard. The following areas of concern were noted: • • The temperature and the pressure of the hot water supply is inadequate in some parts of the house – the manager said that it takes about 20 minutes to fill the upstairs bath. The en-suite facility in the downstairs bedroom has various pieces of polystyrene packaging secured to the wash hand basin and doorframe; when questioned about this the manager stated it was to stop the occupant of the room banging her head. Risk assessments must be conducted to ascertain if the service user is at risk and, if so, more appropriate measures must be taken to eliminate the risk. Bottles of bleach and cleaning fluid were left unattended in bathrooms; these must be removed and stored appropriately and safely. A number of first floor windows did not have devices fitted to restrict the opening (since the inspection the manager has told us that restrictors have been fitted to these windows. The second lounge area was cold and smelled of damp. Radiators were guarded but some of the guards were not properly secured. • • • • Wintofts Residential Home DS0000007831.V371800.R01.S.doc Version 5.2 Page 19 • • • The kitchen area is cramped and untidy and is situated at the end of a room that is part of the manager’s accommodation. Access is via an external door or through the manager’s private lounge. Furniture is old and worn. The home is very cluttered and untidy. Wintofts Residential Home DS0000007831.V371800.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 32, 34 and 35 (Adults 18-65) and Standards 27, 28, 29 and 30 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 34, 35. People who use this service experience good quality outcomes in this area. There is a suitable recruitment and selection procedure and staff are employed in sufficient numbers to meet the needs of the people living in the home. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: On the days of the inspection there were sufficient members of staff on duty to meet the needs of the service users remaining in the home. Examination of staffing rosters and conversation with the manager and a member of staff revealed the manager, who lived on the premises, was on duty most of the Wintofts Residential Home DS0000007831.V371800.R01.S.doc Version 5.2 Page 21 time with additional staff being used to cover peak times and to provide activities both inside and outside of the home. Whilst the present staffing levels appear to be sufficient to meet the needs of the four people currently living in the home these must be reviewed should the present occupancy increase. Only two members of staff are employed at the home, both have received mandatory training and one is the holder of the NVQ level 2 in care. Examination of personnel files showed both members of staff had not started their employment at the home until a Criminal Records Bureau (CRB) check had been completed and two suitable references received. Wintofts Residential Home DS0000007831.V371800.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. 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. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) 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 homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 37, 39 and 42 (Adults 18-65) and Standards 31, 33, 35 and 38 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Wintofts Residential Home DS0000007831.V371800.R01.S.doc Version 5.2 Page 23 37, 39, 41, 42 People who use this service experience poor quality outcomes in this area. The home has inadequate management systems in place to ensure the safety and wellbeing of people living in the home. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: The manager has the necessary qualifications in management and care and has many years experience of working with people with learning disabilities. The people living in the home had been given a satisfaction questionnaire to complete however this was approximately two years ago; there was no evidence of any other form of quality assurance mechanism to measure whether or not the needs of people living in the home were being met and whether they were satisfied with the service. Examination of records revealed improvement and development is needed to ensure the safety and wellbeing of the people living in the home, particularly with regard to care planning and the assessment and management of risk. The manager must ensure that personal and environmental risk assessments are conducted, are regularly updated and any required action taken to ensure the safety and comfort of the people living in the home. Wintofts Residential Home DS0000007831.V371800.R01.S.doc Version 5.2 Page 24 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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 1 23 3 ENVIRONMENT Standard No Score 24 1 25 X 26 X 27 1 28 2 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT Standard No Score 37 2 38 X 39 2 40 1 41 1 42 1 43 X 1 1 X 1 X LIFESTYLES Standard No Score 11 1 12 1 13 1 14 1 15 1 16 1 17 1 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Wintofts Residential Home Score 1 1 2 X DS0000007831.V371800.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA6 Regulation 15 Requirement Timescale for action 01/12/08 2 YA11 12 3 YA17 16(2)(i) 4 YA19 12 & 13 Care plans must be improved so that each person living in the home has a plan of care based on thorough assessments documenting needs and showing how those needs can be safely and appropriately met. Regular reviews must be held and recorded so that changing needs are recognised and appropriate action taken. The registered person must 01/11/08 ensure all persons living in the home are presented with opportunities to mix with other people and are encouraged and supported to engage in suitable activities. The registered person must 01/11/08 promote service user’s health and wellbeing by ensuring the supply of nutritious, varied, balanced and attractively presented meals. The registered person must 01/11/08 ensure the healthcare needs of all persons living in the home are properly assessed and met by appropriate healthcare professionals. DS0000007831.V371800.R01.S.doc Version 5.2 Page 26 Wintofts Residential Home 5 YA20 13(2) 6 YA24 23 The registered person must ensure the health and safety of the person responsible for handling her own medication: by conducting an assessment to ascertain if the person is competent to keep and administer her own medication; by maintaining a record of her current medication; by providing a lockable space in which the medicines are stored. To ensure the home provides a comfortable, pleasant and safe environment for the people who live there the registered person must: • Conduct risk assessments and develop risk management strategies to ensure all bedrooms and communal areas are safe and comfortable. • Ensure an adequate supply of hot water in all parts of the house. • Ensure all bedrooms and communal areas are warm enough for the people living in the home. • Ensure all cleaning fluids and other potentially dangerous materials are stored in a locked cupboard. • Ensure all upper floor windows are fitted with suitable devices to restrict the opening. • Ensure all radiator guards are properly secured. • Consider ways of making communal areas more accessible. The registered person must ensure that comprehensive and DS0000007831.V371800.R01.S.doc 01/11/08 01/12/08 7 YA9 13(4) Wintofts Residential Home Version 5.2 Page 27 detailed personal and environmental risk assessments are conducted and that suitable risk management strategies are put in place to eliminate or minimise identified risk. 01/12/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Wintofts Residential Home DS0000007831.V371800.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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. Wintofts Residential Home DS0000007831.V371800.R01.S.doc Version 5.2 Page 29 - 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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