Inspection on 22/09/05 for Winton House

This inspection was carried out on 22nd September 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Winton House 28/12/07

Winton House 27/02/07

Winton House 16/02/06

Winton House 15/02/05

Winton House 24/06/04

Winton House 24/02/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Langdale Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Winton House 51 Dedworth Road Windsor Berkshire SL4 5AZ Lead Inspector Susan Burton Unannounced Inspection 22nd September 2005 10:15 X10015.doc Version 1.40 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 Winton House DS0000011281.V249911.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 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. Winton House DS0000011281.V249911.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Winton House Address 51 Dedworth Road Windsor Berkshire SL4 5AZ 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) 01753 856466 Abbeyfield (Maidenhead) Society Limited Post Vacant Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (29) of places Winton House DS0000011281.V249911.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th February 2005 Brief Description of the Service: Winton House is owned and managed by The Abbeyfield (Maidenhead) Society. The management and executive committee responsible for the home are all volunteers. The home is located on the main road one mile west of central Windsor and is purpose built and designed for older people needing care. All rooms are single and en-suite; all have television points and telephone lines. The home has a well-maintained attractive garden and is easily accessible. There is a large dining room, separate lounge, hairdressing room and conservatory. Winton House has a Activity Centre called “Helen Cottage” which provides a unique feature to the home. The cottage has cooking facilities and an active arts and crafts group. The home employs the services of an activity organiser who resources and provides a range of stimulating activities. Winton House DS0000011281.V249911.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection on Thursday 22nd September 2005. The inspection focused on some of the management standards as a requirement had been made from the previous inspection in regard to the registration of the Manager. The home had also been failing to send monthly reports to the Commission for Social Care & Inspection, which is required. The inspection looked at residents pre-admission assessments and their care plans which were found to be generally satisfactory but needed to include more specific detail. The inspector examined the homes medication cabinet and found errors in the management of stock control and balances of some scheduled medication. What the service does well: What has improved since the last inspection? The dining room has been updated and refurbished with new chairs and curtains, and new armchairs are also on order for the rest of the home. The home has invested a significant sum in new high-quality electronic baths to provide a safe and pleasant experience for those requiring assistance with bathing. A new notice board has been placed in the reception/hallway which reminds residents of the date, any events taking place and which staff are on duty. Residents commented on how helpful this was. Winton House DS0000011281.V249911.R01.S.doc Version 5.0 Page 6 Staff also now wear name badges, which assists the residents in knowing who is caring for them and enables visitors to know to whom they are speaking. 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. Winton House DS0000011281.V249911.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Winton House DS0000011281.V249911.R01.S.doc Version 5.0 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 the following standard(s): 2,3 Written contracts are available to residents. The information recorded at an individuals pre-assessment was limited but satisfactory. EVIDENCE: A resident recently admitted to the home had on her file a signed contract/terms and conditions. The individual had exercised her choice to consult with her solicitor over the contract and following the consultation had signed the contract herself. The files of three recent admissions were examined, pre-assessment information was seen in place and included assessments from Social Services Care Managers. The assessment of physical health needs as recommended by standard 3.3 are carried out but in limited detail, the modification of the format would assist staff in the recording of this information. Assessments take place Winton House DS0000011281.V249911.R01.S.doc Version 5.0 Page 9 either in hospital where the Manager or Deputy will visit the ward or during respite stays within the home. The Manager is diligent in ensuring that admissions are within the homes registration criteria. Winton House DS0000011281.V249911.R01.S.doc Version 5.0 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 the following standard(s): 7, 8, 9, The home uses a professional care plan format; which enables clear recording of details. The care plans did not include details of specialist or specific care needs. Nutritional assessments need further development. The records of scheduled medication administration and storage were not satisfactory. EVIDENCE: Care plans were examining and found to be clearly written and easy to read. Staff had recorded detail of aspects of each individuals health and welfare needs. The care plans would benefit from greater detail being recorded in regard to special or specific care needs, (such as those with short term memory loss or dietary issues) with actions required by staff also recorded. Care plans should link to all aspects of need. Nutritional assessments need to be more detailed where individuals are known to have potential problems. This should include regular weights, any Winton House DS0000011281.V249911.R01.S.doc Version 5.0 Page 11 instructions in regard to diet and meal supplements and any risk to skin integrity or other health needs. The inspector examined the contents of the medication cabinets scheduled drugs. The record of medication administration did not reflect the actual stock balance; the records did not have double signatures on some occasions, which is poor practice. Staff had not attempted to resolve or correct issues with stock balances and had therefore left the home at risk should any of these controlled substances have gone missing, there would have been no clear audit trail of how much or where the medication had gone. An immediate requirement was issued requiring the home to account for the medication contained within its cabinets and to ensure that records accurately reflect the balances. Staff were also required to sign and record stock levels at each administration, the home was required to ensure that its medication administration met Royal Pharmaceutical guidelines. The CSCI Pharmacy Inspector was asked to visit the home and follow up the the homes actions to address these errors. Winton House DS0000011281.V249911.R01.S.doc Version 5.0 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 the following standard(s): 13,14,15 Residents in the home are enabled to maintain contact with the local community and visitors were encouraged. Individuals are enabled to exercise choice and control in their lives. The dining room provided a comfortable and pleasant surrounding for the residents. EVIDENCE: A church fellowship meeting took place in the lounge during the inspection; this is a regular feature and is enjoyed by many of the residents. The home maintains links with local churches and also a neighbouring care home where residents visit each others home for lunch. The inspector spoke to one resident in the home who was by his own admission someone who likes his own company, staff respected this but also encouraged the gentleman to socialise occasionally so as not to become isolated. Observation of staff interaction with residents at all levels was sensitive and respectful, staff were obviously very aware of individuals specific social and welfare needs. Winton House DS0000011281.V249911.R01.S.doc Version 5.0 Page 13 A new notice board has been place in the reception/hallway which reminds residents of the date, any events taking place and which staff are on duty. Residents commented on how helpful this was. Staff also wear name badges which assists the residents in knowing who is caring for them and enables visitors to know to whom they are speaking. The inspector sat in on a staff handover, which was professional in its manner and allowed all staff to contribute to the report on each individuals progress and future care needs. The homes kitchen was clean, tidy and well organised. Discussion confirmed that records are kept of what residents have eaten. Soft or puree diets are provided for. The homes dining room had been updated some months ago with new curtains, chairs and carpet, which gave a comfortable and homely feel to the room. A large wipe board is situated outside the dining room which has the days menu written up in large writing which assists residents with any visual loss to be able to read it and also acts as a reminder for all residents of the choices available. Winton House DS0000011281.V249911.R01.S.doc Version 5.0 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 the following standard(s): 16 There had been no complaints entered in the homes records. EVIDENCE: The home has a book for visitors/relatives and residents to write their comments in. This was reviewed during the inspection, no complaints were seen entered. A number of thank you cards and letters were available to see in the book. The homes Manager does not record the minor every day grumbles or complaints if there are any as they are dealt with at the time. Some record of these comments would enable more effective audit of the response taken by the home and provide evidence of feedback from residents about the service on a regular basis (the home does complete an annual satisfaction survey every year) Winton House DS0000011281.V249911.R01.S.doc Version 5.0 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 the following standard(s): 19,26 The home provides a safe, comfortable and well maintained environment for the residents. The laundry is clean and hygienic. EVIDENCE: A tour of the home took place; all areas were seen to be very clean and tidy. The home has a full time maintenance man who ensures that any minor repairs are dealt with on a day-to-day basis. The inspector was advised by the Manager that following a visit form the Water Authorities the home was advised to act to prevent the potential risk of Legionella. Subsequently the management committee have spent £46,000 on 3 new high quality electronic baths that provide a comfortable and safe bathing experience for residents who need assistance. The homes 3 assisted bathrooms were visited and the new equipment demonstrated. The new baths provide not only a bath facility but also Jacuzzi treatments, dispenses special oils for moisturising the skin and when empty a special cleaning operation is run to ensure the bath is clean and hygienic and ready for the next person. Winton House DS0000011281.V249911.R01.S.doc Version 5.0 Page 16 The Manager advised that a quote has been received for new armchairs for the home, which will also be of a good standard. The inspector visited the laundry and spoke to the staff member with responsibility for this area. The laundry was seen to be clean, tidy and well organised. Procedures for the management of soiled or contaminated laundry are posted on the wall; alginate bags are used to ensure there is no transfer of contents on to staff or laundry facilities. The staff were reminded to use an apron or tabard as well as gloves when handling soiled laundry. Winton House DS0000011281.V249911.R01.S.doc Version 5.0 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 The staffing numbers on the day of inspection were appropriate for the needs of the resident. EVIDENCE: On the morning of the inspection the Manager, deputy, two senior care assistants and two care assistants were on duty. The activity officer was also on duty and facilitated the Christian Fellowship meeting. This was seen as an appropriate number of staff for the needs of the residents. Winton House DS0000011281.V249911.R01.S.doc Version 5.0 Page 18 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,37 The Manager of the home is not registered with CSCI. The staff team work effectively together for the benefit of the residents. The senior management arrangements in the home have failed to ensure regulations and requirements have been acted on. EVIDENCE: A requirement from the last inspection that, an application for the registration of the Manager is received by CSCI before 1st April 2005 had not been actioned. This was found to be due to the ill health of the Manager. The organisation had not advised CSCI that she was absent for this period, which is required by regulation or explained that this was the reason the requirement had not been met. Winton House DS0000011281.V249911.R01.S.doc Version 5.0 Page 19 The Care Standards Act 2000 requires the Manager of the home to be registered. The Manager had been promoted at the start of the year and at the last inspection in February she and the Responsible Person were both made aware that she must be registered. The Care Standards Act 2000, Regulation 26, also requires that the provider/Responsible Person visit the home monthly and supply a copy of their report to CSCI. The home has a history of being haphazard with its provision of copies of such visits and reminders have been sent on previous occasions. At this inspection the manager was made aware that a report had been received in January 2005 and another in June 2005 and nothing since. These are both failures under the Act, which must be addressed. Enforcement action will be taken should these failures not be addressed. Winton House DS0000011281.V249911.R01.S.doc Version 5.0 Page 20 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 1 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 x 4 x 4 x x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 3 x x x x 1 x Winton House DS0000011281.V249911.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? yes 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 OP3131 Regulation 31 Requirement An application for the registration of the Manager is recived by CSCI within the timescale. The records of medication adminstration are to be accurate, reflect stock balances and are recorded correctly in line with the recommendations of the Royal Pharmaceticaul Societies guidance. Copies of monthly visits to the home by the Responsible Person/delegated person are to be sent to CSCI regulary The Responsible Person ensures the home has a Registered Manager. Timescale for action 01/04/05 2 OP139 9 22/09/05 3 OP26 OP26 22/09/05 4 OP8 31 31/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Winton House DS0000011281.V249911.R01.S.doc Version 5.0 Page 22 1 8 2 16 Care plans are to detail any specialist need with actions needed by staff. Nutrional assessments are to be further developed to ensure a complete overiew of individual dietary and care needs are recorded. Residents comments and concerns are to be recorded Winton House DS0000011281.V249911.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA 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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