Inspection on 22/05/06 for Wisden Court

This inspection was carried out on 22nd May 2006.

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

Wisden Court 18/04/07

Wisden Court 30/11/05

Wisden Court 09/08/05

Wisden Court 29/10/04

Wisden Court 25/05/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Wisden Court Wisden Road Stevenage Hertfordshire SG1 5JD Lead Inspector Mrs Sheila Knopp Unannounced Inspection 22nd May 2006 10:00 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 Wisden Court DS0000019625.V296294.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. 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. Wisden Court DS0000019625.V296294.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wisden Court Address Wisden Road Stevenage Hertfordshire SG1 5JD 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) 01438 354933 01438 369199 runwoodhomes.co.uk Runwood Homes Plc Festus Awogboro Care Home 45 Category(ies) of Dementia - over 65 years of age (45), Old age, registration, with number not falling within any other category (45), of places Physical disability over 65 years of age (45) Wisden Court DS0000019625.V296294.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home may accommodate 45 people with old age or dementia (associated with old age) or physical disability (associated with old age). 30th November 2005 Date of last inspection Brief Description of the Service: Wisden Court is a purpose-built single storey building on a large site about a mile and a half from Stevenage town centre. The home is owned and operated by Runwood Homes PLC. The building is divided into five residential units and a day centre. One unit accommodates service users with dementia and the remaining four accommodate elderly people, some of whom may have physical disabilities. There are 36 long-stay and 9 short-stay single bedrooms with en suite facilities. One unit is used to accommodate service users for short stays or respite care. Each unit is self-contained, with its own lounge and dining room. There is also a central activities area that is used for communal entertainment. Ancillary rooms comprise a kitchen, laundry room, and storage areas. Externally, there are three enclosed courtyard gardens with garden furniture and surrounding grounds. The inspection report is available on request from the manager and a copy is displayed in the home. The current fees for the service provided at Wisden Court range from £549 £575 per week subject to an assessment of needs (confirmed as correct on 30.5.06). Wisden Court DS0000019625.V296294.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is based on an unannounced visit to the home by one inspector who spent a total of 7 hours in the home. The report includes information provided by service users (7), a visitor and staff (7). Four care plans were reviewed following discussions with the service user and staff. Information received about the home since the last inspection in November 2005 has also been reviewed and included in this report. No concerns about this service have been brought to the attention of the Commission between inspections. What the service does well: What has improved since the last inspection? The care plans had been regularly updated and reviewed to ensure that staff follow the agreed plan of care. There is a good range of activities on offer. Service users are able to give their views on the running of the home and contribute ideas to how they would like to spend their time. The activity Wisden Court DS0000019625.V296294.R01.S.doc Version 5.2 Page 6 programme is now displayed in a colourful pictorial format to raise awareness of what is on offer to service users. A new menu is being introduced providing service users with a greater variety of choices at each meal. 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. Wisden Court DS0000019625.V296294.R01.S.doc Version 5.2 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 Wisden Court DS0000019625.V296294.R01.S.doc Version 5.2 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): 3 (standard 6 does not apply to this service) Quality in this outcome area is assessed as good. This judgement has been made using available evidence including a visit to this service. Information is available to prospective service users and their relatives to enable them to make an informed choice about the services provided at Wisden Court. Thorough assessments are carried out by senior staff to ensure that they are able to meet the needs of individuals being admitted to Wisden Court. EVIDENCE: Up to date information about the home is made available to service users and their relatives. There was clear evidence that a thorough assessment process is carried out by a senior staff member before individuals come to stay at the home. As well as meeting the prospective service user and their relatives information is obtained from other health & social care professionals. Wisden Court DS0000019625.V296294.R01.S.doc Version 5.2 Page 9 The information gathered is used to make a judgment on the suitability of the home for that individual and to put a plan of care in place. Senior staff also visit service users who have been admitted to hospital to carry out a further assessment to ensure that their needs can continue to be met on return to Wisden Court and arrangements made to provide any additional equipment required to support them. Wisden Court DS0000019625.V296294.R01.S.doc Version 5.2 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 & 10 Quality in this outcome area is assessed as good. This judgement has been made using available evidence including a visit to this service. Service users receive a good quality of care from staff in a manner, which supports their privacy and dignity. The changing needs of service users is kept under review and specialist advice and support from community health care workers and general practitioners is obtained where required. EVIDENCE: Four care plans were reviewed following discussions with the service users. This confirmed that service users and their representatives are involved in developing a plan of care, which supports their health needs. The care plans had been regularly reviewed by staff to identify if any changes in the way support provided were required and signed by the service user or their representative. They reflected what service users had told the inspector about their care needs and preferences. Individual risk assessments had been recorded and reviewed meeting a requirement from the last inspection. Wisden Court DS0000019625.V296294.R01.S.doc Version 5.2 Page 11 The care plans demonstrated that instructions given by the community nurses had been acted upon and service users had access to chiropodists, dentists and opticians. The systems for ordering, storing, administering and disposing of medication were reviewed. Regular medication reviews and audits are carried out. Staff are provided with information on the medicines that they are giving out so that they are aware of the effects they may have. The stock levels of medicines reviewed matched the records indicating that an accurate account of medication administered to service users is maintained. Staff confirmed that medicines were regularly reviewed by the services users general practitioner. Wisden Court DS0000019625.V296294.R01.S.doc Version 5.2 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): 12, 13, 14 & 15 Quality in this outcome area is assessed as good. This judgement has been made using available evidence including a visit to this service. Service users are involved in planning the activities that take place in the home and are able to contribute their views on how the home is run. Service users confirmed they enjoyed their meals and the kitchen was found to be well managed. EVIDENCE: The activity organiser has continued to develop the range of individual and group activities and events on offer to service users. There are opportunities for service users to express their views. As well as coffee mornings and individual room visits there are monthly service user meetings and family meetings every three months. Minutes of the meetings were available and demonstrated that the views of service users are considered. Service users were occupying themselves in various ways during the morning of the inspection. Staff were encouraging and gentle in their approach. Contact with family and friends are maintained. Special occasions such as birthdays and anniversaries are celebrated. Wisden Court DS0000019625.V296294.R01.S.doc Version 5.2 Page 13 Arrangements are made for individuals to follow their religious and cultural beliefs and maintain community links. Service users had been able to personalise their rooms with familiar furnishings and possessions. All the service users spoke with were positive about the meals they are served. This included 2 people receiving respite care. A new 4-week menu was about to be introduced providing a wider choice of options at each meal. The manager has plans to review how this has been received by service users and involve the cook in discussions with them to identify any adjustments needed. It was reported that the new menu has been nutritionally assessed by a dietician to ensure it meets the needs of older service users. In line with the general upgrading required within the home the manager needs ensure that service users have matching crockery and plate guards / plates with a raised rim are generally available for those who require assistance. There were no requirements or recommendations made following a recent visit by the Environmental Health department on 7.5.06 which indicates the kitchen is well managed in line with current food safety legislation. Wisden Court DS0000019625.V296294.R01.S.doc Version 5.2 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 & 18 Quality in this outcome area is assessed as good. This judgement has been made using available evidence including a visit to this service. There is a positive approach to addressing any issues brought to the attention of the management team. Staff receive training supported by the policies and procedures in place to protect service users. EVIDENCE: A visitor confirmed that issues brought to the attention of the manager are addressed in a positive manner and a good response provided. Information on the home’s complaint procedure is displayed around the home. Regular reviews with service users and their relatives are recorded. Staff receive protection of vulnerable adult training and feel there is an open management approach, which would enable them to raise any concerns. Copies of the Hertfordshire multi-agency procedure to protect service users was available. No concerns have been brought directly to the Commission between inspections. Wisden Court DS0000019625.V296294.R01.S.doc Version 5.2 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 Quality in this outcome area is assessed as poor as both standards assessed have not been fully met. This judgement has been made using available evidence including a visit to this service. A programme of redecoration and replacement of carpets, curtains and furniture has commenced with the redecoration of the lounges and corridors. Progress to date has been slow with no identified dates for completion. This means service users are still living in an environment with worn stained carpets and furniture, which does not support their dignity. A further requirement has been made. Standard 26 was not fully met as a review of staff hand washing facilities is required to reduce the risk of infection. Service users are provided with a good standard of freshly laundered clothing and linen. Wisden Court DS0000019625.V296294.R01.S.doc Version 5.2 Page 16 EVIDENCE: Some areas of the home have been redecorated since the last inspection. Runwood Homes now need to make funds available to bring the furniture, soft furnishings, carpets and curtains up to an acceptable standard. As the needs of service users being admitted to the home increases liquid soap and disposable hand towels are required in all areas where staff carry out personal care, in line with Department of Health guidance, to reduce the risk of infection. Wisden Court DS0000019625.V296294.R01.S.doc Version 5.2 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, 28, 29 & 30 Quality in this outcome area is assessed as adequate as 50 of the standards reviewed were not fully met on this occasion. This judgement has been made using available evidence including a visit to this service. The needs of the current service users were being met in a timely, calm manner by experienced staff who are familiar with their needs. Agency staff are not currently used and there is a low staff turnover. There are systems in place to keep staffing levels under review and make adjustments where required. Staff spoke to the inspector about the difficulties of the current staffing levels when unforeseen problems arise and there is only one member of staff on each unit. There are appropriate procedures in place to recruit staff but these need to be followed on all occasions to ensure that service users are protected and the work history of prospective staff fully explored (standard 29) The quality of care provided is supported by a commitment to staff training and an induction programme for new staff. However the number of staff with NVQ 2 qualifications has not yet reached the 50 level set under standard 28. A requirement has not been made as there is a plan in place to achieve this target. Wisden Court DS0000019625.V296294.R01.S.doc Version 5.2 Page 18 EVIDENCE: Discussions with service users, staff and a visitor confirmed there was a consistent approach among the staff team to meeting the needs of service users. This is supported by the training in care practices that staff receive. The manager reported he is currently reviewing the dependency of the service users with a view to discussing the implications for staffing levels with the funding authority. To meet a requirement made following the last inspection this area must be kept under review. It would be helpful if the Commission were notified of the outcome of the current review. Staffing and management support on the day of inspection was adequate. The care team managers and staff identified that staffing becomes an issue when unforeseen circumstances arise. Additional staff can be provided for example to sit with a frail service user once these needs are identified. Three out of four staff files reviewed provided evidence of a robust recruitment process. Appropriate references had been obtained and Criminal Records Bureau checks had been received. However on one application the worker had not provided a work history therefore their last employer, who was a care home provider was not approached for a reference. Details of the induction programme for new staff were see. Four care staff out currently have qualifications at NVQ level 2 with a further 8 staff completing the course and 7 places due to be offered. Wisden Court DS0000019625.V296294.R01.S.doc Version 5.2 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 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, 33, 35, 36 & 38 Quality in this outcome area is assessed as good. This judgement has been made using available evidence including a visit to this service. Wisden Court was found to be well managed with an open culture in which staff said they could raise any concerns with the management team. The manager is on his way to achieving both the required qualifications detailed under standard 31. There are systems in place for reviewing and auditing the quality of the service provided that includes obtaining the views of service users, relatives and other interested parties. There are systems in place that safeguard the financial interests of service users while enabling them to have access to their personal allowances for day to day expenditure. Staff confirmed they receive regular supervision from senior staff. Wisden Court DS0000019625.V296294.R01.S.doc Version 5.2 Page 20 The health & safety of service users and staff is maintained by the company health & safety policies and staff training. EVIDENCE: The current manager reported he has completed the NVQ 4 in care and is making progress with the Registered Managers award (RMA). To fully meet standard 31 a management qualification is required as well as an NVQ 4 in care. Feedback from service users and relatives is obtained as part of the company’s quality audit. Records of relatives and service user meetings were available. Monthly reports of unannounced visits by a representative of the company are forwarded to the Commission. The financial procedures preclude staff from involvement with service users finances but there are systems in place to enable small amounts of money for personal use to be deposited. This system is audited by the company and records and receipts of transactions maintained. The records checked tallied with the amount of money held. Staff confirmed they receive regular supervision and this was supported by a supervision schedule. Statutory training including health & safety and moving and handling is provided. Accidents are recorded and reported to the Commission. Risk assessments are in place to support safe working practices. The service records examined demonstrated that the required checks are carried out. The hot water temperatures were within the required safety limits. A current insurance certificate was on display. Overall the health & safety systems were assessed as good. One cleaning agent needed to be put away in a locked cupboard and the manager has since advised that regular checks will be put in place to ensure staff put items such as this away after each shift. Wisden Court DS0000019625.V296294.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x x x 2 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x 3 x x 3 Wisden Court DS0000019625.V296294.R01.S.doc Version 5.2 Page 22 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 OP19 Regulation 23(2) Requirement A plan of the redecoration, replacement of carpets, curtains and furniture as identified to bring the home up to an acceptable standard within a reasonable timescale must be sent to the CSCI. Brought forward from 30.11.06. A further plan with completion dates is required. Provide liquid soap and disposable paper hand-towels in all areas staff provide personal care to service users in accordance with Department of Health Guidance. Advice can be obtained from the local Health Protection Agency. A full employment history is required so that any gaps can be explored and references obtained from the previous employer. The manager is advised to follow up the missing reference. Runwood Homes Plc may wish to review their current application form, which only requests a 7-year employment history. DS0000019625.V296294.R01.S.doc Timescale for action 30/06/06 2. OP26 13(3) 30/06/06 3. OP29 18(1) 30/06/06 Wisden Court Version 5.2 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. Refer to Standard Good Practice Recommendations Wisden Court DS0000019625.V296294.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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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