Inspection on 30/11/05 for Wisden Court

This inspection was carried out on 30th November 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

Wisden Court 18/04/07

Wisden Court 22/05/06

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 Alison Butler Unannounced Inspection 30th November 2005 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.V268923.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. Wisden Court DS0000019625.V268923.R01.S.doc Version 5.0 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 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.V268923.R01.S.doc Version 5.0 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). 31st August 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 residents 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 mainly used to accommodate short stay or respite residents. Each unit is self-contained, with its own lounge and dining room. There is a central activities area that is used for communal entertainment. Ancillary rooms comprise of a kitchen, laundry room and storage areas. Externally, there are three enclosed courtyard gardens with garden furniture and surrounding grounds. Wisden Court DS0000019625.V268923.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by two inspectors in the late afternoon/evening. The majority of the time was spent talking with the manager, care team manager, staff, relatives and residents who were present in the home. The atmosphere of the home was warm and friendly. Some Good interaction was observed and was seen to be caring, offering support as appropriate. Care and administration records were checked. What the service does well: What has improved since the last inspection? What they could do better: The décor of the home needs to be brought up to acceptable standard, as previous requirements have still to be met. Information was available to the residents and their families at various points throughout the home that the decoration is soon to begin. The manager must send a plan to the Commission Wisden Court DS0000019625.V268923.R01.S.doc Version 5.0 Page 6 For Social Care Inspection including risk assessments and reasonable timescales for its completion. The previous requirement has been brought forward and a new timescale has been set. The Commission For Social Care Inspection will take further legal enforcement action if this requirement is not met within the new timescale set. Staffing numbers must be increased to ensure the welfare, health & safety of residents and staff is maintained at all times. During the inspection residents were left unattended for periods of up to fifteen minutes. Both residents and relatives made comments to the inspectors that staffing levels were felt not to be adequate as there were times when no staff were available. Residents were happy with the staff and said they really do try but they do not always have the time to spend and talk. Staff need to familiarise themselves with the care plans and ensure they follow them to fully ensure that residents needs are met. Plans should be in place to enable staff to deal appropriately and consistently with residents who have challenging needs. 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.V268923.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 Wisden Court DS0000019625.V268923.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): These inspection standards were not inspected on this occasion. EVIDENCE: See previous report for details of the core standards inspected. Wisden Court DS0000019625.V268923.R01.S.doc Version 5.0 Page 9 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. The quality of information is generally good, with the exception of the risk assessments, which require updating. On the whole residents receive a good quality of care and are supported appropriately by knowledgeable and experienced staff. EVIDENCE: Five care plans were examined and they contained well written and clear guidelines on care needs. They contained a range of risk assessments although some needed reviewing, as this had not been done for over six months. One residents diet had become a problem and it would be useful if all staff recorded what they were offered and what they actually ate. This would be beneficial in looking at any trends and/or preferences. The menu could then be reviewed to reflect the choices for the individual. One resident’s care plan had not had the risk assessments reviewed for over six months. A plan for one resident referred to their behaviour as unpredictable, it would be beneficial if it contained more detail of the behaviour Wisden Court DS0000019625.V268923.R01.S.doc Version 5.0 Page 10 and how the staff are to deal with it. The Plan would provide a consistent approach and they would then be better able to review strategies. Although on the whole the care plans are well written, they are not always followed. It is thought that staff may have become a little complacent. One resident who is prone to bossing or becomes aggressive towards the other residents, was seen to be aiming her aggression at one of resident who then became tearful. The staff member made no comments to this resident although when the care plan was examined it stated that staff should remind them that this behaviour is not acceptable. The staff supported the resident who had been verbally abused to have their personal care attended to in a very caring manner. On returning them to the lounge they proceeded to sit them opposite the resident who had previously been aiming their anger at them. The inspector recommended that they should look at seating them out of sight of this resident. The inspector examined the care plan for the resident who had become tearful and it stated that she could become “anxious and suffer panic attacks”, this was felt could be increased if she is put in the sight of the resident who can be verbally abusive. It is recommended that additional details are included within the care plan as to the seating arrangements of the residents. Residents and relatives spoken to during the inspection were very complimentary about the staff stating the staff were kind and understanding although sometimes they have to wait to be attended to. This is because the staff are extremely busy. See staffing section for further details. Staff were seen knocking and waiting at resident’s rooms prior to entering. Staff had an understanding of the importance of confidentiality within the work. Medication on three units was examined. No missed signatures were discovered medication not dosetted was dated on opening. No discrepancies were found in the recording and the tablets of any given as required medication. The residents profiles required up dating to reflect current medication as some of these were out of date. Wisden Court DS0000019625.V268923.R01.S.doc Version 5.0 Page 11 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 Residents are content with their lifestyles living at Wisden Court. Visitors are welcomed and contact is maintained with the local community. EVIDENCE: A daily activities co-ordinator has been employed in the home. This has increased the variety of activities available. She is very keen to arrange activities and has prepared a programme. New notice boards have been purchased and they are to be put up on completion of the decoration. It is recommended that the activities programme be completed as a pictorial format especially in the dementia unit. The Christmas decorations were being put up in the activities lounge by staff (not on duty), relatives and staff family members. It was looking very festive at the end of the inspection. The units are going to have to wait to be decorated for Christmas as the redecoration is planned to start on 5th December. The staff feel this is going to make it difficult as there will be a lot of upheaval during this time for the residents, especially those that like to walk around. The activities co-ordinator is keen to look at different types of activities and the inspectors gave some information of places to seek further information. Wisden Court DS0000019625.V268923.R01.S.doc Version 5.0 Page 12 She is able to get support from other activities co-ordinators in other Runwood homes and they get together every 3 months and discuss ideas etc. A Christmas fair was due to take place at home on Saturday 3rd December 2005. The home had received a large amount of gifts from family and friends of Wisden Court. The residents were served their evening meal of soup and sandwiches. Those residents spoken to were very happy with the food that was served at Wisden Court. The trolleys are collected from the kitchen. Wisden Court DS0000019625.V268923.R01.S.doc Version 5.0 Page 13 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 Policies and procedures are in place to ensure the protection of the residents. Residents understand how to make a complaint and feel confident that it will be dealt with appropriately. EVIDENCE: Residents spoken to were clear about whom they need to speak to if they were unhappy. One resident said, “the manager is a really nice chap, if we have a problem he will listen and try to sort it out”. A copy of the complaint procedure is displayed on each unit. The manager stated that no complaints had been received since the last inspection. The main issue that residents and relatives spoken to during the inspection they felt that staffing numbers are too low. See Staffing section for further information. Wisden Court DS0000019625.V268923.R01.S.doc Version 5.0 Page 14 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, 20 & 26 The environment is spacious, accessible and reasonably safe. Carpets, decoration and furniture are still in need of replacing and redecoration to provide a more homely environment for the residents. The home is clean to a good standard and had a pleasant atmosphere. EVIDENCE: The communal areas are still in need of redecoration and the replacement of carpets and furniture has still to be actioned. This would dramatically improve the overall feel of the home. A further requirement has been made and a new timescale set. The manager stated that the decoration is due to commence on Monday 5th December 2005 and information is noted on notice boards informing the residents and the relatives. The activities lounge would benefit from curtains being placed up at the windows this would not only look more homely, but also it would keep the heat in, as it felt rather cool on entering this area. Wisden Court DS0000019625.V268923.R01.S.doc Version 5.0 Page 15 There are a lot of information posters on the notice boards in the individual units. Some of the information is not relevant to the residents for example annual leave and training, this should be placed on a more appropriate notice board for example in the staff room. Some of the information that is pinned to the walls could be placed more discreetly for example inside the kitchen cupboards. The manager must put an action plan in place detailing the work that is to be carried out, complete with risk assessments and timescales. A copy must be forwarded to the Commission For Social Care Inspection within the required timescale. A number of the laundry rooms on the units are being taken out of action as the washing machines are breaking down. The laundry is then being done in the main laundry. The manager should consider converting some of these rooms into assisted showers to provide more choice to residents. Although en-suite showers are in place those looked at during the inspection are not in operation. The staff confirmed this has been the case for many years. Work has been carried out on the fire equipment and hose reels have been removed this has left areas of the corridor flooring with carpet missing. The staff need to be extra vigilant with those residents who walk close to the wall as the surface is now uneven. The residents’ rooms were comfortable, clean and furnished appropriately. One resident’s room was to have the carpet replaced. The floor in a residents bedroom was due to be replaced and discussions with the manager took place with a view to looking at an alternative flooring to carpet to meet the individuals needs. The residents spoken to were very happy with their rooms and they are to bring in their own personal possessions. The home was cleaned to a good standard. It is required that pedal bins are purchased for the kitchens as staff are having to open them manually which can be time consuming having to constantly wash their hands, and washing the bin lids (although they are left dirty at times). Wisden Court DS0000019625.V268923.R01.S.doc Version 5.0 Page 16 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, 29 & 30 Staff numbers are not adequate to meet the needs of the residents at all times. The recruitment procedures are robust and offer protection to the residents living at the home. There is on-going training to ensure that staff are competent to do their jobs. EVIDENCE: From the three staff files examined all the relevant checks had been carried out prior to them commencing employment which ensures the protection of the residents. It is reported that 7 staff are deployed on each early shift, two staff cover the dementia unit until 1pm. There is 1 member of staff available for the other four units and one member that provide floating cover. At the time of the inspection a care team manager was in charge of the shift, six carers cover the five units. This only provided one carer on each unit with one floating and the care team manager providing extra support as required. On a number of occasions the inspectors were in a unit either looking at care plans or talking with residents and there were periods of up to fifteen minutes when no staff were available to support the residents. On one unit one resident was standing for a period of ten minutes before a member of staff came back. On examining their care plan this resident is at high risk of falls and must be observed at all times. The staffing levels must be increased to meet the needs of the residents and ensure their safety at times. Wisden Court DS0000019625.V268923.R01.S.doc Version 5.0 Page 17 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): 35 & 38 The resident’s financial interests are safeguarded. The staff try to ensure the health, welfare and safety is promoted and protected at all times although they must ensure that risk assessments are in place and regularly reviewed. EVIDENCE: A sample of records showed that the residents’ finances are well managed and the interests of the residents are safeguarded. Each resident’s money is stored and recorded separately. The manager must ensure that risk assessments are in place for the resident who locks their room at night. Also the manager must put in place risk assessments for the redecoration and replacement plan to ensure the safety of residents, staff and visitors. A copy must be forwarded to the commission. Wisden Court DS0000019625.V268923.R01.S.doc Version 5.0 Page 18 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 2 X X X X X 3 STAFFING Standard No Score 27 2 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X 2 Wisden Court DS0000019625.V268923.R01.S.doc Version 5.0 Page 19 yes 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 OP19OP20 Regulation 23 Requirement Timescale for action 15/01/06 2 OP27 18(1)(a) 3 OP38 13(4) 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. The manager must carry out a 31/12/05 review and increase the numbers of staff at key times to ensure that the units are appropriately manned at all times to protect the safety and welfare of the residents. The manager must ensure that 30/11/05 risk assessments are in place for the individual residents identified and ensure they are reviewed regularly. 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 Good Practice Recommendations DS0000019625.V268923.R01.S.doc Version 5.0 Page 20 Wisden Court 1 Standard OP7OP8 2. 3 4 5 OP7 OP7OP8 OP9 OP12 The manager should ensure that staff record details of the food offered and what is eaten so as to monitor any trends and/or preferences. This would enable the menu to be varied accordingly. The manager should include more detail on how staff manage the behaviour of an individual residents whose behaviour is unpredictable at times. Staff should remember to follow residents care plans so as not to possibly increase their anxiety and ensure consistency of care. The manager should ensure that all residents’ medication profiles are up to date. The daily activities co-ordinator should look at providing the activities programme in a pictorial format. Wisden Court DS0000019625.V268923.R01.S.doc Version 5.0 Page 21 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. Extracts may not be used or reproduced without the express permission of CSCI Wisden Court DS0000019625.V268923.R01.S.doc Version 5.0 Page 22 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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