Inspection on 09/08/05 for Wisden Court

This inspection was carried out on 9th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is 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 22/05/06

Wisden Court 30/11/05

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 Herts SG1 5JD Lead Inspector Tom Cooper Unannounced 09 August 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Name I52 s19625 Wisden Court v242323 090805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Wisden Court Address Wisden Road, Stevenage, Herts, SG1 5JD Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01438 354933 01438 369199 Runwood Homes Plc Festus Awogboro CRH Care Home 45 Category(ies) of DE(E)-45, OP-45, PD(E)-45 registration, with number of places Name I52 s19625 Wisden Court v242323 090805 Stage 4.doc Version 1.40 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). Date of last inspection 29 October 2004 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. Name I52 s19625 Wisden Court v242323 090805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on a weekday afternoon. 44 service users were in residence, with one in hospital. Interviews were conducted with service users and staff in each unit as well as two care team managers and the registered manager. Documentation checked included six care plans, medication records, accident records and activity records. In addition the inspector conducted a brief tour of the residential accommodation and the grounds. Service users appeared to be well cared for in all areas inspected and in conversation all commented favourably on the attitudes and skill of staff. The manager has been in post for approximately one year and on the evidence of this inspection has made a positive impact, with improvements noted in a number of areas as indicated below. Staff spoken with said they enjoyed working in the home and praised the training opportunities provided by the company. It is a shame that some carpets, furniture and decor in the home are basically worn out as this detracted from an otherwise very positive inspection. What the service does well: Service users are well cared for by knowledgeable, well-trained and committed staff. The physical care of service users is good and they were well presented, dressed in clean and comfortable clothing, with tidy hair and fingernails. Individual care needs are well documented using the company’s care plan format. All examples examined contained a consistently high standard of notation, with clear instructions and helpful hints for staff on how to proceed. All service users consulted said they were content in the home. They appear to enjoy very positive, friendly relationships with staff. Although the activities programme was currently fairly curtailed due to the activities coordinator being away on long-term sick leave, the manager has taken steps to expand the activities on offer in the future. When asked about activities no service users expressed any dissatisfaction and several commented that they felt the pace of life suited them well. However a visitor spoken with suggested that little happened from day to day, especially in the dementia unit. Touring the grounds it was evident that much work had been done recently to tidy the courtyard gardens and external grounds so that they now provide attractive facilities for service users to use in fair weather, after reportedly Name I52 s19625 Wisden Court v242323 090805 Stage 4.doc Version 1.40 Page 6 having become severely overgrown earlier in the year. It is important that the current standards are maintained. What has improved since the last inspection? What they could do better: ‘Kylie’ sheets should not be used on chairs as these unsubtle incontinence barriers detract from service users’ dignity. A better solution to the problem of incontinence should be found. Many of the furnishings in the communal areas are basically worn out and must be replaced, especially chairs and carpets that are beyond effective cleaning. The effect of this is to create the impression of an uncared for environment that is in marked contrast to the many strengths of the home documented in this report. It has also created a clearly expressed sense of frustration amongst staff. Improvements have been required in the last two inspection reports yet no action has been taken by the company, despite Name I52 s19625 Wisden Court v242323 090805 Stage 4.doc Version 1.40 Page 7 documented requests from the manager. This is unacceptable, therefore as a matter of urgency all fixtures and furnishings in the home must quickly be brought up to an acceptable standard or the CSCI will take legal enforcement action against the registered provider. The manager must ensure that pre-admission assessment information is always recorded on the relevant form prior to the admission of a new service user as one example was found where only the name, address and age of the individual had been noted. 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. Name I52 s19625 Wisden Court v242323 090805 Stage 4.doc Version 1.40 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Name I52 s19625 Wisden Court v242323 090805 Stage 4.doc Version 1.40 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3, The home’s policy is for a senior member of staff to make an assessment of every prospective service user prior to admission to the home and this is routinely done. However, the manager must ensure that this always happens as one example was noted where no pre-admission needs assessment information had been recorded to demonstrate that the proposed placement was suitable. EVIDENCE: Information was recorded on the company’s pre-admission assessment form. This covers the required areas to meet the standard and ensures that the proposed placement will be appropriate and the home will be able to meet the person’s needs. Pre-admission assessment forms were present in all files sampled. However in one case, only basic information regarding the service user’s previous address and age had been recorded, with no information at all about the person’s needs or any indication that they could be met by the home. The service user concerned was actually present in the home on the day of the inspection and a full care plan had been drawn up that clearly indicated the suitability of the placement. Nevertheless, assessments must be made in advance. Name I52 s19625 Wisden Court v242323 090805 Stage 4.doc Version 1.40 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 standard(s) 7, 8, 9, 10 Service users’ care plans contain regularly updated detailed information regarding their health. personal and social care needs, that enable care staff to monitor and record individual progress and provide a consistent standard of care. The home operates a safe system for handling, storing and administering medication and where appropriate service users are able to take responsibility for their own medication within a risk assessment framework. Service users feel they are treated with respect and enjoy positive relationships with staff. Staff promote individual privacy and confidentiality. EVIDENCE: Six care plans were examined and all contained comprehensive recording of information and action plans under the various headings. These cover a wide range of service users’ needs including all medical and physical needs as well as sensory impairment and dementia. Risk assessments relating to moving and handling and falls were completed and there were clear instructions and hints for staff on how to proceed. Review items raised and decisions taken were recorded on the plans as well as good day to day records of individuals’ Name I52 s19625 Wisden Court v242323 090805 Stage 4.doc Version 1.40 Page 11 progress. Each plan seen had been regularly updated, with any changes agreed noted. Weights had been regularly recorded for those service users with special dietary or nutritional requirements. The documents seen were impressive but the format is bulky and obviously time consuming to complete. Bearing in mind that staffing levels in the home are not high and staff therefore have little spare time for non–care activities such as record keeping it would be sensible to consider streamlining the care plan format, at least in respect of short stay residents. Each service user is registered with a GP. Residents said that staff were very attentive to their healthcare needs and contacted outside medical help when necessary. Care plan records demonstrated the ongoing contacts with NHS and other healthcare professionals. Medication records were checked in two units. Following repeated requirements regarding medication recording practice it was pleasing to note that all medication records seen were clear, with no signature gaps on MAR sheets and running balances noted for all medicines in tablet form. A list of staff signatures and initials is available that indicates staff who administer medication. If a service user wishes to self-administer medication, staff first carry out a risk assessment to establish this will be safe and thereafter discreetly monitor the individual’s performance to satisfy themselves that this remains so. Medication is retained for at least seven days following the death of a service user. Service users spoken with all said that staff were very kind and understanding, treated them with respect and helped them maintain their dignity and privacy. Staff were observed in all units interacting positively with service users, talking to them in a relaxed and conversational manner and evidently maintaining good quality relationships. Service users with dementia were spoken to with great patience, compassion and understanding. All these matters are covered in the home’s policies and procedures, reinforced via the induction and training policies of the company. Staff were observed knocking and waiting at service users’ bedroom doors prior to entering. Staff spoken with had a clear understanding of confidentiality and its importance in their work. In contrast to the positive factors reported above, unsightly protective ‘kylie’ sheets were in place on numerous chairs in the residential units, being used as unsubtle barriers to incontinence. Whilst these sheets may be effective their use is considered poor practice as overt signs that incontinence is expected detract from residents’ dignity. Therefore a more suitable alternative must be found. A requirement was made regarding this issue in the last inspection report but no corrective action had been taken. The manager said that new Name I52 s19625 Wisden Court v242323 090805 Stage 4.doc Version 1.40 Page 12 chairs with protected seats would be provided in the planned refurbishment later in the year. See requirements. Name I52 s19625 Wisden Court v242323 090805 Stage 4.doc Version 1.40 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 Service users feel reasonably content with their lifestyles in the home. Some activities are provided although the designated activities coordinator is off sick. The range and scope of activities provided should be improved and developed to provide greater opportunities for recreation and stimulation for service users, especially those with dementia. EVIDENCE: The home has on the staffing establishment a 25 hour per week activities coordinator’s post. Unfortunately, the current postholder was on long-term sick leave and her absence had hampered the development of the activities programme. Attempts were being made to ensure the post was covered, by means of an advertisement placed locally. There was evidence that some progress had been made since the last inspection, for example increased involvement of the care home residents in some day centre activities. The manager and staff gave details of recent and current activities taking place, including a fete in July, a regular in-house shop, a clothes show the day before the inspection, a performance by “New Review”, unit singalongs, outside volunteers coming in to take bingo sessions and so on. The manager has contacted the local Age Concern branch to obtain advocates for service users and has arranged for the Alzheimer’s Society to provide ideas for suitable activities for service users with dementia. Further evidence of service users’ activities was noted in individual daily observation records. The manager is Name I52 s19625 Wisden Court v242323 090805 Stage 4.doc Version 1.40 Page 14 obviously keen to develop this aspect of service provision and when a coordinator is available again the opportunities on offer should expand. Service users spoken with expressed general satisfaction with their quality of life and none complained of a lack of stimulation or boredom. One visitor commented that she had not observed much “going on” in the home during her visits to a resident. Staff were observed spending time chatting to service users and engaging in lighthearted banter. Name I52 s19625 Wisden Court v242323 090805 Stage 4.doc Version 1.40 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 Service users understand how to make a complaint and feel confident that an appropriate response will be made. EVIDENCE: Most service users spoken with had clear understanding of how to make a complaint and felt that staff would take them seriously. Staff said that most complaints arising concerned the provision of personal care and were always responded to positively. Staff spoken with knew the home’s complaint procedure. They were also able to describe appropriate methods of response to any reported abuse. Care staff had been trained in abuse awareness. Two examples of recent complaints were noted in the complaints file. The manager had thoroughly investigated both and reported back the outcomes to the complainant. Name I52 s19625 Wisden Court v242323 090805 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 24, The environment is spacious, accessible and safe. However much of the furniture and several carpets in the communal areas are worn out and must be replaced so that proper standards of comfort and dignity are restored for service users. The gardens and grounds offer a valuable facility for service users to enjoy. Service users‘ bedrooms are comfortable, well ventilated, adequately furnished and clean. EVIDENCE: The layout of the home in five separate units provides relatively small-scale living areas that are well equipped with individual kitchenettes and ample toilets and bathrooms. All this is conducive to a homely feel. Regrettably, this positive impression was undermined because in the communal areas of the home many of the chairs were old and worn and basically of a design unsuitable for the needs of elderly people with incontinence. The use of “kylie” sheets on chairs compounded the unsuitability of the chairs. In addition, several lounge carpets were badly worn and stained and obviously beyond Name I52 s19625 Wisden Court v242323 090805 Stage 4.doc Version 1.40 Page 17 effective cleaning. These must be replaced with more suitable items to restore the home to proper standards of comfort and dignity. Service users said that they liked the home and found it homely and comfortable so at least there was no evidence that the shortcomings in the furnishings and décor had impinged upon their enjoyment of the home. The manager stated that plans were in hand for a major refurbishment of the home, including all the areas causing concern. In addition all bathrooms were to be retiled. Clearance was merely awaited from head office to start the work planned. It is strongly recommended that the company submit details of the action plan for the improvement of the home to the CSCI as soon as possible. The versatile and committed handyman had recently undertaken a clearance operation on the internal courtyard gardens and the external grounds, which had restored the full amenity and safety of the grounds for service users to use in fair weather. All service users’ bedrooms seen were clean, comfortably furnished in domestic styles and contained personal items such as pictures and ornaments. Call bell lead extensions were fitted as appropriate. Service users spoken with said they liked their rooms and felt at home. They said that call bells were usually responded to promptly and that staff always asked for permission before entering their bedrooms. Name I52 s19625 Wisden Court v242323 090805 Stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 Staffing numbers on duty are adequate to meet service users’ needs but are maintained at minimum levels. The manager should review staff deployment patterns to ensure adequate cover in the lounges at all times. EVIDENCE: Staff reported that seven care staff are deployed on each early day shift to cover the five units with two staff available for floating between units as required and this provided adequate although not impressive cover. Night cover is by three staff awake. The length of time taken up by completing care plan documents was raised as a problem. One visitor commented that on the dementia unit staff spent much time in the afternoons bathing service users, thus leaving the lounge effectively unstaffed. This naturally increases the risk of accidents in that area and should be considered by the manager given the unpredictable behaviour associated with people who have dementia. It is unrealistic to expect service users to raise the alarm if problems arise. Name I52 s19625 Wisden Court v242323 090805 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32 The manager is competent and relates well to service users and staff. The manager provides effective leadership and promotes a caring ethos in the home. The company should provide him with the resources to carry out the necessary improvements to the environment. EVIDENCE: The manager has been in post for a year and has achieved the Registered Manager’s award. The forward progress noted at this inspection in the areas documented elsewhere in this report indicates that he has provided effective leadership. Staff spoken with said that he was caring and approachable and trying hard to raise standards in the home, especially with respect to the premises and the provision of activities for service users. Name I52 s19625 Wisden Court v242323 090805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x x x 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 x 15 x COMPLAINTS AND PROTECTION 1 2 x x x 3 x x STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 3 x x x x x x Name I52 s19625 Wisden Court v242323 090805 Stage 4.doc Version 1.40 Page 21 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 19, 24 Regulation 23 Requirement All worn out furniture, carpets and must be replaced with suitable items, consistent with the homes statement of purpose. Timescale for action by 1/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 3 Good Practice Recommendations Full pre-admission assessment information should be recorded on the relevant form prior to the admission of any service user. It is strongly recommended that the company submit details of the action plan for the improvement of the home to the CSCI as soon as possible. The manager should review the deployment of staff in the dementia unit to ensure that adequate staff presence is provided in the lounge at all times. 2. 3. OP19 OP27 Name I52 s19625 Wisden Court v242323 090805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City, Herts 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 Name I52 s19625 Wisden Court v242323 090805 Stage 4.doc Version 1.40 Page 23 - 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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