Inspection on 19/07/06 for Wispington House

This inspection was carried out on 19th July 2006.

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

Wispington House 17/04/07

Wispington House 21/11/05

Wispington House 22/08/05

Wispington House 26/01/05

Wispington House 24/05/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Wispington House 41 Mill Lane Saxilby Lincoln Lincs LN1 2QD Lead Inspector Mr Doug Tunmore Key Unannounced Inspection 19th July 2006 09:30 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 Wispington House DS0000002480.V304336.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. Wispington House DS0000002480.V304336.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wispington House Address 41 Mill Lane Saxilby Lincoln Lincs LN1 2QD 01522 703012 01522 704547 mikedunbnett3@aol.com 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) Mr Trevor William Brock Mrs Heather May Brock Mrs Heather May Brock Mr Trevor William Brock Care Home 26 Category(ies) of Dementia (3), Old age, not falling within any registration, with number other category (26) of places Wispington House DS0000002480.V304336.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to provide personal care for service users of both sexes whose primary needs fall within the following category:Old age, not falling within any other category (OP) - 26 Dementia - over 65 years of age (DE(E)) - 3 The maximum number of service users to be accommodated is 26. 2. Date of last inspection 21st November 2005 Brief Description of the Service: Wispington House is a detached property, a former farmhouse, adapted to provided accommodation and care for up to 26 older people. The home is situated in large grounds set back from the main road of the village of Saxilby, which has local facilities within walking distance for the more able residents. The City of Lincoln is approximately four miles away. This homes brochure states our aim is to enhance your quality of life by helping you to lead a full and active life as you would expect living in your own home. The home is managed by the proprietors and operates as a family run business, with the proprietor’s son in law also involved in the management of the home. Accommodation is provided on the ground floor and the first floor with a chair lift available to residents accessing this floor. There are twenty single rooms two with en-suite facilities and three double bedrooms provided one being a flat with its own lounge, kitchen and en-suite facility. Both owners, one of whom is the registered care manager, have daily involvement in the running of this home. The current scale of charges at this home is from £335.00 to £370.00. Wispington House DS0000002480.V304336.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and took into account any previous information held by CSCI including the homes previous inspection reports, their service history, the homes pre-inspection questionnaire and residents questionnaires sent to the home by the Commission prior to this inspection. The site inspection consisted of case tracking a sample of two resident’s records and assessing their care. The inspector spoke with the residents who was being case tracked and joined three other residents for lunch. The inspector also spent time with the administrator, the registered manager, one visitor and one carer. A partial tour of the home and a review of a sample of the records were also included. What the service does well: What has improved since the last inspection? What they could do better: Wispington House DS0000002480.V304336.R01.S.doc Version 5.2 Page 6 On the 05/05/06 the home changed its categories to enabled people diagnosed with dementia to be admitted to this establishment. This was on the understanding that a risk assessment was undertaken in relation to the garden area, which leads onto a busy main road; this has not been addressed by the home. The home needs to address the individual requirements of residents in relation to maintaining their dignity and privacy when undertaking personal care needs. Residents wishes needs to be recorded in their care plans. The Commission has not received notification that a resident had been admitted to hospital. It is the responsibility of the registered person to inform the Commission in writing of any issues relating to the health and welfare of residents. The home could keep a record of all outings undertaken by residents and entertainers who visit this home to show that stimulating activities are undertaken for the benefit of residents. The home should ensure that information is given to residents and relatives regarding any quality assurance questionnaires that they have completed in a format that ensures easy reading for residents and visitors. The management team need to undertake unannounced checks during the night to ensure that the residents welfare is being addressed. A record should be kept of these visits. This inspection found that two care workers did not have appropriate Criminal Record Bureau checks (CRB) or POVAFIRST checks at the time of their employment at this home. Due to the risk that this poor practice places residents, an immediate requirement was made. An additional inspection will also be undertaken in the future to ensure that action has been taken by the registered person. 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. Wispington House DS0000002480.V304336.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 Wispington House DS0000002480.V304336.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): 2, 3 & 6 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. Residents are admitted into the home only after a full needs assessment has been carried out either by the home and/or health care or social care agencies. Written confirmation that the home can meet a prospective residents needs is also undertaken prior to admission. All residents have current contracts. This home does not provide intermediate care. EVIDENCE: A review of all information available prior to this inspection including previous inspection reports dated 22/08/05 and 21/11/05 and evidence seen at this inspection in residents files and care plans showed that the home does not admit residents without a care needs assessment being undertaken. Prospective residents are also written to by the home confirming whether they can meet the residents care needs or not. Wispington House DS0000002480.V304336.R01.S.doc Version 5.2 Page 9 The Commission sent Residents questionnaire forms to the home prior to this inspection and three were returned. All three questionnaires confirmed that residents had information about the home prior to admission and that they had received a contract. The files of those residents who were being case tracked contained a current contract setting out the terms and condition of their stay. The home sent nine quality assurance questionnaires dated March 06 (QA) to the Commission and one comment was that ‘all staff made us feel welcome and made sure mum was comfortable in her room’. The two residents who were being case tracked confirmed that ‘the manager visited me at my last home and was helpful in every way’ and the second residents said that ‘my daughter brought me to have a look around and the owners were terrific and when I saw the dining room I wanted to stay’. Wispington House DS0000002480.V304336.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 The quality outcome in this area is adequate. This judgement has been made using available evidence including a visit to this service. The homes policies and procedures provide guidance for the care practices of care staff. Residents or their representatives are involved in the care plans. The home administers medication appropriately to all residents. Pre-admission care assessments and care plans do not always address the intimate care needs of residents. The home does not inform the Commission of accidents to residents. EVIDENCE: This inspection found that residents have individual care plans, which evidenced that health care professionals have seen residents in relation to their health care needs. Residents files also describe their health and welfare needs. Care plans outlined risk assessments, nutritional and dependency assessments A visitor confirmed that his aunt sees a physiotherapist, which is privately funded. A resident confirmed that she see her GP and district nurse. Wispington House DS0000002480.V304336.R01.S.doc Version 5.2 Page 11 Care plans also evidenced that they have been reviewed on a monthly basis or sooner depending on changing needs. The reviews and care plans of residents had been signed and dated by the carer and the resident/representative. The homes service history of notifiable incidents (accidents or admission to hospital of a resident) record did not correspond with a resident’s file who had been admitted to hospital. There was no evidence in the home that the Commission had been notified as required. The questionnaires also showed that three residents felt that staff are always available when they need them. It was noted that the residents were supported in completing the Commissions questionnaires by relatives. A resident stated in her questionnaire that ‘the staff are so helpful and friendly’. Two care plans were seen and it was found that information is available regarding resident’s likes and dislikes. This area of care planning is centred around a personal profile of a resident written by the home, which addresses the residents culture and family history. The care plan identifies preferences and those aspects of residents daily living requirements and expectations. However, care plans were also seen not to have established the intimate care needs of residents and what help they require when bathing or toileting or how their privacy and dignity can be maintained. One residents commented that ‘ staff help me to bathe can’t do it myself, they are very helpful in every way’. Residents/relatives comments made in questionnaires were; ‘a well run residential care home closely supervised by the owners’. The pharmacist inspected the home on the 16/12/05 and recorded that storage and stock control is carried out appropriately and spot checks on medication records. Residents medication cassettes and medication sheets were seen and found to be an accurate record at the time of this key inspection. Residents questionnaires received back from the home showed that two felt that they always get the medical support that they need and one felt that she usually did. One residents made comment in the questionnaire that ‘If a doctor is needed they arrange a visit promptly. The minutes of the team meeting held on the 10/07/06 showed that there were concerns expressed that residents were not being changed when wet by the night care staff. The manager has reminded the carers of their duties and the providers are to undertake night-time visits and record their findings, taking action if required. Wispington House DS0000002480.V304336.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 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. Relatives/friends of service users are made welcome in this home. A range of stimulating activities are made available to residents. A choice of meals are available at this home, which are planned monthly in consultation with service users. EVIDENCE: Three residents questionnaires showed that there are activities and they are always available to residents; one resident commented that activities are usually available. The home has an activities worker who works six hours per week split between three days. The minutes of the residents meeting held on the 23/05/06 evidenced that residents requested to have more trips to the shops and have more outings to a local coffee shop. Another resident asked for more in-house entertainment. This meeting also evidenced that they are planning a holiday for residents in Norfolk. One relative commented that his aunt was asked to go on holiday, but declined. The manager confirmed that she took three residents to Norfolk for three days. There was no written evidence to suggest that outings are undertaken. However, during this inspection residents were observed to be taken to the village by members of staff. Wispington House DS0000002480.V304336.R01.S.doc Version 5.2 Page 13 One resident stated that she had ‘not been to the shops’. One Visitor confirmed that he was made welcome at the home and said that he ‘comes three to four times a week and staff and the owners are very good and helpful’. Two residents confirmed that there are activities in the home and occasionally join in. One residents stated that ‘I like reading and watching television especially sport’. The inspection was undertaken on a hot day and it was noted that drinks were being served and there were drinks in the lounge and residents’ rooms. Resident’s questionnaires evidenced that two always liked the meals and one usually liked the meals. Other written comments received were ‘They are always willing to cook for me, if I do not like the days lunch’. One resident who was being case tracked stated ‘I love the food and everything’, Three residents who the regulator joined for lunch made complimentary comments about the food that was served in the home. It was noted that there was a choice of meals. Wispington House DS0000002480.V304336.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 The quality outcome in this area is poor. This judgement has been made using available evidence including a visit to this service. The home takes the issue of addressing complaints very seriously and has a comprehensive complaints policy. The home does not have robust adult protection procedures for the protection of residents. EVIDENCE: The home has displayed the service users guide, which contains the homes complaints procedures in the main entrance. The home has a detailed complaints procedure. The homes pre-inspection questionnaire evidenced that one complaint had been made since the last inspection. Residents questionnaires recorded overwhelmingly that they were aware of how to make a complaint and knew who to speak to if they were unhappy. The homes pre-inspection questionnaire showed that safeguarding vulnerable adults training has been undertaken on October 05 with further training planned for the end of 06. A residents commented that ‘I feel absolutely safe here, don’t even think of anybody breaking in’ and ‘no trouble with the staff they are very kind. Two personnel files showed that appropriate POVA FIRST checks and Criminal Record Bureau checks (CRB) have not been undertaken. One carer had a CRB Wispington House DS0000002480.V304336.R01.S.doc Version 5.2 Page 15 check from a previous home dated March 05, with no POVAFIRST check or CRB undertaken by this home. Another workers CRB was dated 09/05/06 but she started work on January 06 prior to confirmation of any check undertaken. Wispington House DS0000002480.V304336.R01.S.doc Version 5.2 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 the following standard(s): 19,26 The quality outcome in this area is adequate. This judgement has been made using available evidence including a visit to this service. The home is well maintained, the standard of the environment and its facilities are appropriate to the needs of residents. The home has not undertaken risk assessments on individual residents. The home is clean and smells fresh. EVIDENCE: The home has a maintenance record which records work that has been undertaken since the last inspection. The fabric of the home was seen to be in very good repair both internally and externally. Residents files did not contain risk assessments for the few residents who have dementia in relation to the open garden area leading to the busy main road. The registered manager stated this would be addressed immediately. Wispington House DS0000002480.V304336.R01.S.doc Version 5.2 Page 17 The home employs three domestic workers who each work 20 hours per week. No unpleasant odours were detected during this visit. The residents survey was overwhelming in that they confirmed that the home always smells nice and is clean and tidy. One resident commented that ‘the home is always spick and span’. Three rooms seen, confirmed that residents have personalised their rooms and the home is free of unpleasant odours. Wispington House DS0000002480.V304336.R01.S.doc Version 5.2 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 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 The quality outcome in this area is adequate. This judgement has been made using available evidence including a visit to this service. Appropriate recruitment practices are not in place. Staffing level meets the needs of residents. The home provides adequate training for care staff. Staff were seen to be competent in carrying out their care tasks. EVIDENCE: A review of all information available prior to this inspection including the homes pre-inspection questionnaire and last inspection carried out in November 2005, showed that; personnel files evidenced that thorough recruitment practices are not undertaken to ensure the safety of residents (see National Minimum Standard 18). One care workers file did not have an application form. The provider and administrator confirmed that procedures relating to the recruitment of new staff had not been undertaken as required. The homes pre-inspection questionnaire showed that mandatory training is undertaken as well as training relating to the care of residents who have dementia. Certificates seen at this inspection confirmed that professional trainers had undertaken some of the training. Wispington House DS0000002480.V304336.R01.S.doc Version 5.2 Page 19 The General Social Care Council Codes of Practice, which sets out their responsibilities as care workers looking after vulnerable adults. The homes preinspection questionnaires evidences that 50 of carers have NVQ (National Vocational Qualifications) which means that the home meets the ratio of 50 of care staff trained to level 2. The questionnaire completed by residents showed that three felt that they receive the care that they need and staff are available when they need them. Three felt that they usually receive the care they need. One resident commented that ‘I have just got to press the buzzer and staff come’. The homes pre-inspection questionnaire and the rota evidenced that there are eighteen care staff and six ancillary workers. The duty rota showed that adequate staff numbers are on duty to meet the needs of residents during the day and night shift. A carer was of the opinion that there are enough staff and we spend time with residents especially in the evenings. She also confirmed that that she has undertaken mandatory training as well as induction training. Wispington House DS0000002480.V304336.R01.S.doc Version 5.2 Page 20 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, & 38 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. Records show that residents’ health and general welfare and safety are promoted. The home ensures that the residents have the opportunity to voice their views and opinions. Feedback from questionnaires is not made available to residents/visitors. Residents benefit from the positive leadership of the registered manager. EVIDENCE: The minutes of the last residents meeting held on the May 06 was seen and showed that residents are empowered to voice their opinions and the manager addresses any concerns. Residents stated that the manager is ‘fantastic and helpful in every way’. One carer said that ‘the manager is excellent and she is fantastic to work for’. Wispington House DS0000002480.V304336.R01.S.doc Version 5.2 Page 21 The manager has the Registered Managers Award in management and has also completed her NVQ level 4 in care. She has been a qualified nurse for twentysix years and worked in residential care for twenty-two years. She was able to demonstrate during this inspection a sound knowledge base as to running a care home and was seen to have a caring attitude to the residents. The home does not handle any of the residents monies. All payments are made by direct debit or standing order. Personal allowances are kept by Residents themselves or their relatives. There are a range of policies and procedures available in the home relating to fire safety and fire risk assessments. The homes pre-inspection questionnaire evidenced that fire alarm, fire drills and emergency lighting checks have been undertaken. Care staff also receive fire training as part of the homes initial training and as a regular training event. Wispington House DS0000002480.V304336.R01.S.doc Version 5.2 Page 22 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 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 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 1 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 x 3 x 3 x x 3 Wispington House DS0000002480.V304336.R01.S.doc Version 5.2 Page 23 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 OP19 Regulation 13 (4)(a)(b)( c) Requirement The registered person must ensure that; all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety. The registered person shall not employ a person to work at the care home unless the person is fit to work at the care home and appropriate checks have been carried out prior to starting work. The home must carry out a quality assurance review at appropriate intervals and post the outcomes on the homes notice board for the information of residents and visitors. (Timescale of 25/01/05 not met.) Timescale for action 25/08/06 2. OP18 19(1) Schedule 2 04/08/06 3. OP33 24(a) 25/09/06 Wispington House DS0000002480.V304336.R01.S.doc Version 5.2 Page 24 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 OP29 Good Practice Recommendations The home should have detailed and appropriate recruitment practices in place. Wispington House DS0000002480.V304336.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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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