Inspection on 18/05/07 for Wisteria House

This inspection was carried out on 18th May 2007.

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

Wisteria House 06/10/09

Wisteria House 13/04/08

Wisteria House 26/05/06

Wisteria House 06/12/05

Wisteria House 06/06/05

Wisteria House 24/03/05

Wisteria House 13/01/05

Wisteria House 26/02/04

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 Wisteria House 9 Ayston Road Uppingham Oakham Rutland LE15 9RL Lead Inspector Judith Roan Key Unannounced Inspection 10:30 18th May 2007 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 Wisteria House DS0000006467.V337643.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. Wisteria House DS0000006467.V337643.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wisteria House Address 9 Ayston Road Uppingham Oakham Rutland LE15 9RL 01572 822313 01572 823651 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 Geoffrey Kirk Mrs Kirk Mr Geoffrey Kirk Mrs Joanna Kirk Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places Wisteria House DS0000006467.V337643.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. To be able to admit the named person in category DE(E) subject of variation application V19363 dated 05/07/2005. The registered provider may accommodate a maximum of 13 service users in Wisteria House Care Home when a married couple occupies the double room The registered provider may accommodate a maximum of 12 service users at Wisteria House Care Home when single persons occupy rooms No rooms at Wisteria House Care Home should be used for double occupancy other than those stated 26th September 2006 Date of last inspection Brief Description of the Service: Wisteria House is a care home registered to accommodate up to 12 older people. The home is a small family-run home. It is a detached house built in 1880 and retains many original features. There is a car parking area to the side of the home. Wisteria House is situated in the market town of Uppingham, close to shops and other local amenities. The home has twelve single bedrooms, the majority are spacious and nine are over 20 square metres in size. The upper floors can be accessed by the stairs or the passenger lift located to the centre of the home. There is a large open plan lounge/dining room, which overlooks a private patio garden. All areas of the home is accessible to people using walking aids. A new acting manager has been appointed and is applying to the CSCI to be registered. Clear information about the home is available in the Statement of purpose and service users guide available at the home. The current fees for the home are £400 per week with one slightly smaller bedroom at £390. Wisteria House DS0000006467.V337643.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission of Social Care Inspection is upon the outcomes for Service Users and their views of the service provided. The primary method of inspection used was ‘case tracking’ which involved selecting 2 residents and tracking the care they receive through review of their records, discussion with them, the care staff and observation of care practices. The inspection took place during the late morning and afternoon, over a period of 7.5 hours and was carried out on an unannounced basis. A pre inspection questionnaire completed by the provider was received. The comments made by residents and three relatives are reflected within this report. The report also reflects the outcomes of a random inspection undertaken on the 26 September 2006 and two anonymous complaints received by CSCI. What the service does well: What has improved since the last inspection? The statement of purpose has been updated and is available in the home. Residents’ nutritional needs and weights are now recorded with action identified as required. Residents are assessed if there is a risk of developing pressure ulcers and healthcare professional are fully involved. Residents have manual handling assessments with clear guidance for staff of action needed. Medication administration, storage and disposal meets the guidelines set by the Royal Pharmaceutical Society. Statutory training is up to date for staff at the home. Wisteria House DS0000006467.V337643.R01.S.doc Version 5.2 Page 6 Trained and sufficient numbers of staff are on duty throughout the week to meet resident’s needs. Fire records are kept up to date and available in the home. Accident records are completed for all accidents/incidents in the home. 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. The summary of this inspection report can be made available in other formats on request. Wisteria House DS0000006467.V337643.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 Wisteria House DS0000006467.V337643.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1&3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents can be assured that good information is available to them to aid them in their choice of home. The needs assessment confirms for residents that their needs can be met by the service. EVIDENCE: The Statement of purpose has been updated and provides good information to prospective residents. The document needs to reflect the changes within the CSCI role within complaints. The local Councils Social Service department are the lead agency in respect of complaints. Residents however can still contact CSCI for advice, the contact details for CSCI need to be changed to the new address at the Leicester office. The statement of purpose needs to state the views of resident’s and how the provider gains these. Detailed assessments of needs are completed prior to admission into the home. This process enables the home staff to check out whether they can meet an individual’s need. The first four weeks of admission is a trial period, this is clearly stated in the Statement of purpose and the welcome pack available to new residents. Wisteria House DS0000006467.V337643.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans ensure that resident needs can be fully met within the home. Clear medication audit trails ensure that residents are protected. EVIDENCE: Care plans were seen in files reviewed. They clearly instruct the carers on residents preferences and what support they require. Risk assessments for manual handling, nutrition and pressure areas were developed and improved from the last inspection. Resident’s weights were recorded along health care checks. In discussion with a visiting district nurse it was established that visiting professional had no concerns on the level of care available to the home and that a good working relationship existed. Risk assessments need to be established for resident’s activities outside of the home and direct staff on how these need to be minimised. The medication system has been reviewed and now meets the guidelines set out by The Royal Pharmaceutical Society. During the inspection a member of the staff team was being assessed for parts of their level three NVQ award and was observed to administer medication appropriately. The feedback from the Wisteria House DS0000006467.V337643.R01.S.doc Version 5.2 Page 10 assessor was positive and a clear audit trail was in place. Other carers at the home have received basic medication training from the pharmacist. Evidence was available in staff files that training had been completed and certificated. During the inspection care practices were seen to be respectful and demonstrated a person centred approach. One relative states that ‘the care their relative receives make them feel like they are living in their own home’. All comments from residents were positive in that care needs were always or usually met. Wisteria House DS0000006467.V337643.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Activities within the home are developed around resident’s preferences and provide a wide range of options. Relatives and visitors are warmly welcomed within the home. Meals are varied, home cooked and attractively presented. EVIDENCE: The homes atmosphere is friendly and warm with good indoor and outdoor communal space in which residents can relax. Activities are arranged to suit residents. Several residents are able to independently access the town where they go shopping, meet friends and involve themselves in local community events. One relative survey said that they would like to see more outings arranged by the home. Residents who were able attended on of the local churches each week. During the inspection the inspector was able to talk with several friends who had called to see residents at the home. They were able to give a very positive view of the home and confirmed that they were made to feel welcome by the staff team. Residents were actively encouraged and supported to maintain their independence and links with the local community. Residents always inform staff that they are going out but no record is made of this. On health & safety Wisteria House DS0000006467.V337643.R01.S.doc Version 5.2 Page 12 grounds it would be advisable to discuss with residents how they would like this information be recorded so that in the event of the needs to evacuate the building a record of who was in the home could be available. Meals at the home are freshly cooked and attractively presented. Portions were seen to be adequate and residents were offered more if required. A choice of sweets were offered, however there was no diabetic option available to meet the needs of one resident. The manager needs to discuss the issue with them and healthcare professionals. The outcome of this meeting should be recorded on the residents file. One survey from a relative would like to see more variety on the menu. Wisteria House DS0000006467.V337643.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be assured that any concerns that they raise will be taken seriously and fully investigated. Care practice within the home ensures that resident’s are protected. EVIDENCE: Two anonymous complaints have been received by the CSCI. These have been referred back to the provider for investigation. The most recent complaint was discussed with the acting manager and staff on duty during the inspection. The complaint expresses concern about; senior staff are bullying carers and shouts at residents, infection control processes are poor in that staff are asked to use the same gloves to carry out care tasks with two different residents. The inspector was satisfied the current infection control measures within the home are good and that adequate supplies of personal protective clothing are available. Residents spoken with all confirmed that staff treated them with respect at all times and this was supported by the information contained within the surveys recently undertaken. A full investigation of the complaint received in June 2006 was completed and unfounded. A safeguarding concern was received in July and investigated at the random inspection in September. The inspector found that the carers were aware of safeguarding protocols and all had completed abuse awareness training as part of the statutory training within the home. Wisteria House DS0000006467.V337643.R01.S.doc Version 5.2 Page 14 The complaints procedure is available at the home. One relative was not aware of the complaints procedure, residents however were. The acting manager needs to ensure that the policy and procedure is clearly displayed within the home to ensure that relatives and visitors are informed. Wisteria House DS0000006467.V337643.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,23,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s can expect that the home is well maintained, homely, safe and clean. EVIDENCE: Good feedback was received from most resident’s about the standard of cleanliness within the home. One person said that it was unsatisfactory due to the absence of a cleaner and that care staff were now performing this role. The inspector found the home clean and well maintained. One area of need is to supply liquid soap to the ground floor toilet to maintain the high standard of infection control within the home. Residents were encouraged to bring items with them into the home and bedrooms were personalised. Communal areas were comfortable and sometimes used by residents. Many residents preferred to spend time in their own rooms. A secure garden that is landscaped and maintained is a favourite of some resident’s where they can spend time with others on fine days. A window in the basement needs to be Wisteria House DS0000006467.V337643.R01.S.doc Version 5.2 Page 16 kept locked to ensure that no intruders can enter the building during the day and maintains residents safety. Wisteria House DS0000006467.V337643.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good recruitment procedures ensure that residents are protected. Positive action in training ensures that a competent staff team supports residents. EVIDENCE: On the day of the inspection two staff including the acting manager were on the early shift supporting eight residents. The afternoon shift was two carers of which one was a senior. Two carers also provide care on shift over the weekend. This requirement is now met. The acting manager and provider provided an on call service out of hours. Staff files viewed all demonstrated that relevant employment checks had been completed. A Protection of Vulnerable Adults check is always completed for all new staff followed by a disclosure for the Criminal Records Bureau (CRB) check. Existing employees also have CRB checks. The provider is working to increase the training in the home. Files confirmed that induction training is completed for all new staff and that statuary courses are undertaken. Carers are working towards meeting the National Minimum Standards in relation to National Vocational Standards. At present 36 of the staff have attained level two in care or above. A recommendation is made to support others in the home to achieve the award. Wisteria House DS0000006467.V337643.R01.S.doc Version 5.2 Page 18 Specialist training has been undertaken to meet the needs of residents that have a dementia. Wisteria House DS0000006467.V337643.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,37 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed in the best interests of residents. The home records protect residents. EVIDENCE: The acting manager is working towards their registered manager award and level four in care. The inspector advised the acting manager to make an application for registration to CSCI as soon as possible. The current registered manager who is also the owner will remain in post until this time. Resident’s views are sought and used to develop the service. The provider needs to be clearer on how information on the quality of the service is gained and include a summary of outcomes within the statement of purpose. Daily notes were seen on resident’s files at weekends. This requirement is now met. Wisteria House DS0000006467.V337643.R01.S.doc Version 5.2 Page 20 Residents or their families mainly manage finances independently of the home. The acting manager needs to ensure that resident’s have a facility in their room to keep monies secure as one resident was found to keep their money in an unlocked drawer. Fire records are now kept on the premises and other Health & safety records were made available to the inspector on request during the inspection. All checks were found to be up to date and signed. Accident are recorded, but need to be kept in accordance with Data Protection guidelines. Wisteria House DS0000006467.V337643.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 2 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 3 3 X X 3 X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 2 X X 3 Wisteria House DS0000006467.V337643.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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. 2. 3 Refer to Standard OP1 OP28 OP35 Good Practice Recommendations The Registered Person needs to ensure that information in the Statement of Purpose is updated and reflect show resident’s views are gained. The manager needs to ensure that carers at the home are working towards their NVQ level two in care to achieve the recommended sector workforce standards. The manager needs to review the security arrangements for personal monies kept in resident’s bedrooms. Wisteria House DS0000006467.V337643.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Wisteria House DS0000006467.V337643.R01.S.doc Version 5.2 Page 24 - 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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