Inspection on 08/12/05 for Wisteria House

This inspection was carried out on 8th December 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

Wisteria House 26/07/07

Wisteria House 19/07/06

Wisteria House 27/09/05

Wisteria House 09/02/05

Wisteria House 14/06/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Wisteria House Montacute Road Tintinhull Yeovil Somerset BA22 8QD Lead Inspector John Hurley Announced Inspection 8th December 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 Wisteria House DS0000058877.V258469.R01.S.doc Version 5.1 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 DS0000058877.V258469.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Wisteria House Address Montacute Road Tintinhull Yeovil Somerset BA22 8QD 01935 822086 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) Mrs Siobhan Cecilia Wortley Mr Stephen John Wortley Mrs Siobhan Cecilia Wortley Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places Wisteria House DS0000058877.V258469.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27 September 2005 Brief Description of the Service: Wisteria House is a two-storey Hamstone building situated in the centre of the village of Tintinhull, local amenities are nearby. The home has been registered as a service for older people since 1985. Wisteria House is registered to provide care and accommodation for thirteen people. Due to the physical environment, Wisteria House is best suited to meet the needs of those with low to medium dependency. All rooms are for single occupancy. Mr and Mrs Wortley, have been the registered providers since March 2004. Mrs Wortley is also the registered manager. Wisteria House DS0000058877.V258469.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over six hours. The inspector spoke with the management of the service, service users and staff during the inspection. They also received a number of comment cards prior to the inspection form service users and people important to them. The inspector sampled the policy documentation of the home, the information it provides to prospective service users, individuals care plans and associated assessment documentation and staff records. The inspector also toured the premises and look at a number of service users rooms. What the service does well: What has improved since the last inspection? 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. Wisteria House DS0000058877.V258469.R01.S.doc Version 5.1 Page 6 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 DS0000058877.V258469.R01.S.doc Version 5.1 Page 7 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): 1,2,3,4,6 The documentation examined is clear and concise. Care assessments are comprehensive and form the basis for the delivery of care. EVIDENCE: The inspector sampled the Statement of Purpose and Service user guide. These key documents were in a clear format and contained all of the necessary information. Some further detail with regards to the services data protection policy would further enhance these documents. A sample of the service users contracts was also examined. The contracts informed of what was charged for and what was not. The charges mainly related to personal toiletries, papers and other items of a personal nature. The list of what is not provided is considered to be realistic and in line with most other service providers. Other information provided in the contracts viewed relate to notice periods and accompanied visits to hospitals. The service users assessment documentation was clear and concise. It gave an assessment of need and how the home would meet that need. The Wisteria House DS0000058877.V258469.R01.S.doc Version 5.1 Page 8 documentation also included health care needs, likes and dislikes along with a commentary on how the individual likes to live. For example when the person likes to get up, where they like to have breakfast, dietary considerations sleep patterns etc. There have been no new service users since the last inspection. The manager confirmed that the home does not offer intermediate care. Wisteria House DS0000058877.V258469.R01.S.doc Version 5.1 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 service user care plans reflect the assessment of need and provide a good framework for the staff to provide care in a consistent manner. The on going reviews are robust and evaluated against the original plan. EVIDENCE: Three service user files were examined. The care plans observed give good details with regards to the health and social care needs of the service user. These plans are reviewed on a monthly basis and the effectiveness of any interventions evaluated against the original plan and any longer term aims of the individual. The care plans have been agreed with service users. A service user told the inspector of the basis of their care plan. This was to help them get up and assist them with a wash. They went on to say that the staff can be very helpful and do not rush them, this they felt was important. The staff that the inspector spoke with had good knowledge of the contents of the care plans. The records viewed indicate key dates when service users need to have on going health checks and out patient appointments were necessary. Service Wisteria House DS0000058877.V258469.R01.S.doc Version 5.1 Page 10 users informed the inspector that they felt that they can approach staff if they do not feel well and that they will take action on their behalf. The management of the home has changed its approach to risk assessments, engaging the services of a registered consultant. The risk assessment documents are comprehensive and demonstrate a clear and concise picture of all risks and how they have been minimised. The service user said they felt safe living at the home. At present one service user is responsible for their medication, a risk assessment is in place to ensure that the medicines poise no risk to others at the home. For all of the other service users who require medication the individual documents clearly state the reasons why the home has taken responsibility for this action. Wisteria House DS0000058877.V258469.R01.S.doc Version 5.1 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): 12,13,15 The routines of the home are unhurried and appear to suit the individuals needs. The food on offer is tailored to meet individual’s needs and requirements. EVIDENCE: The inspector discussed with the management what activities were on offer. They were informed that there are a range of activities from reminiscence discussions provided by trained staff, bingo, gentle exercise, opportunities to have religious ceremonies, complemented by bought in activities such as singing. Several service users told the inspector that they knew what activities were taking place, some they liked others they did not. Some of the service users attend a local day centre for extra stimulation, another regularly goes out into the local community on their own to visit friends or go to the local pub. Risk assessments are in place for outings such as this. The staff informed the inspector that the service user choose what to have for tea, the lunch menu being set. (although the setting of this menu is grounded in the staffs knowledge of the likes and dislikes of the individual, seasonal variations and a tried and tested menu) Wisteria House DS0000058877.V258469.R01.S.doc Version 5.1 Page 12 The management confirmed that the menu will been continually reappraised to ensure that new dish’s are introduced from time to time. The inspector noted that the dinning room tables continue to be well laid out and that the staff make efforts to ensure the ambience was good. Wisteria House DS0000058877.V258469.R01.S.doc Version 5.1 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 Service users views are listened to. Service users are protected from abuse through policy and a skilled an knowledgeable staff team. EVIDENCE: There is a detailed complaint procedure and an abridged format is contained within the service user guide. Service users were asked whom they would make a complaint to if they were unhappy about the care they received. All who were asked could clearly identify senior staff members or their own keyworker. There had been one complaint since the last inspection relating to the time it took staff to answer a call bell. The documentation evidenced that this incident had been dealt with both effectively and responsibly. The home also has a clear policy with regards to vulnerable adult concerns. The inspector sampled this document, which was found to give clear guidelines of what to do and under what circumstances. Through general discussion with staff on duty the inspector established that the staff were clear as to their responsibilities and impressed as individuals who would report concerns. Wisteria House DS0000058877.V258469.R01.S.doc Version 5.1 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): 19,20,23,24 The home is maintained to the National Minimum Standards required. EVIDENCE: Since the last inspection no further changes have been made to the environment. The central heating is still problematic but steps have been taken to minimise the impact to service users effected. The temporary measures, an introduction of two electric fan heaters in two bedrooms, have been risk assessed by the external consultant and found to be generally expectable. At the time of the inspection a plumber was still working on the system to try to bring about a more permanent solution. The front entrance continues to be awkward to access but plans are in place to address this in the new-year. The service users own rooms were briefly inspected, as were the communal areas. These areas were found to be clean and no unpleasant odours were apparent. The communal areas retain their domestic feel; service user rooms reflect the occupant’s individual interests and wish’s. Wisteria House DS0000058877.V258469.R01.S.doc Version 5.1 Page 15 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 The homes management continues to ensure that training and individual learning guides and informs care practice. Recruitment procedures are in line with current good practice. EVIDENCE: The manager informed the inspector that the nominated staff act as keyworker to individual service users. They further have responsibilities for ensuring that in-house monthly reviews of the care plans are carried out and amended as necessary. The management provide guidance and a structured format for these reviews. The management informed the inspector that nominated staff has been given responsibility to take a lead role in specific areas of care work such as continence management or the care of the individual with diabetes and how this affects the individual. These staff liaise closely with outside health professionals and share the experience and knowledge gained with the other members of staff. The rotas viewed indicate that there is sufficient staff on duty to meet the service users needs. At night there is one waking member of staff on duty supported by another member of staff who is on call. One member of staff considered that there are good training opportunities at the home such as manual handling, first aid, mental health issues, safe administration of medication and vulnerable adults training. The well-kept records further Wisteria House DS0000058877.V258469.R01.S.doc Version 5.1 Page 16 evidence that training is ongoing and the management have good systems in place to monitor that the training is up to date. The inspector sampled some of the staff files. These files evidence that prospective employees complete an application form, supply names of referees (which are subsequently taken up) and have their details checked against the Criminal Records Bureau lists. During these process’ the individuals’ identity is checked and verified. The files also evidence an induction programme and ongoing supervision. Wisteria House DS0000058877.V258469.R01.S.doc Version 5.1 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): 31,32,33,36,37,38 The home is well managed and provides needs lead service. The management demonstrate that they will work hard to address shortfalls in the National Minimum Standards where identified. EVIDENCE: The manager told the inspector of the new arrangements that have been made to ensure a consistent approach to the management of the home. This being that the manager and care manager have a weekly management meeting to ensure that the work planned can be completed and that any problems to the weekly plan are discussed. The inspector also viewed the documents that have been introduced to ensure that staff training, staff supervision, staff meetings and service user reviews are monitored and evaluated. As identified earlier in this report external consultants have looked at individual and environment risk assessments. The manager has taken action to address any issues brought to their attention through this process. The manager Wisteria House DS0000058877.V258469.R01.S.doc Version 5.1 Page 18 further confirmed that the portable electrical appliances had recently been tested for there safety. The manager informed the inspector that they do not hold any monies for or on behalf of the service user. Wisteria House DS0000058877.V258469.R01.S.doc Version 5.1 Page 19 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 3 3 3 3 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 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X 3 3 X X STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 3 3 Wisteria House DS0000058877.V258469.R01.S.doc Version 5.1 Page 20 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 Refer to Standard OP1 Good Practice Recommendations That the registered manager should consider updating the homes Data Protection statement Wisteria House DS0000058877.V258469.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Wisteria House DS0000058877.V258469.R01.S.doc Version 5.1 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. 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