Inspection on 26/04/05 for Wordsworth House Care Centre

This inspection was carried out on 26th April 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

Wordsworth House Care Centre 08/11/05

Wordsworth House Care Centre 14/12/04

Wordsworth House Care Centre 02/09/04

Wordsworth House Care Centre 17/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Sunny Bank (P.R.S.) Ltd

Ruskin Lodge

Bushell House

Ashwood Court Unit 1

Langrigg House

Parkside

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

CARE HOMES FOR OLDER PEOPLE Wordsworth House Care Centre Wordsworth Street Hapton Burnley BB12 7JX Lead Inspector Marie Dickinson Unannounced 26 April 2005 9.30 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. Wordsworth House Care Centre F57 F07 S9590 Wordsworth Hs V223273 260405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Wordsworth House Address Wordsworth Street Hapton Burnley BB12 7JX 01282 778940 01282 770311 central.division@ashbourne-homes.co.uk Ashbourne (Eton) Ltd 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) Mrs Linda Heyes Care Home 40 17 22 1 Category(ies) of Dementia DE(E) registration, with number Old Age OP of places Mental Disorder MD(E) Wordsworth House Care Centre F57 F07 S9590 Wordsworth Hs V223273 260405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Within the overall registration of 40, a maximum of 17 service users who fall into the category Dementia Elderly, 1 named service user who falls into the category of mental disorder, 22 service users who fall into the category of Older People. 2. Staffing levels are to be in accordance with the Notice issued 17 October 2002 3. The service should at all times employ a suitably qualified manager who is registered with the CSCI 4 Should any of the service users referred to in 1 above be no longer resident in the home, registration must be altered to reflect this Date of last inspection 17/03/05 Brief Description of the Service: Wordsworth House is registered with the Commission for Social Care Inspection to provide personal care and accommodation for forty older people. The home is a purpose built establishment situated in the village of Hapton, Burnley. There are shops and public houses close by and it is near to public transport, rail and bus. Accommodation is in single ensuite bedrooms on two floors with access to the upper floors via a passenger lift. There is a residential and dementia care unit in the home. Wordsworth House is owned by Ashbourne (Eton) Limited. Wordsworth House Care Centre F57 F07 S9590 Wordsworth Hs V223273 260405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was carried out over a two-day period. The Inspector looked at written information and records relating to residents and staff. People who live at the home, visitors and staff on duty were spoken to for their views. The Inspector also looked at how resident’s views were obtained by those responsible for the home and how these could be used to improve their quality of life. The care given to the residents was looked at and the Inspector asked residents about their personal experiences and of life in the home. The previous inspection showed areas of the running of the home that needed to improve and progress and these were looked at. What the service does well: What has improved since the last inspection? Wordsworth House Care Centre F57 F07 S9590 Wordsworth Hs V223273 260405 Stage 4.doc Version 1.30 Page 6 Bedroom doors were kept locked for residents couldn’t do this themselves, and privacy of the residents was fully considered. Key working, where a member of staff takes particular responsibility for a resident had developed further and residents said they were happy with this arrangement. Staff had established routines for their work identified, and the standard of hygiene in the home was high. 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. Wordsworth House Care Centre F57 F07 S9590 Wordsworth Hs V223273 260405 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Wordsworth House Care Centre F57 F07 S9590 Wordsworth Hs V223273 260405 Stage 4.doc Version 1.30 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 standard(s) 1,2,3,5 The arrangements for residents moving into the home were generally satisfactory. The written information (service users guide and statement of purpose) had been updated though out of date copies were still being used. Assessments of needs were carried out prior to admission, although guidance on the assessment form had not been used. EVIDENCE: People were seen looking around the home and a ‘show’ bedroom had been prepared. The service users guide left in the room was out of date and could cause some confusion. The prospective resident was introduced to staff and other people living there. Records showed people had been given a needs assessment prior to admission. However the failure to complete one indicator on the needs assessment form, which was specific to identifying specialist aid/adaptations required, had resulted in one resident being unable to have a bath. Contracts between residents and the home were being properly used. Wordsworth House Care Centre F57 F07 S9590 Wordsworth Hs V223273 260405 Stage 4.doc Version 1.30 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 standard(s) 7,8,9,10 Residents had care plans, which provided basic detail in how residents care needs would be met. They contained correct information and were reviewed regularly. Staff involved residents in this process. Progress in developing care plans identified in the previous inspection had been maintained. Working arrangements with health and social care professionals was good. Medication was managed correctly. Resident’s privacy was considered and they were treated with respect by the staff in the home. EVIDENCE: Daily entries in care records showed how personal care practice was monitored. From these it could be seen that additional specialist support and advice was given to residents where needed. Residents were receiving regular visits from the chiropodist and residents said their doctor visited as necessary. Records of health care visits were kept for reference. The continence advisor had also visited the home, and the staff said all residents had benefited from this service. Wordsworth House Care Centre F57 F07 S9590 Wordsworth Hs V223273 260405 Stage 4.doc Version 1.30 Page 10 Changes in individual circumstances were acted upon promptly. A key worker system operated in the home. Residents spoke highly of their carers and said that staff were very good and felt their right to privacy was respected. Personal care was carried out with consideration given to their dignity. One resident said she could not use the bath and praised the staff for helping her, stating I wish I could have a proper bath, but staff always make sure I have a good wash down from tip to toe every day’. Good practice was observed with administration of medication. Wordsworth House Care Centre F57 F07 S9590 Wordsworth Hs V223273 260405 Stage 4.doc Version 1.30 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 standard(s) 12,13,14,15 Resident’s daily routines in the home allowed them to exercise choice and control over their lives. Activities provided however did not meet with their satisfaction and the home needs to consider ways in which this problem can be sorted out. Residents had maintained good contact with their family and friends. Catering arrangements offered choice of menu but did not fully cater for special diets. EVIDENCE: Some residents said they pleased themselves in their own routines, and said that most staff knew what they preferred such as getting up and going to bed times. Others said they hadn’t really thought about it. Leisure and activity interests had been recorded and in some instances provision was made to enable residents to continue with these. One resident in the residential unit said he had done some gardening and had enjoyed fishing with a friend. Some residents described their life in the home as ‘boring’, and ‘not much to do unless you like bingo’. The activities provided were limited despite a specialist activities coordinator employed for this purpose. From records examined it seems the activities provided in the dementia unit are very Wordsworth House Care Centre F57 F07 S9590 Wordsworth Hs V223273 260405 Stage 4.doc Version 1.30 Page 12 limited. Staff said they hold a variety of activities if time allows. For instance a luncheon club for relatives/friends was very popular. Activities that allow for individuals skills need to be developed. This is particularly important for residents in the dementia unit where their level of dependency and the lack of a unit manager add to the problem. Some residents said they followed a religious faith and were visited by clergy. Visitors said they could visit whenever they wished and staff made them welcome. They were invited to events in the home and informed of any changes in the care of their relative. Comments about the meals served in the home were varied. Some residents felt that the food served was not up to a good standard, with poor variety offered. Two other people said special diabetic diets were not catered for properly. Menus showed a choice of meals for residents. Residents were not given fresh fruit as a regular part of their daily diet. Good practice was observed in the way that residents were given a choice of meals in the dementia unit. Wordsworth House Care Centre F57 F07 S9590 Wordsworth Hs V223273 260405 Stage 4.doc Version 1.30 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 standard(s) 16,17,18 The complaints procedure was clear and accessible for residents and relatives. It was clear that any concern or suggestion was acted upon and taken seriously. Resident’s rights were observed and there were policies and procedures in place to ensure a proper response to any suspicion or allegation of abuse. EVIDENCE: The complaints procedure was given to all residents. Records showed complaints made had been investigated and outcomes recorded. Residents stated they knew how to make a complaint and most were confident issues of concern would be dealt with. Residents were currently receiving postal votes for the election and some indicated they would be voting. Staff who had worked only a short time at the home at the home said they were aware of the abuse policies and procedures. These had been included in induction training. Staff contracts precluded them from financial reward or assisting in or benefiting from the residents wills. Wordsworth House Care Centre F57 F07 S9590 Wordsworth Hs V223273 260405 Stage 4.doc Version 1.30 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 standard(s) 19, 20, 21, 22, 23, 24, 25, 26 The home was maintained to a high standard, and residents lived in a comfortable and homely environment. A good standard of hygiene was achieved. Bathing facilities were also good. EVIDENCE: Routine maintenance in the home and grounds was very noticeable and good practice identified in the previous inspection had been maintained. All the rooms in the home were pleasantly decorated and furnishings in the communal areas were of a good standard. The manager said there was a continuing programme of renewal and new dining chairs were being considered for the residential unit. There were no restricted areas and access to the upper floor was via a passenger lift or staircase. Fire alarms were tested regularly and water temperature checks carried out. Wordsworth House Care Centre F57 F07 S9590 Wordsworth Hs V223273 260405 Stage 4.doc Version 1.30 Page 15 Sufficient seating arrangements in the dining room on the dementia unit had still not been increased as recommended during the last inspection. All residents’ bedrooms were en suite (had toilets and washbasins in them) There were adequate additional toilet facilities situated around the home. One resident unable to use the specialist aids was satisfied with the bathing assistance staff gave her every day. There was a call system in every room that was accessible for residents. Resident’s bedrooms were of a high standard in terms of provision of furniture and decoration. Some residents had been involved in choosing colours for walls and curtains. Residents said they had keys to their doors and bedrooms were kept locked. All radiators throughout the home had been covered with protective guards. Laundry facilities were very good and equipped with washing machines designed for heavy soiling and infection control. Residents clothes were washed and ironed carefully, however some residents complained they did not always get their clothes back and in some instances had been given other peoples. The home was very clean and odour free. Residents commented on the level of cleanliness stating ‘the girls work hard’ and ‘its spotless’. They always had ‘clean bedding and their room cleaned properly every day’. Wordsworth House Care Centre F57 F07 S9590 Wordsworth Hs V223273 260405 Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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) 27,28,29,30 The residents valued regular long serving staff. There was a high turnover of new staff, which affected resident’s well being. Recruitment and selection procedures were not satisfactory or safe and placed residents at risk. There were times identified when the level of staffing did not meet the resident’s needs. Training provided and attended by staff was very good and offered a wide range of topics. EVIDENCE: The home was fully staffed during the inspection. Previous rotas showed that these levels had been maintained, with separate staff groups for the residential and dementia unit. The residents were concerned at the high turnover of staff in the home. One resident said ‘you just get used to a person and they leave’, and preferred the regular staff ‘they trusted’. Residents spoke very highly of the staff describing them as ‘gems’ and ‘very caring and obliging’. Some said ‘staff are kept very busy with hardly a minute to spare’. The level of staff on duty at peak times was inconsistent. Staff said the benefit of an additional member of staff on duty on occasions made a noticeable difference. Staff files showed recruitment checks to be incomplete. In one instance a staff member had started work prior to Protection Of Vulnerable Adults (POVA) Wordsworth House Care Centre F57 F07 S9590 Wordsworth Hs V223273 260405 Stage 4.doc Version 1.30 Page 17 register and Criminal Record Bureaux (CRB) check being completed. This practice must stop immediately. References had been applied for. In one instance a gap in employment had not been questioned. Although information received on the CRB for a person was questionable, the person was allowed to work night shifts when supervision was minimal. The manager said this had been an oversight and the person no longer worked at the home. Staff training was given priority in the home. All staff had attended basic training including specialist training for dementia care. Staff were enthusiastic about their work and said they enjoyed the content of training sessions. Staff said they were encouraged and supported to attend these sessions and also received supervision. Over 50 of staff had trained to National Vocational Qualification in Care level 2 and above. Wordsworth House Care Centre F57 F07 S9590 Wordsworth Hs V223273 260405 Stage 4.doc Version 1.30 Page 18 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) 32, 33, 35, 36 Good professional relationships existed between the manager, staff, residents and visitors. Guidance and support was given to staff to ensure the resident’s quality of life experience in the home was positive. Working systems set up by the manager had not been reviewed and the manager was not aware of difficulties staff had with them. Resident’s personal money was managed well. Good practice was observed in safe working procedures. EVIDENCE: The manager confirmed she continued with her professional development through training and attending management meetings. This aided her management. The means of seeking residents and staff views about the home was both formal and informal, with resident’s, staff and management meetings. Staff confirmed they received routine formal supervision. Relatives were also invited to meetings. Wordsworth House Care Centre F57 F07 S9590 Wordsworth Hs V223273 260405 Stage 4.doc Version 1.30 Page 19 Residents, visitors and staff expressed general satisfaction about the home. Staff said they were given guidance and support, and were confident in the management. Routines for staff in the home were established, and good teamwork was evident. During monthly inspections carried out by senior representatives, monitoring of recruitment was not recorded. This needs to be attended to. It is recommended that new staff be spoken to on these visits. Monitoring of new working systems did require reviewing by management. For example the manager was unaware of difficulties for staff such as obtaining sufficient continence wear for residents. Small amounts of money held for resident’s use was managed correctly. Maintenance and housekeeping was managed very well. Wordsworth House Care Centre F57 F07 S9590 Wordsworth Hs V223273 260405 Stage 4.doc Version 1.30 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 2 3 2 x 3 N/A 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 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 3 3 2 2 3 x 3 3 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 x 2 2 x 3 3 x 3 Wordsworth House Care Centre F57 F07 S9590 Wordsworth Hs V223273 260405 Stage 4.doc Version 1.30 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 3 Regulation 14(1) Requirement The Registered person must ensure a full assessment of need is carried out before a place is offered to that person. The registered person must ask the residents what activities they would like and arrange to provide them. The registered person must ensure residents are provided with suitable, wholesome and nutritious food that caters for special diets. The registered person must make sure satisfactory checks are obtained prior to offering employment as identified in the previous inspection. Timescale for action immediate from 26/04/05 27/05/05 2. 12 12(2)(n) 3. 15 16(2)(i) immediate from 26/04/05 immediate from 26/04/05 4. 29 19(4)(3)( b)(i) shedule 2 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 1 Good Practice Recommendations It is recommended the out of date versions of the service user guide and statement of purpose be withdrawn from circulation. F57 F07 S9590 Wordsworth Hs V223273 260405 Stage 4.doc Version 1.30 Page 22 Wordsworth House Care Centre 2. 3. 4. 5. 6. 7. 8. 12 15 22 27 29 32 33 It is recommended all residents are given opportunities for stimulation, through leisure and activities in and outside the home. It is recommended residents are offered a piece of fresh fruit as part of their diet. It is recommended bathing facilities are reviewed and any aid required for residents to enable them to use the bath should be provided. It is recommended the registered person and provider investigate the reason for the high staff turnover and improve the situation. It is recommended that the outcome of a Criminal Record Bureaux ploice check be considered in relation to the position offered and level of supervision give. It is recommended when introducing new systems of working these are reviewed by the manager to establish how effective they are. It is recommended senior management visiting the home monitor recruitment. Wordsworth House Care Centre F57 F07 S9590 Wordsworth Hs V223273 260405 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Unit 4, Petre Road Clayton-le-Moors Accrington BB5 5JB 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 Wordsworth House Care Centre F57 F07 S9590 Wordsworth Hs V223273 260405 Stage 4.doc Version 1.30 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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