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Inspection on 09/02/06 for Wordsworth House Care Home

Also see our care home review for Wordsworth House Care Home for more information

This inspection was carried out on 9th February 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home provides good care to residents, including those requiring nursing care. Residents are assisted to maintain as much independence as possible and are encouraged to maintain contact with the local community. Meals are appetising and of very good quantity and quality. The premises are comfortable, with a number of lounges and a separate dining room. Residents are treated with respect, their privacy is protected and staff understand and meet their needs. Residents feel safe and well cared for.

What has improved since the last inspection?

Since the previous inspection the home has introduced and implemented a system for formal supervision of all staff.

What the care home could do better:

The home must introduce a system for the assessment of residents wishing to self-administer prescribed medicines, to ensure they do not place themselves or others at risk of harm by improper actions, including unsafe storage of medicines. Arrangements for care staff to receive NVQ (National Vocational Training) training in care must be improved. To meet the National Minimum Standards, the Registered Person must provide to the Commission regular reports about the home. Arrangements for carrying our routine tests and checks of fire safety equipment must be improved to ensure that in the event of need these items can be relied upon to function correctly. There must be evidence of safety of the gas installation, a fire door must be adjusted to fully close, a section of laundry flooring must be made safe and the premises must be comprehensively assessed for Health & Safety compliance.

CARE HOMES FOR OLDER PEOPLE Wordsworth House Care Home 2 Belle Vue Road Swanage Dorset BH19 2HR Lead Inspector Gloria Ashwell Unannounced Inspection 9th February 2006 13:45 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 Wordsworth House Care Home DS0000050583.V282758.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. Wordsworth House Care Home DS0000050583.V282758.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Wordsworth House Care Home Address 2 Belle Vue Road Swanage Dorset BH19 2HR 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) 01929 423614 01929 423614 jan-weekes@btinternet.com Wordsworth House Care Home Ltd Care Home 51 Category(ies) of Old age, not falling within any other category registration, with number (51) of places Wordsworth House Care Home DS0000050583.V282758.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18 April & 10 May 2005 Brief Description of the Service: Wordsworth House is a large, detached, 3 storey property situated in the Durlston part of Swanage town. It is in an elevated position, with many rooms and the gardens offering views over Durlston Park and the sea. The garden is attractive, well maintained and easily accessible by having ramps and rails. Residents at Wordsworth House have the benefit of the local seaside town and the amenities it offers including shops, restaurants and a post office. The home is registered with the Commission for Social Care Inspection to accommodate a maximum of 51 older people with nursing or personal care needs. Accommodation is over 3 floors with 2 double and 6 single rooms on the first floor; 3 double and 14 single rooms on the second floor and 2 double and 17 single rooms on the second floor. The main communal areas consist of a lounge and a dining/sitting room. There are a further 3 small lounges, these may also be used by service users as dining areas. The home has assisted bathing facilities on each floor and there are 2 passenger lifts. Off road parking is available at the front of the house. Wordsworth House Care Home DS0000050583.V282758.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was one of the two statutory inspections required in accordance with the Care Standards Act 2000. The previous inspection concluded on 10 May 2005; since that inspection no complaints against the home have been received or investigated by the Commission. The inspector spoke to 16 residents and 4 visiting relatives, and together with the manager considered other evidence relating to the National Minimum Standards, as described in this report. In recognition of the circumstances and history of this home, which is known to routinely meet most National Minimum Standards this inspection was relatively brief in duration (lasting 3 hours 15 minutes) and focussed on discussion with residents and assessment of only the most essential standards. Standards assessed and found met during the previous inspection were not reassessed during this inspection; this report should therefore be read in conjunction with the report of the previous inspection. What the service does well: What has improved since the last inspection? Wordsworth House Care Home DS0000050583.V282758.R01.S.doc Version 5.1 Page 6 Since the previous inspection the home has introduced and implemented a system for formal supervision of all staff. 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 Home DS0000050583.V282758.R01.S.doc Version 5.1 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 Wordsworth House Care Home DS0000050583.V282758.R01.S.doc Version 5.1 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): 3 (Standards 1& 5 were assessed and found met at the previous inspection) Standard 6 is not applicable because the home does not provide intermediate care. When a new resident moves into the home they are provided with a statement of terms and conditions giving knowledge of the fees and what they do and do not cover. Prior to admission, the needs of each proposed resident are assessed to ensure the home will be properly able to meet them; the home then writes to the prospective resident confirming the ability to properly care for them. EVIDENCE: Following pre-admission assessment, if the home decides to offer a place to a new resident, the manager then writes to the person stating that the home will be able to meet their assessed needs. Wordsworth House Care Home DS0000050583.V282758.R01.S.doc Version 5.1 Page 9 With the letter is sent a contract and statement of terms and conditions of occupancy, stating the number of the bedroom the resident had selected, to ensure no misunderstanding occurs. Wordsworth House Care Home DS0000050583.V282758.R01.S.doc Version 5.1 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, 9 & 10 (Standard 8 was found met at the previous inspection) The standard of health, personal and social care is good and is delivered in accordance with a written plan of care ensuring staff have information necessary to provide correct care to each resident. Medicine storage, handling and recording is properly carried out to ensure that residents receive medicines as prescribed. Residents feel they are treated with respect and kindness by staff of the home. EVIDENCE: Residents feel well cared for; comments included “they work hard…they’re very good”. Staff to whom the inspector spoke were aware of each resident’s health and social care needs. Doctors visit residents unable to attend their surgeries for consultation. As necessary, individual residents in the home are visited by other health professionals e.g. nurse specialists, opticians, chiropodists. . Wordsworth House Care Home DS0000050583.V282758.R01.S.doc Version 5.1 Page 11 Risk assessments form the basis for care plans and daily records describe the care of each resident. The home has not met the recommendation of the previous inspection report to provide evidence that service users and/or their representatives are involved in drawing up and reviewing their plans of care. The recommendation is repeated in this report. Medicine records were accurate and medicines were properly stored. All medicine handling is carried out by registered nurses. To protect against risks of medicine errors handwritten medication instructions should be signed and dated by the writer and countersigned by a colleague who has checked the entry for accuracy. Residents who self-administer have not been assessed by Wordsworth House for their capacity for self-medication (including understanding, dexterity, storage provision). This report contains an associated requirement. Discussion with residents indicated that staff are kind, polite and very helpful regarding their needs, and properly promote their privacy, dignity and wellbeing. Wordsworth House Care Home DS0000050583.V282758.R01.S.doc Version 5.1 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): 13 & 14 (Standards 12 & 15 were found met at the last inspection) The quality of daily life in the home is good with residents assisted to maintain contact with family and friends and to retain as much independence and control over their lives as possible. EVIDENCE: The inspector spoke to a number of residents and the visiting relatives of 2 residents; all expressed satisfaction with the home, including the meal provision, staff, premises and freedom of choice encouraged by the home. Visitors are welcome at any time and residents can go out of the home whenever they wish, and for as long as they wish. Wordsworth House Care Home DS0000050583.V282758.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 (Standard 18 was assessed and found met at the previous inspection) Complaints are managed properly and residents said they are confident their concerns are listened to and taken seriously. EVIDENCE: The home has a written policy and procedure for the management and recording of complaints. No complaints against the home have been received or investigated since the last inspection. Wordsworth House Care Home DS0000050583.V282758.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 and 26 (Standard 25 was found met at the previous inspection) The home is comfortable, clean and suited to the needs of the currently accommodated residents, including those who require nursing and are of high dependency. EVIDENCE: Wordsworth House provides a pleasing, safe and comfortable environment for residents. The home has two passenger lifts providing level access to all parts of the registered premises. Aids including bath hoists and specialist beds are available to assist frail residents. Resident’s bedrooms contain a variety of personal belongings; many residents provide items of their own furniture Wordsworth House Care Home DS0000050583.V282758.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): 28 (Standards 27, 29 & 30 were found met at the previous inspection) The home does not meet the standard for staff training provision so care staff may not have sufficient knowledge to properly carry out their work and may unknowingly place residents at risk of harm or neglect. EVIDENCE: The inspector spoke to a number of staff, including care workers and household staff; all expressed support of management and the home, and were well motivated. None of the 19 care staff currently employed by the home holds a National Vocational Qualification in care; 2 are at present training for this qualification but the home should endeavour to provide more with training opportunities to ensure that at least 50 of the care staff are trained to NVQ standard. Wordsworth House Care Home DS0000050583.V282758.R01.S.doc Version 5.1 Page 16 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): 33, 35, 36, 37 & 38 Residents are satisfied with the home and feel staff care for them well and put them at their ease. The home periodically issues ‘user satisfaction’ questionnaires to ensure that residents and their representatives remain satisfied with all aspects of the home. The home does not manage the finances of any service user. The home has implemented written policies and procedures to promote residents rights and well-being. There are adequate formal and informal arrangements for staff supervision. Some improvements are necessary to ensure that premises and equipment are properly maintained in a safe condition, to protect residents, staff and visitors from harm and injury. Wordsworth House Care Home DS0000050583.V282758.R01.S.doc Version 5.1 Page 17 EVIDENCE: Residents indicated they are satisfied with Wordsworth House; they said they feel safe and well cared for. Periodic meetings of residents and their relatives are held in the home. The home does not manage the finances of any service user; residents either manage their own monies or have relatives or lawyers undertake this on their behalf. Staff work in accordance with a collection of written policies and procedures to ensure continuity of approach and safe working practices. At all times there are staff on duty in the home with knowledge of how to deal with accidents and health emergencies. The manager has met the recommendation of the previous inspection report to introduce a system of regular formal supervision, in addition to the ongoing informal supervision of all staff while carrying out their work. At least once each month the registered provider or a suitable delegate must visit the home to monitor standards, and forward to the Commission a written report of the findings. The most recently received report was for October 2005; it is required that monthly reports are provided. The premises and equipment are generally maintained in a safe condition to ensure residents, staff and visitors are protected from harm and injury, but the home must provide evidence of the safety of specified aspects. Records of fire safety equipment checks and tests included those of fire alarms but not of monthly tests/checks of emergency lighting and extinguishers; this report includes a requirement to ensure that these essential aspects receive appropriate attention. The inspector was shown records indicating the safety of the passenger lift, hoists and the electrical installation. Records indicated that routine servicing of the gas installation and issue of an annual safety certificate took place on 9 June 2004; it is required that evidence of current safety be obtained. Wordsworth House Care Home DS0000050583.V282758.R01.S.doc Version 5.1 Page 18 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 X 28 1 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 3 2 2 Wordsworth House Care Home DS0000050583.V282758.R01.S.doc Version 5.1 Page 19 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. 1. Standard OP9OP9 Regulation 13 Requirement Timescale for action 09/03/06 2. OP3838 23(4) 3. OP37OP37 26 4. OP3838 13 Residents wishing to selfadminister prescribed medicines must be comprehensively assessed for their ability to safely store and dispense these items. Fire safety equipment must be 09/03/06 tested/checked at the required frequencies and accurate records must be kept of these tests/checks. The registered provider must 01/04/06 compile a report of monthly visits on the conduct of the home and provide a copy to the Commission and to the manager. There must be written evidence 01/04/06 confirming the safety of the gas installation. Wordsworth House Care Home DS0000050583.V282758.R01.S.doc Version 5.1 Page 20 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 OP7 Good Practice Recommendations Care files should hold some documentary evidence that service users and/or their chosen representative have been invited to participate in the drawing up and review of care plans. This recommendation is repeated from the previous inspection report. A minimum of 50 of care assistants should hold the NVQ level 2 award in care. This recommendation is repeated from the previous inspection report. 2. OP28 Wordsworth House Care Home DS0000050583.V282758.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Home DS0000050583.V282758.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. 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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