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Inspection on 04/01/06 for Wren Hall Care Home

Also see our care home review for Wren Hall Care Home for more information

This inspection was carried out on 4th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Residents spoken with were very pleased with their care and spoke highly of the staff and the management, stating they were well cared for and staff treated them with respect. The relative spoken with stated the home was marvellous and staff were extremely supportive. Staff spoken with demonstrated an understanding of service users needs and an enthusiasm for their jobs. The manager and staff are to be commended for providing a safe and happy home where residents can maintain as much independence as they are capable of.

What has improved since the last inspection?

The home continues to maintain high standards of care.

What the care home could do better:

Minor improvements are required with regards to ensuring the risk of entrapment is highlighted within plans of care when service users are using bedrails to ensure they are fully protected. The manager was spoken with following the inspection and the policy with regards to restraint was discussed, as this was not observed on the day of inspection, this was considered excellent and covered the risk of entrapment appropriately, this information now needs to be reflected in the plan of care.

CARE HOMES FOR OLDER PEOPLE Wren Hall Care Home 234 Nottingham Road Selston Nottinghamshire NG16 6AB Lead Inspector Karmon Hawley Unannounced Inspection 4th January 2006 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 Wren Hall Care Home DS0000024672.V274412.R03.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. Wren Hall Care Home DS0000024672.V274412.R03.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Wren Hall Care Home Address 234 Nottingham Road Selston Nottinghamshire NG16 6AB 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) 01773 581203 01773 860683 Wren Hall Nursing Home Limited Ms Anita Astle Care Home 41 Category(ies) of Dementia (8), Old age, not falling within any registration, with number other category (41), Physical disability (3), of places Terminally ill (2) Wren Hall Care Home DS0000024672.V274412.R03.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19/10/05 Brief Description of the Service: Wren Hall is a 41-bed care home, providing nursing care for older people of both sexes, situated in the village of Selston. The two-storey building provides three lounges and two dining areas, one in a pleasant conservatory setting. There are 30 bedrooms, all comfortably furnished and decorated to a high standard. Externally there are extensive well-maintained gardens and, to the front of the building, a good-sized car park. All parts of the home are accessible to service users. Wren Hall Care Home DS0000024672.V274412.R03.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place in four hours and was performed by one inspector. The main method of inspection was case tracking, this is a method of sampling the records of four randomly selected service users to ascertain if the needs of service users are appropriately assessed and identified needs are being catered for by the home to maintain optimum health and wellbeing of the service user. Four service users and one relative were spoken with so as to give the inspector an insight into the conditions and standards within the home. Those spoken with were happy with the care received the standards within the home and spoke highly of staff. The registered nurse on duty and the training and quality coordinator assisted in the inspection process and two members of staff were spoken with. Staff were able to demonstrate a good understanding of service users needs and the core values and principles in relation to their job role. There were no requirements made at the previous inspection, on this occasion therefore, the focus was on those standards not assessed last time. What the service does well: What has improved since the last inspection? The home continues to maintain high standards of care. Wren Hall Care Home DS0000024672.V274412.R03.S.doc Version 5.1 Page 6 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. Wren Hall Care Home DS0000024672.V274412.R03.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 Wren Hall Care Home DS0000024672.V274412.R03.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 Service users can be assured their needs will be assessed and met prior to admission. EVIDENCE: Preadmission assessments are carried out in the community prior to service users being admitted to the home. The procedure covers the requirements of this standard and in depth assessments were noted to have taken place within three case files examined. One relative spoken with stated she had had the opportunity to visit the home prior to her spouse being admitted and she had been supplied with all relevant information. Wren Hall Care Home DS0000024672.V274412.R03.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 Service users health, personal and social care needs are assessed and well documented enabling staff to meet individuals needs accordingly, with one minor cross referencing omission regarding a further risk assessment for bed rails. EVIDENCE: Four case files were examined which demonstrated various assessments taking place such as the activities of daily living, pressure area care, manual handling, nutrition and infection control. Information gained from these assessments forms the basis of the plan of care. Care plans in place were personalised and reflected preferences and choices, which had been ascertained during an assessment of this. All identified needs were addressed appropriately and covered risk management plans, with the exception of the risk of entrapment with the use of bedrails. However consent had been gained for the use of bedrails and service users and relatives had undergone discussions with regards to the necessity of these. Staff spoken with were able to identify the risk of entrapment and what they would look for to prevent its occurrence. Daily records were maintained on the computer system and noted significant events. There was evidence of service users and relatives having input into the plans of care. Wren Hall Care Home DS0000024672.V274412.R03.S.doc Version 5.1 Page 10 There was evidence within case files examined that the multidisciplinary team and specialist services are accessed and liaised with accordingly and relevant aids and adaptations were available. Service users were able to substantiate that access to these services is facilitated and one relative spoken with stated a specialised chair had been obtained for her spouse. Wren Hall Care Home DS0000024672.V274412.R03.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): 12,14 Service users are enabled to exercise choice and control over their lives and find the lifestyle experienced in the home matches their expectations and preferences and satisfies their needs. EVIDENCE: An activities coordinator is employed for 18 hours a week, there is a wide variety of activities on offer should a service users wish to join in. Each service user undergoes an assessment with regards to activities so these may be tailored to individual needs. An excellent monthly magazine is also produced by the activities coordinator which offers information about forthcoming events, short stories, puzzles and much more. Service users spoken with stated they enjoyed the activities on offer and discussed those they have joined in with. The large garden is utilised in the warmer months and service users stated they often eat meals outside which they enjoy. Choice is offered at all meals, which staff and service users substantiated and preferences were noted within case notes observed. As noted an assessment with regards to choices and preferences takes place on admission. Visitors may be received in private and one relative spoken with stated she is always made welcome. Service users are enabled to bring in personal possessions and rooms were Wren Hall Care Home DS0000024672.V274412.R03.S.doc Version 5.1 Page 12 noted to be personalised during the tour of the home. Service users if able are facilitated to handle personal finances and a lockable facility/door is provided. Wren Hall Care Home DS0000024672.V274412.R03.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 Service users and relevant others can be confident complaints will be listened to, taken seriously and acted upon. EVIDENCE: There have been no complaints received since the last inspection. Appropriate policies and procedures are in place with this regard and service users and relatives are issued with documentation on how they may complain should they wish to do so. Service users spoken with stated they had no concerns or complaints and should they wish to discuss anything with staff they were approachable, kind and considerate. Staff spoken with were able to discuss how they would handle complaints should they arise. Wren Hall Care Home DS0000024672.V274412.R03.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): 19,26 Service users live in a safe, well-maintained environment, which is clean, pleasant and hygienic. EVIDENCE: A general maintenance man is employed who carries out maintenance within the home, records for which were available for inspection. The home was clean and tidy and well maintained. Ample facilities, aids and adaptations were noted to be in place. Appropriate laundry, hand washing and sluicing facilities were also in place; the laundry was very clean and tidy on the day of inspection. The majority of staff have undertaken training in infection control and health and safety. Wren Hall Care Home DS0000024672.V274412.R03.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 The numbers and skill mix of staff meets service users needs. EVIDENCE: The staff rotas were observed which demonstrated high levels of staff are employed to meet service users needs. Staff stated there were ample staff on duty to meet needs and service users stated that their needs are met. Skill mix is considered when completing the duty rota, which was demonstrated on the day of the inspection. Wren Hall Care Home DS0000024672.V274412.R03.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): 33,38 The home is run in the best interest of service users. The health safety and welfare of service users and staff is promoted and protected, however addition records are required to fully substantiate appropriate fire drills are taking place. EVIDENCE: Annual audits take place and service users, staff and relatives are invited to complete questionnaires to offer their opinions of care received. These were observed and feedback was of a positive nature. Should any matter arise from these action plans are drawn up to address matters positively. Service users meetings are held on a monthly to six weekly basis, records of which were available. Service users and the relative spoken with stated they were extremely happy with care received and had no concerns, they also stated staff were approachable should they need to discuss any matter with them. There Wren Hall Care Home DS0000024672.V274412.R03.S.doc Version 5.1 Page 17 was also evidence available within plans of care to demonstrate relatives and service users are invited to hold reviews with regards to care received. Maintenances and servicing certificates were observed and demonstrated compliance. Staff training was at a good standard and further training is planned for the following months. Staff attend fire drills on a weekly basis and staff spoken with were able to discuss action they would take in the event of a fire, there were no written records available to substantiate these were taking place on the day of inspection, however they were forwarded to the commission for social care inspection on the managers return and records demonstrated that staff are attending fire drills as appropriate. Wren Hall Care Home DS0000024672.V274412.R03.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 4 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 X 14 4 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 4 X X X X X X 4 STAFFING Standard No Score 27 4 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 4 X X X X 4 Wren Hall Care Home DS0000024672.V274412.R03.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? NA 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 OP7 Good Practice Recommendations Ensure cross referencing of detailed risk assessments regarding the use of bed rails is documented Wren Hall Care Home DS0000024672.V274412.R03.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Wren Hall Care Home DS0000024672.V274412.R03.S.doc Version 5.1 Page 21 - 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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