Inspection on 07/12/06 for Wren Park Nursing And Residential Home

This inspection was carried out on 7th December 2006.

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

Wren Park Nursing And... 21/11/08

Wren Park Nursing And... 12/01/06

Wren Park Nursing And... 25/08/05

Wren Park Nursing And... 17/02/05

Wren Park Nursing And... 11/06/04

Wren Park Nursing And... 27/01/04

Wren Park Nursing And... 22/12/03

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Wren Park Nursing And Residential Home Hitchin Road Shefford Bedfordshire SG175JD Lead Inspector Carol Mitchell Unannounced Inspection 7th December 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 Park Nursing And Residential Home DS0000017698.V322229.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Wren Park Nursing And Residential Home DS0000017698.V322229.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wren Park Nursing And Residential Home Address Hitchin Road Shefford Bedfordshire SG175JD 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) 01462 851548 01462 850667 GA Projects Limited Mrs. Elizabeth Mazhar Care Home 46 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (46) of places Wren Park Nursing And Residential Home DS0000017698.V322229.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The maximum number of service users must not exceed 46. No one falling into the category of DE(E) may be admitted into the home where there are already 15 persons of category DE(E) accommodated in the home. To continue to accommodate the person aged 62 accommodated under category OP and who was named in the proposal to vary the conditions of registration. No other person under the age of 65 years of age may be admitted to the home. 12th January 2006 Date of last inspection Brief Description of the Service: Wren Park is a privately run care home for people over 65 years with nursing. There are forty six places, and fifteen of these can be for people with dementia. The home is situated at a short distance from the market town of Shefford. The premises comprise the original old house that has been adapted, and a large extension has been added to provide residential care. There is a garden with hard area and paths, and parking to the front of the building. Information about this home can be obtained by phoning or visiting the home, and there is also an email address. The following information about fees was obtained on 7th December 2007:Lowest residential fee, £425.86, Lowest nursing fee £580 ; Highest residential fee, £460, highest nursing fee £600. Items not covered by the fees are hairdressing (starts at £2), newspapers, and toiletries which are supplied at a nominal rate. Wren Park Nursing And Residential Home DS0000017698.V322229.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report takes account of any information obtained by the Commission since 12/01/06 when the last key inspection took place, and from the unannounced inspection visit. The unannounced inspection visit took place during just over 4 hours on 7th December 2006. The inspector spoke to residents, staff, and the manager during the visit. A sample of records was checked, and the inspector looked around some parts of the building. The inspector would like to take this opportunity to thank everyone involved with the inspection visit. What the service does well: The home is kept very clean and comfortable, and is run in an organised way. People like living at the home, “I am very happy here” one resident said. “The food is good” said another. Staff work at the home who are very enthusiastic about helping people live to the full. They arrange lots of activities for people living at the home to enjoy. Residents can speak up, they know how to complain, and they are listened to. A resident said “I would tell them if I wanted to complain!” People living at the home and their families can complete questionnaires about the home, and residents have meetings. Staff receive training at the home, and the staff enjoy their work. One staff member said, “It’s a good team, they are very nice people to work with.” Staff meetings are held, and the staff feel supported. The health needs of people living at the home are well looked after, and the staff know how to care for the residents. Wren Park Nursing And Residential Home DS0000017698.V322229.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Wren Park Nursing And Residential Home DS0000017698.V322229.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Wren Park Nursing And Residential Home DS0000017698.V322229.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager makes sure she finds out about how people need to be looked after before they move in. Therefore people living at the home can be sure that their needs will be met. EVIDENCE: The home has a brochure with lots of useful information, and people can visit the home as often as they wish before they move in. The manager visits prospective residents in their home or in hospital, and undertakes a full needs assessment (including skin condition), and uses a special form to help with this. Some details are obtained at initial enquiry, either on phoning, or when a relative or prospective resident visits. Wren Park Nursing And Residential Home DS0000017698.V322229.R01.S.doc Version 5.2 Page 9 There are 3 intermediate care places at the home, and referrals usually come from the hospital social worker and nursing staff. People admitted to these beds are visited by, and their care is coordinated by the community rehabilitation team. Wren Park Nursing And Residential Home DS0000017698.V322229.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported by staff who know how to look after them, and the manager makes sure that health professionals such as family doctors, district and specialist nurses are available when they are needed. The manager tries hard to make sure that the care plans are written properly. Therefore people living at the home can be sure that their health needs will be met. EVIDENCE: In discussion, residents said that they are well looked after. Staff observed took care to protect residents’ privacy, and were kind and attentive in their dealings with residents. Staff spoken to could discuss how they care for individual residents. The manager explained that the care plans are being worked on, and she is continuing to encourage staff with this. A small sample of care plans showed Wren Park Nursing And Residential Home DS0000017698.V322229.R01.S.doc Version 5.2 Page 11 that there is a well organised system in place, that residents have care plans and that risks are assessed. Detail within one care plan which should have been included was missing, and the manager agreed that she needs to check care plans for this especially when such detail may relate to such matters as a break in skin integrity. There are strong links with the local family doctors who visit regularly, as do District nurses. A dietician visits to give specialist advice, as do specialists such as community psychiatric and tissue viability nurses. Special equipment such as pressure relieving mattresses and cushions is available and was in use at the time of the inspection visit. There are arrangements in place for dentistry, optician, and chiropody/foot care services. There is an organised system in place for medicines. At the time of the inspection visit, no one was self medicating, but this can be arranged if needed. The nurses or senior carers administer the medicines, and the senior carers have had special training for doing this. The supplying pharmacist does an inspection every year, and found no major problems at the last inspection. A small sample of medicine record sheets was checked and inn order. Infection control is given due consideration, with reminders of correct hand washing technique posted in staff areas, and training about infection control matters is provided. The manager periodically checks that infection control procedures are being adhered to. Wren Park Nursing And Residential Home DS0000017698.V322229.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are staff working at the home who really try to make sure that residents at the home live their lives as fully as they want to. Therefore people moving in can be sure that their expectations of living at the home will be met. EVIDENCE: Residents spoken to said that they enjoy living at the home. The food is good; they are given choices and are never hungry. At the time of the inspection visit, some residents were dining in the dining room and others in their bedrooms. Staff observed assisting with feeding were sensitive and did not rush the meal. Residents were able to confirm that their families can visit whenever they like and that they are made welcome. Wren Park Nursing And Residential Home DS0000017698.V322229.R01.S.doc Version 5.2 Page 13 Dementia care training has now been undertaken by staff at the home, and therefore there is an increased knowledge and enthusiasm for supporting those with dementia in their daily lives. Two committed activities organisers work at the home. One was present on the day of the inspection visit, and discussed with great enthusiasm her role in helping people at the home live to their full capacity. She was able to discuss how individuals are helped to enjoy meaningful occupation despite any problems in some detail. There is a strong emphasis on keeping as fit and mobile as possible, and various exercise sessions to music and ball games are enjoyed by residents and staff. Other activities listed include the following:Art and craft activities (Christmas table decorations were being made at the time of the inspection visit); Gardening; Games such as dominoes and cards; Hand massage and nail care; Visits from museums; Visits from clergy (Ecumenical service every month); Singing and music. Plans for Christmas include an entertainer, a visit by Bedford band, and a Christmas party. The mobile library visits and the home also has its own small library. The home shares a minibus with its sister home so that trips out can be organised. Wren Park Nursing And Residential Home DS0000017698.V322229.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager makes sure that checks are made before staff can work at the home, and staff are trained about the possible harm that residents can come to. If the manager gets a complaint she tries very hard to look at the issues carefully, and can see when she would be helped by some additional training. Therefore people living at the home can be sure that they will be listened to, and protected form harm. EVIDENCE: In discussion, residents were able to explain how they would complain when they need to. Protection of Vulnerable Adults (POVA) training is now established, and staff questioned had received training and were able to say what they would do if they should ever witness anything untoward in the home. The proper checks are made before employed. One complaint has recently been received by the home. This has been taken very seriously, and the investigation was underway at the time of the inspection visit. The manager agreed that especially since the home has not Wren Park Nursing And Residential Home DS0000017698.V322229.R01.S.doc Version 5.2 Page 15 received many complaints, her experience in this field is limited, and she would benefit from additional complaints management training. Wren Park Nursing And Residential Home DS0000017698.V322229.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The owners and manager make sure that decoration is done and new furniture is bought when necessary. Someone is employed to maintain the home. Therefore residents can be sure that theirs is a well maintained and comfortable place to live. EVIDENCE: Residents spoken to said that they like their rooms, and that they go out into the garden, more so in the summer months. There are some paths and a patio area. The services of a maintenance man are shared with the nearby sister home. Wren Park Nursing And Residential Home DS0000017698.V322229.R01.S.doc Version 5.2 Page 17 Since the last inspection visit some rooms have been decorated, as have some corridors, and new carpets and curtains have been fitted to a lounge/dining area. New tables and chairs have been bought. New bed linen has been purchased, and residents’ clothes looked clean and smart. Committed housekeeping staff clean the home to a high standard, and no unpleasant odours were noticed during the inspection visit. Residents are able to bring in personal possessions for their rooms if they wish, and such items were on display in the bedrooms seen. Some corridors in the home were cooler than communal areas. However, residents questioned said that they felt plenty warm enough. In March 2006 a satisfactory fire inspection was undertaken. Wren Park Nursing And Residential Home DS0000017698.V322229.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sufficient staff work at the home, and the staff are trained to do their jobs. Therefore people living at the home can be sure they will be supported by an effective staff team. EVIDENCE: Residents said that the staff are kind and look after them well. Staff observed were attentive and caring in their dealings with residents. Staff could talk with confidence about their role in the home. They enjoy their work, and feel that they are part of a good team that works well together. Staff meetings are held, and staff supervision and appraisals are in place. Additional meetings are held for staff where English is not the first language to ensure better understanding of any communications. English lessons are arranged, and the manager is aware of the need to monitor any possible language associated problems especially in the area of care delivery. The recruitment through an agency of staff from outside the UK was discussed, and it was not clear whether all of the same procedures are followed in cases at home and abroad. (The manager is not able to meet or interview prospective employees before their employment when they are recruited abroad, and Wren Park Nursing And Residential Home DS0000017698.V322229.R01.S.doc Version 5.2 Page 19 interviewing is done by the owners who were not present during this inspection visit to clarify this.) Since the last inspection visit 16 staff have received very helpful training in dementia care, and other training is in place on an ongoing basis. Registered nurses are able to take advantage of professional development opportunities and recent courses have covered bowel management and specialist feeding techniques. A carer spoken to is hoping to soon attend training about the administration of medicines. A sample of staff files and discussion with the manager indicated that the proper checks are made before staff are employed, and that induction training is undertaken. When new staff start work, they are extra to the staffing complement for a few shifts, and then remain under supervision for some time. In conversation, the manager, staff and residents felt that there are now sufficient care staff at the home. Wren Park Nursing And Residential Home DS0000017698.V322229.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The owners and manager try hard to make sure that they find out what residents think, and they listen to what residents say. The home is run in an organised and friendly way. Therefore people living at the home can be sure that it is run with their best interests at heart. EVIDENCE: The manager is well supported by the owners who are actively involved in the running of the home and visit about three times every week. The home is run in an organised and friendly way. There are proper systems in place, for Wren Park Nursing And Residential Home DS0000017698.V322229.R01.S.doc Version 5.2 Page 21 example residents’ money not held by the person concerned is safely kept and recorded. At the time of the inspection visit the owner did not realise it is necessary for her to write monitoring reports every month, but she has stated by phone that this will be easy to do and she will be starting as soon as possible. Residents meetings are held and questionnaires are used to obtain feedback from residents and their families. The manager asks the Activity Organisers to gather the information so that residents can feel more relaxed about raising issues to do with the running of the home if they so wish. The manager looks at the results of questionnaires and addresses any issues as necessary. Minutes of meetings are recorded. Residents were advised at one meeting that they are able to have locks fitted to their doors on request. At the time of asking residents chose not to have locks fitted. Staff meetings are held, and formal staff supervision sessions are in place. However the frequency of supervision sessions needs to be increased slightly and the manager said she will attend to this. Staff reported that there are good relationships with the manager and deputy manager, and that their opinions are listened to. The manager’s job description includes reference to staff recruitment and she needs to have full knowledge of the procedures in place for the recruitment of all staff. The owners and manager may benefit from additional advice or training in the area of human resources. Wren Park Nursing And Residential Home DS0000017698.V322229.R01.S.doc Version 5.2 Page 22 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 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 2 x 3 Wren Park Nursing And Residential Home DS0000017698.V322229.R01.S.doc Version 5.2 Page 23 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 OP29 Refer to Standard Good Practice Recommendations The owners and manager should make sure that procedures are consistently applied when recruiting each staff member. Consideration should be given as to whether additional support in the area of human resources would be beneficial. Wren Park Nursing And Residential Home DS0000017698.V322229.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Wren Park Nursing And Residential Home DS0000017698.V322229.R01.S.doc Version 5.2 Page 25 - 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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