Inspection on 22/06/06 for Wrenbury Nursing Home

This inspection was carried out on 22nd June 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Wrenbury Nursing Home 17/11/09

Wrenbury Nursing Home 02/04/09

Wrenbury Nursing Home 05/04/07

Wrenbury Nursing Home 27/09/05

Wrenbury Nursing Home 31/05/05

Wrenbury Nursing Home 04/01/05

Wrenbury Nursing Home 27/07/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Wrenbury Nursing Home Wrenbury Hall Drive Wrenbury Nantwich Cheshire CW5 8EJ Lead Inspector Wendy Smith Key Unannounced Inspection 22nd June 2006 10:20 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 Wrenbury Nursing Home DS0000041864.V294851.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. Wrenbury Nursing Home DS0000041864.V294851.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Wrenbury Nursing Home Address Wrenbury Hall Drive Wrenbury Nantwich Cheshire CW5 8EJ 01270 780114 01270 780114 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) Wrenbury Ltd Mrs Gaynor York Care Home 33 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (33), of places Physical disability (3) Wrenbury Nursing Home DS0000041864.V294851.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 33 service users to include: * * 2. Up to 33 service users in the category OP (old age, not falling within any other category). Up to 3 service users in the category PD (physical disability). The registered provider must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 27th September 2005 Date of last inspection Brief Description of the Service: Wrenbury Nursing Home is a two storey converted detached property situated in its own attractive grounds in a rural setting. It is close to the local amenities of Wrenbury village and there is a bus service to Nantwich town centre. Ample car parking space is available. Bedrooms are on two floors with a passenger lift and staircase providing access to the first floor. There are twenty-nine single bedrooms, six of which have en suite facilities, and two double bedrooms. All rooms have hand wash basins. Assisted bathing facilities are provided and there are adaptations and aids throughout the home. The home has two lounges and a separate dining room. A telephone is available for residents’ use and a nurse call system is provided in all areas. Wrenbury Nursing Home DS0000041864.V294851.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit took place on 22nd June 2006 as part of the Commission for Social Care Inspection’s statutory inspection programme. The home had 22 residents, of whom 20 were older people and two were younger adults, one of whom was having a short stay at the home. A tour of the building, including all communal areas and most bedrooms, was completed. A sample of records was looked at and time was spent in conversation with the home manager, residents, staff and a relative. Some of the information contained in this report is taken from the preinspection questionnaire that had been completed by the manager. Comments cards were received from two residents and one relative/visitor and a relative was spoken with by telephone. The home’s fees are from £329 to £470 per week. What the service does well: What has improved since the last inspection? Some bedrooms furnishings. have been improved by re-decoration and new soft A considerable amount of work has been carried out to the home’s water systems to ensure that residents are protected from Legionella. Most of the requirements and recommendations previously made have been addressed. Wrenbury Nursing Home DS0000041864.V294851.R01.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. Wrenbury Nursing Home DS0000041864.V294851.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 Wrenbury Nursing Home DS0000041864.V294851.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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective residents are assessed prior to admission to ensure that their care needs can be met at Wrenbury. Intermediate care is not provided. EVIDENCE: Prospective residents are assessed by the home manager prior to admission to ensure that their needs can be met at Wrenbury. At the time of this visit one person was having a short stay at the home. This was his fifth stay at the home. His care plan had not been reviewed on admission to determine whether his needs remained the same. Wrenbury Nursing Home DS0000041864.V294851.R01.S.doc Version 5.1 Page 9 The home has one resident who is under 65 years of age and has physical and learning disabilities. This person’s health and mobility have improved considerably since admission and at reviews with social services in July 2005 and January 2006 it was agreed that more appropriate accommodation should be found for him, where his social needs can be better catered for. The manager said that there had been no progress so far in this regard. Following this visit a social worker confirmed that a more appropriate place was being looked for. Wrenbury Nursing Home DS0000041864.V294851.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, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Each resident has a care plan which shows how their needs are met. Medicines are well managed. EVIDENCE: A sample of care plans was looked at. The documents had been completed to a good standard but reviews and evaluations were not all up to date. Care plans have always been completed to a very good standard at this home, however the manager had only recently returned to work following major surgery and expressed her intention to ensure that they are all brought up to date. The care plans recorded visits to residents by health professionals, and the home manager said that district nurses had provided good support for the staff during her absence. In general, comments made about the care provided at the home were positive however a relative raised some concerns about aspects of personal care and these were passed on to the home manager to be investigated. Wrenbury Nursing Home DS0000041864.V294851.R01.S.doc Version 5.1 Page 11 The arrangements for the ordering, storage, recording and administration of medicines are good. Wrenbury Nursing Home DS0000041864.V294851.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): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to choose how they spend their time and have visitors when they wish. The standard of food is good. EVIDENCE: A relative said that she finds Wrenbury to be a ‘home from home’, and always feels welcome there. She described the staff as ‘lovely’. The resident admitted for respite care said that he has a good relationship with the staff and enjoys his visits to Wrenbury. He has also made some friends among the residents. Another resident spoken with was not happy but felt that there was nothing that the staff could do to make her feel happier. She had moved from a first floor to a ground floor room, which was better for her. She did not think that she would be happy in any residential care setting but would prefer to live with her family. Unfortunately this is not possible. The home does not have an activities organiser but care staff are aware of the day to day social needs of residents and entertainment is provided regularly. Wrenbury Nursing Home DS0000041864.V294851.R01.S.doc Version 5.1 Page 13 A relative described the food as ‘fantastic’. A choice is available at all mealtimes. At lunchtime staff were sitting at the table in the dining room with residents who required assistance and there was no hurry. Wrenbury Nursing Home DS0000041864.V294851.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected by the home’s complaints and adult protection procedures. EVIDENCE: One complaint has been recorded since the last inspection. The complaint record showed that this had been investigated under the home’s complaints procedure and had been resolved by the home manager with involvement from other professionals. An allegation of abuse in December 2005 was reported under Adult Protection procedures and was not substantiated. Wrenbury Nursing Home DS0000041864.V294851.R01.S.doc Version 5.1 Page 15 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a clean, comfortable and well-maintained environment. EVIDENCE: Wrenbury Nursing Home is situated in a peaceful rural location and has a very attractive garden that is accessible and safe for residents. A programme of planned maintenance and refurbishment for the forthcoming year was shared with the inspector. Since the last inspection, some bedrooms have been re-decorated and have new soft furnishings, and generally looked lighter and brighter. The home has a new cooker. Water systems of the home were tested and a considerable amount of work has been carried out to make the systems safe. The building has also been tested for asbestos but no remedial work was required. Wrenbury Nursing Home DS0000041864.V294851.R01.S.doc Version 5.1 Page 16 A previous maintenance person constructed radiator guards from strips of wood however these were not sturdy enough and in some rooms were coming apart and had wide gaps between the strips. Some of these have now been replaced and the manager said that she expects all to be replaced by the end of July 2006. Requirement made All areas of the building were found to be clean and there were no unpleasant odours. A laundry and sluices are provided to meet the required standard. Wrenbury Nursing Home DS0000041864.V294851.R01.S.doc Version 5.1 Page 17 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, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff are provided to meet the needs of residents and training is provided for staff. EVIDENCE: The home employs five registered nurses (including the manager), 21 care staff and eight ancillary staff. Nine of the care staff have an NVQ qualification and the manager said that four others are due to start NVQ in August 2006. Agency staff have been deployed to cover two care staff vacancies, however one new staff member has been recruited and was waiting for employment checks to be completed. The staff file for a registered nurse, who started working at the home in April 2004, was looked at. This contained a job application form, evidence of her qualifications and good references. The manager confirmed that all staff employed have a Criminal Records Bureau disclosure. There has not been much training taking place while the manager was off sick, however fire safety training was booked for Friday June 23rd 2006 and the manager said that attendance was compulsory for all staff. Two nurses were booked on a male catheterisation training day. Wrenbury Nursing Home DS0000041864.V294851.R01.S.doc Version 5.1 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed by a competent and experienced person. EVIDENCE: The manager is a first level registered nurse and has a management qualification. She is registered as manager with the Commission for Social Care Inspection. The manager has been in post for 13 years and has given great commitment to this service. Unfortunately a recent illness has resulted in her having several weeks sick leave however throughout this period she has been available for staff to consult. Residents and relatives were fully informed about the absence of the manager and spoke to the inspector about this. All were very pleased to see her return to work. Wrenbury Nursing Home DS0000041864.V294851.R01.S.doc Version 5.1 Page 19 The home has a quality assurance programme that is carried out on a monthly basis and look at all aspects of the running of the home. The manager also undertakes a three monthly control audit which includes identifying strengths, weaknesses and action to be taken. A pro forma is available to seek the views of relatives. In the absence of the manager this has lapsed in recent months, however regular monitoring visits have been carried out by the responsible individual for the home. Most residents have some personal money in safekeeping in the home’s safe. Records were inspected and showed that these were mostly amounts below £50. Transactions are recorded and signed. The manager provided evidence that all plant and equipment used in the home had been inspected and serviced as required. Some of the radiator covers in bedrooms still need to be replaced, a wheelchair was being used without footplates, but other than this no risks to the health and safety of staff and residents were apparent during this visit. A fire risk assessment is in place. Wrenbury Nursing Home DS0000041864.V294851.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 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 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Wrenbury Nursing Home DS0000041864.V294851.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? YES 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 OP38 Regulation 13 Requirement Residents must be protected from the risk of burns from hot surfaces. Timescale of 30/11/05 not met Timescale for action 31/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Wrenbury Nursing Home DS0000041864.V294851.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Wrenbury Nursing Home DS0000041864.V294851.R01.S.doc Version 5.1 Page 23 - 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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