Inspection on 31/05/05 for Wrenbury Nursing Home

This inspection was carried out on 31st May 2005.

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 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 22/06/06

Wrenbury Nursing Home 27/09/05

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 Unannounced Inspection 31st May 2005 10:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Wrenbury Nursing Home F51 F01 S41864 Wrenbury V228521 310505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Wrenbury Nursing Home Address Wrenbury Hall Drive Wrenbury Nantwich Cheshire CW5 8EJ 01270 780114 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Wrenbury Ltd Mrs Gaynor York Care Home 33 Category(ies) of OP Old Age (33) registration, with number PD Physical disability (3) of places DE(E) Dementia over 65 (1) Wrenbury Nursing Home F51 F01 S41864 Wrenbury V228521 310505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 The home is registered for a maximum of 33 service users to include: * 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). * 1 named service user aged over 65 years with dementia DE(E). This person`s care plan to be reviewed on a monthly basis. 2 The registered provider must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection 4th January 2005 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 situated 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 F51 F01 S41864 Wrenbury V228521 310505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection visit took place on May 31st 2005 over a period of four hours. The home manager was present and provided some of the information contained in this report. The inspection was carried out using a process of cross referencing the documentation of identified residents following discussion with them, and following the delivery of care and support to them. Staff records were inspected. A tour of the building, including all communal areas and most bedrooms, was completed. On the day of the inspection 29 residents were living at the home and one other resident had been admitted to hospital. Three were receiving personal care only and the other people were receiving nursing care. Eight residents contributed their experience of living in the home and three of the staff on duty were spoken with. Comments cards received from two relatives/visitors indicated that they were satisfied with the care provided at the home. What the service does well: Wrenbury Nursing Home is situated in a peaceful rural location and has a very attractive garden that has been made accessible and safe for residents. The home manager and three other members of staff have worked at the home for over ten years and have given great commitment to the establishment. Care is provided within a friendly, informal and homely atmosphere and visitors are made welcome. The home provides good ‘home cooking’ with individual choices and needs catered for. A good proportion of staff have achieved NVQ level 2 qualification and two have NVQ level 3. Those staff who have not yet achieved NVQ qualification are either working towards it or intend to commence the training in June 2005. The standard of record keeping at this home is consistently good. Wrenbury Nursing Home F51 F01 S41864 Wrenbury V228521 310505 Stage 4.doc Version 1.30 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. Wrenbury Nursing Home F51 F01 S41864 Wrenbury V228521 310505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Wrenbury Nursing Home F51 F01 S41864 Wrenbury V228521 310505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 The residents living at Wrenbury Nursing Home had their needs assessed prior to moving into the home to ensure that their needs could be met. EVIDENCE: The care plans belonging to several residents, who had been admitted to the home during May 2005, were examined. These contained evidence that the home manager had visited these people and had assessed them prior to admission being agreed. The care plans also contained assessment documents from social workers and health professionals. Wrenbury Nursing Home F51 F01 S41864 Wrenbury V228521 310505 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 10 Each resident has a plan of care that sets out their needs and details how these needs are met. The health care needs of residents were met in full. Observation of staff practices showed that residents’ privacy and dignity were upheld. EVIDENCE: A sample of care plans was examined. The care plans examined provided details of the resident’s needs and contained evidence that residents and their relatives/representatives had been consulted about their care. The care plans examined were up to date and relevant. They had been reviewed regularly. Wrenbury Nursing Home F51 F01 S41864 Wrenbury V228521 310505 Stage 4.doc Version 1.30 Page 10 Residents spoken with expressed their satisfaction with the personal care they received from the care staff. Pressure sore risk assessment is carried out and reviewed monthly, and residents identified as being at risk of developing pressure sores had appropriate pressure relieving equipment in place. Four residents had pressure sores and their treatment and progress was adequately documented in their care plans. There was evidence of referrals to appropriate medical professionals. On the day of the inspection no residents were very frail and no-one was being cared for in bed. There was evidence of the involvement of a range of healthcare professionals including district nurses for personal care residents, chiropodist and optician. A choice of GP’s is available. Residents receiving nursing care had been assessed for their financial entitlement. At the time of the inspection, all bedrooms were singly occupied and all personal care is carried out in the privacy of the bedroom. During the inspection, residents were observed to be treated with patience, dignity, respect and good humour by the staff. Residents spoken with said that the staff were always pleasant and kind. Wrenbury Nursing Home F51 F01 S41864 Wrenbury V228521 310505 Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 15 Residents are supported to maintain their interests and participate in social activities. Visitors are made welcome to the home at any reasonable time. Residents enjoy a good diet. Wrenbury Nursing Home F51 F01 S41864 Wrenbury V228521 310505 Stage 4.doc Version 1.30 Page 12 EVIDENCE: Social assessments are completed in the residents’ care plans. A variety of activities and entertainment is provided at the home. Several residents have a daily newspaper delivered. Residents spoken with said that staff assist them to get up and go to bed at a time of their choosing. Residents have a choice of two lounges or may choose to spend the day in their own room. Visitors are welcomed to the home at any reasonable time. One resident said that her husband visits every evening. The son of another resident was reading the newspaper to his mother in the lounge. Breakfast is served between 8am and 10.30am and this was seen on the morning of the inspection. Residents can take their meals in their own rooms, in the dining room or, on occasions, snack meals can be taken in the lounge. Alternative dishes are provided at all meals for any resident who does not wish to have the meal of the day. Snacks and drinks are available between meals. The home’s cook has been in post for 17 years and has a good knowledge of the individual needs and preferences of residents. Residents spoken with confirmed their satisfaction with the meals provided and said that the food served was of a consistently good standard. Wrenbury Nursing Home F51 F01 S41864 Wrenbury V228521 310505 Stage 4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 Some revision to policies and procedures, and additional staff training, are needed to ensure that residents are protected from abuse. EVIDENCE: The previous inspection identified that policies and procedures in place for Adult Protection needed to be revised to ensure that they make clear the responsibility of each member of staff to report any concerns to an outside agency if necessary; and that additional training would be required to accompany the new policies and procedures. The home manager said that she had not yet been able to complete this process therefore the requirement remains outstanding. Requirement outstanding Wrenbury Nursing Home F51 F01 S41864 Wrenbury V228521 310505 Stage 4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 23, 24, and 26 Communal areas of the home are well-maintained but some of the bedrooms are in need of refurbishment and a small number of windows need to be painted. The home was generally clean and good laundry and sluicing facilities are provided. Wrenbury Nursing Home F51 F01 S41864 Wrenbury V228521 310505 Stage 4.doc Version 1.30 Page 15 EVIDENCE: The home is set in a rural location but is within a short distance of Wrenbury village, and the town of Nantwich is easily accessible. The home employs a maintenance person who undertakes all routine maintenance and decoration. Storage space is available in secure outbuildings at the rear of the home. There are a small number of wooden windows at the rear of the property that need to be re-painted. See Requirement. The home has two spacious lounges and a large dining room. In addition there is a small sitting area near to the nurses’ station where there is a coffee machine and a payphone. The dining room is light and bright and can accommodate all service users. It was decorated in 2004 and the furniture has been re-painted. The wood floor is also in need of restoration. The garden has been improved and a wooden fence has been erected. This has provided a pleasant and safe sitting area for residents which can be accessed from the lounges. Most bedrooms were personalised with residents’ own furniture, pictures and ornaments etc. Locks are not fitted to any rooms but the manager said that these would be provided if requested following a risk assessment. Several bedrooms were generally shabby in appearance and in need of decorating, recarpeting and new furniture and soft furnishings. The registered person must draw up a programme of refurbishment for these rooms. See Requirement There has been no change to the number or size of bedrooms since the home was first registered. At the time of the inspection all rooms were singly occupied. The premises were found to be reasonably clean, however staffing problems were making it difficult for a high standard of cleaning to be maintained consistently. Laundry facilities are very spacious and comply with this standard. Policies and procedures for the control of infection are in place and there are appropriate contracts for the collection of waste. The home has a sluicing disinfector. Wrenbury Nursing Home F51 F01 S41864 Wrenbury V228521 310505 Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28 and 29 The home provides a sufficient number and appropriate skill mix of staff. Care staff have appropriate qualifications or are working towards them. There are appropriate recruitment procedures but these had not been followed in full for one new member of staff. EVIDENCE: Examination of the duty rota showed that there was a registered nurse on duty at all times. Five care staff are on duty during the day, three in an evening and two at night. Catering, domestic and maintenance staff are also employed. Seven care staff have NVQ level 2 qualification. A further ten care staff were registered with the Cheshire Consortium to commence working towards NVQ level 2 in June 2005. Two staff have NVQ level 3 and three others have almost completed this award. This information was provided by the home manager. A sample of staff files was inspected. These showed that recruitment procedures were generally followed. However a registered nurse, who had been recruited since the last inspection, did not have a reference from her last employer. See Requirement. Wrenbury Nursing Home F51 F01 S41864 Wrenbury V228521 310505 Stage 4.doc Version 1.30 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not inspected on this occasion. EVIDENCE: Wrenbury Nursing Home F51 F01 S41864 Wrenbury V228521 310505 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 3 x x 3 2 x 3 STAFFING Standard No Score 27 3 28 3 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 2 x x x x x x x x Wrenbury Nursing Home F51 F01 S41864 Wrenbury V228521 310505 Stage 4.doc Version 1.30 Page 19 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. Standard OP18 OP19 OP24 Regulation 13(6) 23(2)(b) 16(2) Requirement The registered person must ensure that staff receive training about No Secrets. Wooden windows at the rear of the building need to be repainted. The registered person must produce an action plan detailing how bedrooms will be refurbished over forthcoming months. New staff should not be employed without a reference from their last employer. Timescale for action 31/8/05 31/8/05 30/9/05 4. OP29 19(1)(b) 31/5/05 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 Good Practice Recommendations Wrenbury Nursing Home F51 F01 S41864 Wrenbury V228521 310505 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Unit D, Off Rudheath Way Gadbrook Park Northwich Cheshire, 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 F51 F01 S41864 Wrenbury V228521 310505 Stage 4.doc Version 1.30 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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