Inspection on 05/04/07 for Wrenbury Nursing Home

This inspection was carried out on 5th April 2007.

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 22/06/06

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 Unannounced Inspection 5th and 10th April 2007 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.V332769.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. Wrenbury Nursing Home DS0000041864.V332769.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wrenbury Nursing Home Address Wrenbury Hall Drive Wrenbury Nantwich Cheshire CW5 8EJ 01270 780114 F/P 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 Old age, not falling within any other category registration, with number (33), Physical disability (3) of places Wrenbury Nursing Home DS0000041864.V332769.R01.S.doc Version 5.2 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). Date of last inspection 22nd June 2006 Brief Description of the Service: Wrenbury Nursing Home is a two storey converted detached property situated in its own grounds in a rural area. It is close to the local amenities of Wrenbury village and near to Nantwich town centre. The home’s fees are from £450 to £470 per week Wrenbury Nursing Home DS0000041864.V332769.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit took place on 5th and 10th April 2007 over a total of four hours. The home had 26 residents, all of whom were older people. A tour of the building, including all communal areas and some bedrooms, was completed. A sample of records was looked at and time was spent in conversation with the home manager, residents and staff. Some of the information contained in this report is taken from the preinspection questionnaire that was completed by the manager. Comments cards were provided for residents, visitors and visiting professionals and five were returned. What the service does well: What has improved since the last inspection? There has been significant investment to improve the environment and provide new equipment. Wrenbury Nursing Home DS0000041864.V332769.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Wrenbury Nursing Home DS0000041864.V332769.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 Wrenbury Nursing Home DS0000041864.V332769.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): 3 Quality in this outcome area is good. 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: At the time of the visit there were 26 residents living at the home, all older people. Two new residents had been admitted during March 2007. They had both been admitted from hospital and were visited and assessed by the home manager prior to admission being arranged. The assessments were recorded in writing and had been used to develop care plans. A social worker who completed a survey form confirmed that the home always makes contact to gain as much information as possible about potential residents. Wrenbury Nursing Home DS0000041864.V332769.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care needs of residents are met according to their wishes and preferences and this is recorded in their care plans. EVIDENCE: Each resident has a care plan that details their needs, any risks identified and the care that they require. A sample of the care plans was looked at. The care plans were detailed and were clearly written. When residents’ needs had changed, the care plans had been revised to reflect this. At the time of the visit two residents were very frail and had pressure sores. They had been seen by the tissue viability nurse specialist and her advice was being followed in the treatment of the ulcers. Appropriate pressure relieving equipment was being used. Wrenbury Nursing Home DS0000041864.V332769.R01.S.doc Version 5.2 Page 10 The most recently admitted residents had both been admitted from hospital in a very poorly condition. One of these people is now looking forward to being able to return home soon. She said that she was very happy with the care she had received at Wrenbury and that the staff had encouraged her to regain her independence. She intends to visit the home twice a week for day care. The other new resident had been visited by the hospital consultant and he had written in her care plan that she is making ‘excellent progress’. The home has a regular weekly visit by the local GP, who also provides an ‘out of hours’ service. The arrangements for the ordering, storage, recording and administration of medicines are good. At the time of the visit no residents required controlled drugs. All bedrooms are singly occupied. The residents spoken with considered that staff were polite and respectful. A comment received from a visitor was that the home is ‘very caring for the variety of conditions of the residents’. A relative commented that ‘They manager to deliver excellent nursing care in an environment that makes people welcome and feels like a home rather than an institution’. A social worker considered that the client they placed at Wrenbury was ‘treated with dignity and respect at all times’. Wrenbury Nursing Home DS0000041864.V332769.R01.S.doc Version 5.2 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. 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: Residents have a choice of two comfortable lounges or can spend their time in their own room if they wish. The bedrooms are personalised with residents’ own belongings. Five residents were spoken with and all expressed their satisfaction with daily living arrangements. The home has one resident who is a smoker. Following risk assessment he is able to smoke in his own bedroom on the ground floor at the end of a corridor. His door has been fitted with an automatic closing device. 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. Relatives and friends can visit at any reasonable time. One gentleman said that he goes out with his family. Wrenbury Nursing Home DS0000041864.V332769.R01.S.doc Version 5.2 Page 12 The head cook has worked at the home for 20 years. She is currently working towards a national vocational qualification. She and the home manager have developed new menus which include a choice of two main meals at lunchtime. The dining room is bright and spacious. The tables all had table cloths and had salt and pepper. Residents were enjoying a cooked breakfast with pot of tea. The cook had been baking cakes for Easter. She said that three residents prefer to have their meals on a tray in their rooms but the others all come to the dining room for their meals. A visitor confirmed that ‘the food is very good with help for those who need it’, another commented that ‘the food is excellent’. Wrenbury Nursing Home DS0000041864.V332769.R01.S.doc Version 5.2 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. 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. Any complaints received are responded to appropriately and staff are aware of Adult Protection policies and procedures. EVIDENCE: Since the last CSCI inspection, the home has received three complaints. These were fully documented in the complaints folder and had been investigated and responded to by the home manager. There have been two abuse allegations that were investigated by social services and proved to be unfounded. The correct procedures were followed by the home. Wrenbury Nursing Home DS0000041864.V332769.R01.S.doc Version 5.2 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. 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 comfortable and homely environment. EVIDENCE: In general the environment is comfortable and homely but the main part of the home is an old building that requires ongoing maintenance and upgrading. There has been considerable investment in major improvements including a new glass roof in the entrance corridor and a new nurse-call system. Some windows have been replaced and two flat roofs have been replaced. The carpet in part of the ground floor corridor is badly marked and carpet tiles seen in a bedroom were not in very good condition. A relative commented that some of the lounge chairs could do with renewal, however there were no complaints from residents. Wrenbury Nursing Home DS0000041864.V332769.R01.S.doc Version 5.2 Page 15 The home has a full-time maintenance person and he was decorating a vacant bedroom at the time of the visit. He has replaced the radiator covers in most bedrooms, but two radiators were seen that were not adequately protected and could present a possible risk of burns to a resident. The maintenance person said that he would attend to any radiators that are not adequately protected and could make new covers for them. The home was visited by an environmental health officer in January 2007 and some recommendations for improvements were made. Most of these have been actioned and the manager said that the others are in hand. A relative commented that the laundry is particularly good. Wrenbury Nursing Home DS0000041864.V332769.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provides enough skilled and qualified staff to meet the needs of residents but good recruitment procedures are not always followed. EVIDENCE: The home employs seven nurses, 18 care assistants and nine ancillary staff. 13 carers (75 ) have a national vocational qualification in care and the manager said that four others are due to start NVQ in the near future. Cleaning staff have completed a national vocational qualification relevant to their work and the two cooks are working towards a qualification. The maintenance person and the home manager are doing a health and safety course. Moving and handling training was updated for 12 staff in November 2006 and nearly all of the staff attended fire safety training in February 2007. During the two visits to the home there were enough staff to meet the needs of the residents and the staff rotas indicated that adequate staffing levels are maintained. The staff spoken with were pleasant and helpful. Wrenbury Nursing Home DS0000041864.V332769.R01.S.doc Version 5.2 Page 17 Staff records were looked at for the three most recently recruited staff, a nurse and two care assistants. The required documents were all in place for one of the carers, however the other carer, who had just started working at the home did not have a POVA first check and there was only one reference. The manager said that this member of staff is supervised at all times, and the carer confirmed that she is working at all times with another experienced carer. No references or Criminal Records Bureau disclosure were seen for the nurse, but there was evidence of her registration with the Nursing and Midwifery Council, and the manager said that she had been employed before at the home. Wrenbury Nursing Home DS0000041864.V332769.R01.S.doc Version 5.2 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. 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. In general the home is well managed by a competent and very experienced person, but self-auditing needs to be carried out. EVIDENCE: The home manager has been in post for several years. She said that she now works far less hours as a ‘hands on nurse’ to enable her to devote more time to management. She is currently doing a Health and Safety course and is planning to attend training about current best practice in ‘End of Life Care’. A relative commented on the ‘exceptional ability and commitment’ of the manager. Wrenbury Nursing Home DS0000041864.V332769.R01.S.doc Version 5.2 Page 19 Regular staff meetings are held and the registered person attends whenever possible. The home does not hold resident or relative meetings but the manager said that she regularly gets the views of residents and relatives informally on a one to one basis. The home has an auditing tool that covers all aspects of the business, however this has not been carried out for more than a year. The manager said that the registered person now visits three times a week. The home does not look after the finances of any residents but small amounts of personal spending money can be put in safekeeping and full records are kept. Information provided by the manager indicated that all plant and equipment are regularly checked, serviced and maintained. A recent visit by the Fire Officer resulted in three requirements being made. One has been fully actioned and the others are due to be completed by the end of June 2007. Wrenbury Nursing Home DS0000041864.V332769.R01.S.doc Version 5.2 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 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 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Wrenbury Nursing Home DS0000041864.V332769.R01.S.doc Version 5.2 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 and 31/08/06 not met in full. New staff must not be employed at the home until a POVA check and two written references have been obtained. Timescale for action 31/05/07 2. OP29 19 Schedule 2 16/04/07 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.V332769.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Wrenbury Nursing Home DS0000041864.V332769.R01.S.doc Version 5.2 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. 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