Inspection on 06/01/09 for Wurel House

This inspection was carried out on 6th January 2009.

CSCI found this care home to be providing an Excellent service.

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

Wurel House 09/05/06

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Thorndene

Insight - Eastchurch

Southfields

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Lyncol House

Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Wurel House 135 London Road Sittingbourne Kent ME10 1NR     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Lisbeth Scoones     Date: 0 6 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Wurel House 135 London Road Sittingbourne Kent ME10 1NR 01795430831 Telephone number: Fax number: Email address: Provider web address: david.adekola@yahoo.co.uk Name of registered provider(s): Type of registration: Number of places registered: Mr David Adeolu Adekola care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accomodated is 4 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category : Learning disability (LD) Date of last inspection Brief description of the care home Wurel House is registered to provide care and support to four adults with learning disabilities. The house is staffed 24 hours. A staff team consisting of a manager, deputy manager and support workers supports the residents. The registered provider ensures that information about the service is available to residents. The service user guide, statement of purpose, and reports from the Commission for Social Care inspection are available to residents and are kept in the dining area. All residents have their own copy of the service user guide. Monthly fees range from £1100 to £1250. Wurel House is situated within walking distance of Sittingbourne town centre. There is off street parking. Residents have access to a house car. 4 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection comprised discussions with the manager and deputy manager, conversations with all residents, an accompanied tour of the home, a shared meal at lunch time and the examination of records in respect of care plans, risk assessments, menus, rotas, staff files and medication records. Following the inspection, two care managers were contacted to ascertain their view on the service provided to their clients. The inspection was further informed by an AQAA (annual quality assessment and audit) completed by the manager prior to the inspection. The CSCI has received no complaints about the service. Care Homes for Adults (18-65 years) Page 5 of 28 Judgements have been made in relation to each outcome area in this report, based on records viewed, observations and verbal responses given on the day. These judgements have been made using the Key Lines of Regulatory Assessment (KLORA), which are guidelines that enable The Commission for Social Care Inspection (CSCI) to be able to make an informed decision about each outcome area. The previous key inspection, which was the first following registration, was carried out on 9th May 2006. An Annual Service Review was carried out on 25th of January 2008. This was the second key inspection. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 28 Care Homes for Adults (18-65 years) Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents can be confident that their individual needs and aspirations will be assessed. Evidence: At the time of inspection four residents were living at Wurel House. Pre-assessment documentation for a recently admitted resident evidenced that the admission procedure is comprehensive and thorough. Information is gathered about individual residents, their families, advocates, carers, care managers and the homes own assessment. As is stated in the AQAA, A structured transition for prospective residents is organised where they have the opportunity to visit the home, stay for meals and meet with other residents and staff. Assessment documentation included details on prospective residents strengths and weaknesses, skills, health, behaviour, likes and dislikes and a full social history. Information thus obtained informs the care plans. Care plans are based on the needs Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: and aspirations of the residents and include risk assessments. Conversations with a recently admitted resident confirmed their involvement in the assessment process. The manager regularly reviews the Statement of Purpose and Service User Guide. These are available in pictorial format thus ensuring residents easy access to the information. Pictures of the home are shown to a prospective resident during assessment. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents know that their needs are assessed, reviewed and recorded and personal goals are reflected in their individual plan. Residents can be confident they will be supported to make decisions about their lives and supported to take risks. Evidence: All care plans and accompanying documentation were read, all residents and the deputy manager spoken with. The team at Wurel House has worked well with the residents to develop care plans and risk assessments designed to ensure that residents are supported appropriately with assessed needs and aspirations. Individual care plans are written in close correlation to the assessment of needs. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: Discussion with residents evidenced they are consulted and involved with developing and implementing their own care plans, with support from the team at Wurel House. All care plans are signed by the resident and by the manager or key worker. Every resident has person centred plan folder which incorporates the regularly reviewed care plan and risk assessments, medical records, personal history and profile and goal setting. Some goals have been achieved. It was recommended that all sections are dated to assist with updating when necessary. It was further recommended that all forms are completed. These issues were discussed with the manager at the time. Two care managers contacted after the inspection reported that their clients are well supported by the staff team. Residents are supported to manage their own finances. Residents monies are safely stored and records maintained of any transactions. Such records are regularly audited. See also standard 23. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are fully supported in making lifestyle choices. They are provided with opportunities to develop social, emotional, communication and independent living skills. Evidence: Staff support the residents in making decisions about their lives and the running of the home. As stated in the AQAA, The achievement of the principles of ordinary living is a core principle of how we support our residents. It was observed that the staff interact with the residents in a comfortable and inclusive manner. On the day of inspection residents and the deputy manager were sitting around the computer discussing holiday options. Previous holidays were talked about in great detail. A resident said how much he had enjoyed a trip to Disneyland and another to the Isle of Wight. A special extended holiday is currently in the planning stages. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: The home has a policy on promoting Equality and Diversity thus promoting the rights, choice and independence of the residents. Staff training is provided to support the residents in meeting their diverse interests and preferences. Opportunities for suitable work placements and education are constantly being explored and discussed. A resident has been supported to go to college to obtain an NVQ qualification. Two residents are supported in attending church. A resident attends a Day Centre three times a week. Residents have been supported to attend learning disability conferences. A resident has obtained a Certificate in First Aid and Health and Safety (through Skillnet). Residents attend some training courses with the staff team as e.g. fire safety awareness. A resident proudly showed his First Aid certificate. Residents are encouraged and supported to make positive lifestyle choices. A resident said, It is good here. I like my room. I have achieved a lot and feel well supported. Another resident said that he liked all the staff. I trust them. Risk assessments provide boundaries for the residents and strike a balance between encouragement to make positive decisions and protecting the individual. Residents accompany staff on food and other shopping, planning the menu, cooking, preparing snacks and drinks, cleaning, washing up and other domestic chores. Two residents said they go out all the time and visit shops and leisure outlets. One resident has recently applied for a job and is awaiting the outcome of the interview. It is evident from talking to the residents that staff are good listeners and know them very well. Their individual choices and aspirations are realised through care planning and through day-to-day activities within the home. Residents are encouraged to maintain links with their families. The manager reported good support from residents relatives. Residents are provided with a good choice of wholesome and varied meals. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are protected and supported by the homes policies and procedures for dealing with medicines. Residents can be confident that their personal, physical and emotional support needs will be met. Evidence: Medication administration systems were discussed and documentation viewed. Written guidelines are maintained in residents files as to what the medication is prescribed for and their side effects. Medication charts (MAR sheets) are well maintained. There is a PRN (as required) protocol. All staff are trained in the administration of medication. It is evident that residents are well supported with their personal, physical, emotional and health care needs. Their personal preferences and needs are known and respected by the staff. Such preferences are recorded in residents care plans and residents are supported to access health professionals in the community. This includes GPs, Learning Disability team, district nursing team, private chiropodist, optician, dentist, Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: diabetic nurse, psychiatrist and psychologist if necessary. Any visit or input from health professionals is recorded on a Professional Input page. Training is provided for health related issues such as management of diabetes. Residents are regularly weighed. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be confident that their views are listened to and acted upon. Residents are protected from harm. Evidence: A resident showed the complaints procedure on display in the kitchen area and said, I would discuss any problem or concern with the staff . Another resident said he was aware of its location and knew how to use it. The procedure is in a pictorial format and written in plain English. Staff support the residents in making them aware of the complaint procedure. Every resident has a designated key worker they can talk to. The manager and deputy manager confirmed that residents are encouraged to give feedback on their home daily. Discussions usually occur naturally at meal times, which are pleasant, unhurried and interactive. A resident chairs the Residents meetings. The manager reported that contact has been made with some advocacy services with a view to becoming advocates for the residents. The home has received no complaints. The staff team have all received basic adult protection training during their induction and at regular intervals thereafter as demonstrated on the training matrix. The Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: manager demonstrated a real commitment in ensuring that residents are protected from harm. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a homely, comfortable, well-maintained, clean and safe environment. Evidence: It is evident that the residents at Wurel House are proud of their home. An accompanied tour of the premises was made and three bedrooms visited in the presence and with permission of the residents. A resident said, It is nice and clean, another, I like my room. We had a great Christmas with a tree, loads of presents and decorations. Wurel House is decorated and furnished to a high standard. All areas are homely and comfortable, clean and hygienic. The regular cleaning and maintenance of the environment is reflected on the shift plan. Health and safety equipment and services such as central heating, electrical equipment and fire extinguishers are regularly maintained. Health and Safety checklists are in place. The manager discussed the building plans for extending the home. This would provide an additional bathroom and toilet and a room, which can be used for sleep-in duties. The back garden has been made user friendly with a raised pebbled area, table and Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: chairs, shrubs and plants. In the Summer, barbecues are held. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from being supported by sufficient numbers of competent and trained staff. Residents can be confident they will be protected by the homes recruitment policy and practices. Evidence: On the day of the inspection on duty were the manager and deputy manager. In the afternoon a support worker came on duty. Staffing levels vary depending on the planned activities. Staff reported that there is good communication between all the staff. There is a communication book, staff complete a daily report and receive a comprehensive handover. A shift plan indicates duties to be carried out. Staff meetings are held regularly. Staff take turns in chairing these. There is a waking member of staff on night duty. With the planned extension, a sleep-in room would be provided. See also standard 27. Staff files evidenced that staff are provided with a thorough induction during their initial weeks at the home. This includes coaching and shadowing shifts, reading policies and procedures, reading all care plans and risk assessments and getting to know the Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: routine of the house. A formal signed training booklet confirms training received. Staff are supported by the management team on a daily basis during comprehensive handovers. In addition, they receive regular, well-documented supervision and attend monthly team meetings. Observations during the inspection evidenced that staff support residents competently respecting their choices and promoting their dignity. Recruitment procedures are robust thus protecting residents from harm. Staff files are very well maintained and organised. Staff are well trained. 50 of staff have a NVQ qualification. In addition to induction and NVQ, staff have completed all statutory training as evidenced on the training matrix. Staff have been provided with recent Safeguarding Vulnerable Adults and medication training. Additional specialist training would be provided in accordance with the needs of the residents. Recently, staff have had training in diabetes management. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from living in a well run and safe home. Residents can be confident that their views underpin all self-monitoring and review by the home. Evidence: Wurel House is well run and managed. The registered provider is also the day-to-day manager. Both the manager and deputy manager are very experienced and have obtained the Registered Managers Award (RMA) qualification. They work well as team. The manager keeps himself updated by accessing research findings through Kent University. The provider praised the deputy manager for her contribution to the successful running of the home. The position of team leader is currently vacant. This was discussed in relation to roles and responsibilities. All residents were spoken with during the inspection. These conversations evidenced that they live in an environment where they feel happy, safe and relaxed. They feel Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: well supported, respected and cared for. There is an open door policy. During the inspection residents popped in and out of the office for a chat. Staff are motivated and competent. Excellent communication was observed between staff and residents. Through discussions with staff and residents, documents examined and observations made during the inspection, it is ascertained that residents views are central to the way Wurel House operates. Residents input, suggestions and ideas are sought and acted upon in an effort to constantly review and where necessary improve the service. A formal annual quality assurance questionnaire is requested from residents, staff, family and representatives. Care managers carry out regular reviews. Two care managers contacted expressed their satisfaction with the service their clients receive. It is evident that investments are constantly being made to maintain and upgrade the home. As already referred to an extension is in the planning stages. Through policies, procedures, staff training and risk assessments, the home ensures that the residents and staff are safe. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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