Inspection on 09/05/06 for Wurel House

This inspection was carried out on 9th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Wurel House 06/01/09

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Wurel House 135 London Road Sittingbourne Kent ME10 1NR Lead Inspector Sarah Montgomery Key Unannounced Inspection 9th May 2006 09:00 Wurel House DS0000065407.V292410.R01.S.doc Version 5.1 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 Wurel House DS0000065407.V292410.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 Adults 18-65. 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. Wurel House DS0000065407.V292410.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Wurel House Address 135 London Road Sittingbourne Kent ME10 1NR 01795 430831 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) Mr David Adeolu Adekola Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Wurel House DS0000065407.V292410.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection NA Brief Description of the Service: Wurel House is registered to provide care and support to four adults with learning disabilities. The house is staffed 24 hours, and a staff team consisting of a manager, deputy manager, and support workers supports service users. The registered provider ensures that information about the service is available to service users. The service user guide, statement of purpose, and reports from the Commission for Social Care inspection are available to service users and are kept in the dining area. All service users 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. Service users have access to a house car. Wurel House DS0000065407.V292410.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Sarah Montgomery conducted this unannounced inspection on May 9th 2006. Evidence was gathered from reading documents, talking to staff and management, and speaking with service users. What the service does well: What has improved since the last inspection? What they could do better: The home’s medication file does not comply with national minimum standards. It is suggested that care plans could be more proactive, and risk assessments require additional detail. Wurel House DS0000065407.V292410.R01.S.doc Version 5.1 Page 6 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. Wurel House DS0000065407.V292410.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Wurel House DS0000065407.V292410.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users can be confident that their individual needs and aspirations will be assessed. EVIDENCE: Inspection of service user files evidenced a thorough pre-assessment process. At the time of inspection three service users were living at Wurel House. In assessing this standard, the inspector looked at service user’s preassessment documentation, spoke to each service user individually, and discussed with staff and management the home’s process of gathering information. In addition, the statement of purpose and service user guide was read in order to cross reference, and to enable a judgement regarding suitability of placement. The home has demonstrated a thorough approach to pre-assessment, gathering information about individual service users, their families, advocates, carers, care managers, and from conducting their own assessment. Wurel House DS0000065407.V292410.R01.S.doc Version 5.1 Page 9 Assessment documentation included details on prospective service user’s skills, health, behaviour, likes and dislikes, and a full social history. Care plans based on the needs and aspirations of service users, including risk assessments, were developed using the information gathered during the pre-assessment period. Conversations with service users confirmed their involvement in the assessment process. One service user said ‘He (the manager) asked me lots of questions, but then I asked him a lot too’. Wurel House DS0000065407.V292410.R01.S.doc Version 5.1 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users know their needs are assessed, but would benefit from having clear goals reflected in their individual plans. Service users can be confident they will be supported to make decisions about their lives and supported to take risks. EVIDENCE: To assess the above standards, the inspector read through care plans and risk assessments, looked at a sample of notes from individual daily recordings, and spoke with service users and staff. The team at Wurel House has worked with service users to develop care plans and risk assessments designed to ensure service users are supported appropriately with assessed needs and aspirations. Individual care plans are written in close correlation to the assessment of needs. Wurel House DS0000065407.V292410.R01.S.doc Version 5.1 Page 11 Current care plans lack detail. Although they are descriptive of the need, and of the desired outcome, the steps to achieving the outcome need to be more specific to enable clear guidance for service users and staff. Similarly, risk assessments require more detail. Some risks identified in preassessment documentation have not been translated into risk assessment tools. Review dates on care plans and risk assessments are annual. It is recommended that care plans and risk assessments are reviewed at least quarterly, or sooner if necessary Discussion with service users 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 service user and by the manager or keyworker. Wurel House DS0000065407.V292410.R01.S.doc Version 5.1 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the 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, 15, 16 and 17. Quality in this judgement area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from being supported in making lifestyle choices. EVIDENCE: Observations of interactions between staff and service users evidenced an environment in which service users are included at all times in making decisions about their lives and about the running of the home. On the day of inspection service users were being supported to choose where they wanted to go on holiday. Service users are encouraged and supported to make positive lifestyle choices. One service user told the inspector; ‘It’s lovely here, they help you. We go shopping for the house, go out to lunch and dinner a lot, go to college, go to the beach. This is the best place I have ever lived in’. Another service user spoke to the inspector about being involved in the local community, stating that ‘it’s great living near college and the shops, I go out all the time’. It was clear from further comments made by service users that Wurel House DS0000065407.V292410.R01.S.doc Version 5.1 Page 13 they are listened to, and their individual choices and aspirations are realised through care planning and through day-to-day life in the home. Some risk assessments indicated that behaviour guidelines are in place to protect service users from making lifestyle choices that have, in the past proved detrimental to their well being. Conversations with individual service users evidenced that they have an awareness of these restrictions, and feel supported and encouraged by staff to make positive decisions. Wurel House DS0000065407.V292410.R01.S.doc Version 5.1 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Service users are not sure whether they are supported by the home’s policies and procedures for dealing with medicines. Service users can be confident that their personal, physical, and emotional support needs will be met. EVIDENCE: Shortfalls were identified when inspecting the medication file. One service user has been prescribed Risperidone PRN medication. However there are no written guidelines, either in the service user’s personal file, or in the medication file, on why or when to give this medication. Several service users are prescribed medication. There are no guidelines on file regarding why the service user is taking a medication, or what possible side effects could occur. Service users preferences regarding how they like to take their medication are not recorded. The medication file does not contain individual photographs of service users. Wurel House DS0000065407.V292410.R01.S.doc Version 5.1 Page 15 There are no dividers between service users MARS sheets. The MARS sheets are difficult to read due to the file covering the left hand side of the sheet. The inspector spoke with a staff member regarding service users support needs with their personal, physical and emotional health. The staff member spoke knowledgably and sensitively about individuals, demonstrating familiarity with the needs and wishes of service users. Care plans and assessment documentation detail individual service user’s needs. The home can evidence through records (healthcare notes, review notes, appointments) that service users are supported to access health professionals in the community. This includes psychiatry and psychology if necessary. Wurel House DS0000065407.V292410.R01.S.doc Version 5.1 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be confident their views are listened to and acted upon. Service users are protected from harm. EVIDENCE: The inspector asked a service user about how to make a complaint. The service user told the inspector ‘I would talk to somebody and look on the wall to help me’. The complaints procedure is on the wall in the kitchen. It is in a central place, and service users confirmed they were aware of its location and how to use it. The home has worked hard in a developing an accessible complaints procedure. It is in a pictorial format and written in plain English. The manager and deputy manager both confirmed that service users are asked to give feedback on their home daily. Discussions usually occur naturally over dinner, and comments regarding concerns are encouraged. The home has received no complaints. The staff team have all received basic adult protection training during their induction. The manager spoke knowledgably about his responsibilities in ensuring that service users are protected from harm. Wurel House DS0000065407.V292410.R01.S.doc Version 5.1 Page 17 Wurel House DS0000065407.V292410.R01.S.doc Version 5.1 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be confident they live in a homely, comfortable and safe environment. EVIDENCE: The service users at Wurel House are proud of their home. The inspector was given a tour of the home by a service user who was very enthusiastic about the environment. Wurel House is decorated and furnished to a high standard. All areas are homely and comfortable. Service users have clearly made it their own, and feel relaxed and at home. All areas of the home are clean and hygienic. Wurel House DS0000065407.V292410.R01.S.doc Version 5.1 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from being supported by competent and trained staff. Service users can be confident they will be protected by the home’s recruitment policy and practices. EVIDENCE: Discussions with the staff on duty evidenced that all staff receive a thorough induction during their initial weeks at the home. This includes coaching and shadowing shifts, reading policies and procedures, reading through all service users care plans and risk assessments, and getting to know the routine of the house. Staff are supported by the management team on a daily basis. In addition, they receive regular supervision, and team meetings are monthly. Observations during the inspection evidenced that staff support service users in a competently and in a way which ensures choice and dignity. Inspection of staff files evidenced that the home is robust in its recruitment, and in ensuring that service users are protected from harm. Wurel House DS0000065407.V292410.R01.S.doc Version 5.1 Page 20 The registered provider is also the day to day manager. A independent person, currently teaching social care will be conducting Regulation 26 visits. Wurel House DS0000065407.V292410.R01.S.doc Version 5.1 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 and 39. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from living in a well run home. Service users can be confident that their views underpin all self-monitoring and review by the home. EVIDENCE: All service users were spoken with during the inspection. Conversations evidenced they felt supported, respected and cared for, and lived in an environment which they felt happy and relaxed in. Staff were motivated and competent. Communication between staff and between staff and service users was good. Wurel House is a new service. It is supporting its service users and its staff, and has quickly developed into a well run home. Wurel House DS0000065407.V292410.R01.S.doc Version 5.1 Page 22 Discussions with both staff and service users, reading of documents, and observations during the inspection, all evidenced that service users views are sought on the service, and that their input, suggestions and ideas all have a real impact on how the service is currently delivered and how it will grow. Wurel House DS0000065407.V292410.R01.S.doc Version 5.1 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X X X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 1 X 3 X 3 X X X X Wurel House DS0000065407.V292410.R01.S.doc Version 5.1 Page 24 NA 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 Standard YA20 Regulation 13(2) Timescale for action The registered person shall make 10/05/06 arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. Requirement 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 YA6 Good Practice Recommendations More detail is included in care plans to enable staff to support service users towards gaining independent living skills. Wurel House DS0000065407.V292410.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Wurel House DS0000065407.V292410.R01.S.doc Version 5.1 Page 26 - 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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