Inspection on 23/02/06 for Wyatt House

This inspection was carried out on 23rd February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Wyatt House 20/01/09

Wyatt House 04/08/08

Wyatt House 27/11/07

Wyatt House 09/03/07

Wyatt House 24/05/05

Wyatt House 31/08/04

Wyatt House 05/04/04

Similar services:

Insight - Eastchurch

Southfields

Thorndene

Magenta

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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 Wyatt House 1 Radford Road Tinsley Green Crawley West Sussex RH10 3NW Lead Inspector Mr E McLeod Unannounced Inspection 23rd February 2006 09:30 Wyatt House DS0000036981.V276335.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 Wyatt House DS0000036981.V276335.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. Wyatt House DS0000036981.V276335.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Wyatt House Address 1 Radford Road Tinsley Green Crawley West Sussex RH10 3NW 01491 579270 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) Wyatt House Limited Mrs Caroline Howell Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Wyatt House DS0000036981.V276335.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th May 2005 Brief Description of the Service: Wyatt House is registered to provide accommodation for up to eight adults who have a learning disability. The service users within the home also have associated challenging behaviour. The home currently has eight residents. The service is situated in the village of Tinsley Green near Crawley. Accommodation is provided on ground floor level. All the rooms are for single occupancy. The service is set in large grounds. Wyatt House DS0000036981.V276335.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was arranged to follow up the previous requirement and recommendations made, and to inspect against some of the standards not assessed at the previous inspection. The inspector was on the premises for four hours, during which one of the residents was present and four other residents were there for part of the time (having been out for a drive with staff). None of the residents present are able to verbalise or use a recognised sign language, and the inspector was therefore unable to seek their views on the care provided. The inspector observed interactions between residents and staff, and spoke with two members of staff and the registered manager. A partial inspection of the premises was made, care plans and staff recruitment records were sampled, and servicing records were also sampled. The inspector would like to thank everyone who contributed to the inspection. What the service does well: Individual plans are clearly setting out the care to be provided for the resident, and what is to be achieved. New activities are being tried with residents to encourage their development. Residents are being assisted and supported to be more independent, take individual decisions, and to take responsible risks as part of a more independent lifestyle. Residents are being assisted towards a more fulfilling and independent lifestyle. Residents are making use of local facilities such as shops, leisure centres and cinemas, and examples were given of how individual resident’s quality of life and self-confidence are being enhanced by this. Residents’ medication is being regularly reviewed by the prescribing doctor. There is a homely, comfortable and safe environment for residents. Bedrooms are being personalised in accordance with the resident’s wishes. Wyatt House DS0000036981.V276335.R01.S.doc Version 5.1 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 Wyatt House DS0000036981.V276335.R01.S.doc Version 5.1 Page 7 contacting your local CSCI office. Wyatt House DS0000036981.V276335.R01.S.doc Version 5.1 Page 8 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 Wyatt House DS0000036981.V276335.R01.S.doc Version 5.1 Page 9 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): EVIDENCE: None of these standards were assessed during this visit. Wyatt House DS0000036981.V276335.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, 9 Individual plans are clearly setting out the care to be provided for the resident, and what is to be achieved. Guidelines on the care plans need to be signed by the manager, dated and reviewed. Residents are being assisted and supported to be more independent, take individual decisions, and to take responsible risks as part of a more independent lifestyle. EVIDENCE: Three sets of care plans were sampled. The inspector noted that monthly reviews of the care plans are being recorded, and what the resident and staff and trying to achieve are being recorded. Residents’ likes and dislikes are being clearly set out. New activities tried were being recorded, and the outcome or progress made was being noted. It was noted that some of the guidelines provided for staff as part of the care plan had not been signed by the manager or dated, and it was not noted when the guidance was due for review or had been reviewed. The inspector considered that this could lead to out of date guidance being left on the care plan and acted upon by staff. Wyatt House DS0000036981.V276335.R01.S.doc Version 5.1 Page 11 Staff advised the inspector of ways in which residents were being supported to self-care, such as in the continence care of one resident which was successfully encouraging the resident to be more independent and take individual decisions. Activities plans for residents are based around what the resident is most interested in doing. As part of a more independent lifestyle, one resident is being supported to maintain free movement while minimising the risk of accidents. Wyatt House DS0000036981.V276335.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 Residents are being assisted towards a more fulfilling and independent lifestyle. EVIDENCE: Staff advised that four of the residents attend college, and have opportunities to join in peer group activities while there. On the day of the inspection a group of residents had gone out for a car drive in the countryside. Residents are making use of local facilities such as shops, leisure centres and cinemas, and examples were given of how individual resident’s quality of life and self-confidence are being enhanced by this. Staff are supporting residents’ contact with friends and families by phone calls and participating in outings. It was also noted that members of families take part in some of the care plan review meetings. Staff encourage residents to build their skills, such as in using the kitchen, helping make their bed, and taking clothes to the laundry. Interactions Wyatt House DS0000036981.V276335.R01.S.doc Version 5.1 Page 13 between staff and residents observed indicated that residents’ rights and dignity are being supported by staff. It was the view of staff that more outings are being provided for residents, and there is now more emphasis on assisting residents to build their skills. Wyatt House DS0000036981.V276335.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): 20 Arrangements for the administration of medicines have been improved upon since the previous inspection. Residents’ medication is being regularly reviewed by the prescribing doctor. EVIDENCE: Recommendations made at the most recent pharmacist’s visit (4.5.05), such as the provision of an additional cupboard for medication and extending the use of blister packs, were noted to have been complied with. Records of reviews of medication were sampled, and medicine administration records were sampled. The medication reviews sampled were taking place every six months with the prescribing doctor. The registered manager Mrs Howell advised the inspector that none of the residents at present administer their own medication Wyatt House DS0000036981.V276335.R01.S.doc Version 5.1 Page 15 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): EVIDENCE: These standards were not assessed at this inspection. Wyatt House DS0000036981.V276335.R01.S.doc Version 5.1 Page 16 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, 26, 30 A homely, comfortable and safe environment for residents is being provided. EVIDENCE: A partial tour of the premises was carried out. This included the two additional bedrooms added to the service since the previous inspection. Some of the bedrooms have been personalised in accordance with the resident’s wishes. However, this is something which takes time and careful planning, and some of the bedrooms for newer residents were still in the process of being personalised. An assessment is made of the safety of the bedroom for the individual resident. All areas of the home visited were clean and hygienic. The laundry facilities provided are domestic in nature, and the inspector suggests that with the heavy workloads the washing machines and dryers take, the provider should review the need for machines which are built to a higher standard and have greater capability. Mrs Howell advised that sluicing facilities are not required at present. The premises are furnished and decorated to a good standard, and provide a reasonably homely, comfortable and safe environment. Wyatt House DS0000036981.V276335.R01.S.doc Version 5.1 Page 17 The grounds and gardens are maintained to a good standard. It is being proposed that the garden fences be moved to provide more outdoor space for residents. The development of an enclosed sensory garden is also being proposed. Wyatt House DS0000036981.V276335.R01.S.doc Version 5.1 Page 18 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): 35, 36 The previous recommendation made on the need for staff to receive annual appraisals is assessed as met. Progress has been made in respect of the requirement on staff being put forward for the NVQ in care qualification minimally at level 2. 9 members of care staff have yet to commence NVQ training, and so this requirement has been renewed. EVIDENCE: A requirement was made at the previous inspection in respect of the need for all care staff to be offered training towards the National Vocational Qualification (NVQ) in care at least at level 2. There are 17 care staff at present, of whom 2 have NVQ at level 3, and 1 has NVQ at level 2, the inspector was advised by Mrs Howell. Mrs Howell also said that 4 staff at present were undertaking NVQ2, and 1 person was undertaking NVQ3. There has therefore been progress in the provision of NVQ training for care staff in the home, while the majority of staff in the home have not completed or been undertaking NVQ training. Mrs Howell advised that staff in the past had undertaken NVQs which were accredited under the Learning Disability Award Framework (LDAF) which is recommended under standard 35.8. Mrs Howell said that she had found the Wyatt House DS0000036981.V276335.R01.S.doc Version 5.1 Page 19 local operation of the LDAF accreditation not satisfactory, and therefore NVQs being undertaken by staff were now not those accredited under LDAF. Records of staff supervision and the annual staff appraisal were sampled. Staff interviewed said that the appraisal process had been helpful and had allowed staff to, for example, discuss career progress. It was the view of staff that communication between staff and the morale of the staff team have improved since the previous inspection. Wyatt House DS0000036981.V276335.R01.S.doc Version 5.1 Page 20 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): 39, 42 The home has an annual development plan which meets recommendations made at the previous inspection. EVIDENCE: There is an annual development plan for the home, covering the period between July 2005 and June 2006, which sets out how the service will further develop during this period. Some of the objectives have already been achieved, and some others are being progressed. Mrs Howell said that the plan had been drawn up taking into account views of the service which had been expressed by residents, their families, and involved professionals through returned questionnaires and discussions. The recommendation made in respect of this is now assessed as met. It was the view of Mrs Howell that one area of improvement has been in the more professional way in which care records are being recorded by staff, using more professional language and ensuring better records are being kept. Wyatt House DS0000036981.V276335.R01.S.doc Version 5.1 Page 21 Risk assessments carried out in the home were sampled, including the monthly health and safety inspection reports. Policies and procedures, such as those covering the control of infection, risk assessment, and food hygiene were also sampled. Servicing records, including the gas safety inspection of 27.1.06, the fire service visit of 21.4.05, and the fire equipment check were sampled. Electrical checks in respect of the extension work carried out were also sampled. A current insurance certificate including liability insurance is displayed in the manager’s office. Wyatt House DS0000036981.V276335.R01.S.doc Version 5.1 Page 22 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 X 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 X 23 X ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 3 X X X 3 X X X 3 Wyatt House DS0000036981.V276335.R01.S.doc Version 5.1 Page 23 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 YA35 Regulation 18 Requirement The company needs to ensure that NVQ training is offered to all established staff as part of their on going development. The provider must ensure that all parts of the care plan are kept under review Timescale for action 28/05/06 2. YA6 15.2 28/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA30 Good Practice Recommendations The provider should review the need for washing machines which are built to a higher standard and have greater capability. Wyatt House DS0000036981.V276335.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 Wyatt House DS0000036981.V276335.R01.S.doc Version 5.1 Page 25 - 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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