Inspection on 09/03/07 for Wyatt House

This inspection was carried out on 9th March 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 no outstanding requirements from the previous inspection report, but made 4 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 23/02/06

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 Mrs K Allen Unannounced Inspection 9th March 2007 09:45a Wyatt House DS0000036981.V330567.R01.S.doc Version 5.2 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.V330567.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 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.V330567.R01.S.doc Version 5.2 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 Post Vacant Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Wyatt House DS0000036981.V330567.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th December 2006 Brief Description of the Service: Wyatt House is registered to provide care and accommodation for up to eight adults who have a learning disability. The service users within the home also have associated challenging behaviour and there are currently eight residents. The service is situated in the village of Tinsley Green near Crawley. The accommodation is on the ground floor and all of the rooms are for single occupancy, six of which have en-suite facilities. The service is set in large grounds, which are easily accessible to residents. Wyatt House DS0000036981.V330567.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Prior to the site visit a review was made of the contact between the home and the Commission for Social Care Inspection (CSCI) since the last inspection. This included an analysis of incident reports and those of other statutory bodies such as the fire service as well as any complaints and changes to the registration of the home. The manager completed a pre-inspection questionnaire giving up to date information about the service. The visit took place from 9:45am over seven hours. During the visit all of the residents were spoken to in communal areas and two visitors discussed their views of the home. The manager and two staff were interviewed and others were seen whilst going about their duties. In addition a number of records were seen. Residents had very little verbal communication and were therefore unable to directly express their views about the home. They did, however, appear relaxed and at home in their own environment. There is currently no registered manager however Ms Ann Heffer has been appointed to the position subject to registration. She is in the process of submitting her application to the Commission for Social Care Inspection (CSCI). Four requirements have been made and are shown in “What they could do better” below. What the service does well: What has improved since the last inspection? What they could do better: Wyatt House DS0000036981.V330567.R01.S.doc Version 5.2 Page 6 All new service users must have an assessment to ensure that the home can meet their needs. Guidelines must be drawn up for the resident who needs to be physically restrained, for everyone’s safety. The drive up to the house must be made safe so that it is not a hazard to residents, staff, visitors and drivers. Two references must be obtained prior to a new member of staff starting work at the home. 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. Wyatt House DS0000036981.V330567.R01.S.doc Version 5.2 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 Wyatt House DS0000036981.V330567.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is adequate. Prospective service users do not always have a written assessment of their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All residents have lived at the home for over a year and are within the homes category of registration. Documentation was obtained regarding their needs prior to them moving into the home. However there was no evidence of the home doing their own assessment to ensure that they could meet the needs of the individual concerned. For example, one person had moved from another home owned by the same organisation and the assessment had not been updated. This may have lead to incompatibility at the home and the placement is now under review. Wyatt House DS0000036981.V330567.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. Residents’ needs and personal goals are reflected in an individual plan of care. They are able to make decisions about their lives and are supported to take risks as part of an independent lifestyle. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All residents have a written plan of care, which gives details of their needs. This includes their cultural, health and personal care needs. Care plans are signed by a representative, usually a relative and they are regularly reviewed. In one case, it was evident for that person’s safety that staff needed to restrict access to certain parts of the building. They did this by holding the person concerned yet there were no guidelines for staff to follow to ensure that this was done safely. Staff respect residents rights to make decisions. They did this by offering them choices regarding what they ate, how they spent their time, informing them of activities/events and providing them with access to advocates. Wyatt House DS0000036981.V330567.R01.S.doc Version 5.2 Page 10 All residents are encouraged to take part in all aspects of their lives such as domestic tasks, activities and learning. They are supported in taking risks and accompanied by staff if this is necessary. Written risk assessments are made for example with regard to using public transport, swimming, horse riding, and using bedrooms unsupervised. Wyatt House DS0000036981.V330567.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is excellent. Residents take part in appropriate activities and are part of the local community. They have appropriate personal relationships and their rights are respected. They are offered a healthy diet in suitable surroundings. This judgement has been made using available evidence including a visit to this service. EVIDENCE: One person attends college on a part-time basis and staff provide others with educational activity whilst at the home. This includes learning to make drinks, cook and travel as well as practising language and enjoying the countryside. Residents use local amenities such as the swimming pool, local bus, pubs, restaurants and shops. They are on reasonable terms with their neighbours. A good programme of activities is provided and supported by the numbers of staff deployed. These include walks, swimming, cinema, use of a special sensory room, horse or carriage riding and bowling. Good contact is maintained with family by the majority of residents who see their relatives on a very regular basis. One person went out with their parents Wyatt House DS0000036981.V330567.R01.S.doc Version 5.2 Page 12 during the visit and another had visitors at the home. They confirmed that they come every week and are always welcome. Also that staff consult them and keep them informed. Daily routines take account of the activities which residents are participating in so they are flexible. One person had not slept well and therefore was encouraged to sleep in, following which she had her breakfast. Staff respect residents choice and freedom and whilst providing good supervision do enable them to be alone or make their own decision within a good framework of risk assessment. Privacy is maintained by ensuring bathrooms and toilets have locks and that people can lock their own rooms if it is safe for them to do so. Guidelines are provided to staff with regard to privacy and dignity when administering medication as well as when residents wish to be in their own company,. Staff were keen to engage with residents and spoke very positively about them. They were patient and understanding and obviously had a good rapport with them despite limited verbal communication. There is unrestricted use of the grounds although most people need to be accompanied for their own safety. The kitchen is kept locked so that residents only have access with a member of staff. This ensures that they can participate in domestic tasks such as making a drink or helping to prepare a meal but that they do this in a safe environment. There is a written menu, which shows that a varied diet is provided. Supplies included plenty of fresh fruit and vegetables. Only staff who have received appropriate training in food hygiene prepare the meals. A separate dining room is provided and it is suitably furnished so that people can sit together and enjoy their meal. Some do not benefit from this so staff accompany them when they are ready to eat. Special diets are catered for and residents’ weight is monitored. Wyatt House DS0000036981.V330567.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. Residents receive good personal support and their needs are met. They are protected by the homes medication policy and procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All residents are able to get around the home without support or the use of a wheelchair. Personal care is provided in their own room, en-suite or bathroom. They choose their own clothes and are supported in having their hair cut locally. One person needs to wear a helmet to prevent self-harm and it was clear that this was old and ill fitting. The acting manager confirmed that she was liaising with this person’s representative in order to obtain a replacement which was acceptable. Residents have a written health action plan and support is given to them with regard to health needs. This includes attendance at the GP surgery, dentist and optician. A record is kept of all health appointments which includes details of action to be taken and when this is carried out. None of the residents are considered able enough to look after their own medication and only staff who have received training are involved in its administration. Good systems are in place to ensure that medication is safely Wyatt House DS0000036981.V330567.R01.S.doc Version 5.2 Page 14 stored and accurate records kept on the receipt, administration and disposal of medicines. A contract is in place from a local chemist to support the home in looking after medication. Wyatt House DS0000036981.V330567.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Residents views are listened to and acted upon and they are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a written complaints procedure which is known to relatives and residents. There have been no recorded complaints. Staff receive training in adult protection and the home has its own policy and procedure. Staff were able to describe the action they would take should they suspect someone was being mistreated. The management of the home is currently investigating an allegation of abuse. They are following their own procedures and involving the appropriate authorities. This has identified the need for further training for staff which is being provided. It is anticipated that the matter will be resolved satisfactorily and the actions identified will be implemented. The arrangement for handling residents’ money ensures that it is safe and accurately accounted for. Wyatt House DS0000036981.V330567.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. Resident live in a homely and comfortable environment although their safety is compromised by the state of the drive to the home. The premises are clean and hygienic. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The premises are in a residential area and indistinguishable from surrounding properties. There is a drive off the main road into the grounds and this is very poor. It has large potholes, ruts where cars have been and the surface is mud and gravel. It therefore constitutes a hazard to everyone who uses it including residents and visitors. The manager confirmed that she had requested that the drive be maintained and resurfaced but it is yet to be done. All of the accommodation is on the ground floor which makes it easily accessible. Ongoing maintenance has improved many areas of the home and remedied some areas of damp which had been identified. Further plans are in hand including improvement to the garden so that it is of more interest to residents. However, one person is employed to undertake all of maintenance Wyatt House DS0000036981.V330567.R01.S.doc Version 5.2 Page 17 throughout the organisation and this can mean that he is taken away from planned work to attend to an emergency, thus delaying routine maintenance. The premises meet the requirements of the local fire service and environmental health department. They are clean throughout with no offensive odours. A laundry is situated away from food preparation areas and is now fitted with suitable equipment including a washing machine with a sluice cycle and hot wash to prevent infection. Wyatt House DS0000036981.V330567.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is adequate. Residents are supported by competent staff some of whom are trained. They are not always protected by the homes recruitment procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff adopted a helpful attitude to residents who were comfortable in their company. They listened carefully to them and responded to their needs and wishes. They ensured that all necessary information was carefully passed on to those who needed it and had formal arrangements for making sure all jobs were done. For example, staff were delegated to cook the meal, to escort people on activities and to support them when they went to bed. These arrangements were recorded so that everyone was made accountable for whatever their delegated duties were. This also enabled the management of the home to monitor how the service was operating. Three staff have an NVQ which falls below the standard for 50 of staff to have obtained this qualification. However, there is now an ongoing NVQ training programme and it is anticipated that this target will be met in the near future. Wyatt House DS0000036981.V330567.R01.S.doc Version 5.2 Page 19 Staff confirmed that they went through a recruitment procedure which included an interview and Criminal Records Bureau (CRB) check. However, records showed that two written references were not always obtained for new staff before they took up their position. Staff are subject to a probationary period of six months and provided with a contract of employment both of which are good practice. Induction training is provided for all staff and this is recorded. There is an ongoing training programme which includes first aid, infection control, medication, food hygiene and fire safety. Individual supervision is provide where staff can discuss their progress and agree training needs. Wyatt House DS0000036981.V330567.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. Residents benefit from a well run home which is run in their best interests. The health and safety of residents is protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Whilst there is no registered manager the person in charge has been the deputy at the home for some time and was recently appointed to the manager’s position. She has completed her Registered Managers Award and intends to submit her application for registration with the CSCI in the near future. She is clear about her duties and understands to whom she is accountable. The position of deputy manager is currently vacant and under review. There is an annual development plan which has been drawn up by the manager. This is based on a survey of families whose relatives live at the Wyatt House DS0000036981.V330567.R01.S.doc Version 5.2 Page 21 home. This showed that they wished for more communication between the home and themselves. The manager has, therefore arranged for staff to telephone them each week with an update on their relatives’ behalf. The questionnaire will be sent out every six months. A weekly report is sent by the manager to the regional office on all operations within the home. In addition, monthly monitoring visits are made to the home by a senior member of the organisation. Policies and procedures are reviewed and kept up to date. Action is taken promptly on requirements and recommendations made by CSCI. As previously stated there is a training programme which ensures staff understand and follow good health and safety practices. Contracts are in place for the maintenance of the boilers, heating, gas supplies and the fire fighting equipment. Radiators are covered throughout the building. A detailed record of accidents is kept. Wyatt House DS0000036981.V330567.R01.S.doc Version 5.2 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 2 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 2 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 4 X LIFESTYLES Standard No Score 11 X 12 3 13 4 14 X 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 4 x 3 X 3 X X 3 x Wyatt House DS0000036981.V330567.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. 4. Standard YA2 YA6 YA24 YA34 Regulation 14 15 23 19 Requirement All new residents must have a written assessment Guidelines must be drawn up in the case where a resident needs to be restrained The drive must be made safe and maintained Two written references must be obtained before new staff take up their position Timescale for action 30/03/07 30/03/07 31/05/07 30/03/07 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 Wyatt House DS0000036981.V330567.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Wyatt House DS0000036981.V330567.R01.S.doc Version 5.2 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. 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