Inspection on 07/10/05 for Wycar Leys Care Home (Bulwell)

This inspection was carried out on 7th October 2005.

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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Wycar Leys Care Home (Bulwell) 30/10/06

Wycar Leys Care Home (Bulwell) 19/07/05

Wycar Leys Care Home (Bulwell) 31/03/05

Wycar Leys Care Home (Bulwell) 22/02/05

Wycar Leys Care Home (Bulwell) 24/02/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Wycar Leys Care Home (Bulwell) Snape Wood Road Bulwell Nottingham NG6 7GH Lead Inspector Lee West Unannounced Inspection 7th October 2005 10:30 Wycar Leys Care Home (Bulwell) DS0000034961.V252230.R01.S.doc Version 5.0 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 Wycar Leys Care Home (Bulwell) DS0000034961.V252230.R01.S.doc Version 5.0 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. Wycar Leys Care Home (Bulwell) DS0000034961.V252230.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Wycar Leys Care Home (Bulwell) Address Snape Wood Road Bulwell Nottingham NG6 7GH 0115 9762111 0115 9762888 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) Wycar Leys (Bulwell) Limited Vacant Care Home 16 Category(ies) of Learning disability (16) registration, with number of places Wycar Leys Care Home (Bulwell) DS0000034961.V252230.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th July 2005 Brief Description of the Service: Wycar Leys, Bulwell has been converted to provide spacious well-maintained accommodation for up to 16 younger adults with learning difficulties in a former purpose built residential home for older people. The home is situated in a housing estate with access to local facilities. The accommodation is divided into two units. The ground floor – The Cottage – and the first floor – The Homestead – each with separate external access. There are large enclosed gardens which contain some appropriate activity equipment. There is a minibus available for the service users. Wycar Leys Care Home (Bulwell) DS0000034961.V252230.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection began at 11.00am and was carried out over 5 hours. The method used was case tracking. That is the inspector talks with service users about their expectation and experiences of living at the home, analyses the records of the service users and talks with staff to ensure that those living at the home have their needs met and health and welfare maintained appropriately. The service users in The Cottage use mostly nonverbal communication, so observation, staff interaction, with some verbal responses and records were the methods used to monitor the standards. The service users in The Homestead were spoken with, 5 members of staff between the two units were also interviewed A full tour of both floors was undertaken. The acting manager was available during the inspection and Sally Hamilton from Wycar Leys, The Mews was also present for the inspection and feedback at the end of the inspection. What the service does well: What has improved since the last inspection? The acting manager is maintaining the records specified in Schedule 4 and is working with the regional management to improve these. Any necessary use of restraint is recorded to include the circumstances and the nature of the restraint. Wycar Leys Care Home (Bulwell) DS0000034961.V252230.R01.S.doc Version 5.0 Page 6 The Homestead dining room window sills have been repainted and the lounge has been refurbished to a standard the service users say they are very proud of. Two bathrooms have been redecorated, with one awaiting completion. The Cottage has also refurbished areas and redecorated. The two units are beginning to reduce isolation and have appropriate activities jointly. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Wycar Leys Care Home (Bulwell) DS0000034961.V252230.R01.S.doc Version 5.0 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 Wycar Leys Care Home (Bulwell) DS0000034961.V252230.R01.S.doc Version 5.0 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): 1,2,3,4,5, The home provides information prospective service users need to assist with their decision about where to live. There are written contracts The new service users have their needs assessed before admission. EVIDENCE: There have been a number of new service users in the home and observation of interactions between them and staff which are open and positive, illustrate that they are comfortable. There is evidence, in the individual care plans case tracked, of contracts with terms and conditions. The new service users were given time to settle in before making the decision to stay long term, with an opportunity to visit the home. The service users and their advocates are given time to make this decision, as shown in the documentation case tracked and service users know that the home will meet their needs and aspirations through the initial assessment process. Wycar Leys Care Home (Bulwell) DS0000034961.V252230.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9, The home involves the service users in their individual care plans, making decisions about the assistance and support required for independence and involvement in the home. The service users are supported to participate in life within the home and to maintain an independent lifestyle. Care plans require reviews. EVIDENCE: Service users in The Homestead explained they have opportunities to develop their independence whilst living at Wycar Leys. They also confirmed that they are aware of their care plan and especially the activity timetable which they have been involved with. One service user spoken with said that his ideas are listened to and he enjoys the activities in his plan . Some others spoke about their trip to the fair and going on the rides. Care plans case tracked included risk assessments to support being as independent as possible. Care plans for service users in The Cottage show the assistance needed by service users to help make decisions and also to take part in things around them. These take into consideration the degree of ability of service user and also the communication skills of the service user. There is evidence in the activity records and day to day records that service users in both The Cottage and The Homestead are supported to take risks as Wycar Leys Care Home (Bulwell) DS0000034961.V252230.R01.S.doc Version 5.0 Page 10 part of an independent lifestyle. The main care plans tracked indicate that updating has not taken place and this is necessary to maintain the validity of the plans. The day to day records and the activity records are updated. Team Leaders said that this updating is the manager’s responsibility. Wycar Leys Care Home (Bulwell) DS0000034961.V252230.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16, The service users are supported to take part in appropriate leisure activities in the home and local community. Their rights are respected and they are helped to recognise their responsibilities. Service user’s personal development is addressed to include age, peer and cultural activities. The home encourages personal and family relationships but there is no evidence of addressing sexual relationships. EVIDENCE: Some service users spoken with mentioned going to Stonebridge Farm to help with animal care and reading and writing. One service user is doing woodwork. Comments like “its good” “I love getting to know the animals” were made. The proximity to the local shops and community centre helps encourage service users to be involved in the local community. Events have been held in the community centre for service users. With the use of a minibus, trips are enjoyed by the service users who explained how they enjoyed the fair. One service user had been to Blackpool for the week. Wycar Leys Care Home (Bulwell) DS0000034961.V252230.R01.S.doc Version 5.0 Page 12 Service users are encouraged to maintain personal and family relationships where possible and service users spoken with said they had visits from family and sometimes go out with them. Others have not had contact with families but the home have records of why this is so. There is one female service user at present. Staff were not comfortable with the topic of sexual relationships within the home and this area is not identified as a need within care plans. Observation of interactions between staff and service users on the day of inspection evidenced the recognition and respect for service users rights and the inspector observed service users keeping their rooms tidy one of the assigned responsibilities. Diet was not assessed at this inspection but service users spoken with all said the food was very good and that they had choices if they didn’t like something. Wycar Leys Care Home (Bulwell) DS0000034961.V252230.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19, Service users are supported with their physical and emotional needs in the way they prefer. None of the service users administer their own medication. EVIDENCE: Care plans and risk assessments case tracked show the level of personal support the service users want and need. They address the physical needs and deal with some of the emotional needs, but do not address the sexuality aspect of service user emotions. Service users spoken with in The Homestead are happy with the level of care they are receiving and said they would “soon let everyone know if I wasn’t happy with things.” Due to the level of ability of the service users it is not appropriate for selfmedication, so this is identified in the care plans and staff administer medication. Medicines Administration Records were inspected and found to be in order. The medications were kept locked away appropriately. Wycar Leys Care Home (Bulwell) DS0000034961.V252230.R01.S.doc Version 5.0 Page 14 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): 22,23 The service users views are acted on and are protected from harm or abuse. Complaints are recorded. EVIDENCE: During the inspection interactions between staff and service users were observed and, particularly in the Homestead where service users are very vocal, their ideas were being listened to and staff were in the process of acting on these ideas. Staff are aware of the Protection of Vulnerable Adults and those interviewed clarified what their role was in this area. The Team Leaders spoken with were also clear on their roles and responsibilities around abuse. The Care plans case tracked showed that whilst there was challenging behaviour from some service users strict guidelines were identified to protect them and others from any harm. Any complaints are recorded, action taken, but no written evidence of outcomes of complaints was seen. Wycar Leys Care Home (Bulwell) DS0000034961.V252230.R01.S.doc Version 5.0 Page 15 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): 24,25,26,27,28,30 The Home is comfortable and both The Cottage and The Homestead are homely and safe. The bedrooms are all personalised and promote independence. The toilets and bathrooms meet the needs of the individuals. The communal areas are conducive to the homely atmosphere and all areas are clean and hygienic. EVIDENCE: There has been a programme of refurbishment in the home and service users in The Homestead were happy to show their new lounge area with its new furniture and décor. Bathrooms have been refurbished and one remains to be completed in The Homestead. The Activities room and Sensory room in The Cottage contain specialised equipment to help maximise independence and the sensory room with its fibre optics, music, water tubes, and therapeutic lighting has a calming effect on the service users. Individual rooms have been decorated and furnished to individual tastes with service users own possessions. Service users’ rooms have sinks and toilets and some in the newer part of The Cottage also have showers. One service user was moved into a room with a shower to assist in the promotion of independence. Wycar Leys Care Home (Bulwell) DS0000034961.V252230.R01.S.doc Version 5.0 Page 16 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): 31,32,33,34,35,36 Staff are clear about their roles and responsibilities and are competent to support service users. Recruitment policies protect service users, but The Cottage does use Agency workers. Staff training is ongoing however although staff are well supported by the management team. The supervision of staff requires improvement. EVIDENCE: Staff spoken with explained their roles and responsibilities which were outlined in the job descriptions. Training is ongoing and records confirm what the staff have said, that they are doing NVQ3 and have regular training including First Aid, Fire procedures, Medicines and Safe Lifting. The Cottage, because there have been new admissions, have been using agency staff, but try to use the staff known to the service users to reduce the adverse effect strangers working within the home can have. Case tracked staff records contained references, training and supervision notes. Some files have no photographs and some have not received any supervision for a considerable time. The Team Leaders supervise their teams, but in some records seen, areas of concern addressed by the member of staff being supervised have not been addressed. Staff spoken with during the inspection though said they felt supervision was appropriate. There is evidence that team leaders have received training on supervision. Wycar Leys Care Home (Bulwell) DS0000034961.V252230.R01.S.doc Version 5.0 Page 17 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): 37,38,40,41,42,43, The home is run as two independent units The Homestead and The Cottage, but the service users are the centre of the approach to the development by the home. The Service users best interests are safeguarded by the policies and procedures and health and safety procedures. The record keeping reflects the best interests of the service users, but is in need of improvement in some areas. The acting manager has been in post for a short time only and improvements are taking place to improve records and procedures. EVIDENCE: The acting manager and the regional management team are using their management skills to develop a well run home. Some of the changes already started include integrating both units in activities as appropriate. The Cottage and The Homestead though still maintain their different staff team. The policies and procedures seen at the time of inspection, followed correctly, promote the health, safety and welfare of the service users. Records were seen that confirm this. The majority of the records seen were up to date, but Wycar Leys Care Home (Bulwell) DS0000034961.V252230.R01.S.doc Version 5.0 Page 18 the main care plans have not been updated recently and this activity which staff said was the manager’s requires dealing with for both units. Some staff records have omissions to be corrected. Supervision and recording of supervision by the acting manager particularly with night staff are necessary as this has not been carried out for some time. The acting manager is supported by the Regional Management at Wycar Leys in Bilsthorpe and Sally Hamilton (Wycar Leys, The Mews) was present during the inspection as duty manager to support the acting manager. Wycar Leys Care Home (Bulwell) DS0000034961.V252230.R01.S.doc Version 5.0 Page 19 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 Score 2 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 3 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 X 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 2 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 2 CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Wycar Leys Care Home (Bulwell) Score 3 2 X x Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 2 3 3 DS0000034961.V252230.R01.S.doc Version 5.0 Page 20 None 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 YA6 Timescale for action 15(2)(a)(b) The registered person shall keep 09/12/05 (c)(d) the service user’s plan under review and after consultation with the service user or his representative revise the service user’s plan and notify the service user of any such revision. 12(3) The registered person shall, for 09/12/05 the purpose of providing care to service users, and making proper provision for their health and welfare, so far as practicable ascertain and take into account their wishes and feelings 17(2) The registered person shall 09/12/05 maintain in the care home the records specified in Schedule 4(11) 18(2) The registered person shall 09/12/05 ensure that persons working at the care home are appropriately supervised 17(1)(a) The registered person shall 14/10/05 maintain in respect of each service user a record which includes the information documents and other records specified in Schedule DS0000034961.V252230.R01.S.doc Version 5.0 Page 21 Regulation Requirement 2 YA15 3 YA22 4 YA36 5 YA41 Wycar Leys Care Home (Bulwell) 3(2)relating to the service user 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 YA19 Good Practice Recommendations The registered person ensures that the healthcare needs of service users are assessed and recognised and that procedures are in place to support to gain access to up to date information and advice about general health issues including expression of personal sexual feelings. Wycar Leys Care Home (Bulwell) DS0000034961.V252230.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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. 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