Inspection on 09/01/07 for Wychwood

This inspection was carried out on 9th January 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Wychwood 25/07/05

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 Wychwood 38 London Road Southborough Tunbridge Wells Kent TN4 0PX Lead Inspector Ruth Burnham Key Unannounced Inspection 9th &11th January 2007 09:30 Wychwood DS0000064671.V303346.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 Wychwood DS0000064671.V303346.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. Wychwood DS0000064671.V303346.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wychwood Address 38 London Road Southborough Tunbridge Wells Kent TN4 0PX 01892 535623 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) www.pepenbury.info Larkfield Hall Limited Mr Stephen Richard Shepherd Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Wychwood DS0000064671.V303346.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Bedroom 5 to be available for service users as part of an induction/introduction to service, or emergency placement given risk assessment indicates assessed needs could be met. These placements to be up to 48 hours duration. To admit one service user with the provision of respite care who has a head injury and whose date of birth is 3.2.1973. 2. Date of last inspection Brief Description of the Service: Wychwood was registered in May 2005 as a respite service for four service users with learning disability, one bedroom is equipped to meet the needs of service users with a physical disability, a fifth bedroom is available for very short term emergency or trial stays. The house is detached and set back from the main road through Southborough, it has a large garden and a patio area. Four bedrooms are on the first floor; the fifth room that is suitable for a wheelchair user is on the ground floor. Service users who stay at Wychwood access day care facilities during the week, a variety of activities are offered during evenings and weekends. Local facilities are within easy reach and the centre of Tunbridge Wells is approximately two miles away. The fees structure is complex and is decided by the Local Authority. Levels of fees can be obtained by application to the provider or to Kent County Council. Wychwood DS0000064671.V303346.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced was carried out on 9 January 2007 when the inspector was in the home from 09:00 to 13:00, during that time the manager and staff were spoken with, a tour of the premises was made and a number of records and documents were examined. A further visit was made on 11 January 2007 from 15:30 to 18:45 when time was spent with the 2 service users who were staying at the home. Wychwood was found to be well run. The manager is qualified and experienced, staff on duty were knowledgeable and confident and service users were comfortable with the service and enjoying their stay. What the service does well: What has improved since the last inspection? What they could do better: At the last inspection a requirement was made that wheelchair users should be able to access the main garden area. It is recognised that this would be expensive and disruptive. As service users only stay for very short periods and there are plans to move the service to a purpose built property in 2008 which will be suitable for people with physical disabilities it has been agreed that alterations will not be insisted upon at this time. Wychwood DS0000064671.V303346.R01.S.doc Version 5.2 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. Wychwood DS0000064671.V303346.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 Wychwood DS0000064671.V303346.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1-5 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. People who are considering using the service benefit from good information and an opportunity for a trial stay. Information is detailed and accessible and admission procedures ensure that care needs can be met. EVIDENCE: People who are thinking about using the service receive initial information from Social Services teams through whom referrals for respite care are made. The home provides a statement of purpose and service user’s guide, which is available to prospective service users and their families; these are available in pictorial form. Once a referral has been received the manager then undertakes an assessment of need. People who are considering using the service are invited to visit and can choose to have introductory stays of a night or two. One of the bedrooms can be used for short-term emergencies or introductory visits for a maximum of 48 hours. During the inspection there were 2 service users staying at the home both of whom said how much they enjoyed being there. Care plans include written and pictorial agreements signed by service users. Wychwood DS0000064671.V303346.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 - 10 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. People who use the service can be confident their needs will be met and that they will be consulted about how this will be achieved. Good risk management systems promote their safety and independence. EVIDENCE: Throughout the inspection it was very evident that choice and consultation of service users is viewed as a very important part of their respite care. People who use the service have their care needs assessed and a plan of care is recorded. Care plans sampled included information about individual preferences regarding personal care, interests and activities. Risk assessments are in place relating to a range of activities. Service users are consulted about the way in which the home is run, a service users’ meeting is held twice weekly in order for staff to consult about choice of menu and activities. Service users stay in the home for short periods of time, they benefit from good staff support with their daily care needs. Interactions observed during the Wychwood DS0000064671.V303346.R01.S.doc Version 5.2 Page 10 site visit was warm and friendly and it was clear that service users have confidence in the staff team. Service users are treated with dignity and respect and confidentiality is maintained when handling their personal information. Care plans and other confidential documents are kept in the locked office. Service users have access to their personal care plans and staff assist them to understand the contents where necessary. Wychwood DS0000064671.V303346.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11 - 17 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. People who use the service benefit from staff support to continue their normal day activities; they have opportunity to choose to engage in a variety of leisure activities. Choice and independence is encouraged. EVIDENCE: Service users are able to continue to attend their normal day activity venues whilst staying in the home; Wychwood has a minibus and transports service users to day care if other transport is not arranged. Activities suggested at service users’ meetings and evidenced in care plans and daily record sheets are appropriate and varied, activities include bowling, the cinema, local pubs and places of interest. There is a television, a hi fi system, indoor games, DVDs and videos for service users to enjoy during their stay. The birthday of one of the residents was being celebrated during the site visit and an outing to an adult pantomime had been arranged for the evening. Service users are treated with respect and encouraged to be independent, they are given the choice to look after their own spending money or for staff to lock it up for safe keeping with the service user signing agreement for this on their care plan. Wychwood DS0000064671.V303346.R01.S.doc Version 5.2 Page 12 During the site visit the evening meal was being prepared, service users choose menus with staff support, menus include a variety of healthy meals, where packed lunches are taken to day care these are made up and the contents recorded. Service users have opportunities to go shopping with staff. Wychwood DS0000064671.V303346.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 - 21 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Service users benefit from the sensitive and flexible support of staff who understand their personal and healthcare needs and preferences; they are protected through the safe handling of medication. EVIDENCE: People who use the service benefit from sensitive staff support with their personal and healthcare needs, the manager said that all current service users retain their own GPs during their stay in the home, staff provide support to access professional healthcare wherever necessary. Service users are protected through policies, procedures and practice in the safe handling of medication which is stored securely. There is a medication cabinet and a controlled drugs cupboard, the manager said that a suitable fridge is available should any medications need refrigeration. Staff who handle medication receive appropriate training, medication records were up to date and well maintained. Wychwood DS0000064671.V303346.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. People who use the service are protected by clear policies and procedures and appropriate checks on staff prior to appointment, they are encouraged to offer comment or complaint. EVIDENCE: People who use the service are encouraged to offer comment or complaint, there is a complaints procedure that is in text and pictorial format and is displayed on the notice board in the entrance to the home. A service user said that if he were unhappy about anything he would talk to staff or the manager. People who use the service are protected through good policies and procedures and staff are provided with training in adult protection. A service user spoken with stated that if he had a complaint he would speak to carers at the home or the manager. Service users are also protected through rigorous recruitment and selection procedures that include carrying out criminal record checks and taking up a minimum of 2 references before staff are appointed. Wychwood DS0000064671.V303346.R01.S.doc Version 5.2 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 - 30 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. People who use the service enjoy a safe, clean and welcoming environment. The premises could be improved upon to increase choice, independence and safety however future plans will address all these shortfalls. EVIDENCE: People who use the service benefit from the comfortable and welcoming environment that is well decorated and clean. The four main bedrooms are spacious with the downstairs room being designed to promote the independence of service users with physical disabilities. Facilities provided include sufficient toilets and bathrooms, reasonably sized and furnished bedrooms, a lounge/dining room and well equipped kitchen and laundry. The ground floor bedroom is wheelchair accessible and has an en suite adapted shower room; bedrooms upstairs are equipped with wash hand basins. Shared spaces are of a good size and the lounge dining room is partitioned so that the areas used for eating and for watching TV and relaxing are separate. There is a large garden, the patio area is accessible to wheelchair users via a side entrance to the garden as there are steps down from the rear of the house, this provides a restriction to the activities that wheelchair users can Wychwood DS0000064671.V303346.R01.S.doc Version 5.2 Page 16 participate in outside and could make those less physically able feel less included and different, the manager has obtained quotes to make the garden more accessible but these still sit with the provider and it is unlikely that expensive work will be carried out given that the accommodation is temporary with plans for a purpose built house which is expected to be available in 2008. As service users are only accommodated for short stays up to a maximum of 14 days it would seem unreasonable to insist on major alterations to outside areas at this stage. The laundry is well equipped and is reached via the patio; there are several steps to negotiate. The majority of service users can access the laundry with staff support although do not use the washing machines, plans seen for the new house will address all these issues. Wychwood DS0000064671.V303346.R01.S.doc Version 5.2 Page 17 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 – 36 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. People who use the service enjoy the support of a committed and well-supervised staff team who are well trained and understand the varied needs of service users. EVIDENCE: People who use the service benefit from the well trained and supervised staff team; two support workers are on duty when service users are present in the home. Staffing levels at night are determined through risk assessment processes and vary according to need. Staff spoken with were clear about their roles and confident with the service users and service users were clearly comfortable with them. Service users are protected through sound recruitment policies and procedures, records kept in the home include all the documentation required by regulation such as evidence that criminal record checks have been carried out and written references had been obtained. Staff receive regular monthly supervision and staff meetings are held. Induction training is given and includes manual handling, health and safety and epilepsy. Update training and training on specialist topics is also provided. Staff said they felt well supported by the manager of the unit and enjoyed working there. Wychwood DS0000064671.V303346.R01.S.doc Version 5.2 Page 18 There was one staff vacancy, the existing staff team is covering this shortfall in hours, the staff rota has been revised to include the full names of staff on duty. Wychwood DS0000064671.V303346.R01.S.doc Version 5.2 Page 19 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 - 42 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. People who use the service benefit from the competent leadership and support of the management team. Their health and safety is promoted. EVIDENCE: People who use the service benefit from the competent leadership and support of the management team. They are protected from harm through policies and procedures that are comprehensive and are regularly reviewed. Safety checks are carried out on all installations and equipment. Records are kept safely and securely and those seen were up to date. The home has an open and inclusive atmosphere and it was very apparent that the service users in residence during the inspection, felt at home and in control of their time there in terms of choices and access to personal records. Wychwood DS0000064671.V303346.R01.S.doc Version 5.2 Page 20 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 3 2 3 3 3 4 3 5 3 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 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 4 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 N/A 3 3 3 3 3 3 x Wychwood DS0000064671.V303346.R01.S.doc Version 5.2 Page 21 NO 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. Standard Regulation Requirement Timescale for action 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 Wychwood DS0000064671.V303346.R01.S.doc Version 5.2 Page 22 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. 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