Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: Wymeswold Court London Lane Wymeswold Loughborough Leicestershire LE12 6UB The quality rating for this care home is:
two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Martin Hefferman
Date: 0 2 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area.
Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection.
This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 23 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home
Name of care home: Address: Wymeswold Court London Lane Wymeswold Loughborough Leicestershire LE12 6UB 01509881615 01509881635 wymeswoldcourt@schealthcare.co.uk www.southerncrosshealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Southern Cross Care Homes No 2 Ltd care home 40 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: 1. The registered person may provide the following category/ies of service only: Care home only Code PC 2. The maximum number of service users who can be accommodated is: 40 No one under 60 years of age who falls within the category DE to be accommodated at Wymeswold Court No person falling within the PD(E) category should be accommodated at Wymeswold Court when 40 persons who fall within the PD(E) category are already residing at the home 20 0 0 Over 65 20 40 40 Care Homes for Older People Page 4 of 23 No person to be accommodated at Wymeswold Court under the categories DE or DE(E) when 20 persons in total of these categories/combined categories are already residing in the home The maximum number of persons to be accommodated at Wymeswold Court is 40 to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category Code OP Physical disability Code PD Dementia Code DE Wymeswold Court Care Home is registered to provide personal care to male and female service users who fall within the following categories :- Physical Disability over the age of 65 years PD(E) 40 Old Age (OP) 40 Dementia over the age of 65 years (DE(E)) 20 Dementia (DE) 20 Date of last inspection Brief description of the care home Wymeswold Court is registered to provide personal care and accommodation for forty older people. The home is owned by Southern Cross Limited. The premises are located about five miles from the town centre of Loughborough close to shops, pubs, the post office and other amenities. The home is easily accessible by private transport. The premises were built as sheltered housing for older people but prior to completion were converted and registered as a nursing home. The premises were later registered to provide residential care only. The premises consist of two floors and the first floor is accessible by use of a passenger lift or stairs. A number of facilities, for example a choice of lounge and dining areas, can be found on both floors. There are thirty-eight single bedrooms, six with en-suite facilities and one double room with en-suite facility. There is a well maintained courtyard garden to the rear of the building. At the time of this inspection, the weekly fees ranged from £334 to £550 per week. Care Homes for Older People Page 5 of 23 Summary
This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection peterchart Environment Staffing Management and administration Poor Adequate Good Excellent How we did our inspection: Two inspectors visited Wymeswold Court on 2nd April 2009. The visit lasted approximately seven hours. The main method of inspection used on that day was case tracking which involved selecting people who live at the home and tracking the care they receive through review of their records, discussion with them & staff and observation of care practices. This inspection also took account of all information received since the date of the last key inspection, including the providers annual quality assurance assessment. No comment cards were received on this occasion. Wymeswold Court was last inspected on 18th April 2007. Care Homes for Older People Page 6 of 23 What the care home does well: What has improved since the last inspection? What they could do better: One person expressed concern about male carers washing her. There was no reference to her preference in her care plan. Individual plans should be reviewed to ensure that they are specific about peoples preferences regarding their personal care. Several people stated that whilst they enjoy the activities that are provided, they would like more. The registered manager was in process of recruiting an activity organiser at the time of the visit. Two radiators on the first floor were very hot to touch. Immediate action was taken to Care Homes for Older People
Page 7 of 23 address this issue and the registered manager stated that they would be replaced at the earliest opportunity. We also noted an unpleasant odour in the entrance and main lounge. Action should be taken to ensure that the premises are kept odour free. Staff records had not been updated to reflect all of the training that had taken place. An up-to-date record must be kept of the training undertaken by staff. One of the staff members whose records were inspected had been supervised during March 2009 and January 2008; the second during November, July and April 2008. Staff members must receive appropriate supervision to ensure that the needs of people who use the service are met and that they are protected from harm. Staff should receive formal supervision at least six times a year. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 23 Details of our findings
Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 23 Choice of home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have access to the information they need to make an informed choice about where they live. Evidence: A copy of the homes statement of purpose and service user guide were on display in the reception area. The registered manager agreed to update both documents to reflect changes to the companys operations manager and ourselves. He stated that the guide is available in braille and on audiotape upon request. A copy of our last inspection report was also on display in reception. Assessments were available for the people who were chosen for the purposes of case tracking. The records that were inspected contained copies of an interactive assessment tool (covering community links and social & physical activity) and a social profile, both of which have been developed since the date of the last inspection. The home had also obtained copies of assessments completed by the local authority.
Care Homes for Older People Page 10 of 23 Health and personal care
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff members generally have access to the information they require to ensure peoples individual needs are met. Evidence: Individual plans were available for the people who were chosen for the purposes of case tracking. They covered a range of issues and were written from the perspective of the person who uses the service. The plans that were inspected had been evaluated monthly. Risk assessments have been completed on issues such as falls, malnutrition, pressure areas and moving & handling. A risk assessment and care plan relating to locking a persons door when she is not in her room had been signed by her next of kin. Records indicate that people who use the service are in contact with a range of healthcare professionals. Information provided prior to the visit indicates that the manager and a district nurse from a local surgery undertake a weekly round to ensure that people are in good health. The manager would like to extend the initiative to the other surgery used by people at the home. The records that were inspected and direct
Care Homes for Older People Page 11 of 23 Evidence: observation during the visit indicate that staff use diversion techniques to manage challenging behaviour when working with people with dementia. Four safeguarding alerts were received during the six months preceding the visit. They relate to alleged failures to provide adequate care; to seek appropriate medical intervention following injuries and to concerns regarding moving & handling practices. Action has been taken to minimise the risk of these incidents occurring again. Staff members have received training on first aid and moving & handling. Outdated equipment has been removed and new equipment has been ordered. Staff members have been told to contact senior managers for advice and support following any incidents. Medication administration records had been completed satisfactorily. Arrangements for the storage of medication met relevant requirements. The senior staff who are responsible for the administration of medication have received training. Staff members treated people who use the service with respect and were mindful of their right to privacy. People who use the service stated that they are looked after well. One person did however express concern about male carers washing her. We were not able to find any reference to her preference in her care plan. Care Homes for Older People Page 12 of 23 Daily life and social activities
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Action is being taken to ensure that the daily life of the home & the social activities provided meet the preferences and expectations of the people who use the service. Evidence: People who use the service stated that they enjoy the activities that are provided. Several people reported that they would like more. On the day of the visit, staff members in one of the lounges played card games with a couple of people before lunch and encouraged others to dance to music in the afternoon. Staff in a second lounge involved people in a ball game and sat & talked to them whilst doing their nails. The registered manager stated that he was in process of recruiting an activity organiser who would start shortly. An interactive assessment tool, which covers community links and social & physical activity, and a social profile have been developed since the date of the last inspection. The latter details peoples preferences in respect of their daily life. A number of people received visitors during the course of the inspection. Information received prior to the visit indicates that the home has held two dementia awareness evenings for people who use the service, their families & friends and the local community.
Care Homes for Older People Page 13 of 23 Evidence: People who use the service stated that they enjoy the meals that are provided. The chef was observed speaking to people in the lounges about the choices available. Menus are displayed on notice boards around the home and picture menus are available for those who require them. A system has been introduced to monitor the nutritional value of all of the food provided and the results are displayed. Care Homes for Older People Page 14 of 23 Complaints and protection
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Action has been taken to ensure that the homes arrangements for handling complaints and responding to allegations of abuse protect people who use the service. Evidence: The people we spoke to knew how to complain and were confident that any issues they raised would be addressed. The homes complaints procedure was displayed around the home. The registered manager agreed to amend the procedure set out in the service user guide to reflect changes to the companys operations manager & ourselves. Records indicate that two complaints have been received since the date of the last inspection, one of which was ongoing at the time of the visit. The registered provider had undertaken an investigation into the complaints and identified measures to be taken to address the issues raised. The home has policies & procedures on the protection of vulnerable adults. Staff members attended abuse training during January & February 2009. The staff we spoke to were aware of the action they should take if they suspect someone is being abused. Four safeguarding alerts were received during the six months preceding the visit. They relate to alleged failures to provide adequate care; to seek appropriate medical intervention following injuries and to concerns regarding moving & handling practices. Action has been taken to minimise the risk of these incidents occurring again (see Health & Personal Care).
Care Homes for Older People Page 15 of 23 Environment
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service live in a comfortable, safe & well maintained environment. Evidence: People who use the service stated that they are happy with the environment in which they live. The areas of the home that were inspected were decorated and furnished to a satisfactory standard. A number of improvements have been made since the date of the last inspection, including the provision of three dimensional signs, photographs on peoples doors and coloured toilet seats to assist people with dementia. The homes gardens have been landscaped. The registered manager stated that they were in the process of developing a lounge on the first floor into a reminiscence area and an activity room into a cinema. We found that two radiators on the first floor were very hot to touch. Immediate action was taken to address this issue. The registered manager stated that the radiators would be replaced at the earliest opportunity. We also noted an unpleasant odour in the entrance and main lounge. Care Homes for Older People Page 16 of 23 Staffing
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Action has been taken to ensure that the homes arrangements for the recruitment & training of staff protect people who use the service. Evidence: Staffing levels at the time of the visit were adequate to meet the needs of the people who use the service. Staff members were present in both lounges at all times. The staff records that were inspected indicated that pre-employment checks have been completed. Staff members have received training on fire safety, food hygiene, moving & handling, health & safety, abuse & the protection of vulnerable adults, infection control, nutrition and medication. The registered manager stated that staff have received training on first aid and moving & handling in response to the issues raised by a number of safeguarding adult alerts. The staff members we spoke to confirmed this to be the case. We could not however find a record of first aid training having been undertaken. Information provided prior to the visit indicates that nine of the twenty five members of staff have obtained National Vocational Qualification level 2 or above. A member of staff has completed a train the trainer course to enable her to provide in-house training. Care Homes for Older People Page 17 of 23 Management and administration
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home appears to be run in the best interests of people who use the service. Evidence: Southern Cross are in the process of recruiting a manager for Wymeswold Court following the promotion of the current registered manager. The companys operations manager stated that the latter would remain at the home until a suitable replacement has been appointed and inducted. Monthly audits are undertaken by the registered manager on a range of issues. The operations manager visits the home at least monthly to complete the reports required by Regulation 26. Records are kept of peoples individual finances on computer and receipts are issued for money given out. Advice was given that these receipts should be signed by two members of staff. Care Homes for Older People Page 18 of 23 Evidence: One of the staff members whose records were inspected had been supervised during March 2009 and January 2008; the second during November, July and April 2008. Staff members have received training on safe working practices (see Staffing). Records indicate that fire tests and drills have been completed at the required frequency. Care Homes for Older People Page 19 of 23 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 20 of 23 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 30 18 An up-to-date record must be kept of the training undertaken by staff. This is to demonstrate that they have received appropriate training. 31/05/2009 2 36 18 Staff members must receive appropriate supervision. This is to ensure that the needs of people who use the service are met and that they are protected from harm. 31/05/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations 1 10 Individual plans should be reviewed to ensure that they are specific about peoples preferences regarding their personal care. Action should be taken to ensure that the premises are kept odour free. 2 26 Care Homes for Older People Page 21 of 23 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations 3 36 Care staff should receive formal supervision at least six times a year. Care Homes for Older People Page 22 of 23 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 23 of 23 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
