CARE HOMES FOR OLDER PEOPLE
Wymondley Nursing Home Wymondley Nr Hitchin Hertfordshire SG4 7HT Lead Inspector
Louise Bushell Unannounced Inspection 28th February 2006 10:00 X10015.doc Version 1.40 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 Wymondley Nursing Home DS0000019630.V285186.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. 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. Wymondley Nursing Home DS0000019630.V285186.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Wymondley Nursing Home Address Wymondley Nr Hitchin Hertfordshire SG4 7HT 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) 01438 312434 01438 355659 Wymondley Nursing and Residential Care Home Limited Ms Joanne Kendell Care Home 59 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (59), of places Physical disability over 65 years of age (59), Terminally ill over 65 years of age (59) Wymondley Nursing Home DS0000019630.V285186.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. 5. 6. This home may accommodate up to 4 older people who require personal care. This home may accommodate up to 3 older people with dementia who require personal care. This home may accommodate 59 older people who require nursing care. This home may accommodate 59 older people with physical disability who require nursing care. This home may accommodate 59 older people with terminal illness who require nursing care. This home may accommodate 59 older people who require convelescent nursing care. 2nd August 2005 Date of last inspection Brief Description of the Service: The building is a former vicarage with a large modern extension. The provider, Wymondley Nursing and Residential Care Home Limited, was first registered by Hertfordshire County Council under the Registered Homes Act 1984 in March 1990 prior to the current registration under the Care Standards Act 2000. The home provides nursing care and accommodation for older people, with or without physical disabilities and for older people with terminal illnesses. It is also registered to provide personal care for 3 older persons with dementia. The home is situated in the village of Wymondley, close to the towns of Hitchin, Letchworth and Stevenage, a short distance from the village centre with facilities such as the church and pub. The home has links with organisations in the village. Access to public transport is limited. Accommodation is provided on three floors served by 2 passenger lifts. All bedrooms are single rooms, 22 with en-suite toilets. There are several day rooms. The building stands in extensive, attractive grounds, greatly enjoyed by many service users. There is ample car parking space in front of the home. Wymondley Nursing Home DS0000019630.V285186.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an extremely positive inspection, seeking the views of the service users and visitors to the home. Time was spent with manager of the home discussing the improvements that have been made following the last inspection. The majority of time was spent with service users determining their views of the home. This inspection only looked at those standards not inspected previously and the remaining key standards. The reader is encouraged to view the previous inspection report along side this report to gain a holistic view of the home and its continued ability to meet standards. It must be noted that where information has remained from the last report, this has been carried forward to this report. What the service does well:
The environment continues to be maintained to a high standard with both internal and external decoration being well maintained and presenting a homely feel. The home continues to provide 40 hours per week for maintenance and repairs. All service users rooms are decorated to personal taste and all are encouraged to personalise their rooms. During the inspection the views of a visitor were sought, many positive comments were made in respect of the home in general a visitor summed it up as being “a wonderfully caring and compassionate source.” Many positive comments were received from the service users, one stating that “the home provides excellent care, the staff are brilliant.” The home is set in wonderfully maintained parklands, the back garden area has recently been landscaped and a water feature is now a favoured centrepiece of many of the service users. The area is wheelchair accessible and many positive comments have been received regarding the grounds, which are enjoyed by many. The home provides a wide range of activities and employs a specific activity coordinator to work with service users. Currently the home provides approximately 30 hours per week, but also provides external entertainers, in house library delivery and weekly communion. Feedback from service users confirmed the range of activities available and comments were received stating, “we always have fun and like the music and games.” Activity plans were available throughout the home. Supervision and appraisals are offered and feedback from staff spoken to confirm that the process was effective and a useful tool. Records were well maintained for all staff. Wymondley Nursing Home DS0000019630.V285186.R01.S.doc Version 5.1 Page 6 Staff were indirectly observed interacting with all service users appropriately, the team appeared person centred and focused on ensuring that individual needs were being met. There is an effective key worker and named nurse system in place, which ensures sound management of each service users care plans and social fulfilment. The home has a sound referrals and assessment process in place which encourages and enables involvement of the service user throughout the process. The inspector spoke with a service user whose views were sought during the last inspection when he moved in as a new service user. The service user was approached during this inspection for feedback. Praise was given again regarding the caring nature of the staff and the approachable manor of the management team. The service user stated “the food and the care provided is high quality, when I left hospital they said I would not walk again, now with the help of the staff I am walking, they are wonderful”. What has improved since the last inspection? What they could do better:
Wymondley Nursing Home DS0000019630.V285186.R01.S.doc Version 5.1 Page 7 No requirements were made during this inspection. 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. Wymondley Nursing Home DS0000019630.V285186.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Wymondley Nursing Home DS0000019630.V285186.R01.S.doc Version 5.1 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Each service user has a written contract / statement of terms and conditions, thus ensuring that the rights of the service user are protected and supported. EVIDENCE: Each service user is issued with a written contract stating the terms and conditions of their residency. The statement of terms and conditions includes: rooms to be occupied, overall care and services (including food) covered by fee, fees payable and by whom (service user, local or health authority, relative or another), additional services (including food and equipment) to be paid for over and above those included in the fees, rights and obligations of the service user and registered provider and who is liable if there is a breach of contract, terms and conditions of occupancy, including period of notice (e.g. short/long term intermediate care/respite). The registered manager and the service user sign all contracts. These are held on the service users file and were available for inspection. Wymondley Nursing Home DS0000019630.V285186.R01.S.doc Version 5.1 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected on this occasion. Please refer to the previous report for details. EVIDENCE: These standards were not inspected on this occasion. Please refer to the previous report for details. Wymondley Nursing Home DS0000019630.V285186.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected on this occasion. Please refer to the previous report for details. EVIDENCE: These standards were not inspected on this occasion. Please refer to the previous report for details. Wymondley Nursing Home DS0000019630.V285186.R01.S.doc Version 5.1 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected on this occasion. Please refer to the previous report for details. EVIDENCE: These standards were not inspected on this occasion. Please refer to the previous report for details. Wymondley Nursing Home DS0000019630.V285186.R01.S.doc Version 5.1 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected on this occasion. Please refer to the previous report for details. EVIDENCE: These standards were not inspected on this occasion. Please refer to the previous report for details. Wymondley Nursing Home DS0000019630.V285186.R01.S.doc Version 5.1 Page 14 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected on this occasion. Please refer to the previous report for details. EVIDENCE: These standards were not inspected on this occasion. Please refer to the previous report for details. Wymondley Nursing Home DS0000019630.V285186.R01.S.doc Version 5.1 Page 15 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 Service users financial interests are safeguarded and thus their privacy, dignity and rights are supported and protected through the home’s policies and procedures. EVIDENCE: The registered manager ensures that service users control their own money except when they state that they do not wish to or they lack capacity and that safeguards are in place to protect the interests of the service user. Service user do not have any finances held on site and are supported as required through family and solicitors. Wymondley Nursing Home DS0000019630.V285186.R01.S.doc Version 5.1 Page 16 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X X Wymondley Nursing Home DS0000019630.V285186.R01.S.doc Version 5.1 Page 17 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. 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 Wymondley Nursing Home DS0000019630.V285186.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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