Inspection on 28/07/05 for Wyndham House

This inspection was carried out on 28th July 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 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

Wyndham House 05/01/09

Wyndham House 09/01/07

Wyndham House 03/03/06

Wyndham House 07/12/04

Wyndham House 15/06/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Wyndham House Martlet Road Minehead Somerset TA24 5PR Lead Inspector Shelagh Laver Announced 28th July 2005 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 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. Wyndham House D53 - D02 S16037 Wyndham House V234184 280705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Wyndham House Address Martlet House Minehead Somerset TA24 5PR 01643 703934 01643 703253 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Somerset Care Limited Mrs Madeleine Vivienne Flanagan Personal Care Home Only 35 Category(ies) of Old Age (35) registration, with number of places Wyndham House D53 - D02 S16037 Wyndham House V234184 280705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 7th December 2004 Brief Description of the Service: Wyndham House is registered with the Commission for Social Care Inspection (CSCI) to provide personal care for up to 35 people over the age of 65. The home is owned by Somerset Care and managed by Madeliene Flanagan. The home is planning to provide within the registered numbers two Step Up/Step Down beds intended to assist service users to avoid hospital admissions. 15 rooms are contracted to Somerset Social Services. A major building project has commenced to provide an additional 16 bedrooms. An action plan has been completed to minimise disruption to existing service users risk assessment have been completed. The new building will eventually be linked to the existing one by a conservatory. It is hoped that the building will be completed early in 2006. The home is situated in close walking distance from the centre of Minehead, providing access to a wide range of facilities. The property is a three storey older house with a modern two-storey extension. The location of the home allows service users to enjoy a seaside town environment if they are sufficiently mobile. There are 35 single bedrooms, three of which have ensuite facilities. Service users are encouraged to furnish their rooms with their own possessions and have an opportunity to choose the colour scheme. There is a programme of organised activities, which encourages interaction between service users. The home has been adapted to maximise independence and contains sufficient specialised equipment. There are well-established systems ofof care and staff management. Wyndham House D53 - D02 S16037 Wyndham House V234184 280705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection took place on one day over six hours and was conducted by one inspector. A tour of the premises took place where a selection of bedrooms and all communal areas were seen. Seventeen service users returned comment cards completed by themselves or a named relative. The responses indicated that all felt well cared for and safe. One card said “ we feel protected with such caring and thoughtful staff. Their patience and dedication is a great reassurance.” Any comments made in the cards were discussed with the manager. Three letters were received from relatives of service users. One relative made an appointment to speak with the inspector. She had “Nothing but praise” for the staff and described ways in which her father had been assisted and cared for through “ups and downs.” Another relative praised the pleasant and friendly atmosphere. Three other relatives were spoken with during the day. Twelve service users were spoken with individually. The inspector met other service users taking part in activities in the sitting room and during lunch. The registered manager was on duty and was able to assist the inspector. The area manager was also visiting the home and received feedback from the inspector. Records relating to care, staff and health and safety were examined. What the service does well: It is clear that the registered manager’s aim in running the home is to provide the best possible individual care to service users. There is an established positive group of carers. 73 are qualified to NVQ level 2 and above. There is a comprehensive training system. Service users confimed they were well cared for at Wyndam House. There were many very positive comments. For example one service user said “I couldn’t be better cared for…I am lucky to be here…” Service users benefit from the contributions made by all members of the support staff. Service users enjoy a wholesome and varied menu which takes into account the needs and preferences of people in the home in a very individual way. The home environment is well maintained. It safe, clean and comfortable. The home makes the best of the communal areas and bedrooms areas available. Wyndham House D53 - D02 S16037 Wyndham House V234184 280705 Stage 4.doc Version 1.30 Page 6 Service users are actively supported in the development of a variety of lifestyles and daily routines that suit them individually. There is a varied activities and social programme enjoyed by many. There are also opportunities for service users to spend their days as quietly as they wish. The home has good support from the local GP and district nurses. What has improved since the last inspection? What they could do better: This is well run home where service users are pleased with the care they receive and relatives expressed satisfaction with staff attitudes and support. However one relative expressed concerns but felt unable to approach staff. The “Seeking your Views” policy on complaints is well displayed. The manager could take general action to reaffirm her willingness to address issues. (For example at the next relatives meeting or via a newsletter.) It is important that all relatives know that the only way issues of concern can be addressed is by bringing them to the notice of the manager or area manager who will then take appropriate action. The company has a strong system of supervision and management that enables staff issues to be addressed at all levels. Please contact the provider for advice of actions taken in response to this Wyndham House D53 - D02 S16037 Wyndham House V234184 280705 Stage 4.doc Version 1.30 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Wyndham House D53 - D02 S16037 Wyndham House V234184 280705 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Wyndham House D53 - D02 S16037 Wyndham House V234184 280705 Stage 4.doc Version 1.30 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 standard(s) 1,2,3,4,5, The manager ensures that the home can fully meet the assessed needs of prospective service users prior to making a decision about admission. The pre-admission process is detailed and well managed. The manager ensures that prospective service users are provided with appropriate information which will assist them in making a decision about admission. EVIDENCE: The home has produced a Statement of Purpose and Service User Guide which is made available to service users, prospective service users and their representatives. The home’s current fee range is dependant upon the room to be occupied and the assessed needs of the service user. Current fees are £380- 410 with the higher fee being for en-suite rooms. Wyndham House D53 - D02 S16037 Wyndham House V234184 280705 Stage 4.doc Version 1.30 Page 10 The manager ensures that prospective service users are fully assessed prior to admission. A letter from a relative that the initial visit, information received and moving in process had conducted efficiently and helpfully by the staff. The manager stated that a service user is visited if possible and information from other health professionals and for example hospital care notes are taken into account. Service users are invited to visit the home whenever this is possible. The assessment period extends to a one month and service users are issued with a contract at the end of this period. Documentation relating to pre-admission assessments was seen in the three care plans examined. Wyndham House D53 - D02 S16037 Wyndham House V234184 280705 Stage 4.doc Version 1.30 Page 11 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 standard(s) 7,8,9,10. The home takes appropriate action to ensure the health care needs of service users are met. The home’s procedure for the management and administration of medication was found to be satisfactory. Service users are treated with respect. Care practices support privacy and dignity. Care plans are completed in a methodical way using an appropriate format. EVIDENCE: All service users have care plans maintained. Three were examined and were found to be overall up to date and well maintained. There were monthly reviews. It was noted that one Waterlow assessment and manual handling assessment had not been up-dated to reflect the changing needs of a service user. There was also detailed evidence in the daily records that one service user was experiencing problems not identified in the care plan. Wyndham House D53 - D02 S16037 Wyndham House V234184 280705 Stage 4.doc Version 1.30 Page 12 Care plans are compiled from appropriate assessments which include preadmission assessment, prevention of pressure sores, moving and handling needs and nutrition. The Somerset Care care planning system is used and is initially completed in great detail by the manager. The planning of individual care was noted to be very thorough and included guidance on the psychological care and specific emotional support required by service users. All staff attended to and addressed service users with respect and in a dignified manner. All service users asked confirmed that they are well cared for at Wyndham House. It was observed from care plans that service users have access to appropriate health care professionals. There was evidence of particularly good support from the GP practice with weekly visits from the doctor. During the inspection community nurses arrived to provide treatment and undertake reviews with service users. Service users receive visits from chiropodists and opticians. Some maintain links with services in the community. The home uses the Monitored Dosage System (MDS) with some additional boxed prescriptions and pre-printed MAR charts. All records examined were appropriately completed. Medicines were seen to be appropriately stored. An anomaly regarding the administration of insulin was discussed and action agreed. Wyndham House D53 - D02 S16037 Wyndham House V234184 280705 Stage 4.doc Version 1.30 Page 13 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 standard(s) 12, 13, 14 and 15. Service users are able to chose a variety lifestyle patterns in the home. The home provides a wholesome and varied menu which takes into account the needs and preferences of service users. Arrangements for service users to maintain contact with family and friends is good. The home provides activities and entertainments to enrich the service users lives. EVIDENCE: Staff were observed to encourage and support staff to maintain independence and mobility. Service users choose how they spend their day. Some were in the sitting rooms taking part in activities on the day of inspection. Others prefer to spend time in their rooms. The home menu is wholesome and appetising, varied and takes into account the needs and preferences of service users. Wyndham House D53 - D02 S16037 Wyndham House V234184 280705 Stage 4.doc Version 1.30 Page 14 The inspector observed the menu that includes an alternative each day. Examples of meals included roast chicken and stuffing,sausage bacon and mushroom and ham salad. There is a sweet trolley that includes a hot sweet, fresh fruit and ice creams. There is a choice of breakfast cereals, toast and fruit each day. All service users were pleased with the standard of food in the home. The two dining rooms are pleasant and tables are set with smart tablecloths and flowers. One relative said she was pleased that meals never seemed rushed. Visitors are made welcome at any reasonable time in accordance with the wishes of the service user. There is a choice of communal areas ensuring there is always “a quiet spot”. Some service users prefer to meet visitors in their rooms that were seen to contain sufficient seating. It was clear on the day of inspection that the social interaction between the member of staff and the group members was as important as the activity itself. Service users were smartly dressed and have the regular services of a hairdresser. Wyndham House D53 - D02 S16037 Wyndham House V234184 280705 Stage 4.doc Version 1.30 Page 15 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 standard(s) 16,17,18 The complaints procedure in this home is good with evidence that the views of service users/visitors are listened to and acted upon. Procedures and policies aim to protect service users from abuse. EVIDENCE: There had been no complaints. Service users spoken to knew who they were able to speak to if they wished to complain. Service users were encouraged to vote in the last election. Staff recruitment procedures, training, supervision contribute to the protection of service users from abuse. One comment card stated “We feel protected with such a caring and thoughtful staff. Their patience and dedication is a great reassurance. Wyndham House D53 - D02 S16037 Wyndham House V234184 280705 Stage 4.doc Version 1.30 Page 16 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 standard(s) 19,20,21,22,23,24,25 and 26. Service users live in a comfortable, safe and clean environment and are able to personalise their own bedrooms. The home’s environment is able to meet the assessed needs of service users. The home provides specialist equipment to ensure the needs of service users are met. EVIDENCE: All communal areas and most bedrooms were seen at this inspection. Bedrooms were pleasant and comfortable and it was evident that service users were encouraged to bring personal possessions into their rooms. There are few en-suites in this home however service users are satisfied with arrangements. Specialist beds and pressure relieving equipment were seen to be in place where there was an assessed need. Service users informed the inspectors that they were very satisfied with their rooms. Wyndham House D53 - D02 S16037 Wyndham House V234184 280705 Stage 4.doc Version 1.30 Page 17 There is a choice of sitting areas and the standard of decoration and furnishing is homely. The home has two lounges and dining rooms. There is a large hall that provides additional sitting area. Service users have a choice of where to spend the day. Some prefer to spend a great deal of their time in their bedroom although all are encouraged to come to the dining room for lunch if they are well. Overall the home is very pleasantly decorated and well maintained. The standard of cleanliness was very good. Domestic staff on duty were satisfied with the time provided to care for the home and the equipment provided. Wyndham House D53 - D02 S16037 Wyndham House V234184 280705 Stage 4.doc Version 1.30 Page 18 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 and 30 The home ensures that there are sufficient staff on duty to meet the service users needs. The home’s recruitment practices are robust and designed to protect the service users. Staff are well trained and have access to a range of mandatory and developmental training opportunities. EVIDENCE: On the day of inspection there were six care staff on duty. Also on duty was the cook and kitchen assistant and three domestic staff. The inspector spoke with the maintenance man who described the training he received to do his job. The duty rota showed permanent staff working in numbers to meet the needs of service users. Staff spoken to confirmed they had received manual handling up-dates and fire training. There is an annual training plan that includes all staff. The inspector saw records of training and staff confirmed training was regular and organised to meet their needs. Care standardisation, medication training, management and activities training had been provided for specific staff. The Wyndham House D53 - D02 S16037 Wyndham House V234184 280705 Stage 4.doc Version 1.30 Page 19 home is committed to NVQ training. 73 of staff are qualified to NVQ Level 2 or above. This exceeds National Minimum Standard 28. Two recruitment files were observed. Both contained evidence of a thorough recruitment process. There is an excellent check list for recruitment files. Wyndham House D53 - D02 S16037 Wyndham House V234184 280705 Stage 4.doc Version 1.30 Page 20 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35, 36, 37, 38. The home is effectively managed by the registered manager who promotes a clear and inclusive style of management. Measures are taken which ensure the needs and well-being of service users takes priority and that staff are appropriately supported and supervised. The home’s systems for ensuring the health, safety and welfare of service users and staff are structured and well managed. EVIDENCE: The manager demonstrated through discussion with the inspector she had a very clear understanding of the needs of service users living at the home. Staff benefit from regular meetings. Supervision takes place and is recorded. Wyndham House D53 - D02 S16037 Wyndham House V234184 280705 Stage 4.doc Version 1.30 Page 21 There is an experienced administrator responsible for managing the finances of the home and maintaining appropriate records. At the time of this inspection, the home was taking appropriate steps to ensure the health & safety of service users, staff and visitors to the home. The following records were examined: FIRE – Records indicated that appropriate checks were being carried out on the home’s fire detection and fire fighting equipment. Regular training is conducted for all staff. SERVICING – Servicing schedules indicated that hoists are serviced according to LOLER. . There are planned dates for all servicing. ACCIDENT– The home maintains appropriate records relating to accidents at the home. The accident records include action to be taken and evidence of analysis. HOT WATER/SURFACES – Bath hot water outlets are thermostatically controlled to reduce the risk of scalding. Those checked at this inspection were found to be within the acceptable limits. First aid training is provided for staff. Wyndham House D53 - D02 S16037 Wyndham House V234184 280705 Stage 4.doc Version 1.30 Page 22 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 2 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 3 3 3 3 3 3 Wyndham House D53 - D02 S16037 Wyndham House V234184 280705 Stage 4.doc Version 1.30 Page 23 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 OP26 Regulation 13 Requirement The manager must ensure that best practice is followed with regard to the storage of catheter night bags. The bags must be stored with caps in place. Staff must be reminded of the possible infection control issues. Care plans must be up-dated to reflect new and changing care needs as well as the detailed daily records. Timescale for action 15/08/05 2. OP7 13 15/08/05 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 OP29 Good Practice Recommendations The company recruitment checklist should be used. Wyndham House D53 - D02 S16037 Wyndham House V234184 280705 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Riverside Chambers Castle Street Tangier Taunton TA1 4AL 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. Extracts may not be used or reproduced without the express permission of CSCI Wyndham House D53 - D02 S16037 Wyndham House V234184 280705 Stage 4.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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. 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