Care Home: The Willows

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What the care home does well The Willows is a "home from home" and services and accommodation are provided in an individual way, to meet individual preferences. The rooms are well furnished and comfortable and the residents enjoy the food and activities provided by the staff. The staff team is very well trained and all care workers are trained to NVQ standards and provide care in a professional way. The staff team is small and care workers and the management work closely together for the benefit of the residents and their families. What has improved since the last inspection? The home had recently reopened at the time of the last inspection and procedures had just been re-established. The manager has continued to review and update all the home`s policies and conducts regular audits of the services and procedures to ensure that high standards are maintained. Staff and residents meetings take place and visitors take part in events in the home and have attended a barbeque and other events. What the care home could do better: No requirements have been made as a result of this inspection. Key inspection report Care homes for older people Name: Address: The Willows 197 Darkes Lane Potters Bar Hertfordshire EN6 1AA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Patricia House     Date: 2 5 1 1 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 23 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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: The Willows 197 Darkes Lane Potters Bar Hertfordshire EN6 1AA 01707659205 01707659205FP thewillows2@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Follett Care Limited care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The home may accommodate one named service user who has a diagnosis of dementia for as long as the needs of that service user can contine to be met. Date of last inspection Brief description of the care home The Willows is a detached Edwardian period, family house that has been converted into a residential care home for elderly people. The home is situated at the end of the main shopping parade in the town of Potters Bar. The home has a front yard with parking facilities for up to 4/5 cars and a very secluded garden at the rear of the property, which is set to lawn and benefits from a fish pond and mature trees. There is easy access to the Motorways and the main line railway station. Current fees for the home range between £595 and £650 per week. The last inspection report is displayed in the entrance hall and copies are available on request. Copies of Care Homes for Older People Page 4 of 23 Over 65 12 0 Brief description of the care home the homes Statement of Purpose and Service Users Guide are also available from the office. 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 Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The last key inspection of this service was completed on 6th December 2007. The information in this report is based on an unannounced inspection of the home, which took place over one day with one regulation inspector carrying out the work of the Commission. For the purposes of this report the Commission will be referred to as we. The manager was on duty throughout the day and we spoke with staff, residents and a visitor. We visited all parts of the home and checked a variety of records. Before the inspection the manager had completed and returned to the Commission an annual self-assessment quality review, the Annual Quality Assurance Assessment, (the AQAA).This document included statistical information about the home and confirmation of policy reviews and equipment checks. Care Homes for Older People Page 6 of 23 Completed quality surveys from care staff and residents have also been returned to the Commission and comments from these have been referred to in this report. We have also reviewed any other information we have received about this service since the last inspection. Care Homes for Older People Page 7 of 23 What the care home does well: What has improved since the last inspection? What they could do better: 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 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 who use the service are provided with appropriate information so they can decide if the home is right for them and can be confident their needs will be documented and met. Evidence: The home has a written Statement of Purpose and Service Users Guide and copies are displayed in the entrance hall and are given to all residents and prospective residents so that people are clear about the services provided in the home. We checked a selection of residents records and in all cases detailed assessments had been completed when the resident entered the home. We also saw care summaries on files from referring agencies. From the information recorded initial care plans had been completed so that all care staff could be clear about peoples individual needs and how best to meet them. 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. People who use the service have their care needs recorded so that staff can be sure that individual needs are identified and met. Procedures followed in the home for the administration of medication are thorough and help to protect residents from the risk of harm. Evidence: We tracked a selection of care plans after speaking to the residents concerned. The information provided was relevant to the needs of the individuals and provided details of allergies, choices and preferences for personal care and social activity. There are care summaries at the front of each record enabling staff to quickly check the individuals care needs and the plan to meet them. Care staff also complete daily notes about the residents twice each day and these are well documented and provide up to date information about the person concerned. Appropriate risk assessments have been completed for every resident, and currently none of the residents are unable to weight bare. We noted that all the care plans are in a person centred format and had care plan agreements signed by the residents. We saw night care records completed by care staff for each resident and completed Promotion of Independence Care Homes for Older People Page 11 of 23 Evidence: details showing the agreed support plans for the people concerned. Monthly reviews of the care planning had been completed to ensure that information was still relevant. We saw evidence on care records that peoples health needs are promoted by staff. G.P., nursing and chiropody visits are made and nutritional screening ensures that everyones dietary needs are assessed and met. A separate Health folder is kept in which everyones health details are recorded. The residents and visitor we spoke with confirmed that care staff assist with personal care where this is needed and do so in the way people choose. We were told that visitors are made welcome in the home at all times and that staff treat everyone with respect. We checked the system for administering medication during the inspection. Most is provided in blister packs and medication is kept appropriately locked away when not in use. We found no errors in the medication records we checked. The staff we spoke with confirmed that all staff receive training in the administration of medication and the homes medication policy has been updated since the last inspection. Although no controlled drugs are administered at present, the manager said she will purchase a controlled drugs record book in line with current guidelines for the safe administration of medication. The staff also confirmed that a record book will now be completed for the general stock of paracetamol to enable accurate audits to take place. 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. People who use the service enjoy the daily activities they choose and enjoy well balanced meals which help them maintain their good health. Evidence: We spoke with some of the residents and a visitor, as well as staff members. The residents and their visitor confirmed that they were content with the activity provision in the home. The Willows is very much a family home and people were clear about how they wanted to spend their days and enjoy the homely atmosphere. We saw details of some of the recent activities which had taken place, including an art afternoon, newspaper discussions and games events. The care staff provide the activities and are planning a Christmas card making session. The staff told us that residents generally do not want to go out for many trips and often do not want to go into the garden in the summer. Some people like doing crosswords and residents said they like to spend time chatting to the staff. Care staff said that activities will continue to be planned and offered but that the residents wishes would always be respected. A barbeque was held in the summer and a Christmas party will be held in the near future and families and friend are invited to these events. Residents meetings are held regularly and minutes are taken. Activity planning is always a topic at these meetings. Care Homes for Older People Page 13 of 23 Evidence: The relative we spoke with confirmed that visitors were always welcomed in the home whenever they arrived and that their views were always sought about the running of the home. Most residents have relatives or advocates who help them handle their finances. Small amounts of personal allowances are also kept locked in the office. We tracked the money held for one resident and the amounts held tallied with the records and receipts. The manager is currently setting up a new system for storing these small amounts for each resident. We visited the kitchen during the inspection. All areas were clean and hygienic. All staff have completed food hygiene training. The residents we asked said the food at the home was lovely and that they help to plan the menus. Drinks and snacks are available at all times and the food stocks seen were plentiful with lots of fresh produce available. Sherry is offered and enjoyed at meal times as well as a selection of fruit juices. The staff said that currently none of the residents need a special diet and said that they will now keep records of the food actually eaten by residents in line with environmental health guidelines. 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. Procedures followed in the home ensure that residents are protected from the risk of abuse and can be confident that any concerns they might have will be listened to and acted on. Evidence: The home has written policies on Making a Complaint, Safeguarding Adults and Whistle Blowing. The staff we asked said they were fully aware of these and their implications. The residents we spoke with said they would not hesitate to voice a concern if they had one and the visitor we asked confirmed they were aware of how to make a complaint. The manager has completed Safeguarding training with the Local Authority and demonstrated a clear understanding of the process for referring any safeguarding issues. 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 benefit from living in a home which is well maintained and clean and where hygiene standards protect them from the risk of infection. Evidence: We visited all areas of the home briefly. All areas were extremely clean and well presented. Bedrooms are mostly spacious and contain lots of the residents own belongings. Magnetic door closures have been fitted to ensure fire safety and we saw the records of hot water temperature checks which are completed daily to ensure the water is delivered at a safe temperature at all times. All communal bathrooms and toilets contain liquid soap and paper towels as recommended in guidelines for good infection control. 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. People who use the service are supported by appropriate numbers of well trained staff and are protected by the thorough recruitment procedures in operation in the home. Evidence: The residents we spoke with said that there were always enough staff on duty in the home to meet all their needs. Care staff provide all the ancillary duties in the home as well as the activities. However we found that the home is well run and the staffing arrangements meet all the current needs of the people living there. Staff training is given a high priority in the home and those we spoke with confirmed they had completed courses in safeguarding, medication administration and manual handling. All existing care staff have now completed NVQ 2 training and two are completing NVQ level 3. Two new members of staff are enrolled to start NVQ training the following week. The care staff we spoke with confirmed they have an excellent staff team who work well together and that everyone has individual supervision where any issues can be addressed. We checked a selection of staff recruitment records. In all cases evidence of all appropriate recruitment checks had been in place before the employee started work at Care Homes for Older People Page 17 of 23 Evidence: the home. The manager will just ensure that full work histories are recorded to ensure the safety of residents in the home. Care Homes for Older People Page 18 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. People who use the service benefit from living in a home which is well run and where their views are always taken into account. Procedures followed in the home ensure that the safety and welfare of residents is promoted at all times. Evidence: The manager has extensive experience of running a care home and has completed a management qualification. The manager has applied to register with the Commission. The residents and care staff we spoke with praised the manager and said the home is well run for the benefit of the residents. Minutes are kept of the regular staff meetings held and care workers said that their views are always listened to. There is a formal quality assurance programme in operation and surveys are sent out annually to all stakeholders, including G.Ps. The returned surveys we saw were all positive in their comments. We saw details of the last residents meeting which was held in October. The manager completes a summary of the quality outcomes from all the sources of information and these reports Care Homes for Older People Page 19 of 23 Evidence: demonstrate satisfaction with the services provided at the home. Fire safety records and accident reporting records were well documented and up to date and we saw no hazardous substances left accessible in the home. All staff complete first aid training for the safety of the residents and the manager said she will complete a risk assessment to ensure the level of staff training is appropriate. The manager reviews and up dates all the homes policies regularly Care Homes for Older People Page 20 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 21 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 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 Care Homes for Older People Page 22 of 23 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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 CQC 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!