Care Home: The Willows

What the care home does well We observed one person was experiencing alot of pain. The home has taken steps to refer to the MacMillan nursing service for further advice on effective pain management for this person. The home is also consulting the tissue viability nursing service for advice on treatment for those people who have pressure sores or pressure damage. The home has improved upon the recording of the medication administration records (MAR) sheets. Staff are now consistently recording the amount of medication that is coming into the home for each person. This will allow staff to audit medication and make sure that people are receiving the medication they need. What the care home could do better: We looked at the weight charts of four people, in two cases people had lost weight but there was no evidence to show the home had taken any action to address this. One new admission to the home had not had their weight recorded at all, another new person had two different recordings of weight upon their admission. The home must make sure that they do this accurately and consistently so that they can monitor any unexplained weight loss or gain and take appropriate action. The home must make sure that when people move into the home they have care plans in place that clearly show how their needs are to be met. We looked at the care records of two people who were recently admitted to the home. In both cases care plans were incomplete. One person`s care plans failed to include health issues identified in their assessment such as catheter care, pressure sore care and specific moving and handling requirements. Pressure relieving equipment must be set at the correct setting for the person using it. This means that staff must take account of the manufacturers instructions for use. Once this is done it will mean that people get the maximum benefit from the pressure relieving equipment they need. We looked at the pressure relieving mattresses of two people, both mattresses were turned to the maximum setting making the beds very hard. One person said "this bed is killing me its so uncomfortable". The home had not recorded these people`s weights and could therefore not confidently say on what setting the mattresses should be. The nurse in charge told us the mattresses were new, she also told us that the instructions for each mattress may still be in the box. When we checked one persons pressure relieving mattress we observed them almost rolling over the top of the bed rails. The bed rails in use were not high enough to prevent this. We have asked the manager to review the bed rails for this person and consider height extendable bed rails to offer more protection. The manager should also re assess those people who have bed rails and a pressure relieving mattress in place to make sure they are compatible with one another. People who have or who are prone to pressure damage must also have a care plan that clearly explains the treatment necessary to promote healing. We saw in one person`s care records that their pressure sore required redressing every three days. There was no care plan in place, this means that staff would find it difficult to know what to redress the wound with and when to do it. We did see assessments in people`s files by the tissue viability nurse and their recommendations for treatment. This is positive as it shows the home is consulting with specialist practitioners in the best interests of the people living here. The home must increase the number of slings it has in use for the hoists in the home. At present there are only one set of small, medium and large slings on each floor. The medium sized sling we saw had become considerably worn and was in need of replacement. This was discussed with the manager during this inspection. She confirmed that one new sling had recently been purchased but would take steps to order more. Inspecting for better lives Random inspection report Care homes for older people Name: Address: The Willows Dangerfield Lane Darlaston Walsall West Midlands WS10 7RT one star adequate service The quality rating for this care home is: The rating was made on: 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. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Mandy Beck Date: 1 2 1 1 2 0 0 8 Information about the care home Name of care home: Address: The Willows Dangerfield Lane Darlaston Walsall West Midlands WS10 7RT 01215687611 01215687989 willowsnursinghome@yahoo.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Regal Care (Darlaston) Limited care home 48 Number of places (if applicable): Under 65 Over 65 48 old age, not falling within any other category Conditions of registration: 0 48 frail elderly people over the age of 60 years who require nursing care That the following staffing levels are adhered to as minimum numbers and subject to increase as dependency levels require: 8:00 am - 8:00pm - 2 trained nurses 8:00pm 8:00am - 1 trained nurse 7:00am - 2:00pm - 9 carers 2:00pm - 9:00pm - 7 carers 9:00pm - 7:00am 4 carers Date of last inspection Brief description of the care home The Willows is a modern purpose built home first registered in May 1998. There are 48 large single bedrooms, all but one having en-suite and a number being linked, to accommodate couples. There are three good size lounges, two with dining area providing spacious communal areas on both floors. The rooms are spacious and colour co-ordinated, each has a good-sized double glazed window and on the ground floor, patio doors to the gardens. Rooms are light and airy with a view onto either the garden Care Homes for Older People Page 2 of 9 Brief description of the care home or onto Dangerfield Lane/Moxley Road. In addition to the en-suite provision there is a plentiful number of baths, showers and toilets distributed around the building. The enclosed gardens are large and accessible from downstairs, bedrooms and lounge area. The ancillary services of catering, laundry housekeeping and maintenance are provided in-house. The home provides plentiful off road parking. Fees for this home are not available in the Service user guide. Readers of this report are asked to contact the home directly for more information about the fees they will be charged. Care Homes for Older People Page 3 of 9 What we found: This unannounced random inspection to the home was planned to check the compliance with outstanding requirements from the key inspection May 2008. We found that improvements are still needed and that not all of the requirements from the key inspection have been met. What the care home does well: What they could do better: We looked at the weight charts of four people, in two cases people had lost weight but there was no evidence to show the home had taken any action to address this. One new admission to the home had not had their weight recorded at all, another new person had two different recordings of weight upon their admission. The home must make sure that they do this accurately and consistently so that they can monitor any unexplained weight loss or gain and take appropriate action. The home must make sure that when people move into the home they have care plans in place that clearly show how their needs are to be met. We looked at the care records of two people who were recently admitted to the home. In both cases care plans were incomplete. One persons care plans failed to include health issues identified in their assessment such as catheter care, pressure sore care and specific moving and handling requirements. Pressure relieving equipment must be set at the correct setting for the person using it. This means that staff must take account of the manufacturers instructions for use. Once this is done it will mean that people get the maximum benefit from the pressure relieving equipment they need. We looked at the pressure relieving mattresses of two people, both mattresses were turned to the maximum setting making the beds very hard. One person said this bed is killing me its so uncomfortable. The home had not recorded these peoples weights and could therefore not confidently say on what setting the mattresses should be. The nurse in charge told us the mattresses were new, she also told us that the instructions for each mattress may still be in the box. When we checked one persons pressure relieving mattress we observed them almost rolling over the top of the bed rails. The bed rails in use were not high enough to prevent this. We have asked the manager to review the bed rails for this person and Care Homes for Older People Page 4 of 9 consider height extendable bed rails to offer more protection. The manager should also re assess those people who have bed rails and a pressure relieving mattress in place to make sure they are compatible with one another. People who have or who are prone to pressure damage must also have a care plan that clearly explains the treatment necessary to promote healing. We saw in one persons care records that their pressure sore required redressing every three days. There was no care plan in place, this means that staff would find it difficult to know what to redress the wound with and when to do it. We did see assessments in peoples files by the tissue viability nurse and their recommendations for treatment. This is positive as it shows the home is consulting with specialist practitioners in the best interests of the people living here. The home must increase the number of slings it has in use for the hoists in the home. At present there are only one set of small, medium and large slings on each floor. The medium sized sling we saw had become considerably worn and was in need of replacement. This was discussed with the manager during this inspection. She confirmed that one new sling had recently been purchased but would take steps to order more. 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 2. Care Homes for Older People Page 5 of 9 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 6 of 9 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 38 12 Peoples pressure relieving mattresses must be on the correct setting for their weight. This will enusre that people are getting the maximum benefit from the equipment in use. 05/12/2008 2 38 12 There must be more slings 05/12/2008 available for staff to use with the hoist. The slings currently in use should be checked to make sure they are fit for purpose. This will help reduce the risk of injury to people and also make sure the correct fitting sling is available for people to use. 3 38 12 Peoples bed rails and 05/12/2008 pressure relieving equipment must be compatible with one another. This will help reduce the risk of injury to people Recommendations Care Homes for Older People Page 7 of 9 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 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. 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