Care Home: The Willows Care Centre

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What the care home does well Families told us that the staff were caring and kind, that they were made to feel welcome and kept up to date with care issues affecting their family member. The training records showed that staff had had up to date training in safeguarding older people and that they had all had a one day dementia awareness course. Residents were seen to be well dressed and free to stay in their rooms, sit in the lounge or walk around in the unit as they wished. The atmosphere in the dementia care units was relaxed and calm. Staff have recently stopped wearing uniforms as part of a project to make the home more friendly and less `clinical` although there were mixed views from relatives and staff as to whether they liked this idea. The standard of food is good. On the day of the unannounced visit the main meal was roast beef and Yorkshire pudding followed by trifle as part of a St George`s Day celebration, with an alternative choice of cauliflower cheese. Residents were able to choose what they preferred at the meal time and did not have to order in advance, whichis good practice. The dining room was well laid and residents were helped discretely where necessary. Residents were well dressed and had been supported to maintain their personal care. They had access to a hairdresser or could use their own if they wished. What the care home could do better: The home must ensure that all residents have a care plan which is developed in a timely way, is updated regularly and when the residents condition changes. Risk assessments must be undertaken and if someone is identified of being at high risk of developing pressure damage, of falling or of losing weight, a personalised care plan must be developed, implemented, monitored and reviewed regularly. Dietary intake charts must accurately reflect people`s food and fluid intake and repositioning charts should be maintained if someone develops pressure damage. Residents skin integrity must be checked carefully, including their heals, and early indications of pressure damage must be noted and acted upon quickly. The home must ensure that residents receive their medication in a timely way and that there are sufficient care staff with medication training on duty at night to ensure that people receive their night medication at the time prescribed. Handwritten entries to the medication charts must be signed by two people to show that the entry is an accurate transcription of the prescription. Where the medication administration chart is changed, for instance `when required` is added, this must be signed by two people and a copy of the revised prescription must be available in the home. The home must ensure that all staff are aware of how resident`s food should be fortified for those who are losing weight and require high calorie meals. Staffing levels and the skill mix of staff on the dementia care units should be reviewed to ensure that there are sufficient staff with the correct skills and knowledge to meet people`s needs in a timely way. Consideration should be given as to whether one team leader on duty at a time for both units provides sufficient senior experience to ensure resident`s needs are met reliably, particularly if anyone is unwell or requires more attention than usual. There should be a greater focus on providing more activity on the dementia care units to help people retain their skills and to bring interest and constructive diversion to their day. Whether people from the dementia care units can participate in activities such as the St George`s Day celebration should not depend on whether there is space for them in the downstairs lounge. The manager should ensure that no one is deprived of their liberty without the correct authorisation under the Mental Capacity Act 2005, Deprivation of Liberty safeguards. The manager should ensure that a safeguarding referral is made for all residents who sustain an injury for which the cause is not known. Random inspection report Care homes for older people Name: Address: The Willows Care Centre Heathercroft Great Linford Milton Keynes Buckinghamshire MK14 5EG two star good 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. 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: Chris Sidwell Date: 2 2 0 4 2 0 1 0 Information about the care home Name of care home: Address: The Willows Care Centre Heathercroft Great Linford Milton Keynes Buckinghamshire MK14 5EG 01908679505 01908694309 jackie.blease@excelcareholdings.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Nichola Bonner Type of registration: Number of places registered: Conditions of registration: Category(ies) : Willows Care Centre Ltd care home 116 Number of places (if applicable): Under 65 Over 65 0 0 dementia old age, not falling within any other category Conditions of registration: 0 0 The maximum number of service users to be accommodated is 116. The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) Old age, not falling within any other category (OP). Date of last inspection Care Homes for Older People Page 2 of 10 Brief description of the care home The Willows Care Centre is purpose built and was completed in November 2005 and is home to 116 people. The decoration and furnishings are of good quality and provide an attractive environment. The home is arranged on three floors, one floor is for frail elderly residents who need help with personal care, one is for residents who have dementia and the ground floor is for residents who require nursing care. There is a mixture of privately funded service users and service users funded by the local authority. All rooms are spacious and have en-suite facilities of a toilet, hand basin and shower. All floors have their own communal lounge and dining room. There are secure, well-maintained gardens with seating. The home is close to the centre of Milton Keynes, with a large shopping centre and other community facilities. Care Homes for Older People Page 3 of 10 What we found: This unannounced inspection was undertaken because we had received concerns about the care of people with dementia. We visited the dementia care unit and did not visit the other areas of the home at this inspection. We found that people were cared for in a relaxed and calm atmosphere. The care of six people was followed through. Their needs had been assessed before they moved to the home and they all had care plans. These had not however been developed in a timely way, were not all up to date and residents care and medication needs were not always met in a timely way. Two people had developed pressure damage since moving to the home. Residents had been supported to maintain their personal hygiene and there were no offensive odours in the home. The standard of food is good although more attention should be paid to fortifying food for people who are at risk of losing weight and ensuring that those who are not eating receive sufficient nourishment. There was little activity in the dementia care unit although carers did try to support residents to undertake every day tasks where they were able. Some residents were able to join a St Georges Day celebration in the downstairs lounge but not all. Residents were free to walk across the two units although did not have access to a garden unless they were accompanied. Staff said that some residents expressed a wish to go home or became agitated. The home had not considered whether they were restricting peoples freedom under new legislation for which they should apply to the local authority for authorisation to ensure that any restriction was in the persons best interest. Staff were knowledgeable about the need to safeguard older people from abuse. The manager had made the appropriate referrals to the local authority in most but not all cases. Complaints are generally managed well and residents families told us that minor concerns were addressed. Records of written complaints are kept and most had been dealt with in a timely way. One remained outstanding and should be addressed promptly. What the care home does well: Families told us that the staff were caring and kind, that they were made to feel welcome and kept up to date with care issues affecting their family member. The training records showed that staff had had up to date training in safeguarding older people and that they had all had a one day dementia awareness course. Residents were seen to be well dressed and free to stay in their rooms, sit in the lounge or walk around in the unit as they wished. The atmosphere in the dementia care units was relaxed and calm. Staff have recently stopped wearing uniforms as part of a project to make the home more friendly and less clinical although there were mixed views from relatives and staff as to whether they liked this idea. The standard of food is good. On the day of the unannounced visit the main meal was roast beef and Yorkshire pudding followed by trifle as part of a St Georges Day celebration, with an alternative choice of cauliflower cheese. Residents were able to choose what they preferred at the meal time and did not have to order in advance, which Care Homes for Older People Page 4 of 10 is good practice. The dining room was well laid and residents were helped discretely where necessary. Residents were well dressed and had been supported to maintain their personal care. They had access to a hairdresser or could use their own if they wished. 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 set out on page 2. Care Homes for Older People Page 5 of 10 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 6 of 10 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, 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 7 15 The home must ensure that all residents have an up to date care plan which is regularly reviewed to reflect their current care needs. To ensure everyones care needs are identified and met in a timely way. 18/06/2010 2 8 13 The medication administration records should not be changed without reference to the current prescription To ensure people receive medication in line with the doctors prescription. 07/05/2010 3 8 13 The home must ensure that 07/05/2010 there are sufficient staff with medication training on duty at all times. To ensure residents receive the correct medication at the time prescribed. 4 8 13 The home must ensure that any handwritten entries to 07/05/2010 Care Homes for Older People Page 7 of 10 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 the medication administration chart are signed by two people to show that they are a correct transcription of the prescription. To reduce the risk of residents receiving incorrect medication. 5 8 12 The home must ensure that 25/06/2010 residents do not develop severe pressure damage and that the early signs are noted and acted upon. To ensure residents health care needs are recognised and acted upon quickly 6 8 12 The home must ensure all staff are aware as to how residents meals can be fortified should they require a high calorie intake due to weight loss. To help protect residents from weight loss due to a poor appetite. 7 17 13 The manager must ensure that no one is deprived of their liberty without the necessary authorisation under the Deprivation of Liberty Safeguards. To protect people from unlawful restraint and to ensure that actions taken to keep them from harm are undertaken in their best Care Homes for Older People Page 8 of 10 25/06/2010 14/05/2010 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 interest. 8 18 13 The registered manager 14/05/2010 must ensure that a safeguarding referral is made should a resident sustain an unexplained injury. To protect them from harm. 9 27 18 The staffing levels and skill mix on the dementia care unit must be reviewed. To ensure that there are sufficient staff with the necessary knowledge and skills to meet residents needs in a timely way. 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 25/06/2010 Care Homes for Older People Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission 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. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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