Care Home: Wagtail Close

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What the care home does well Wagtail Close respite care unit is part of the Wagtail care scheme which aims to assist people to retain and develop their skills and learn new things which will make it possible to move to a more independent setting if that is what they wish. The unit provides a positive experience for people who use the service as well as a break for their carers and families. The service is unique in that it provides care and support to people with physical disabilities. The premises are purpose built and fully adapted to meet the needs of people with mobility problems. Staff and management have a good working knowledge of each person and and talked about their likes, dislikes, levels of support they needed. Care plans details the care people need but also set out the goals and aims for living with more independence. What has improved since the last inspection? The length of stay is now flexible and people can vary the start day of their stay. This gives carers more flexibility to plan time away. Staffing levels and management arrangements have been reviewed and revised to reflect the needs of the scheme as a whole. What the care home could do better: The service continues to review and revise its care and support arrangements to the care home and other services on site. Close monitoring of all aspects of the service will help to ensure that the service is working in the best interests of everyone who uses the scheme The service should seek advice from the Fire Safety officer and replace or fit door closures so that people`s independent access to their rooms is not compromised. The home should notify the Commission of significant events including those that may adversely affect the health and wellbeing of people who use the service. (Regulation 37) This will help the Commission make sure that the service is responding well to any situations that arise. CARE HOME ADULTS 18-65 Wagtail Close 15 Wagtail Close Bradford BD6 3YJ Lead Inspector Sughra Nazir Unannounced Inspection 12th March 2009 10:00 Wagtail Close DS0000037554.V374576.R01.S.doc Version 5.2 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 Wagtail Close DS0000037554.V374576.R01.S.doc Version 5.2 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 Adults 18-65. 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. Wagtail Close DS0000037554.V374576.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wagtail Close Address 15 Wagtail Close Bradford BD6 3YJ 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) 01274 885336 01274 817624 sheila.suddards@bradford.gov.uk City of Bradford Metropolitan District Council Department of Social Services Mrs Sheila Suddards Care Home 3 Category(ies) of Physical disability (3) registration, with number of places Wagtail Close DS0000037554.V374576.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th March 2007 Brief Description of the Service: Wagtail Close is a respite care unit that provides short stay accommodation for people who would otherwise live in their own home with support. It is in the Westwood Park area of Bradford. The home is a joint project between Hanover Housing and Bradford Social Services, and is registered to provide personal care for up to 3 adults with physical disabilities. The respite unit opened in September 2002. The respite unit has 3 self-contained flats. They each have a lounge, kitchen area, one bedroom, and en-suite facility with a level access shower. All the flats are wheelchair accessible. The flats have overhead tracking in the bedroom and bathroom. This means people can be assisted between the two rooms in a hoist if they need to be. Two of the flats have a kitchen, which has been fitted with height adjustable worktops and specialist adaptations to promote independence. The respite unit also has a communal lounge and enclosed gardens. Wagtail Close is part of a housing scheme for people with physical disabilities. Respite users can access many of the main facilities. This includes a restaurant with bistro, shop, hairdressers, and communal lounges. The level of fees charged varies depending on the level of need. Wagtail Close DS0000037554.V374576.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This report is based on information gathered in a number of ways. We looked at information we have received about the service since the last key inspection. This includes comments from people who have used the service. We asked for information to be sent to us before the inspection, this is called an annual quality assurance assessment. There were some difficulties receiving and interpreting this information. On an unannounced visit to the service we talked to staff and the manager. We also checked some of the records, policies and procedures the service has to keep. We concentrated on the key standards and what the outcomes are for people using the service. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the service does well: Wagtail Close respite care unit is part of the Wagtail care scheme which aims to assist people to retain and develop their skills and learn new things which will make it possible to move to a more independent setting if that is what they wish. The unit provides a positive experience for people who use the service as well as a break for their carers and families. The service is unique in that it provides care and support to people with physical disabilities. The premises are purpose built and fully adapted to meet the needs of people with mobility problems. Staff and management have a good working knowledge of each person and and talked about their likes, dislikes, levels of support they needed. Care plans details the care people need but also set out the goals and aims for living with more independence. Wagtail Close DS0000037554.V374576.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: 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. The summary of this inspection report can be made available in other formats on request. Wagtail Close DS0000037554.V374576.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Wagtail Close DS0000037554.V374576.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 People using this service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. A thorough admission and assessment process helps people to decide if the home will suit their needs EVIDENCE: People and their carers are given detailed information about the service. A multidisciplinary meeting usually takes place involving the person and their carers to help decide if Wagtail Close will suit their needs. Other people invited to the meeting could include the persons key health professionals. Peoples needs are thoroughly assessed and a phased admission is planned at the persons own pace including trial visits etc. This process gives the person and their family the opportunity to make an informed decision and helps the home decide if they are able to meet the persons needs. The assessment helps staff develop a suitable plan of care and support. Wagtail Close DS0000037554.V374576.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 People using this service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Detailed care planning helps the service make sure that peoples individual needs are met. EVIDENCE: We looked at one individuals care and support plan. This showed that people are involved in developing and reviewing their plans. The plan reflected the individuals preferences and needs and clearly demonstrated the persons involvement in making all the decisions that affect them. People are supported to take risks as they would do so living independently. We saw there was an agreement in place for the handling of one persons cigarettes. This was fully discussed and agreed between the person and staff. Where any activity involves a potential risk, an assessment is made and plans are agreed to minimise the risk, while still supporting peoples right to independence and choice. These assessments are reviewed and kept up to date. Wagtail Close DS0000037554.V374576.R01.S.doc Version 5.2 Page 10 All the evidence we saw clearly indicated that the homes staff support people to maintain their independence and improve the quality of their lives. There was evidence of the service involving advocates to represent and support people. Wagtail Close DS0000037554.V374576.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 , 14 , 15 16 and 17 People using this service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. People enjoy a varied lifestyle which generally meets their choice and preferences. They are actively supported to engage in local community and leisure activities EVIDENCE: We saw evidence that the service contacts the person before their stay to ask them about their plan for their stay. This is good practice as it helps the service plan staffing levels and make arrangements for any activities the person may wish to undertake. Whilst staying at Wagtail Close people are able to continue attending any day centres or community services they would usually attend. In addition they are encouraged and supported to participate in activities offered on the Wagtail Close supported living scheme. Wagtail Close DS0000037554.V374576.R01.S.doc Version 5.2 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 People using this service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Peoples health and personal support requirements and preferences are met. EVIDENCE: We saw that people are supported to maintain their personal hygiene, hairstyles and appearance. Peoples personal care needs are documented and reviewed at each stay. The service works well with healthcare professionals both before and during peoples stay. Staff told us about links with other agencies who support people with head injuries, epilepsy, stroke etc. This helps the service plan for and meet peoples needs during their stay. There is a medication policy and procedures in place to ensure the safe handling of medication. Medication is booked in on arrival and checked out when people leave. The home ensures that any medication that accompanies people to daycentres or community services has an administration record for Wagtail Close DS0000037554.V374576.R01.S.doc Version 5.2 Page 13 other staff to complete. This helps to make sure people get their medication safely and as prescribed. This is good practice. Wagtail Close DS0000037554.V374576.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People using this service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Robust complaints and protection procedures keep people safe. EVIDENCE: There have been no complaints to the service or to the Commission about the respite care scheme. The local authority has a robust complaint procedure which would be instigated in the event of a complaint, this includes timely responses and a detailed investigation. Complaints procedures are in place for staff, carers and visitors. Relatives are also informed at review meetings, or visits that they can raise issues that will be addressed seriously. Training on keeping people safe from abuse is made available to staff during their induction and regularly updated. This helps the service make sure that staff know how to spot and report any practice that puts people at risk. Wagtail Close DS0000037554.V374576.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People using this service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. People live in a clean and safe environment. The service has plans to respond to areas needing refurbishment and upgrading. EVIDENCE: Whilst staying at Wagtail Close people live in individual flats which each have a lounge, kitchen area, one bedroom, and en-suite facility with a level access shower. All the flats are wheelchair accessible. The flats have overhead tracking in the bedroom and bathroom. This means people can be assisted between the two rooms in a hoist if they need to be. Two of the flats have a kitchen, which has been fitted with height adjustable worktops and specialist adaptations to promote independence. This is excellent practice and means people can use the facilities with as much independence as possible. The respite unit also has a communal lounge and enclosed gardens. Wagtail Close DS0000037554.V374576.R01.S.doc Version 5.2 Page 16 All areas of the home seen were clean and homely. The assessment of peoples needs includes any equipment they will need to facilitate their independence and safety. The service also works with a multidisciplinary team to make sure the environment will meet the persons needs before the stay. This is good practice. At a previous inspection staff explained that the doors to enter into flats are very heavy. These are fire doors and staff now make sure that they are not propped open so that fire safety precautions are not compromised. Automatic door closures are not fitted. Some people are not able to open the doors on their own and have to wait for staff to allow them access to their own flat during their stay. This may compromise peoples independence and choice. The service should seek advice from the Fire Safety Officer and implement a solution. Some areas of the home are now in need of refurbishment. The manager told us that there are plans in place to redecorate communal areas. New furniture for the lounge was chosen in consultation with people using the care service but is not yet in place due to supplier issues. Wagtail Close DS0000037554.V374576.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 People using this service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. People are supported by competent and qualified staff recruited through robust recruitment processes. EVIDENCE: Staffing levels are tailored to the number of people using the respite care facility and to their level of needs. This can include having 1 staff on duty overnight with additional sleep-in cover as needed. The supported living scheme has expanded and the service is working with people who use the scheme and their families to clarify their expectations of roles and responsibilities. A review of staffing support to the supported living scheme is underway and this will help to ensure that the needs of people using the respite scheme are not overlooked or compromised. We spoke to a person using the respite care service and they told us that staff are friendly and helpful. The feedback sheets we saw at the home told us that people found staff to be caring. Wagtail Close DS0000037554.V374576.R01.S.doc Version 5.2 Page 18 We looked at two staff files and saw that all the required checks are carried out. This helps to make sure that the service only employs people who are safe to work with vulnerable adults. Staff have access to thorough induction training and there are high levels of NVQ National Vocational Training. The service have been able to arrange specific training in order to help meet individual needs. This is good practice. Wagtail Close DS0000037554.V374576.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 People using this service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. People can be confident that the homes management safeguards their views rights and best interests. EVIDENCE: The manager for the service is also the registered manager for the domiciliary care service on site. There is a deputy manager and assistant manager and roles and responsibilities continue to be clarified to help make sure that the scheme is managed well. Wagtail Close DS0000037554.V374576.R01.S.doc Version 5.2 Page 20 We saw that the information technology at the home is very slow and at times this has made it difficult for the service to send information including their annual self-assessment. People who use the service are surveyed after each stay and the feedback sheets we saw told us that people gave the service good or excellent ratings. Some people have asked the service not to survey them after each visit as this can mean they are filling in a survey every few weeks. The service has responded to feedback and put an action plan in place to review the care and support arrangements to the domiciliary care, supported housing and respite care home to make sure that the scheme is working in the best interests of all the people who use these services. Staff told us about an incident involving the evacuation of another support scheme and the temporary movement of people into these premises. The provider did not send us a notification to tell us about the action they took to make sure that there was no adverse impact on the wellbeing of people using the respite scheme. Statutory notifications should be sent to us about significant events. The home has access to comprehensive policies and procedures for local authority residential services. Some of the standardised documentation has to be changed to fit in with the needs of this specialised service. Wagtail Close DS0000037554.V374576.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 2 x Wagtail Close DS0000037554.V374576.R01.S.doc Version 5.2 Page 22 No 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. 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. 1 2 Refer to Standard YA24 YA42 Good Practice Recommendations The service should seek advice from the Fire Safety officer and replace or fit door closures so that peoples independent access to their rooms is not compromised. The home should notify the Commission of significant events including those that may adversely affect the health and wellbeing of people who use the service. (Regulation 37) This will help the Commission make sure that the service is responding well to any situations that arise. Wagtail Close DS0000037554.V374576.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Wagtail Close DS0000037554.V374576.R01.S.doc Version 5.2 Page 24 - 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. 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