Care Home: Wallace House

What the care home does well The staff collect information about the person before they move into the home to make sure individual care needs can be met. Care plans show that staff contact other professionals regarding people`s care. Medication procedures and storage facilities have improved since the last visit to the home. Staff are respectful and sensitive when helping and speaking to people. Visitors are always welcome and there are links with the community. There is a designated activities person and people can choose to join in a range of events if they wish. Clear information is available should anyone have a concern and they can be confident that they will be listened to. The food being served is nutritious and well presented and there is choice and variety for the people living in the home. A refurbishment programme has improved the environment which is clean and free from any odour. Staff are receiving training so that they can continue to care for people properly. There is now a manager employed who is showing guidance and leadership to the staff team. All maintenance and health and safety checks are completed which minimises risks to those living,working and visiting the home. What the care home could do better: Staff must make sure that care plans are clear,detailed and up to date regarding wound care and new admission information. Staffing levels at peak times need to be reviewed.The outstanding requirements from the last key inspection need to be actioned as amatter of urgency. Inspecting for better lives Random inspection report Care homes for older people Name: Address: Wallace House Ravensworth Road Dunston Gateshead Tyne & Wear NE11 9AE 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: Irene Bowater Date: 0 3 0 2 2 0 0 9 Information about the care home Name of care home: Address: Wallace House Ravensworth Road Dunston Gateshead Tyne & Wear NE11 9AE 01914603031 01914602996 wallacehouse@schealthcare.co.uk 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) : Southern Cross BC OpCo Ltd care home 40 Number of places (if applicable): Under 65 Over 65 40 old age, not falling within any other category Conditions of registration: 0 The registered person may provide the following category of service only: Care Home with Nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following categories: Old Age, not falling within any other category, Code OP - maximum number of places 40 The maximum number of service users who can be accommodated is: 40 Date of last inspection Brief description of the care home Wallace House is a care home that provides permanent accommodation with personal care support and nursing care for up to a total of forty older people, some of whom may have a physical disability and or sensory loss. The property is situated on a main thoroughfare in Dunston, and is within walking distance of a range of local amenities, including a health centre, pharmacy, shops, places of worship and public houses. The Metro Centre shopping complex is also only a short distance away. The area is well Care Homes for Older People Page 2 of 10 Brief description of the care home served by public transport. Accommodation is purpose built over two levels, each with facilities that include lounges, dining areas and bathrooms. All bedrooms are single with en-suite toilets and one room is suitable for sharing by a couple. Off road car parking is available at the rear and side of the home. At the front there is a small garden and patio area that can be reached from one lounge, which people may enjoy in good weather. The building can be easily accessed inside and out by people using wheelchairs. Fee rates vary from 394 pounds to 449:50 pounds.The free nursing care element is set nationally. Items not covered by the fees include hairdressing, toiletries, newspapers, clothing and person items. Care Homes for Older People Page 3 of 10 What we found: The random inspection was carried out to look at the way the home has responded to the requirements made at the last key inspection. The visit was undertaken on Tuesday 3 February 2009 and during the visit the manager was available to assist with collecting the information needed. Three care plans were examined.This included the care provision of people with pressure damage and a person who had recently been admitted. All showed that detailed pre admission and admission and risk assessments are completed.These include dependency,falls risk pressure ulcer risk and prevention,nutrition using the Malnutrition Universal Risk Tool(Must) and continence. The records for the management of wounds were detailed and up to date. They showed that they were being managed effectively and that the staff were getting appropriate advice if necessary from the Tissue Viability Nurse. However one person who had recently been admitted did not have an up to date plan of care which placed him at risk. Information about how staff are going to support those who have a poor appetite were detailed and included information from Speech and Language Therapists,(SALT) and dietitians. Care plans also specify that food must be fortified with cream,full fat,and give snacks between meals. A review of the last requirements for medication was carried out.Medication Administration Records (MAR) showed no gaps in recording and handwritten directions are now written in full to prevent any errors.New medicine and storage facilities have been provided. The company uses the NUTMEG system for balancing the nutritional content of food provision. Choices available for all meals and people had plenty of snacks and drinks throughout the day. There are dining rooms on both floors .Tables were set nicely for lunch and all had a vase of fresh flowers and menus on each table. Lunch choices were mince,cabbage,cauliflower and potatoes or salmon fish cakes. Other choices given included sandwiches or salad.Fruit and cream,yoghurts or ice cream were available for dessert. The meal time experience differed on each floor. Upstairs was quieter with people managing their meals themselves with minimum support and the meal took about half an hour to complete. Downstairs it was much busier. At least seven people needed full assistance and others needed support and prompting to eat their meal. Care Homes for Older People Page 4 of 10 The two carers worked very hard to try to make sure that people had enough of hot food to eat but it was not possible to make sure sufficient support was given at all times. Staff were having to help more than one person at a time which means individualised care was not given and the mealtime experience not enjoyable. There were also meals being served in peoples bedrooms at this time.The lunchtime meal on the ground floor took over one and a half hours to complete. An activities person has been appointed since the last visit to the home.Activities are displayed and include pamper days,one to one, board games, sing a longs, bingo,and films. An activity book is available in reception with photographs of various events. On the day of the visit several people enjoyed a game of bingo,some preferred their own company and others enjoyed watched television and chatting to the staff. People said: they were happy, had good staff, no complaints, and liked the food. The records of the management of complaints and concerns since the last visit were examined. These were detailed and contained the information necessary to make sure that the people are safeguarded and that any concerns can be investigated effectively. On the day of the visit the home was clean,tidy and free from any offensive odours.A refurbishment programme is in place and carpets and lounge chairs have been replaced. All of the bathrooms and shower facilities are now in working order although there is some damage to walls and paintwork from constant use of wheelchairs and trolleys. It was confirmed that the kitchenette in the upstairs dining room is to be refurbished as the flooring,units and carpet is damaged. The home has a manager who is completing her application to become registered. On the day of the visit there were two qualified nurses and five care staff on duty.There were sufficient ancillary staff including activities,domestics,laundry,maintenance,cook and kitchen assistants. Although the staffing levels are currently meeting peoples needs observation throughout the lunchtime period showed that on the ground floor people had to wait for some time for assistance. Also the nurse was busy with other tasks and was not able to help the care staff support those who needed a lot of help.The manager needs to review the staffing levels at peak times so that peoples needs can be met properly. The manager has been in post since September 2008.She is in the process of applying to become registered with the Commission for Social Care Inspection. There are a series of audits being carried out as part of the quality assurance programme which can give the manager a good indicator of the standards and areas where improvements can be made. Care Homes for Older People Page 5 of 10 She has also started surgeries where relatives or those who live in the home can come and discuss any issue they may have. The regional manager visits on a regular basis and monitors development of the service.Records of any remedial action to improve the service are available. In house maintenance records are up to date and staff have completed mandatory training. What the care home does well: What they could do better: Staff must make sure that care plans are clear,detailed and up to date regarding wound care and new admission information. Staffing levels at peak times need to be reviewed. Care Homes for Older People Page 6 of 10 The outstanding requirements from the last key inspection need to be actioned as amatter of urgency. 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 7 of 10 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 15 12 The registered persons must 01/09/2008 review the organisation of mealtimes. The registered persons must 01/10/2008 replace the vinyl flooring and sink unit in the upstairs kitchenette. The registered persons must 01/09/2008 ensure that there are enough staff deployed at mealtimes. 2 20 16,23 3 27 18,24 Care Homes for Older People Page 8 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, 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 8 15 The registered persons must 27/02/2009 ensure that details regarding wound care are recorded and updated from admission and there after on a continuing basis. This is to make sure peoples health care is monitored and improved. 2 27 18 The registered persons must 27/02/2009 ensure that there are additional staff available at peak times. This is to make sure peoples individual care needs are met especially at mealtimes. 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 9 of 10 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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