Care Home: Walnut House

Similar services:

• Coopers Mill Ltd
• Bramley Avenue (73)
• Paradise Lodge
• Grangewood
• Upaya Ananda
• Newton Court (1-2)
• Kings Lane (32)
• Pemdale

What the care home does well Walnut House is a well run home that provides a homely, comfortable and safe environment, which is clean and hygienic. People`s bedrooms are individual and private and shared spaces complement their individual rooms. People living at Walnut House are able to make choices about their lives and are actively involved in compiling their care plans. Risk assessments are very empowering, person centred and clearly written, focussing on how to enable people to do things as safely as possible, rather than avoiding situations. The people living at Walnut House are able to have regular contact with their family and friends. The meals are good and the people living at Walnut House often help with cooking, shopping and choosing what is on the menu. What has improved since the last inspection? Building work has been completed since the last key inspection to add an extension, which contains a staff sleep-in room and a small office. What the care home could do better: A review of the quality of care must be undertaken. The Statement of Purpose, and Service User Guide, for Walnut House needs to be updated and each person given a copy of the revised version as soon as possible. The complaints procedure needs to be updated and each person living at Walnut House should be given a copy of the revised version as soon as possible. All staff who are involved in food handling/preparation must have up-to-date food hygiene certificates. It is recommended that Walnut House has its own health and safety maintenance records, including the `monthly hazard hunt` on the premises. It is recommended that the people living at Walnut House are encouraged and supported to undertake accredited food hygiene training. The policies and procedures manual should be revised and updated as soon as possible. CARE HOME ADULTS 18-65 Walnut House 49a Norwich Road Dereham Norfolk NR20 3AS Lead Inspector Debra Allen Unannounced Inspection 23rd May 2008 08:20 Walnut House DS0000027591.V365043.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 Walnut House DS0000027591.V365043.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. Walnut House DS0000027591.V365043.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Walnut House Address 49a Norwich Road Dereham Norfolk NR20 3AS 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) Autism Anglia whitstone@nacha.org.uk Mrs Marie Ann Large Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Walnut House DS0000027591.V365043.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Up to four adults of either sex with a learning disability, not falling within any other category may be accommodated. Date of last inspection: 24th May 2006 Brief Description of the Service: Walnut House provides accommodation and care for up to four people with a learning disability and is situated in the grounds of Whitstone House, which is managed by the same organisation. Access to the Home is through the shared garden or through the larger Home and there is parking to the front of Whitstone House. The Home is situated on a main road into the market town of Dereham. All the service users have single bedrooms and share the communal facilities. This has enabled the registration to be formally extended to four residents on a permanent basis. The basic weekly fees at Walnut House are currently £795; these may increase according to individual needs, such as additional staffing levels. Up until very recently, Walnut House was managed by the Norfolk Autistic Community Housing Association, but has since been taken over by a different organisation - Autism Anglia. Walnut House DS0000027591.V365043.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 star. This means the people who use this service experience good quality outcomes. Care Services are judged against outcome groups, which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out, by using information from previous inspections, information from the providers, the residents and their relatives, as well as others who work in or visit the home. This has included a recent unannounced visit to the home. This report gives a brief overview of the service and the current judgements for each outcome group. This inspection was carried out over a period of four and a half hours, during which time three people living at the home were spoken with and discussions were held with the manager and a member of staff. A tour of the premises was also carried out, guided by two of the people who live at Walnut House. Care plans, staff files, health and safety information and other records required for regulation were also examined as part of the inspection process. An Annual Quality Assurance Audit (AQAA) document was completed by the manager and submitted to the Commission in July 2007 and an Annual Service Review (ASR) was completed by the Commission in September 2008. Four requirements and three recommendations have been made as a result of this inspection. What the service does well: Walnut House is a well run home that provides a homely, comfortable and safe environment, which is clean and hygienic. People’s bedrooms are individual and private and shared spaces complement their individual rooms. People living at Walnut House are able to make choices about their lives and are actively involved in compiling their care plans. Risk assessments are very empowering, person centred and clearly written, focussing on how to enable people to do things as safely as possible, rather than avoiding situations. The people living at Walnut House are able to have regular contact with their family and friends. Walnut House DS0000027591.V365043.R01.S.doc Version 5.2 Page 6 The meals are good and the people living at Walnut House often help with cooking, shopping and choosing what is on the menu. 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. Walnut House DS0000027591.V365043.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 Walnut House DS0000027591.V365043.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): 1 & 2 Quality in this outcome area is good. People are provided with the information they need to decide if the home is right for them and a full needs assessment is completed before people move in. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All four service users have lived at Walnut House for a number of years, the most recent admission being 2005, and the three people who were spoken to during the inspection all said they were very happy living there. The care plan for the person most recently admitted confirmed that a full needs assessment was carried out prior to moving in and a discussion with the manager confirmed that there was an admissions and assessment procedure in place for any future, prospective, service users. Due to the very recent take-over of the Organisation by Autism Anglia, the Statement of Purpose and Service User Guide for Walnut House needs to be updated and each person given a copy of the revised version as soon as possible. A requirement has been made in this respect. Walnut House DS0000027591.V365043.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, 8, 9 & 10 Quality in this outcome area is good. The people living at Walnut House are involved in decisions about their lives and have opportunities to be actively involved in planning the care and support they receive. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four care plans were looked at in detail and all contained good evidence that people are actively involved in compiling their care plans and statements were seen stating: [name] has contributed to this care plan. This care plan was read and explained to [name] and they have agreed to it in its entirety. The contents of the care plans included comprehensive information under standard headings such as Personal Details, Care Plan, Risk Assessments, Current Medication, Current Walnut House Annual Review, Walnut House Monthly Reviews, Current Day Services Review and Day Service Timetable. Walnut House DS0000027591.V365043.R01.S.doc Version 5.2 Page 10 The information seen under these headings was found to have been regularly reviewed and updated and individuality was seen to have been consistently maintained and promoted throughout. Observations during the morning of the inspection showed all four people making choices with regard to what they wanted to do; one person remained in their room until after the others had left for their daily work placements/day services, one person was watching television and another was cleaning the bathroom. Two people assisted with a tour of the premises, during which they said how much they liked living at Walnut House and how they enjoyed going to their day services. The diaries and daily records also showed choices and levels of enjoyment with regard to daily routines and activities. Risk assessments were seen to be very empowering, person centred and clearly written, focussing on how to enable people to do things as safely as possible, rather than avoiding situations. Some of the risk assessments seen covered areas such as self-medicating, swimming, going out in the community, shopping, travelling in minibus/people carrier, walk in countryside, working on allotment, bathing/washing, ironing, having own room key and using kitchen facilities. All of these were seen to have been reviewed at regular intervals, mostly six monthly. All personal information and records relating to the people living at Walnut House were seen to be stored securely; thereby ensuring confidentiality is maintained. Walnut House DS0000027591.V365043.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): 11, 12, 13, 14, 15, 16 & 17 Quality in this outcome area is excellent. The people who live at Walnut House are able to make choices about their lifestyle and are supported to participate in various activities, which suit their individual needs, choices and aspirations. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Discussions and observations during the inspection confirmed that independence and empowerment is very much promoted at Walnut House and people are supported and encouraged to live their lives as they choose, at their own pace, as much as possible. Discussions with the people living at Walnut House and information noted within the care plans, confirmed that daily routines and activities included bowling, gardening, computer studies, sports/games/exercises, listening to music, using the play-station, swimming, bingo, quizzes, cinema, meals out, Walnut House DS0000027591.V365043.R01.S.doc Version 5.2 Page 12 shopping, pub visits, cycle rides, watching television, socializing and visiting friends or family. It was confirmed, through discussions and records seen, that people continue to be able to have regular contact with their family and friends and one person stays with their family every other weekend. Visitors are also welcome to visit the people living at Walnut House. Some recent outings have included sailing, barbecues, trip to the zoo and a trip to the circus. Although a mealtime wasn’t observed, the kitchen and dining room had a very homely and comfortable atmosphere and the people spoken to during the inspection confirmed that they enjoyed the food and that they often helped with the cooking and the shopping and chose what was on the menu. Each person makes their own packed lunch of which there were some very healthy and appetising varieties noted. Some of the recent meals noted from records looked at included chicken curry, turkey escalopes, take-away, roast pork, pork chops & sausages, gammon and battered fish. Desserts included cheesecake, low fat rice pudding, fruit, yoghurt and crumble. In view of the fact that the service users are very actively involved in food handling and preparation, a recommendation has been made that they could be supported and encouraged to undertake accredited food hygiene training. Walnut House DS0000027591.V365043.R01.S.doc Version 5.2 Page 13 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 & 20 Quality in this outcome area is good. The health and personal care that people receive is based on their individual needs and the principles of respect, dignity and privacy are put into practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans looked at gave clear explanations with regard to how people wanted and needed to be supported with their personal care and there was evidence of an enabling approach, rather than ‘doing-things-for people’. It was noted from information in the care plans and daily notes that people mostly only require prompting in areas of personal care and hygiene and clear guidance and descriptions of each person’s capabilities were also recorded – i.e. [name] is completely independent with their personal hygiene and does it to a very high standard. Occasional reminders may be needed for changing clothes. Walnut House DS0000027591.V365043.R01.S.doc Version 5.2 Page 14 Evidence was also seen, in the care plans, of involvement and support from external professionals such as GP, community nurse, psychiatrist, chiropodist, dentist and optician. Very good information and record keeping was observed in respect of healthcare and wellbeing. Three people living at Walnut House are currently taking prescribed medication. Although nobody is currently administering or looking after their own medication, everyone is protected by the home’s policies and procedures and staff are well trained in this area. No errors or omissions were noted from the records that were looked at during the inspection. Walnut House DS0000027591.V365043.R01.S.doc Version 5.2 Page 15 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 & 23 Quality in this outcome area is good. Service users feel their views are listened to and acted on and they are protected from abuse, neglect and self harm as much as is possible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Discussions with three of the people living at Walnut House confirmed that they knew what to do and who to speak to if they were unhappy about anything. Staff files and discussions with the manager confirmed that staff have received training in adult protection. As a result of the recent takeover by Autism Anglia, the complaints procedure needs to be updated and each person living at Walnut House should be given a copy of the revised version as soon as possible. Walnut House DS0000027591.V365043.R01.S.doc Version 5.2 Page 16 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, 25, 26, 27, 28 & 30 Quality in this outcome area is excellent. Walnut House provides a homely, comfortable and safe environment, which is clean and hygienic. People’s bedrooms, toilets and bathrooms are individual and private and shared spaces complement their individual rooms. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the premises, guided by two of the service users, showed Walnut House to be clean, hygienic and very pleasantly decorated throughout most areas, with numerous improvements noted. It also had a very comfortable and homely atmosphere. Both service users were happy to show me their rooms, which they both said they were very happy with. Both rooms seen looked very comfortable and personal. Three of the four people were seen using the various communal areas, the fourth person had chosen to stay in their room until later, and everyone appeared very relaxed and content. Walnut House DS0000027591.V365043.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, 35 & 36 Quality in this outcome area is good. The home has robust recruitment policies and procedures and staff are well supported and supervised, which helps to ensure service users are protected. Some areas of training are in need of updating. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Training records were looked at and evidence was seen of courses attended such as first aid, fire safety, React, physical intervention, medication and adult protection. However, it was noted that only one member of staff who supports people at Walnut House had an up-to-date food hygiene certificate. A discussion with the manager and one member of staff, together with records seen during the inspection, confirmed that staff receive one-to-one support and supervision on a regular basis. Walnut House DS0000027591.V365043.R01.S.doc Version 5.2 Page 18 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, 40 & 42 Quality in this outcome area is good. Walnut House is a well run home, in which the service users’ overall health, safety and welfare is promoted and protected, although a formal quality assurance process still needs to be developed to help ensure good practice is monitored and people’s views are listened to. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A discussion with the manager confirmed that she worked at Walnut House for a number some years prior to being appointed as the registered manager and is still in the process of NVQ level 4 training but aims to have this completed this year. Walnut House DS0000027591.V365043.R01.S.doc Version 5.2 Page 19 A formal quality assurance process still needs to be developed which shows how the service is meeting the needs of the people living at Walnut House and consulting with them. Although this is a repeat requirement, the timescale has been extended in view of the recent takeover by Autism Anglia. Meanwhile, Walnut House continues to be accredited annually by an external assessor and receives an Autism Accreditation Report. This looks at selected core standards in relation to the care of people with autistic spectrum disorders. The new policies and procedures manual, provided by Autism Anglia, is not yet complete and the service is still referring to a number of the policies and procedures supplied by the previous provider, NACHA. A recommendation has therefore been made for this to be completed as soon as possible. The regulated checks for fire, environmental health, water and electric were found to be satisfactory and cleaning materials/hazardous chemicals were seen to be stored appropriately. However, a number of these records are maintained jointly with Whitstone House and a recommendation has been made for Walnut House to have its own maintenance records, including the ‘monthly hazard hunt’ on site. Walnut House DS0000027591.V365043.R01.S.doc Version 5.2 Page 20 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 2 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 2 23 3 ENVIRONMENT Standard No Score 24 4 25 3 26 3 27 3 28 4 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 4 3 LIFESTYLES Standard No Score 11 3 12 4 13 3 14 4 15 4 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 X 3 X 2 2 X 3 X Walnut House DS0000027591.V365043.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? Yes 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. 1. Standard YA39 Regulation 24 Requirement A review of the quality of care must be undertaken, as specified in regulation 24 of the Care Homes Regulations 2001. Repeated Requirement: Timescale extended in view of recent change of provider/organisation. The Statement of Purpose and Service User Guide for Walnut House needs to be updated and each person given a copy of the revised version as soon as possible. The complaints procedure needs to be updated and each person living at Walnut House should be given a copy of the revised version as soon as possible. All staff who are involved in food handling/preparation must have up-to-date food hygiene certificates. Timescale for action 31/08/08 2. YA1 6 31/08/08 3. YA22 22 31/08/08 4. YA35 18 30/09/08 Walnut House DS0000027591.V365043.R01.S.doc Version 5.2 Page 22 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. Refer to Standard YA24 Good Practice Recommendations It is recommended that Walnut House has its own health and safety maintenance records, including the ‘monthly hazard hunt’ on the premises. It is recommended that the people living at Walnut House are encouraged and supported to undertake accredited food hygiene training. The policies and procedures manual should be revised and updated as soon as possible. 2. 3. YA12 YA40 Walnut House DS0000027591.V365043.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eastern Region Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge CB21 5XE 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 Walnut House DS0000027591.V365043.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. 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!