Care Home: Waltham Hall Nursing & Residential Home

Similar services:

• Byars Care Home
• St Marys Nursing Home
• Bramble Lodge
• Parkmanor Residential Home
• Thornham Grove
• Hunter`s Lodge
• London Road Neurological and Specialist Care Unit
• Carlton Care Home

What the care home does well The home provides staff to look after the residents who are recruited thoroughly and receive comprehensive training. The staff look after the residents in a caring and considerate way. The home provides a safe, comfortable and homely environment for the residents to live in. The residents are given choice in their meals that are presented well. The residents` views are taken into consideration and put into place to make sure that their choices are met. The residents receive activities that suit their needs and take into consideration their previous interests. Visitors to the home are made very welcome and families are communicated with about changes to the resident. What has improved since the last inspection? A new lock on the front door has been provided to make sure that the residents are protected. The staffing numbers have improved to meet the needs of the residents. The registered provider is recording his monthly visits to the home. In addition to the requirements made at the last visit, the home has put in place most of the recommendations made by us. What the care home could do better: The home could make sure that the daily records contain enough information that the staff coming on duty can see easily what has happened to the residents during the previous shift. They could make sure that all the residents have photographs on their files to make sure that staff can identify them correctly. That all the staff undertaking medicine administration are aware of how to dispose of medicines that a resident refuses to take. That where a resident is being given medicines with the help of jam that it is documented that this has been discussed and permission obtained to administer them in this way.Waltham Hall Nursing & Residential HomeDS0000001931.V377462.R01.S.doc Version 5.2 Consideration should be given to replacing the medication system with a safer and easier method of use. They could print the menus on the tables in a large print to make it easier for the residents to read. Consideration could be given to employing domestic staff at the week-ends to make sure that the standards of cleanliness are always maintained. The personal accounts should always have two signatures on them to protect the resident and the staff. The home must make sure that they continue to monitor the staffing levels so that there are always enough to meet the residents needs. Key inspection report CARE HOMES FOR OLDER PEOPLE Waltham Hall Nursing & Residential Home Melton Road Waltham On The Wolds Melton Mowbray Leicestershire LE14 4AJ Lead Inspector Thea Richards Key Unannounced Inspection 4th September 2009 09:00 DS0000001931.V377462.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought 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. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Waltham Hall Nursing & Residential Home DS0000001931.V377462.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Waltham Hall Nursing & Residential Home DS0000001931.V377462.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Waltham Hall Nursing & Residential Home Address Melton Road Waltham On The Wolds Melton Mowbray Leicestershire LE14 4AJ 01664 464865 01664 464881 waltham-hall@tiscali.co.uk 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) Claregrange Limited Mrs Patricia Jane Fielder Care Home 61 Category(ies) of Old age, not falling within any other category registration, with number (61), Physical disability (61) of places Waltham Hall Nursing & Residential Home DS0000001931.V377462.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered persons 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 are within the following category: Old age, not falling within any other category - Code OP. Physical disability - Code PD. The maximum number of service users who can be accommodated is 61. 8th September 2008 2. Date of last inspection Brief Description of the Service: Waltham Hall Nursing and Residential Home is a large converted house in the Leicestershire village of Waltham on the Wolds. It is on the main road between Melton Mowbray and Grantham and is accessible by public and private transport. There is parking available at the front of the home. It is registered to provide personal and nursing care to sixty-one people over the age of sixty-five. Claregrange Ltd owns the home, which is managed by Mrs. Jane Fielder, who is a nurse and an experienced manager who has been in post for several years. The accommodation is on two floors and the first floor can be reached by the stairs or by the two passenger lifts. There are bedrooms, lounges and dining rooms on both floors. There are forty-eight single bedrooms with en-suite facilities, eleven single bedrooms without en-suite facilities and one double bedroom with en-suite facilities. There is a large, well - maintained garden to the front, side and rear of the house, which can be easily reached by the residents, relatives and visitors. The home enjoys pleasant views over the surrounding countryside. Waltham Hall Nursing & Residential Home DS0000001931.V377462.R01.S.doc Version 5.2 Page 5 Fees are charged weekly and range from £474.00 to £671.00 and will be individually assessed dependent on the persons care needs. Additional charges are made for items, such as hairdressing, private chiropody and magazines and newspapers. The Statement of Purpose, the Service User Guide and the current Commission for Social Care Inspection (CSCI) report are available for residents and their families on request. The current registration certificate from the CSCI and the Employers Liability Certificate are displayed in the entrance hall. Waltham Hall Nursing & Residential Home DS0000001931.V377462.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The Quality rating for this service is 2 Star. This means that the people who use this service experience good quality outcomes. This was a key inspection of a care home for older people, which ended with an unannounced visit to the service. Before the visit we [throughout the report the use of we indicates the Care Quality Commission], spent five hours reviewing information received by the Care Quality Commission [CQC] since the last key inspection on the 6th and 8th September 2008. The visit took place on the 4th September 2009 and lasted eight hours. During the visit we checked all the key standards as identified in the National Minimum Standards. This was achieved through a method called case tracking. Case tracking means that we looked at the care provided to three of the residents. To achieve this we spoke with the staff supporting their care and looked at the records relating to their health and welfare. We spoke with the residents and visiting families. With their permission the residents bedrooms were looked at. We also checked how the home was run and organised. This included looking at staff records, training and how the staff are organised. We looked at health and safety records, menus, minutes of meetings and the quality audit. The policy for handling complaints and how the home dealt with them was looked at. We looked at how prospective residents and their families are given information about the services the home can offer and whether they are suitable for them. During the visit we spoke with the nurse in charge, the residents, the staff and families visiting the home. We also spoke to a district nurse visiting the home. We looked at the Annual Quality Assurance Assessment (AQAA) that the home had sent to us when we asked for it. Waltham Hall Nursing & Residential Home DS0000001931.V377462.R01.S.doc Version 5.2 Page 7 What the service does well: The home provides staff to look after the residents who are recruited thoroughly and receive comprehensive training. The staff look after the residents in a caring and considerate way. The home provides a safe, comfortable and homely environment for the residents to live in. The residents are given choice in their meals that are presented well. The residents views are taken into consideration and put into place to make sure that their choices are met. The residents receive activities that suit their needs and take into consideration their previous interests. Visitors to the home are made very welcome and families are communicated with about changes to the resident. What has improved since the last inspection? What they could do better: The home could make sure that the daily records contain enough information that the staff coming on duty can see easily what has happened to the residents during the previous shift. They could make sure that all the residents have photographs on their files to make sure that staff can identify them correctly. That all the staff undertaking medicine administration are aware of how to dispose of medicines that a resident refuses to take. That where a resident is being given medicines with the help of jam that it is documented that this has been discussed and permission obtained to administer them in this way. Waltham Hall Nursing & Residential Home DS0000001931.V377462.R01.S.doc Version 5.2 Page 8 Consideration should be given to replacing the medication system with a safer and easier method of use. They could print the menus on the tables in a large print to make it easier for the residents to read. Consideration could be given to employing domestic staff at the week-ends to make sure that the standards of cleanliness are always maintained. The personal accounts should always have two signatures on them to protect the resident and the staff. The home must make sure that they continue to monitor the staffing levels so that there are always enough to meet the residents needs. 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Waltham Hall Nursing & Residential Home DS0000001931.V377462.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Waltham Hall Nursing & Residential Home DS0000001931.V377462.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents needs are always assessed before moving into the home and they have good information to help them make the right choice about the home. EVIDENCE: We saw the Statement of Purpose and information pack which contained thorough information about the home. These have been updated over the last year and there are plans to update them again this year with new photographs. They can be made available in large print or in another language if needed to make sure that they can be read and understood by as many people as possible. Waltham Hall Nursing & Residential Home DS0000001931.V377462.R01.S.doc Version 5.2 Page 11 The residents and families spoken with confirmed that they had been given copies of them before their relative was admitted. The nurse in charge and the AQAA told us that all potential residents were given them and had a full pre admission assessment before admission. The residents and the families spoken with confirmed that they had had a visit from the matron of the home and had the information that they needed to make a decision about coming into the home. All of the residents case tracked had thorough, completed pre admission assessments in their care plans. These had been completed by the manager. The prospective resident and their families are encouraged to visit the home and have the opportunity of having a meal in the home before they are admitted. Waltham Hall Nursing & Residential Home DS0000001931.V377462.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff meet all the individual care needs of the residents, with privacy, dignity and respect. EVIDENCE: We case tracked three of the residents’ records and they were all found to contain good individual evidence of the care being given to the residents and reflected the care that they needed. There was evidence that the residents and/or their relatives had been involved in planning the care. Two of the files did not have photographs of the resident on them, which could give a problem for staff identifying them. We spoke with many residents and families who all told us that they received the care that they needed and that they were happy that they received it. Waltham Hall Nursing & Residential Home DS0000001931.V377462.R01.S.doc Version 5.2 Page 13 The care plans contained all the required information, but repeated itself in places, making some information difficult to find. The daily record of care had been completed but did not give enough information for staff coming on duty to get a complete picture of the residents’ day or night. The care staff were seen to be treating the residents with dignity, respect and consideration when talking to them and giving them care. A comment received: The staff look after me well There are records of the involvement of G.P.s, chiropodist, optician and speech and language therapists, where needed in the care plans, showing that thorough health care is being provided for the residents. There are records of the residents’ nutritional needs and weight, which makes sure that they are eating well and are not losing or gaining large amounts of weight. These are taken into consideration when the home assesses the risk of the resident getting a pressure sore. We spoke with a district nurse who was visiting. She was very happy that the residents were well cared for and that the staff referred them to her as soon as they needed his care. The staff carried out any instructions that she left. There was evidence that the care plans are regularly reviewed and the residents and the families spoken with confirmed that they had been involved and were aware of the care to be given and that they were happy with it. The staff spoken with were aware of the care needs of the residents. The residents, the families spoken with told us that they were happy that all care needs were being met. There were risk assessments in place to cover all the identified risks for the residents and how the staff should manage those risks. This makes sure that the residents and the staff are protected from any risks that have been identified, without restricting their activities. Medication records for the case tracked residents were in order. Medicines are given by the trained nursing staff who have regular updating and training in medicines. Waltham Hall Nursing & Residential Home DS0000001931.V377462.R01.S.doc Version 5.2 Page 14 We saw that the medicines were administered individually and the residents were seen to be taking them. Some of the residents are being given medicines with the help of jam, where this is happening it should be documented in the care plan that this has been discussed with the resident or their family and the doctor. Medicines are still being supplied in packets and consideration could be given to having them provided in a monitored dosage system where each tablet is in a separate pop out card. This is a safe method of administration, helping to make sure that the resident is always given the right medicines and saving the staff time. The staff spoken with were knowledgeable about the medicines and where to obtain information. They were also aware of the requirements for the receipt, storage and disposal of medicines. A member of staff spoken with told us that she would dispose of medicines that had been refused down the sink or toilet. This is not safe practice as it could pollute the water system. The manager carries out a monthly written audit of the medicines and the medicine sheets to make sure that they are correct. The controlled [dangerous] drugs and records were checked and found to be in order. There was a policy and a risk assessment in place to assess whether residents are safe to have responsibility for their own medicines. Waltham Hall Nursing & Residential Home DS0000001931.V377462.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides activities that the residents enjoy and take part in and meets their spiritual and nutritional needs. EVIDENCE: The home has an activities group that, arranges activities in response to the residents wishes and publicises them on the notice boards around the home. The activities that the residents take part in are documented in their care plans. The care plans describe the residents past life and their interests so that the home can help them continue those interests if they wish to. Activities include craft work, newspapers, nails, hairdressing, card games, board games, relaxation classes and outside entertainment such as singers. Waltham Hall Nursing & Residential Home DS0000001931.V377462.R01.S.doc Version 5.2 Page 16 The residents appeared happy with the activities and the families told us that they were happy with the amount of activities and that the residents joined those that they wished to. Trips out of the home are arranged but we are told that these are limited with staff not being available to accompany the residents and the vehicle not being available. Visitors are welcomed into the home at any time and are invited to attend social functions and the regular resident/family meetings. On the day of the visit we saw many visitors to the home and saw the welcome that they were given. The menus seen gave choices of meals and the cook and the staff were aware of individual needs and choices. Soft diets were presented well with all the different items separate. Individual menus were available on the tables, but could be printed in a large print to make sure that the residents could read them. The chef told us that menus were discussed with the residents and that the home planned the meals around the food that was ordered by the provider. She also told us that she received was good quality deliveries of food. Religious needs are catered for by the residents having a regular service in the home or by visits from a local minister. The hairdresser visits regularly every fortnight and there is a dedicated hairdressing room. Waltham Hall Nursing & Residential Home DS0000001931.V377462.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good systems in place to support and protect residents and staff are aware of the processes EVIDENCE: There is a complaints policy in place which gives the details of how to complain and who to complain to in the home if they needed to. The policy could be made available in a large print and other languages if it was needed, which makes that as many people as possible could read it. The complaints form was clear and easily followed. Neither the home, nor the Care Quality Commission have received any complaints since the last Key Inspection on the 8th September 2008. The residents and the families spoken with told us that they were aware of how to make a complaint and were happy that it would be dealt with properly. The staff were aware of how to deal with a complaint and were happy that they would be dealt with correctly. Waltham Hall Nursing & Residential Home DS0000001931.V377462.R01.S.doc Version 5.2 Page 18 The staff spoken with were able to describe how they would deal with an allegation of abuse, knew the areas where abuse could happen and could describe the process that they would go through if they suspected any abuse. They confirmed that they had had training in safeguarding adults and whistle blowing and the nurse in charge and the records seen supported this. They were confident that the management would handle any issues correctly. We looked at the accident book, which had been completed correctly. These practices make sure that the residents are safe from any abuse and that any concerns are handled properly. Waltham Hall Nursing & Residential Home DS0000001931.V377462.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents and staff are well protected by the policies and procedures in the home that provides a safe and pleasant environment to live in. EVIDENCE: Waltham Hall Nursing and Residential Home is a large converted house in the Leicestershire village of Waltham on the Wolds. Waltham Hall Nursing & Residential Home DS0000001931.V377462.R01.S.doc Version 5.2 Page 20 The lock on the front door has been replaced as required at the previous inspection, but the door was unlocked on our arrival. We were told that it was playing up and it was locked by the end of the visit. The home has large lounges and dining rooms on each of the two floors that were bright, well decorated and suitably furnished. All the bathrooms seen were clean and well equipped and clear of any hazards. An area on the ground floor has been developed to include a bathroom and vanity area where the residents will be able to have alternative treatments such as aromatherapy. There were bedrooms on the first and second floors that could be reached by the stairs or the lift. The bedrooms of the case tracked residents that were seen, with their permission, were clean, bright, well decorated and personalised. Most of the bedrooms have en-suite facilities. The residents spoken with told us that they were pleased with their rooms and that they were kept clean and decorated. I can have my own things in my room. There was evidence of equipment in the home to help the residents, such as wheelchairs, special mattresses and hoists and the home has been provided with hand-rails and ramps to help them get around. The kitchen has had a recent Environmental Health Officer inspection and was given a good rating. There are extensive grounds around the home that include a wooded area and patio and seating areas. The residents are able to walk in the gardens or they are accessible by wheelchair. Fire alarm testing, drills and instruction were found to be up to date, this was confirmed by the records seen, the staff spoken with and the nurse in charge. Hot water temperature records were found to be up to date and within recommended levels. The residents and the families spoken with were happy with the cleanliness of the home, and told us that the staff worked hard to keep it clean. Waltham Hall Nursing & Residential Home DS0000001931.V377462.R01.S.doc Version 5.2 Page 21 There are staff employed to complete the cleaning in the home and they have had training in health and safety. The cleaning products are stored in a locked cupboard, which we saw. This was confirmed by the staff spoken with, the records seen and by the manager. The home does not have cleaning staff on duty at the week-end, which can cause extra work for the care staff and in a 60 bed home having cleaning staff working at the week-end should be considered. Waltham Hall Nursing & Residential Home DS0000001931.V377462.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents are protected by the recruitment and training practices in the home. EVIDENCE: We looked at three staff files all of which included all the required documentation of two written references, a Protection of Vulnerable Adults check and a Criminal Records Bureau check. The application form did not have enough space for a complete employment history on it, which is needed so that the employer can discuss any gaps in employment. The staff spoken with told us that they could not start work until they had all the paperwork in place. The staff spoken with confirmed that they had received recent training in moving and handling, dementia, safeguarding of vulnerable adults and first aid. Waltham Hall Nursing & Residential Home DS0000001931.V377462.R01.S.doc Version 5.2 Page 23 This was confirmed by the records seen and the nurse in charge. The manager holds a training matrix showing when courses would be held and which staff needed to attend. The residents and the families spoken with felt that the staff were well trained to do their job and that there were usually enough staff to look after them. The new staff have a one day basic induction and then follow the TOPPS induction workbook that can take up to six weeks to complete. The home has achieved the requirement that 60 of the staff have completed or are completing a National Vocational Qualification [NVQ] at level 2 or above. The National Vocational Qualification is a qualification for care staff to make sure that they receive training in the needs of the resident group whom they are caring for. Three of the staff are working towards a foundation degree in palliative and supportive care to give them a more thorough knowledge of caring for people who are dying. The staffing levels have improved since the last inspection however there are still occasions that the staffing level is not meeting the needs of the residents. The residents and families spoken with told us about this and the staff spoken with confirmed it. Waltham Hall Nursing & Residential Home DS0000001931.V377462.R01.S.doc Version 5.2 Page 24 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents’ views are taken into account and their safety is protected by the practices in a home that is run in their best interests. EVIDENCE: The manager was not available on the day of the visit and one of the nurses was in charge of the home. The manager who is a registered nurse has Waltham Hall Nursing & Residential Home DS0000001931.V377462.R01.S.doc Version 5.2 Page 25 managed the home for several years and has completed the registered managers’ award and has achieved a diploma in palliative care. There are regular meetings held for the residents and for their families, to discuss activities and menus in addition as to how the home is meeting their needs. These were confirmed by the resident, their family and by the minutes that we saw. There is an annual quality questionnaire sent to the residents and their families and the questionnaires that we saw on the visit confirmed this. The families and the residents told us that they had completed the questionnaire. We received positive comments from the residents and the families at the visit, amongst which were that the staff were very supportive of them and their relative. The residents accounts were seen and found to be in order but did not always have two signatures on each entry. This would make sure that the resident and the member of staff handling the money are protected. We saw that receipts were obtained for purchases. There was evidence from the staff spoken with and from the records seen with that they are having regular, formal supervision with their line manager. Formal supervision of the staff gives them and their line manager the opportunity to discuss work and training issues and needs. There are regular staff meetings held, confirmed by records held and by the staff spoken with. The areas of health and safety such as hot water temperatures and fire alarm testing were found to be in order. Waltham Hall Nursing & Residential Home DS0000001931.V377462.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 2 X 3 X 3 Waltham Hall Nursing & Residential Home DS0000001931.V377462.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? No 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. 2. Standard OP7 OP9 Regulation 17(1)(a) 13(2) Requirement That the care plans have a photograph of the resident as specified in Schedule 3. That the correct method of disposal of medicines is used. Timescale for action 30/09/09 30/09/09 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 OP7 OP9 Good Practice Recommendations The daily record of care could contain a fuller description of the residents’ day or night. That where medicines are being given in jam that this is discussed, permission obtained and documented, taking into account the residents capacity under the Mental Capacity Act. That the menus that are on the tables are produced in a large print. That consideration is given to employing cleaning staff at the week-ends. That the staffing levels are always adequate to fulfil the residents’ needs. DS0000001931.V377462.R01.S.doc Version 5.2 Page 28 3. 4. 5. OP15 OP26 OP27 Waltham Hall Nursing & Residential Home 6. OP34 That two signatures are always obtained for every transaction in the residents’ personal allowance accounts. Waltham Hall Nursing & Residential Home DS0000001931.V377462.R01.S.doc Version 5.2 Page 29 Care Quality Commission East Midlands Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries.eastmidlands@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Waltham Hall Nursing & Residential Home DS0000001931.V377462.R01.S.doc Version 5.2 Page 30 - 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!