Care Home: Walton Manor

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What the care home does well To make sure the home can meet peoples personal and health care needs these are assessed before they are admitted. People are fully involved with the assessment process and have a say in how they are supported and cared for. Peoples plan of care is looked at regularly and amended to reflect peoples changing care and support needs. Records show people are supported by local General Practitioners and District Nurses and Liaison Teams. People live in a well maintained and well decorated home that is clean and comfortable and safe. The domestic staff are to be commended for their efforts in maintaining such a high standard of cleanliness for people living in the home. There are extensive gardens for people to enjoy during the summer months. There are two large lounges/ dining areas, a large conservatory leading to the garden at the rear and a small quiet lounge/ library that is also used for receiving visitors. There are some new apartments available complete with lounges, dining area and kitchenette. These either have a balcony overlooking the garden or patio doors leading to the garden. Mealtimes are flexible and people choose when and where they would like to have their meals. There is a choice of menu and there is evidence of people requesting and being provided with alternatives of their choice. The satisfaction surveys show people living in the home and their relatives are very pleased with the menu and the meals provided. There is also a trolley offering people snacks throughout the day. Peoples care and support needs are met by staff that have a National Vocational Qualification at Level 2 and above and this includes domestic and kitchen staff. This standard of investment in NVQ training for people working in the home is to be commended. People are protected by the way staff are recruited and selected as references, Police and POVA (Protection of Vulnerable Adults List) checks are taken up before they are employed. Staff training records also show that the health , safety and welfare of people living in the home is promoted and protected as they have Health and Safety, First Aid, Moving and Handling, Infection Control and Safeguarding training. There is a range of activities organized for those that wish to participate, including social evenings , garden parties, residents meetings, crafts, entertainers, shopping trips and coffee mornings. The returned satisfaction surveys show people living in the home, their relatives and advocates are very happy with the support and services offered. What has improved since the last inspection? The home employs a gardener/ handyman and the gardens to the front and rear are maintained to a very high standard. There are seats and garden furniture provided throughout the gardens for people to enjoy during the summer months. There are some new apartments available that enable people to maintain Independence and these include a small lounge area, bath room or shower room, kitchenette and balcony or patio doors overlooking the garden to the rear. More staff now have a National Vocational Qualification at Level 2 or above ensuring care and support is provided by staff that are qualified. What the care home could do better: It is acknowledged that people are protected by the way medicines are dealt with as those giving medicines are trained to do so safely. The medicines system is also checked regularly by the Registered Manager. However, as a matter of good practice it has been a number of years since the the medicine administration system has been checked by a Pharmacist. It is acknowledged that staff receive the training they need and require to meet peoples care and support needs. However, there is no central record of staff training and these are kept in individual staff files. As a matter of good practice the Registered Manager should consider providing a master sheet or MATRIX showing staff training attended and future planned training. It is acknowledged that people have a say in the running of the home and how they are supported an cared for. However, the information on the quality assurance satisfaction surveys has not been collated or a report provided reflecting what people say about the quality of the support and services provided. Key inspection report Care homes for older people Name: Address: Walton Manor 187 Shay Lane Walton Wakefield WF2 6NW     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Tony Railton     Date: 0 3 0 7 2 0 0 9 This is a review of 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. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 24 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. 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 Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Walton Manor 187 Shay Lane Walton Wakefield WF2 6NW 01924249777 01924249777 neilgreenhalgh@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Walton Manor Ltd care home 47 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 47 The registered person may provide the following category of service only: Care home only - Code PC, 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 Date of last inspection Brief description of the care home Walton Manor is a privately owned care home for older people situated in Walton village on the outskirts of Wakefield. It is set back from the road in large wellmaintained grounds, having gardens to the front and the rear. Car parking space is available. The home offers accommodation for 47 older people in single and double bedrooms over two floors accessible by two shaft lifts. Most rooms have en-suite facilities and including six suites. There are communal areas of different sizes and a newly built conservatory to provide comfortable areas for the people who live there to relax in. The provider makes information about the service available to enquirers via the service user guide. A copy of the inspection report is available on the reception Care Homes for Older People Page 4 of 24 Over 65 47 0 Brief description of the care home desk. The fees charged in July 2007 were from #420 to #685; hairdressing, chiropody and personal newspapers are charged in addition to the fees. Care Homes for Older People Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection visit confirms the homes Three Star Rating which means people using the service experience excellent outcomes. This visit started at 09:00 and ended at 13:30. During this visit there was the opportunity to meet people living in the home and observe the daily routines. Some peoples records were seen and included assessments, care plans, reviews, daily and medical records. Some staff records were also seen and included application forms, references, police and POVA (Protection of Vulnerable Adults List) checks. Some staff training records and supervision notes were seen. Some peoples medicines and finances were seen and checked. A tour of the premises was undertaken. There was the opportunity to speak to the cook and kitchen assistant and to sample the lunchtime meal There was also the opportunity to speak to the Owner, Registered Manager, General Manager, Senior Carers, support workers, Activities Coordinator and domestic staff. This was a very positive visit and the inspector would like to thank the Manager and the staff team for their hospitality, cooperation and patience throughout this unannounced inspection. Care Homes for Older People Page 6 of 24 Care Homes for Older People Page 7 of 24 What the care home does well: What has improved since the last inspection? What they could do better: It is acknowledged that people are protected by the way medicines are dealt with as those giving medicines are trained to do so safely. The medicines system is also checked regularly by the Registered Manager. However, as a matter of good practice it has been a number of years since the the medicine administration system has been Care Homes for Older People Page 8 of 24 checked by a Pharmacist. It is acknowledged that staff receive the training they need and require to meet peoples care and support needs. However, there is no central record of staff training and these are kept in individual staff files. As a matter of good practice the Registered Manager should consider providing a master sheet or MATRIX showing staff training attended and future planned training. It is acknowledged that people have a say in the running of the home and how they are supported an cared for. However, the information on the quality assurance satisfaction surveys has not been collated or a report provided reflecting what people say about the quality of the support and services provided. 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. Care Homes for Older People Page 9 of 24 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. To make sure peoples personal and health care needs are met these are assessed before coming to live in the home. People and their relatives are fully involved in the assessment process and have a say in what happens to them and how they live their lives. Evidence: To make sure peoples personal and health-care needs are met these are assessed before coming to live in the home. The assessments include mobility, (moving an handling), and nutritional assessments. These include risk assessments showing staff what they must do to minimize any risks to people using the service. The information provided also includes a Life Book that includes peoples social history, choices and preferences. The signatures in peoples records show they and their relatives and in some cases advocates are fully involved in the assessment process. The registered manager confirmed the home does not provide a specialist intermediate rehabilitation service. Care Homes for Older People Page 11 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are involved and have a say in how their personal and healthcare needs are met and they are protected by the way medicines are dealt with. Evidence: The homes returned quality assurance surveys show people living in the home and their relatives are very happy with the care and support provided. The reviews show people and their relatives are fully involved and have a say in how they are cared for and supported. The daily records and medical records contain descriptive words to reflect and show peoples choices and preferences and any decisions they make about how they live their daily lives. Throughout the visit people were observed being treated with dignity and having their wishes respected. People are protected by the way medicines are dealt with as a sample of three peoples medicines were checked and found to be correct. To make sure the medicines are dealt with properly and people are safe the medicines are audited on a weekly basis by the manager. This practice is to be commended. To further protect people living in the home staff training records show those giving medicines have been trained to do so safely and correctly. However, the manager says the medicine system has not been checked by a Care Homes for Older People Page 12 of 24 Evidence: Pharmacist for some years. Care Homes for Older People Page 13 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People find the lifestyle experienced in the home matches their expectations and they enjoy a choice from a varied and balanced diet. Evidence: To make sure people living in the home get enough to eat records show there are nutritional screening assessments completed and peoples nutritional input is monitored and weight checked. People have a choice of menu and are asked every morning what they would like to have for the day. Records show people can also choose something else that is not on the menu an this is provided. Records show people also choose when and where they have their meals. Records show and the manager confirmed there are also snack trolleys taken around the home four times a day. The homes returned satisfaction surveys show people living in the home and their relatives think the meals provided are excellent. The lunchtime meal was sampled and found to be well cooked, well presented and tasty. Some people living in the apartments have a small kitchenette and they and their visitors can make drinks and snacks if they wish. Records show people can have a newspaper of their choice delivered in the morning and people take advantage of this service. Discussion with the activities coordinator and the record of activities show there are is a range of activities organized for people to participate if they so wish. The records show there Care Homes for Older People Page 14 of 24 Evidence: are social evenings, garden parties, BBQs and birthday parties. Records also show there are shopping trips and residents meetings, and visiting entertainers, church events and coffee mornings. The mobile library also visits the home. The returned quality assurance surveys show people and their relatives are very happy with life in the home and the activities provided. Care Homes for Older People Page 15 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know what they say will be taken seriously and acted upon and they are also protected from any kind of abuse. Evidence: To make sure people living in the home are safe the records show that staff receive Safeguarding training to protect people from any kind of abuse. Theres a Safeguarding Policy and Procedure for staff to follow that includes the local Wakefield Adult Safeguarding Protocols. The service history shows the home has had one Safeguarding referral since the previous inspection visit. The minutes of the safeguarding meeting show the home acted appropriately to protect people living in the home. Everyone has access to the complaints policy and procedure as the Service User Guide which is given to everyone entering the home has a large print copy of the complaints policy for them to read. The complaints policy and procedure is also displayed around the home for residents and visitors to see. The record of complaints show there have been 4 complaints since the previous inspection visit. Records show that these have been appropriately dealt with and people know that what they say will be listened to and acted upon. Staff training records also show new staff have training on dealing with complaints as part of their induction. Care Homes for Older People Page 16 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is comfortable, well decorated, well maintained and safe. Evidence: A tour of the premises found it to be decorated and maintained to a very high standard. There are two large lounges/dining areas and a large conservatory leading to extensive gardens to the rear. The gardens are maintained to a high standard and there is garden furniture provided for people to use during the summer months. The new self contained apartments have either a balcony overlooking the gardens or patio doors leading to the garden. One person living in one of the apartments said its lovely and they have everything they need. Discussion with the domestic staff found they have all the equipment they need to maintain a high standard of cleanliness throughout the home. The general manager and domestic team are to be commended for there efforts in maintaining such high standards of cleanliness for people living in the home. To make sure people are safe records show the passenger lifts and hoists are serviced and checked regularly. Also to keep people safe the emergency equipment and fire alarms are tested regularly. The maintenance records also show the health and safety of people living in the home is promoted and protected. The homes returned quality assurance surveys show people living in the home and their relatives are more than happy with the accommodation and services provided. Care Homes for Older People Page 17 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples care and support needs are met by trained and qualified staff and they are protected by the way staff are recruited and selected. Evidence: On the day of the visit there was enough staff available to meet peoples care and support needs in a relaxed and unhurried manner. People were observed throughout the visit treating people with dignity and respecting their wishes. To protect people living in the home a sample of three staff records show two references, police and POVA (Protection of Vulnerable Adults List) checks are taken up before they are employed. To keep people safe records show all staff have induction training that includes Moving and Handling, First Aid, Infection Control and Food Hygiene. To make sure peoples rights are promoted training records also show some staff have had Mental Capacity Act and Dementia training. To further protect people records also show some staff have Deprivation of Liberty Training. The Registered Manager says that nearly all staff now have a National Vocational Qualification at Level 2 and above. They said that this includes domestic and kitchen staff. This good practice is to be commended. Records also show staff giving medicines have attended advanced ASETT courses in how to give these safely and correctly.The homes returned quality assurance surveys show people living in the home and their relatives are happy with the staff and the care and support provided. Records show that the work staff do is supervised regularly and their work appraised annually. The minutes of the staff Care Homes for Older People Page 18 of 24 Evidence: meetings show they have the opportunity to comment on the running of the home. Care Homes for Older People Page 19 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well run, well managed home that is run in their best interests and promotes their health, safety and wellbeing. Evidence: The way the home is managed makes sure peoples personal care and health care needs are met and their health and wellbeing to promoted and protected. A sample of residents records including assessments, care plans, daily and medical records show the care management systems are good. The staff records including staff selection and recruitment, training and supervision and appraisals show people are protected and their health and safety is promoted by the way staff are managed. The minutes of the residents meetings and returned service user surveys show people have the opportunity to comment on the running of the home. However, the information gathered through satisfaction surveys has not yet been collated or a report provided showing what people say about the services and support provided. Peoples financial interests are protected as three peoples monies were checked and found to be correct and safely administered. The maintenance records show there are regular checks and Care Homes for Older People Page 20 of 24 Evidence: servicing of the emergency and specialist equipment used by the home. Staff training records show the health and safety of people is promoted as staff have Health and Safety, Moving and Handling, Infection Control, First Aid and Food Hygiene training. Care Homes for Older People Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 24 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 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 1 9 As a matter of good practice the home might consider having the medicine administration systems checked by a Pharmacist annually. As a matter of good practice the manager of the home might consider maintaining a master record of staff training or a training MATRIX to show others and in particular the inspectorate at a glance what training staff have had and what is planned for the future. The information gathered through quality assurance surveys should be collated and a report provided showing what they said and what changes were made to the way the home runs as a result of their comments. 2 30 3 33 Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 Email: enquiries@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. 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