Care Home: Washington Manor

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What the care home does well The service makes sure people are given enough information about the home and what they can provide so that they can make a choice of whether they want to live there. People can visit the home and in some cases will be offered an overnight stay so that the home will know if they can meet the needs of people. The dining arrangements were pleasant, service users were offered a choice of meal for lunch and staff were courteous and respectful throughout the mealtime. The service has a complaints procedure that is used should a service user or their relatives have a concern or complaint they would like addressed. The service have received no complaints since the service opened. The home has recruitment procedures in place when taking on new staff and this makes sure the right staff are able to work in the home. Service users comments were positive about the service and staff throughout the visit. What has improved since the last inspection? This inspection was the first inspection to be carried out since the home opened in December 2008. What the care home could do better: Every person living in the home has a personal plan of care that staff can follow to make sure the needs of people are met but the care plans in place are not completed with enough detail that will tell staff what they need to do to meet those needs. The monitoring and evaluation of the care plans are repetative and do not make sure that peoples care needs remain the same or need any changes made to them. Although recruitment procedures are followed when taking on new staff, in the staff records looked at one of the files did not contain references from former employment and therefore management cannot be sure the right staff work in the home. Key inspection report Care homes for older people Name: Address: Washington Manor Washington Manor Hollin Hill Road Concord Washington Tyne and Wear NE37 2DP     The quality rating for this care home is:   two star good 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: Eileen Hulse     Date: 2 4 0 8 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 27 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 27 Information about the care home Name of care home: Address: Washington Manor Washington Manor Hollin Hill Road Concord Washington Tyne and Wear NE37 2DP 01915652294 01915652303 info@stmartinscare.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): St Martins Care Limited Name of registered manager (if applicable) Mrs Jacqueline Dale Type of registration: Number of places registered: care home 68 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 68 The registered person may provide the following category of service only: Care home only, Code PC. To service users of the followin gender: Either. Whose primary care needs on admission to the home are within the following categories: Old Age, not falling within any other category, Code OP, maximum number of places 68. Dementia, Code DE, maximum number of places 68. Date of last inspection Brief description of the care home Washington Manor owned by St Martins Care Limited is a large purpose built care home situated on the edge of a housing estate in the Concord area in the centre of Washington and opened in 2008. It can accomodate 68 older people and includes 34 Care Homes for Older People Page 4 of 27 Over 65 0 68 68 0 Brief description of the care home places for people with dementia type illnesses. The home is close to local amenities such as the Library, The Galleries Indoor shopping mall and the Concord shopping areas, Local Churches and GP surgeries. The home is easy to get to with a bus route at the front door and a large car parking facility at the front of the service and a public car park to the rear. It is a 3 storey building offering single bedrooms with en-suite facilities that are easily reached by a passenger lift and stairways. There are 34 bedrooms for older people on the ground floor and 34 bedrooms for older people with dementia care needs on the first floor. The services of the home such as the kitchen, laundry, staff room and store rooms are located in the basement. There is a range of bathrooms, showers, wcs, lounges and dining rooms on the ground and first floors and all parts of the building are easily reached and accessible to people. The home is set within well maintained grassed areas and flower bedded gardens with plenty sitting areas surrounding the home that service users can use in the summer months. The home cannot provide nursing care. The fees are £407.00 to £422.00 per week depending upon the care needs. Additional charges are made for personal items, hairdressing and toiletries. Care Homes for Older People Page 5 of 27 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: two star good 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: What the inspector did The first inspection of this service was completed on 24th August 2009 This is an overview of what the inspector found during this inspection The quality rating for this service is 2 STAR. This means that people who use this service experience good quality outcomes. How the inspection was carried out. Before the visit we looked at information we have received since the home opened in December 2008 How the service dealt with any complaints and concerns since the home opened. Any changes to how the home is run. The providers view of how well Care Homes for Older People Page 6 of 27 they care for people. The views of people who use the service their relatives and staff. During the visit we observed staff practice and talked with people who use the service and looked at how well their needs are met. We looked at other records which must be kept. Checked that staff had the knowledge skills and training to meet the needs of the people they care for. We looked around the building to make sure it was safe, clean and comfortable and checked if any issues needed to be addressed. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: 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 8 of 27 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 9 of 27 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. Assessments are included within the plans of care for all service users that help to form the basis of the individual care plan, this ensures that before admission takes place the home is able to know if the care needs can be met by them. The home does not provide intermediate care. Evidence: All service users currently living in the home have had pre admission needs assessments carried out by a care manager and the manager of the home prior to their admission. When a vacancy occurs, a referral is made from a care manager by contacting the home with details and the manager and a member of staff will visit the prospective service user either in hospital or their own home to carry out the home assessment. Following the assessment and after receiving the care managers core care plan assessment, the manager will then decide if the home can meet the needs of the person. It the placement is suitable then the prospective service user and their families are invited into the home to spend some time there so they can decide if it is Care Homes for Older People Page 10 of 27 Evidence: suitable to them. In the past some service users have visited the service on a number of occasions sometimes taking a meal with the people who live in the home. In some instances an overnight stay is offered. This gives the person the time to decide if they would like to move in and ensures the correct equipment and care plans are in place prior to their admission. The homes admission and assessment procedures make sure that people have an informed choice about moving into the home. They are given good information about the home and the services provided within the service user guide and this tells people what they can expect from the service. Following admission, each service user has a care plan developed from information gathered during the assessment so that when followed by staff it helps the care needs to be met on a daily basis. The person lives in the home for six weeks to see if they want to live there permanently and to ensure the home can meet their needs. This period is followed with a review meeting held between the service user and their representatives, the home staff and the care manager. Care Homes for Older People Page 11 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users living in the home have individual plans of care, however, they do not explain in detail how the care needs are to be met by staff and therefore the home cannot be sure that care needs are being met on a daily basis. Service users have access to all NHS facilities and services and this ensures healthcare needs are met and good medication administration procedures ensure that medicines are administered safely. Evidence: All service users have an individual care plan that is completed by staff and gives the staff guidance on how the care needs of people living in the home will be met and during the visit four care plans were looked at. The care plans are organised with an index to find information easily and they included areas such as pre admission assesments, personal information and photograph, admissions checklist, personal life history and risk assessments. However, the files are bulky and contain old and out of date information and the day to day care plans do not include sufficient information to guide staff to ensure that the care needs are met on a daily basis. They give little detail as to how the care needs should be addressed. All care plans looked at were Care Homes for Older People Page 12 of 27 Evidence: signed by the service user or their representatives. One care plan stated that one aim was to keep (name) secure within the building, it also stated that staff to be aware of (names) wherabouts and staff to alert others if service user could not be found but did not give any further details for staff to follow and did not guide staff to follow the missing person procedure. Risk assessments are in place and used alongside the care plans. These are detailed and include good information to identify the risk and inform staff how to follow the assessments so that the risk is minimised. The risk assessments are updated at a monthly risk assessment review that looks to see if any changes are necessary to the record keeping. Although staff actions, monitoring and evaluation of the care plans is reviewed on a regular basis staff are unclear as to the content of this information. No monitoring of the care plan takes place therefore, when the evaluations are completed they have no information to form an evaluation and therefore staff are repeating content that should only be detailed in how the care needs are to be met, one evaluation stated, When (name) gets depressed care staff to give re-assurance. The evaluations are repetative and give no clear indication that the care is being met or that the care plans are being followed by staff as staff record in the evaluations what is written in the staff intervention section of the care plan. All service users have a choice of GP and there are regular visits from all local GPs and other healthcare professionals such as Psychiatric Consultants, District Nurses, Chiropodists, Dental service and Opticians. Service users needing to attend hospital appointments are escorted by a member of staff or if the person prefers a family member. Anyone being admitted into hospital are accompanied by a member of staff who stay with the person until family or friends arrive. The home uses a monitored dosage medication system that is delivered to the home on a monthly basis by a well known pharmacy and only senior staff administer medications to service users. Medicine administration records were signed, up to date and well maintained with photo identity of the service users. A medication audit of drugs held by the home confirmed medication was correct and recorded correctly and observation of staff administering medication was done. This confirmed that staff followed the guidelines of the homes medication procedures. However, controlled drugs used by the home were stored in a double locked cabinet that when the home has more service users living there will be too small. Staff responsible for administering medication have completed the NVQ Level 3 Care Homes for Older People Page 13 of 27 Evidence: medication option training and all staff receive workbook medication training from the company who supply medicines to the home. Care Homes for Older People Page 14 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social activities are made available and service users are encouraged and supported to join in activities of their choosing and ability and this helps to contibute to varied and fulfilling days. Evidence: An activity co-ordinator is employed and works a thirty five hour week working monday to friday to provide a broad range of activities and outings for the people who live there. Each service user has an activity file that includes a front page with personal details and a photograph. However, the files are bulky with un-necessary information and the recordings contain a lot of group activity work rather than information on the individual. The records do not state if the person has enjoyed the activity or if they have been asked to participate and refused to be involved. one service user commented that The staff are all lovely and there is always sonething going on. A church service is held once a month and another church visits to give holy communion. On the day of the visit, the activity of the day was the news. Newspapers were purchased that were given to people in the lounges to read and discuss and a dvd was showing the History of Sunderland which people clearly enjoyed. Care Homes for Older People Page 15 of 27 Evidence: During the visit, a lunchtime meal was taken with service users. Tables were well set with tablecloths, condiments, sugar bowls, milk jugs and containers of individual sauces. No serviettes were on the tables but were available if service users requested them. Service users were all offered a choice of meal whilst seated at the dining room tables, the meals were pleasantly served from a hotlock trolley with a main choice of liver or mince pie and vegtables and cold drinks were also offered to everyone. Outside each dining room a four week menu was on display for everyone to see and in the dining room a wall board also showed the choices available for lunch. However, jam sponge and custard was the dessert but no alternative was available. The lunchtime meal was pleasant, staff were courteous and respectful to people and anyone requiring staff support with their meal was given help in a sensitive and dignified manner. During the meal, one service user repeatedly said the dinner was good. Care Homes for Older People Page 16 of 27 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. Service users and their families have the information they need should they have a concern or complaint about the service and good safeguarding policies and procedures are available and this helps to protect service users should an abuse situation arise or be suspected. Evidence: The home has a complaints procedure that is given to service users and their representatives following admission into the home and tells people how to make a complaint and the length of time it will take before a response is received and it also explains to the complainant how the service will deal with the complaint. The complaints procedure is also made available in different formats such as applying the procedure on yellow paper for anyone with sight impairment, it is on a CD disc and also on the computer. One complaint has been received since the home opened and this is currently being investigated. Some service users spoken with during the visit made the following comments, I have nothing to complain about its a lovely home If I am unhappy about something the staff always sort it out My family have been given information telling them what to do if I am not happy Records evidenced that the care staff have received safeguarding training from the Care Homes for Older People Page 17 of 27 Evidence: Local Authority and from an external training company and within staff discussions it was clear they would know what to do should an abusive situation be suspected or a complaint be received whilst they were on duty. Safeguarding procedures are made available to all staff. There have been no issues regarding suspected abuse since the home opened. Care Homes for Older People Page 18 of 27 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. The home is clean, comfortable and well maintained. This provides people who live there with a pleasant and safe place to live. Evidence: The home is a purpose built property offering accommodation in a homely setting. There is a variety of communal areas for service users to choose from and the large entrance area is a popular place where service users can see the comings and goings of the home. This newly built home has been opened for eight months and all the communal areas and a sample of bedrooms looked at are well maintained and in good decorative order with many homely and personal touches. There were no health and safety issues or areas needing attention but should any maintenance issues be identified are addressed immediately by the companies own maintenance team. Staff have completed training in Infection Control and domestic staff keep the home at a good standard of cleanliness and free from any odours. Care Homes for Older People Page 19 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Well trained and competant staff are in post and there are good recruitment procedures used and this helps to ensure that the correct staff are employed and that service users are kept safe and receive a good quality of care. Evidence: The home do not yet have the maximum number of service users living in the home. The duty rota reflected the numbers of staff on duty on the day of the visit and the staffing levels were adequate to meet the current needs of forty one service users currently living in the home. The staff on duty included the Manager, assistant Manager, one senior care, six care assisants, three domestic staff plus a trainee, the housekeeper, a laundry person and two kitchen staff. The home has a policy and procedure on staff recruitment that is used when the home have staff vacancies. The Manager was able to explain in detail the process that is used from sending out the initial application form to the letter that is sent offering employment in the home. Staff do not commence employment until all of the necessary checks have been carried out following prospective staff success at interview. Over fifty percent of the care staff currently employed in the home have achieved an NVQ qualification in care and another thirteen staff are working towards completeing Care Homes for Older People Page 20 of 27 Evidence: NVQ Levels 2 and 3. All mandatory training has been completed and is up to date and the training matrix identifies the training that staff have completed that includes Fall Prevention Course, Safeguarding, Dementia Awareness and End of Life. Inspection of the personal staff files for two members of staff both of whom was recently recruited was carried out. Both personal files were organised and kept up to date and the information included most of the necessary documentation that the home is required to keep such as employment checklist, photograph, job application, interview notes, personal identity and criminal record bureau checks. Of the two records checked, in one file the references were not there but home stated they had been received. Care Homes for Older People Page 21 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is currently well managed by a person who is appropriately qualified to manage the service and health and safety procedures are maintained and therefore this helps to ensure the smooth running of the service and that service users are kept safe. Evidence: The Manager has been at the home since it opened in December 2008. She has many years experience in social care services in various departments including homecare, community care and spent some time working in a hospital. She Manager has worked for the company for ten years and during this time she has worked in different homes as a carer, a senior carer and a deputy manager and for the last six years has managed other care homes in the company. The Manager has completed her Registered Managers Award and has gained NVQ Levels two and four and part units of level three. Staff one to one individual supervision sessions are in place and records of this are Care Homes for Older People Page 22 of 27 Evidence: held on staff personal files, service users and staff meetings are held monthly and the introduction of a quality assurance system is being developed and continues to be updated regularly. Observation of the practice of staff showed that they all follow safe working practices at all times. Care Homes for Older People Page 23 of 27 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 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 Monitoring and evaluation must be evident within the care plans This helps to know that information is correct and has not changed in the care plans 08/12/2009 2 7 15 All care needs must be included within the care plans This ensures that staff have the knowledge to meet needs on a daily basis 08/12/2009 3 29 19 Two references must be obtained for all staff being employed This ensures recruitment policies have been followed and the right staff have been employed 08/12/2009 Care Homes for Older People Page 25 of 27 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 26 of 27 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. 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. Care Homes for Older People Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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