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Care Home: WCS - The Limes

  • Alcester Road Stratford Upon Avon Warwickshire CV37 6PH
  • Tel: 01789267076
  • Fax: 01789414627

The Limes is a home for twenty-seven older people. The home is owned by Warwickshire Care Services, a voluntary sector organisation. The Limes provides personal care to twenty-four permanent service users with three additional bedrooms reserved for short stay. The home also caters on weekdays for up to sixteen-day care service users. Accommodation is on two floors. There is a lounge/dining area on the ground floor and separate lounge and dining areas on the first floor. Nineteen of the bedrooms have en-suite facilities. The home is very close to the town centre of Stratford-upon-Avon. It has parking on site and is near to the train station. The currently weekly charges for both residential and day care are displayed on the notice board in the entrance of the home. Additional charges are made for private chiropody, hairdressing, personal items, toiletries and newspapers/magazines.

Residents Needs:
Old age, not falling within any other category

Previous Inspections

This may not be the latest inspection for this service as we are having techinical problems updating from CQC - please check directly on the regulators website for the most recent report; bestcarehome hopes to be back to regular updates shortly.

For extracts, read the latest CQC inspection for WCS - The Limes.

CARE HOMES FOR OLDER PEOPLE WCS - Limes, The Alcester Road Stratford On Avon Warwickshire CV37 6PH Lead Inspector Martin Brown Key Unannounced Inspection 28th July 2008 08:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address WCS - Limes, The DS0000004268.V368617.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. WCS - Limes, The DS0000004268.V368617.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service WCS - Limes, The Address Alcester Road Stratford On Avon Warwickshire CV37 6PH 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) 01789 267076 01789 414627 admin@wcslimes.f9.co.uk Warwickshire Home Care Services Limited Mrs Lesley Jane Eaton Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27) of places WCS - Limes, The DS0000004268.V368617.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th June 2007 Brief Description of the Service: The Limes is a home for twenty-seven older people. The home is owned by Warwickshire Care Services, a voluntary sector organisation. The Limes provides personal care to twenty-four permanent service users with three additional bedrooms reserved for short stay. The home also caters on weekdays for up to sixteen-day care service users. Accommodation is on two floors. There is a lounge/dining area on the ground floor and separate lounge and dining areas on the first floor. Nineteen of the bedrooms have en-suite facilities. The home is very close to the town centre of Stratford-upon-Avon. It has parking on site and is near to the train station. The currently weekly charges for both residential and day care are displayed on the notice board in the entrance of the home. Additional charges are made for private chiropody, hairdressing, personal items, toiletries and newspapers/magazines. WCS - Limes, The DS0000004268.V368617.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This report has been made using evidence that has been accumulated by the Commission for Social Care Inspection. The inspection visit was unannounced and took place on 28th July, between 8am and 4pm. During the inspection, people living at the home were seen and spoken with. The manager, the care manager, ‘housekeeper’ and other staff on duty were spoken with, and interactions with residents were observed. Relatives of two residents, and two professionals with l contact with the home were spoken with during and after the inspection. The Annual Quality Assurance Assessment, completed and returned by the manager, also informed the inspection. This gave a brief summary and self assessment of the home’s achievements, how it benefited users of the service, and how it could improve in the future. Policies and procedures and care records were examined, and four service users were ‘case tracked’, that is, their experience of the service provided by the home was looked at in detail. This was done by examining their care files, talking to staff involved in their care, talking to them, and observing interactions and care. A meal was taken with residents. Staff, management, and users of the service were welcoming and helpful throughout the inspection. What the service does well: The service provides a spacious, well-maintained home where people feel safe, secure and well looked after. Residents were positive about staff and cooking. ‘A lot of darlings’ was one comment on the staff, whilst ‘the food is excellent’ was a reference made at mealtime. Comments were made regarding the staff treating residents ‘with respect’, and observations throughout the inspection showed staff being attentive, warm, and respectful at all times. Staff commented that ‘the training is excellent’. WCS - Limes, The DS0000004268.V368617.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. WCS - Limes, The DS0000004268.V368617.R01.S.doc Version 5.2 Page 7 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 WCS - Limes, The DS0000004268.V368617.R01.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective residents benefit from clear information concerning what the service has to offer. They can be confident that shortcomings notified by two recent complaints are being addressed. EVIDENCE: The home has clear, up-to–date information readily available concerning the home and what it offers for all prospective users of the service. There had been two recent complaints regarding the care of two residents receiving respite care. These were investigated by the service, following the involvement of the local authority ‘Safeguarding’ team. The service accepted that there had been shortcomings in care, and was able to demonstrate that actions had been put in place to ensure that these shortcomings are avoided in future. WCS - Limes, The DS0000004268.V368617.R01.S.doc Version 5.2 Page 9 Assessments of a sample of people using respite care were examined. These showed adequate assessment of need and how those needs were to be met. There had been a lack of clarity regarding staff being aware of a person saying their needs were met, when they actually hadn’t been. The manager was aware of this, had highlighted it, and was in the process of amending this in preparation for this person’s next anticipated respite stay. The manager was also clarifying criteria in respect of who could be admitted, to ensure that they only admitted people if they were clear they could satisfactorily meet their needs. In furtherance of this, a larger room has now been made available for respite, to enable care needs to better met, and to allow flexibility in meeting people’s needs and wishes – for example, allowing bed and furniture to be positioned in a variety of ways. The home also provides a day service, with a lounge and dining room set aside for this purpose. The manager advised that this day service also served as a taster’ for many of the home. People often subsequently, came for respite, or permanent care, as needs or circumstances dictated. WCS - Limes, The DS0000004268.V368617.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are set out in individual care plans and met by the home, with outside help as needed. Care plans may benefit from being a little more ‘user friendly’, and ensuring that all care issues are clear to all staff at all times. Staff are attentive to individual care needs, and the service seeks outside professional support when needed to support the well being of individuals. Medication is managed satisfactorily. EVIDENCE: A sample of four care plans were examined. These included a brief social history, relevant health information, specific risks and how they are managed, body maps, an assessment on a corporate assessment form, and an additional corporate form that enables monthly reviews over a yearly period. These are pre-printed forms, but the notes are hand-written, and include notes that update the care plans. At the end of the year, a new review form is to be WCS - Limes, The DS0000004268.V368617.R01.S.doc Version 5.2 Page 11 started, and relevant notes transferred. Looking at, for example ‘oral care’, information regarding this, with additional hand-written notes, could be found consistently in several different care files. A recent complaint showed that not all staff had been entirely clear on one person’s care needs. There was some discussion with staff and management as to whether these forms were accessible, in terms of providing ‘instant’ information for staff needing it, and whether care plans printed on a computer would be easier to read and to update. A relatively new staff advised that she usually got information regarding a person’s needs by asking another member of staff, rather than reading care files, which she only had time to do if she had time at the end of a shift. Staff spoken with were familiar with individual care needs and how to meet them. A visiting health professional was spoken with, who felt that the home was always prompt in letting them know of areas of concern and appropriately asking for assistance in areas such as vulnerable skin, continence and general well-being. Pressure relieving pads and mattresses were in use where needed. Where swallowing difficulties were noted, the Speech and Language Team were involved. One person whose care was looked at was subject to medical fluctuations in her well-being. This was recorded, outside professional help was always involved, and staff were aware of symptoms. One person with visual impairments was every pleased with the home, and said that it was ‘easy to find the way round’. Call bells were seen to be answered promptly. Staff have individual monitors, so that the calling of bells does not disturb the whole home. Residents have either fixed call bells or portable pendants, depending on which is preferred or found to be more suitable. Staff were seen to be attentive when assisting people in wheelchairs, ensuring that, for example, footrests were properly in place and people’s feet were safely placed in them whilst moving. Staff were observed to be respecting people’s dignity and privacy. Residents spoken with talked of staff being attentive and helping when needed, and were very complimentary bout the staff. ‘Staff are very good’, ‘they are brilliant’ were typical comments. One resident commented ‘some staff are better than others’, but wouldn’t add to this remark. WCS - Limes, The DS0000004268.V368617.R01.S.doc Version 5.2 Page 12 Medication records on both floors were looked at. Records were seen to be accurate, reflecting and informing medication administration. Most medications are dispensed via a monitored dosage system. A sample of those that are dispensed from original packaging were counted, and amounts remaining all tallied with the record of amounts dispensed. Such amounts are not stock controlled daily, in order to identify any error immediately. Staff advised that when administering medication, they wear a red tabard, which serves as a request to others not to disturb them whist involved in this task. Additional stocks of medication are stored in a locked cupboard, in a communal area. Management agreed that this was not appropriate, and that a more suitable location would be found. The record book for Control Medication was also examined. All medication dispensed was signed by two staff, and all counted down accurately. In one instance, a number was written over, rather than crossed out with a single line and rewritten. Where medication continued on a page further on the book, this page was noted, but where the page had continued, the previous page was not noted there. This made ‘tracking back’ some medications more difficult than it needed to be. WCS - Limes, The DS0000004268.V368617.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although some activities are taking place, residents may benefit from a wider range of activities to suit individual needs. More attention to meeting the needs of people with hearing difficulties may benefit those people. Residents appreciate a good choice of freshly prepared food served in congenial surroundings, and with additional healthy snacks and drinks available at other times. EVIDENCE: The manager advised that, at present, the service endeavours to have at least one memorable group activity a month. Recent events have included a cheese and wine party, a cream tea afternoon, and an outing to a pub lunch, although a barbecue had to be cancelled owing to a poor weather forecast. Residents had varying opinions on activities. One or two said they would like more things to do, others said they were content, with one saying ‘most people come here for a rest’. WCS - Limes, The DS0000004268.V368617.R01.S.doc Version 5.2 Page 14 The home endeavours to make events such as Father’s day, Mother’s day, and Easter special for residents, with small gifts. One resident enjoys helping with small chores and tasks, and is supported in this. The manager and others acknowledged that the deployment of an activities organiser might support the organisation of more regular ‘group’ activities, as well as ones tailored to individuals, whether it be a trip to the local shops, or some individual ‘pampering’. The home advertises, at the entrance, a ‘loop’ system for the hard of hearing, but staff seemed unaware of this, or how it worked to the benefit of any resident, other than to note it could not be used with the current ground floor television. One person with profound hearing loss, but fluent in sign language, had no one but a weekly visitor to communicate. Communication with others in the home was by simple gestures, and all commented how nice this person was. The manager advised that previous efforts to find others with a similar fluency to communicate with this person had not been successful. A meal was taken with residents at lunchtime. This was tasty and freshly prepared, and enjoyed by residents in an unhurried manner. Several residents remarked on the good quality of the food; one enthused, in particular, about the consistent good quality of the pastry, and the ‘splendid’ cook. Special meals are catered for. Staff were aware of one person’s difficulties with strawberries, and had an alternative ready. Fresh fruit salad, nicely presented for easy eating in a bowl and with a spoon, was available for residents on this warm mid-morning. One resident said ‘we get ‘treats’, like ice cream, when it’s hot.’ The home has a Heartbeat award for good nutritional practice, and the most recent Food Hygiene visit had awarded the kitchen the top mark. WCS - Limes, The DS0000004268.V368617.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints by residents and others are listened to and acted upon, and help the home minimise and eliminate poor practice and improve the service for everyone. EVIDENCE: The complaints log was looked at. The two recent complaints were discussed at length. There had been an anonymous complaint from the previous year. The manager was able to show how this had been investigated. There were a number of complaints recorded throughout the year, on relatively minor matters. These all demonstrated an open transparent system in which complaints and concerns were acknowledged, and helped the organisation improve its service. Relatives spoken with said they were confident of being able to raise any issues that they weren’t happy with. Residents spoken with said they would tell staff or one of the managers if they weren’t happy with anything. Most said, though, that they hadn’t anything they ever wished to complain about or raise. One person commented that she was quite happy with the service, but also accepted that ‘nothing is perfect’. Where people had ‘complaints’ it tended to be not with the service, but with their own personal health, well-being and circumstances. WCS - Limes, The DS0000004268.V368617.R01.S.doc Version 5.2 Page 16 One issue that had been raised, at a residents meeting, and been acted upon, was the moving back of lunch from midday to one o’clock. Residents spoken with said they were happy that this had been done. Staff showed a good knowledge of abuse and of what actions to take if it were suspected. Training in abuse and protection is part of ongoing training for staff. Personal monies for residents were looked at. A sound, transparent system is in place. Those finances looked at were seen to be accurate and properly recorded and checked. WCS - Limes, The DS0000004268.V368617.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,21,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a roomy, clean, and well-maintained environment with plenty of alternative sitting spaces both inside and outside. Two of the communal areas could benefit from more natural light. EVIDENCE: It was a hot day, but many of the rooms, in shade at varying times of the day, remained relatively cool. The upper storey was warmer. There is a choice of outdoor areas; again, different areas are cool at varying parts of the day. Several residents were outside at various times of the day, enjoying the sunshine or the shade. All but six rooms have en suite facilities. Those that do not are near to toilets and bathrooms. Bathrooms were all clean, pleasant and with sufficient room to meet needs. There is one ‘special’ bath, but the manager advised that this was at present out of order, awaiting the arrival of a ‘part’. She advised that WCS - Limes, The DS0000004268.V368617.R01.S.doc Version 5.2 Page 18 residents tended to prefer the ‘ordinary ‘ baths, with optional chair lifts. Showers are also available. There is an upstairs lounge with kitchenette attached. This kitchen area is now used for hairdressing, and has two large standing hairdryers in. A number of wheelchairs were also ‘stored’ there. This lounge was less frequented than another area, basically part of the corridor, called ‘the bridge.’ From here, residents could sit and observe the building work and watch people coming and going. Several residents said they liked to sit there and ‘watch what was going on’. The manager advised that there were plans to screen off the ‘hairdressing area from the rest of the lounge, and make this lounge more attractive. It was not popular with residents who commented that ‘all you could see were trees.’ Two steps had hazard tape on. The manager advised that they had been told they must put this tape on, for Health and Safety reasons, but agreed to see if there were any ‘less institutional’ methods available for ensuring safety. The lounge and dining area downstairs did not have a great deal of natural light, so that additional lights were on, even on a sunny summer morning. An emergency light was on all the time. The ‘housekeeper’ advised that this was an older model, and that new ones that had been fitted could be turned on and off. Staff agreed that having lights on in the daytime could be disorientating for some people. The home was clean throughout, with no unpleasant odours noted. The laundry was in good order, with appropriate hygiene and infection control practices in place. There are sluice rooms on each floor. WCS - Limes, The DS0000004268.V368617.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported by a properly recruited and trained team of staff. They can be confident that there are sufficient staff to meet their needs, but might appreciate additional staff support to give the option of undertaking individual or group activities. EVIDENCE: Residents spoken with were positive about the staff, with ‘very satisfied’ and ‘the staff are very good’ being typical comments. One resident said the staff were ‘a lot of darlings’. There was also the comment ‘not sure if there’s enough staff’ made by one resident, although no specific shortfall could be identified. There had been concerns at the previous inspection as to whether there were sufficient staff to meet individual and collective needs. The manager advised that at that point the home had a number of residents with particularly high needs. She advised that this was not now the case, and the home had received some more hours to use on staffing. She advised that a further member of staff had been recruited, and hours were available to provide extra staffing flexibly to meet specific individual needs as they arose. During the inspection, staff appeared sufficient to meet care needs, with calls being answered promptly, and support being given at a pace residents were WCS - Limes, The DS0000004268.V368617.R01.S.doc Version 5.2 Page 20 comfortable with. As noted previously, the availability of an activities organiser might support residents in more activities and individual attention. Staff spoke appreciatively of the training they were offered. There was evidence of an on-going programme of ‘refresher’ training in areas such as falls prevention, catheter care to help meet individual needs or rectify previously identified shortfalls. The manager advised that the training system was flexible enough to meet needs as they arose. For example, if someone was admitted or diagnosed with Parkinson’s, she was confident that relevant training could be promptly organised. The manager advised that over 50 of staff had achieved National Vocational Qualification level two or above. The manager was advised, in discussion, that some training on supporting people with hearing difficulties may be beneficial to people in the home. A sample of staff records were examined. Appropriate recruitment processes and recording was being followed. There was a checklist of employment and recruitment on the office wall, for quick reference. A new member of staff spoken with was able to explain the induction process and how supervision and learning was suitably managed. There was not a risk assessment covering one employee’s health. The manager agreed to ensure that one was put in place promptly. Staff spoken with showed a good awareness of residents’ needs and how to meet them. Observation of interactions showed a warm but professional rapport between staff and residents. WCS - Limes, The DS0000004268.V368617.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well-managed home which is run in their best interests, and where their health, safety and welfare are safeguarded. EVIDENCE: The manager has acted promptly to acknowledge and rectify shortcomings identified by two recent complaints. Improvements following the previous inspection have been made, and the manager, and other staff, were prompt in finding solutions to issues raised during the current inspection. Mechanisms are in place for getting residents’ views of the service. There are residents’ meetings, as well as the complaints procedure, and visits from senior management. There are regular catering reviews with comments from residents. A good example of residents’ views being heeded is the fact that WCS - Limes, The DS0000004268.V368617.R01.S.doc Version 5.2 Page 22 lunch has been moved back an hour, after residents said that it was too near breakfast time. Residents’ comments concerning the care generally centred on food and the staff. Comments on these were broadly favourable. ‘Very satisfied’, ‘a nice place’ and ‘we’re treated with respect’ were typical comments. Two visitors spoken with were complimentary about the home and the service it provided. Personal monies that the home looks after on behalf of residents were looked at. A sound, transparent system is in place. Those finances looked at were seen to be accurate and properly recorded and checked. The person responsible for ‘housekeeping’ was able to explain satisfactorily the procedures for safeguarding against fire and procedures in the event of smoke alarms sounding. The Annual Quality Assurance Assessment details suitable fire and other essential health and safety checks. No noticeable hazards, or compromises of health and safety were observed during the inspection. There were some hoists and wheelchairs in communal areas such as corridors and hallways, but these were stored in alcoves and under stairways, and were not an obstruction. One person with a visual impairment had noted that the home is ‘easy to get around’, ‘with no obstructions’. WCS - Limes, The DS0000004268.V368617.R01.S.doc Version 5.2 Page 23 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 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x 3 x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 WCS - Limes, The DS0000004268.V368617.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action 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. 3 4. Refer to Standard OP7 OP9 OP9 OP9 Good Practice Recommendations Care plans could be made more ‘user friendly’, so that residents could be more confident that information in them is read and understood by staff. It is recommended no medication should be stored in a communal area. Daily stock control of ‘non blistered’ medication would help further ensure that any errors were noted immediately, to protect the well-being of residents. Any mistakes in recording in the Controlled medication book should be corrected in a transparent way, so all can be completely confident that residents’ well-being is not compromised. The employment of an activities organiser may benefit residents by making more individual and group activities available. The service should ensure that those who need it, can fully benefit from the ‘loop’ system. DS0000004268.V368617.R01.S.doc Version 5.2 Page 25 5. 6. OP12 OP14 WCS - Limes, The 7. 8. 9. 10. OP14 OP19 OP19 OP19 The service should renew efforts to ensure profoundly deaf residents have others to communicate with. The steps currently with yellow and black ‘hazard’ markings would look less institutional if some other way of safeguarding people using them could be identified. The home should seek to maximise ‘natural’ light in areas of the home where it is scarce, such as the upstairs lounge and the downstairs dining room. Emergency lighting should be able to be switched off when not needed, so that residents are not unduly disorientated. WCS - Limes, The DS0000004268.V368617.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection West Midlands Office West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI WCS - Limes, The DS0000004268.V368617.R01.S.doc Version 5.2 Page 27 - 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. 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The Provider has not yet updated their profile and added details of the services and facilities they offer. If you are the provider and would like to do this, please click the "Do you run this home" button under the Description tab.

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