Care Home: Welham House

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What the care home does well The home is well run and provides a comfortable homely place for residents to take long-term care. There are enough staff on duty to meet the needs of residents staying at the home. The care home is set in the town of Spilsby which enable residents to have easy access to the community. The home provides transport to allow residents to go out into the community, take part in activities and to attend the Orby day centre and local colleges for their education. The care home works closely with residents to ensure their choices and wishes are considered when individual goals and long-term plans are made. The home particularly ensures that the rights of individual residents are maintained. Skill training to encourage the development of independent skills are being provided with the provision of two bed sits which been set within the care home. This provides additional skill training, and allows the residents to live in a semi setting with 24-hour support. The care home ensures that relatives and friends maintain contact with residents. Resident`s families are actively involved in reviews and care planning. What has improved since the last inspection? Staff supervision is now been provided on a regular basis to all staff. This has resulted in the needs of staff been identified and appropriate training opportunities provided by the company. There is a noticeable improvement in the quality of teamwork within the home since the last inspection. Management support from the registered manager to staff was found to be excellent. What the care home could do better: The registered manager of the home is committed to ensure that the care home regulations continue to be met. CARE HOME ADULTS 18-65 Welham House Hundleby Road Spilsby Lincs PE23 5LP Lead Inspector Ken Hague Unannounced Inspection 13th August 2008 09:00 Welham House DS0000002564.V370137.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Welham House DS0000002564.V370137.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Welham House DS0000002564.V370137.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Welham House Address Hundleby Road Spilsby Lincs PE23 5LP 01790 752989 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) Boulevard Care Julie Dorrans Care Home 14 Category(ies) of Learning disability (14) registration, with number of places Welham House DS0000002564.V370137.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The provider may provide the following category of service only: Care Home - Code PC To service users of the following gender: Either Whose primary care needs on admission are within the following category: 2. Learning Disability - Code LD The maximum number of service users to be accommodated is: 14 Date of last inspection 3rd July 2006 Brief Description of the Service: Welham house care home is owned by Bouvard Care Ltd. It is situated in the town of Spilsby. The 2-storey detached house has been adapted and extended to provide accommodation for 14 service users. The home caters for service users with a learning disability who require permanent or respite care. Bedroom accommodation is in single rooms. The home has a large through lounge and a separate dining area. Access to the first floor is obtained by a flight of stairs. The home has good access to the local community. A car park for visitors is provided at the rear of the care home. On road parking is also available. Welham House DS0000002564.V370137.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 3 star. This means the people who use this service experience Excellent quality outcomes. The inspection took place over 5 hours. The registered manager was present throughout the inspection. Feedback was given at the conclusion of the site visit. The main method of inspection used was called ‘case tracking’ which involved selecting three residents and tracking the care they receive through the checking of their records, discussion with them and the staff, and where more appropriate observation of interaction between staff and residents and related care practices. A sample of care records was inspected. A member of staff was interviewed and the opinions of three residents were sought. An (AQAA) Annual quality assurance assessment was completed by the care home and sent to the Commission for Social Care Inspection prior to the site visit. This is a selfassessment document completed by the providers of the care home. It sets out evidence from the provider to demonstrate that they are meeting the Care Home Regulations. It is normal procedure to obtain written feedback from residents prior to the site visit using a document called “have your say”. This document sets out a number of questions for residents to answer. In the case of this key inspection it was not possible to send out these documents within set timescales. The opinions of the residents were sought in discussions held at the site visit. Their views are reflected within this report. What the service does well: The home is well run and provides a comfortable homely place for residents to take long-term care. There are enough staff on duty to meet the needs of residents staying at the home. The care home is set in the town of Spilsby which enable residents to have easy access to the community. The home provides transport to allow residents to go out into the community, take part in activities and to attend the Orby day centre and local colleges for their education. The care home works closely with residents to ensure their choices and wishes are considered when individual goals and long-term plans are made. The home particularly ensures that the rights of individual residents are maintained. Skill training to encourage the development of independent skills are being provided with the provision of two bed sits which been set within the care home. This provides additional skill training, and allows the residents to live in a semi Welham House DS0000002564.V370137.R01.S.doc Version 5.2 Page 6 setting with 24-hour support. The care home ensures that relatives and friends maintain contact with residents. Resident’s families are actively involved in reviews and care planning. 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. Welham House DS0000002564.V370137.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Welham House DS0000002564.V370137.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There are procedures in place which are used for the assessment of new residents to the service. This ensures that all of their personal care needs, health care and social needs are met. EVIDENCE: The Inspector looked at the care records for three residents being case tracked. All individual resident’s files contained a detailed assessment which set out the resident’s social needs, care needs, any identified risk and its management. Health care needs, personal choice and wishes were recorded on individual care plans. All care records were filed in a consistent manner including an index at the front of each file. Records were written in plain English therefore making them easy to read. Records were dated and signed by the writers. All individual care plans seen at the site visit had been reviewed with the resident. Residents spoken to during the site visit were able to discuss their individual care plan. This standard was exceeded. Welham House DS0000002564.V370137.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6,7 & 9Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The home identifies the health, personal and social cares needs of each resident and records them on their care plan. This enables staff to meet their needs in a manner, which is described within the individual’s care plan. Staff respect the dignity and privacy of residents. EVIDENCE: The individual care records of the residents been case tracked all contained a care plan. This had been written from information gathered at an initial assessment. The care plans contained the care and social needs of all residents. Health care needs were identified and recorded. Care plans were easy to read and understand. They set out the ways in which individual service users needs should be met and included their choices and wishes. Risk assessments have been completed and where a risk was identified the management of that risk was set out in the care plan, all care records plan have been reviewed regularly. Residents stated that they are involved in the writing of their own care plans and reviews. Care records were filed in a Welham House DS0000002564.V370137.R01.S.doc Version 5.2 Page 10 consistent manner. There were records of visits to GP and consultants. Residents stated that their health care needs were being met by the care home. There was evidence within the care records seen on this visit that resident’s choices and wishes are being balanced against any identified risk. Welham House DS0000002564.V370137.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,15,16 &17Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. A range of activities are provided for residents which enables them to have an active and interesting social life. The home’s menu offer choices and meets the dietory needs of residents. EVIDENCE: Residents are provided with activities and social skill training at the Orby Day Centre which is owned by Boulevard Care. Residents can attend local educational colleges as an alternative to the Orby Day Centre. Resident’s care plans identified individual goals for personal development. Care records contained evidence that goals are being achieved. Residents stated they go out into the community to carry out their own shopping sometimes with a member of staff. Discussions with staff management and residents provided evidence that the home works closely with relatives and visiting is encouraged. Residents are Welham House DS0000002564.V370137.R01.S.doc Version 5.2 Page 12 encouraged to make home visits were this is possible. Some residents choose to take holidays with their own individual families. The evidence from care records is that families are actively involved in the review of individual residents care plans and support packages. The individual dietary needs of all residents are recorded within their care plans. This includes the likes and dislikes of the resident in respect of food. The homes menu demonstrates that choice is offered to all residents. Discussions with residents produced evidence that they are happy with the quantity and quality of food provided to them. All residents spoken to during the site visit confirmed that their dietary needs are being met by the care home. Welham House DS0000002564.V370137.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18,19 & 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Care plans identify all areas of need and provide detailed care instructions for staff; this enables staff to provide appropriate care. Residents’ health needs are being met. EVIDENCE: Observation and discussions with residents showed that staff are aware of the need to respect residents’ privacy. Bedroom doors are fitted with locks and residents stated that staff ask permission to enter bedrooms before they come into their rooms. A resident stated, “I feel staff are kind and help me, they take time to listen to me.” A second resident stated “staff respected my views and support me in becoming more independent. Residents have access to Community Health Care Services. Care records and care plans contained the details of each residents individual health needs and how these were to be met by the home using Community Health Care Services. There are recordings of visits by GPs and the home when appropriate normally residents are enabled to visit the GP surgery. Welham House DS0000002564.V370137.R01.S.doc Version 5.2 Page 14 None of the residents at the home were self-medicating at the time of the site visit. Staff training records and discussions with management and staff provided evidence and staff have been trained in the Administration and storage of medication. Medical records sampled provided evidence that the medication procedure of the home is being followed. Welham House DS0000002564.V370137.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 & 23 Quality in this outcome area is Excellent This judgement has been made using available evidence including a visit to this service. There are robust up to date procedures for the handling of complaints and allegations of abuse. The residents feel comfortable at being able to raise any concerns they may have with the management of the care home. EVIDENCE: The Registered manager stated that the home has a complaints policy, which is displayed in the home. An individual copy is given to all residents. All of the residents spoken to during this inspection were aware of this procedure. Residents stated that they were confident in being able to raise any concerns with the registered manager or a member of staff. The home and the Commission for Social Care Inspection have received no complaints since the last inspection. The home has an abuse policy within its procedures manual. In addition, there is a copy of the LCC Vulnerable Abuse procedures in the care home. Staff confirmed that they had received training in the identification and prevention of abuse. Detailed discussions with the managers and registered manager of the home produced further supporting evidence to demonstrate that residents have been protected from any potential abuse. There were two recorded incidents where the home has taken appropriate action to protect residents. These had been very difficult situations to manage. Care records provided evidence that staff at Welham House DS0000002564.V370137.R01.S.doc Version 5.2 Page 16 the home and management had protected the residents and supported them through difficult and complex situations. Welham House DS0000002564.V370137.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 & 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents live in a comfortable, homely, clean environment with a choice of communal areas and personalised bedrooms. EVIDENCE: The home has an ongoing maintenance program and improvement to the home have been made since the last key inspection. Residents expressed their satisfaction with the environment of the care home and their own individual bedrooms. A resident asked the inspector to look at his rooms to see how it had been personalised by the individual resident. Residents are enabled to look after their own bedroom with the assistance and support of the staff. A resident said “I am very satisfied with this room”. There were no health and safety issues identify during the site visit. Four individual rooms were viewed during this visit including two which are used for semi- independence training. They were all very individualised there were signs of ongoing maintenance and the bedrooms contain appropriate furniture to meet resident’s needs. Welham House DS0000002564.V370137.R01.S.doc Version 5.2 Page 18 The exterior of the care home is well maintained car parks and garden areas are very presentable. Residents can sit out in the garden area in the summer months. The home is furnished to a high standard. Welham House DS0000002564.V370137.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32 34 & 35 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. A well-supported and competent staff team ensure residents individual needs are met. EVIDENCE: Staff stated that in their opinion there is sufficient staff on duty to meet the needs of residents, included during the nighttime period. Discussions with staff and the inspection of training records provided evidence that Staff have been provided with training opportunities including some specialised courses. There was evidence found in the inspection of recruitment records that all staff have been recruited safely and provided with inductions. A file for a new member of staff contained all of the information set out in the care home regulations Further evidence that the homes recruitment and training plan is being followed was found in the AQAA form returned to the Commission for Social Care Inspection. The sampling of individual Staff personal files provided evidence that staff are provided with opportunities to obtain NVQ qualifications. Welham House DS0000002564.V370137.R01.S.doc Version 5.2 Page 20 The residents stated that they feel safe living the care home. One resident stated “I enjoy living here I feel safe.” Staff stated they felt that the home is a safe environment in which to work. There were no health and safety issues identified during the site visit. Welham House DS0000002564.V370137.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 37,39 & 42 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The home is well run, with good leadership and guidance from the registered manager. Staff are being adequately supervised. Working practices promote the health and safety of residents. Residents are confident that their views are considered at all reviews of their services. EVIDENCE: Staff stated that the registered manager is approachable and very supportive to staff. She gives them clear guidance and leadership and there is an understanding within the staff group that residents needs are paramount. Residents said that the registered manger is always around for them to speak to and helps them when they need anything. Pre inspection information shows that regular residents meetings are held and quality assurance surveys are carried out. Welham House DS0000002564.V370137.R01.S.doc Version 5.2 Page 22 The registered manager said that she carries out staff supervision in accordance with national guidelines. Formal interviews with staff provided evidence that this statement was correct. Staff confirmed that the registered manger helps them to develop their own individual skills. There are financial procedures in place to ensure that resident’s financial interests are safeguarded and protected. The Inspector observed that there was a relaxed, and supportive atmosphere within the home throughout his visit. Welham House DS0000002564.V370137.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 Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 4 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 x x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 4 x 3 x x 3 x Welham House DS0000002564.V370137.R01.S.doc Version 5.2 Page 24 no Are there any outstanding requirements from the last inspection? 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. Refer to Standard Good Practice Recommendations Welham House DS0000002564.V370137.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Welham House DS0000002564.V370137.R01.S.doc Version 5.2 Page 26 - 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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