Care Home: Wellington House Nursing Home

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What the care home does well In the surveys we asked people what the service does well and these are some of the comments people made: "I am happy that my home is Wellington House as it has been for the past 9 years". "We have been consistently happy with all aspects of the care at Wellington House, comfort, cleanliness, personal hygiene, the friendliness and helpful nature of all the staff, indeed everything seems very good". "It takes care of all aspects of the residents needs, physical, medical and social". "Mum is well looked after and she is comfortable there. Can`t find any fault with the home". People we spoke to during the visit made similar comments, three people said they would give the home a score of 9 out of 10, with 10 being the best. During the visit the atmosphere in the home was relaxed and friendly, staff greeted people pleasantly when they came into the room and staff were kind and respectful in their interactions with people. People`s needs are assessed before they move in and they are encouraged to visit before making a decision about moving in. When new people arrive staff have information about their needs and one of the owners is always available to help people settle in. People or their representatives are involved in planning how their care needs will be met, people are encouraged to make decisions and are supported in keeping their independence. This helps to make sure people are given the support they need and want in a way that respects their wishes. The home provides people with a varied and interesting programme of social activities inside and outside the home. People said they enjoy the food, people are offered choices and are involved in planning the menus. The environment is clean and well maintained. The home has a 4 star rating (the highest is 5) from Environmental Health for its standards of food safety and hygiene. The home has a low staff turnover and this helps to give people continuity of care. The number of staff on duty changes to take account of people`s changing needs. People are protected because all the required checks are done before new staff start work. Staff are supported to develop their skills and knowledge and the home has achieved the Investors in People award. The management team are accessible and approachable. People told us they have confidence in the management team and have no hesitation in talking to them if they have any concerns. What has improved since the last inspection? No requirements were made at the last inspection. The management team are continually looking at ways to improve the service and in their AQAA they gave us examples of improvements they have made. For example, they have added a new conservatory and this has created more communal space on the ground floor. They have also make a lot of changes to the garden, they have put in a ramp leading from the conservatory to a paved area so that people can now sit outside. The home has introduced a daily "chocolate round" to help people increase their calorie intake. This is good practice and is now being adopted by other services. The home is in the process of replacing all the beds with profiling beds, these are particularly good for people with high dependency needs. What the care home could do better: In their self-assessment they home told us about some of their plans to continue to improve the service over the next year. They continue to encourage people using the service to put forward their ideas and suggestions for improvements. Key inspection report Care homes for older people Name: Address: Wellington House Nursing Home 82-84 Kirkgate Shipley West Yorkshire BD18 3LU     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Mary Bentley     Date: 1 7 0 3 2 0 1 0 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 26 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Wellington House Nursing Home 82-84 Kirkgate Shipley West Yorkshire BD18 3LU 01274531244 01274596573 admin@whnh.wanadoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Wellington House Nursing Home Limited Name of registered manager (if applicable) Miss Alison Jane Pitts Type of registration: Number of places registered: care home 33 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 physical disability Additional conditions: Date of last inspection Brief description of the care home Wellington House is registered to provide personal and nursing care and for the most part it caters for older people. The home is situated close to Shipley town centre and is convenient for Bradford and Leeds. There are good public transport links. It is well maintained both internally and externally. Most of the accommodation is in single rooms, the home has 3 shared rooms. Approximately half the rooms have en-suite facilities. There are communal rooms on the ground and first floor and bathrooms and toilets are located throughout the home. A new conservatory provides additional communal space on the ground floor. There is a passenger lift and stair lift. The home has well tended gardens and a patio. Car parking is available in the grounds. Care Homes for Older People Page 4 of 26 0 Over 65 33 Brief description of the care home The home has a no smoking policy. In March 2010 the weekly fees ranged from GBP535.00 to GBP700.00. The actual fee is determined by how much care the person needs. Additional services such as hairdressing and private chiropody are available at an additional cost. Please contact the home for more detailed information about the fee structure. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This is what we used to write this report: The annual quality assurance assessment (AQAA) which the home completed for us before the visit. The AQAA is a self-assessment which focuses on outcomes for people using the service and it tells us about improvements that have been made and plans for further improvements. It also gives us some numerical information about the service. The results of any visits that we have made to the service since the last key inspection which was carried out on 17 April 2007. Surveys returned to us by people using the service or from people with an interest in the service. On this occasion we received 8 surveys from people living in the home and 6 from staff. Some of the surveys sent to people living in the home were completed by Care Homes for Older People Page 6 of 26 relatives on their behalf. Information we have about how the service has managed any complaints. What the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. Relevant information from other organisations. A site visit carried out by one inspector between the hours of 9:30 am and 2.30 pm. The visit was unannounced. During the visit we spoke to people living in the home, visitors, staff and management. We looked at various records including care records,looked at some parts of the home and observed staff as they carried out their duties. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated it is likely enforcement action will be taken. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? No requirements were made at the last inspection. The management team are continually looking at ways to improve the service and in their AQAA they gave us examples of improvements they have made. For example, they have added a new conservatory and this has created more Care Homes for Older People Page 8 of 26 communal space on the ground floor. They have also make a lot of changes to the garden, they have put in a ramp leading from the conservatory to a paved area so that people can now sit outside. The home has introduced a daily chocolate round to help people increase their calorie intake. This is good practice and is now being adopted by other services. The home is in the process of replacing all the beds with profiling beds, these are particularly good for people with high dependency needs. 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 9 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are given information about the service and their needs are assessed before they move in. This helps to make sure the home will be able to meet peoples needs. Evidence: One relative said they looked at four homes before deciding which one to choose for their mother and said Wellington House stood out the most with care and facilities on offer. Another said they had planned to visit two homes but when they came to Wellington House they knew it was the right one and they said they have not been disappointed. In their self assessment the home told us that peoples needs are always assessed before they move in to be sure the home will be able to meet those needs. People we spoke to confirmed this and we saw completed pre-admission assessments in the care records. Care Homes for Older People Page 11 of 26 Evidence: The home told us people are encouraged to visit and can stay overnight if they want to before making a decision about moving in permanently. Eight people who completed surveys for us said they had been given enough information about the home to help them decide if it was the right place for them before they moved in. Staff told us they are given information about peoples needs before they arrive in the home. They said they know about peoples needs when they arrive and this helps people to settle in. The owners told us that one of them is always available when new people arrive so that they can answer any questions and help the person settle in. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal and health care needs are met in a way that respects their privacy and dignity and takes account of their preferences and abilities. Evidence: These are some of the comments made by people who completed surveys for us. One person said we have been consistently happy with all aspects of the care at Wellington House another said the home communicates well with people and their families and went on to say they find time to get to know the ways of residents and their needs. People we spoke to during the visit told us they are very happy with the care at Wellington House. Two relatives said they have peace of mind knowing that their loved ones are well cared for. We looked at two peoples care records. The care records have information about how peoples health, personal and social care needs and provide clear guidance for staff on how to meet those needs. We saw that people or those close to them are involved in Care Homes for Older People Page 13 of 26 Evidence: care planning and the people we spoke to confirmed this. There are risk assessments in place relating to areas of potential risk for example developing pressure sores or falls. When people are identified as being at risk there are action plans in place to show how the risks will be managed. Peoples nutritional needs are assessed and where appropriate referrals are made to external professionals such as GPs or dieticians. The home has introduced a daily chocolate round to try to increase peoples calorie intake. This has proved very popular and successful and is being adopted by other services as good practice. The home told us they work closely with other health and social care professionals to make sure peoples needs are identified and met, we saw evidence of this in the records. The home told us they have revisited their core values in the last year. We asked staff how this related to their day to day working practices. They told us it meant treating people with respect, helping them to be as independent as possible, letting people have choices and communicating clearly with people. For example, giving people time eat their meals themselves rather than staff doing it for them and asking people what they want to eat and drink and not assuming that because they had tea one day they would want tea everyday. Our observations during the visit showed that staff put this into practice, for example they noticed that one person had spilled some breakfast on their clothes and asked discreetly if the person would like to go to their room and change. There are suitable systems in place to make sure that medicines are managed safely and to make sure that people get their medicines as prescribed. The home told us that over the past year they have continued to improve end of life care for people. They use the Liverpool Care Pathway which is a model of good practice for end of life care. This helps them to work closely with the person, their family/friends and other professionals to make peoples last days are as peaceful and dignified as possible. Over the next year the home plans to make further improvements to the way they manage end of life care and in particular to advance care planning. Care Homes for Older People Page 14 of 26 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. People living in the home are provided with opportunities to take part in a variety of social and leisure activities, to keep in contact with their family and friends and to exercise choice and control over their lives. Evidence: The home has an activities organiser and information about planned activities is displayed. In addition to group activities there are one to ones for people who do not want to join in group activities. The homes newsletter was also available in various places around the home. It includes information about planned events, staff changes and other things that are going on. One feature of the newsletter is the residents corner which is a profile of the life of one of the people living in the home. Staff said people enjoy reading the newsletter which is colourful and well presented. The home told us they encourage flexibility in daily routines and people are asked what they want to do. We saw evidence of this during our visit. On the day we visited the hairdresser was in the home and several people enjoyed Care Homes for Older People Page 15 of 26 Evidence: having their hair done. The home has a volunteer who visits most days, she spends time talking to people and doing things like helping people to read the paper. She said she has been coming to the home for many years and enjoys her visits very much. Some relatives said how much they appreciated the time she spends with people. The home has visitors from the local church and there is a regular communion service for people who want to take part. The home organises outings for people, sometimes individually and sometimes in groups. Visitors told us they are always made welcome and can visit at any time. During the visit we observed the meal service at lunch time. It was well organised, people had chosen their meals earlier in the day and staff reminded them what they were having as they gave out the meals. People were asked if they wanted to wear protective aprons and were offered condiments. Staff helped people discreetly and people were given time to enjoy their food. The home publishes a weekly menu and the meals for the day were displayed on the notice boards. People told us they enjoy the food. The home told us they organise different theme days with foods from different countries to add variety and interest to the menus. People are consulted about planned changes to the menus. Care Homes for Older People Page 16 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be assured their concerns will be taken seriously and acted on. People are protected from harm and their rights are respected. Evidence: People who completed surveys for us said they know who to speak to if they are unhappy and know how to make a formal complaint if they need to. The home told us they have not had any complaints and none have been referred to us. The owners are very much involved in the day to day running of the home and are easily accessible to people. They told us they encourage people to talk to them about any concerns that they have so that issues can be resolved quickly and this means that people seldom feel it necessary to make formal complaints. People we spoke to during the visit confirmed this, they told us they would have no hesitation in talking to the owners if they had any concerns. They said that when they had raised concerns these had been dealt with appropriately. There are policies and procedures in place to make sure people are protected. Staff have received training in safeguarding (Adult Protection). One of the staff is booked on a train the trainer course for safeguarding and this will mean they are able to deliver this training in house. Discussions with staff confirmed that they understand their responsibilities in making sure people are protected and their rights are promoted. The owners are familiar with the local authority safeguarding procedures Care Homes for Older People Page 17 of 26 Evidence: and make appropriate referrals. Care Homes for Older People Page 18 of 26 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 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 clean and comfortable and provides a pleasant and suitably equipped place for people to live. Evidence: The home was clean when we visited and people told us it is always clean and fresh. The home has added a conservatory and this has created more communal space on the ground floor for people to use. They have also made improvements to the garden area so that there is somewhere pleasant for people to sit outside when the weather permits. There is an ongoing programme of refurbishment to make sure the home continues to provide a pleasant place for people to live. Staff told us they have all the equipment they need, for example, hoists to meet peoples needs. There are suitable systems in place to reduce the risk of cross infection and staff have received training in infection control. Care Homes for Older People Page 19 of 26 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. People are cared for by a trained and competent team of staff. All the required checks are done before new staff start work and this helps to make sure people are protected. Evidence: These are some of the things people said about the staff - all the staff are kind, friendly and hard working. They seem to bend over back wards to sort things out, the staff are great, always there to help and listen the staff on the whole listen to my comments. People told us that staff are usually available when they need them. The staffing levels are kept under review to take account of peoples changing needs. There are usually between 6 and 7 care staff on duty during the day and 4 in the evening. In addition there is always one nurse on duty and one of the owners is in the home most days. Overnight there are a total of 4 staff including one nurse. The home also employs an activities organiser and has separate staff for housekeeping, catering, administration and maintenance. Six staff completed surveys for us; they told us that all the required pre-employment checks were done before they started work. The staff records we looked at confirmed Care Homes for Older People Page 20 of 26 Evidence: this. Staff told us they get the training the need to keep them up to date with new ways of working and to help them understand and meet peoples needs. They told us they are well supported by the homes management. One of the staff said the staffing levels are good and the residents get good care and the management are very nice to staff. All new staff have induction training in line with the Skills for Care common induction standards. These are national standards designed to help new staff get the knowledge and skills they need to care for people. The home has an ongoing programme of NVQ (National Vocation Qualification) training and 64 of care staff have achieved an NVQ at level 2 or above. The home holds the Investors in People award. This is a quality standard awarded to organisations that are able to demonstrate their commitment to delivering quality services through staff training and development. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management team provides strong leadership and work hard to maintain an open and inclusive atmosphere where people are encouraged to make decisions, exercise choice and express their views of the service. Evidence: The registered manager, Jane Pitts, is a joint owner of the home with her sister. They are both registered nurses with several years experience. The have an active role in the day to day running of the home, one of them is in the home most days and in addition to managing the home they work as nurses on a number of shifts every week. This means they are easily accessible to people and people told us they have confidence in the management team. They said the home is not perfect but they know that if they have any concerns they can talk to the owners and they will be sorted out. Staff told us they are supported by the management team, one of the staff said Wellington House is very happy and friendly place for both residents and workers. Care Homes for Older People Page 22 of 26 Evidence: The home completed their self-assessment and sent it back to us in good time. It gave us all the information we asked for. The home has policies and procedures in place in relation to the Mental Capacity Act and the Deprivation of Liberty legislation. Staff have received training and more is planned. In addition issues around peoples capacity and rights are discussed in staff hand overs and some procedures have been changed to take account of this legislation, for example assessments about the use of bed rails have been updated to include information about peoples capacity. This helps to make sure staff are aware of their responsibilities in this area. No one was being deprived of their liberty when we visited. People using the service and their representatives are encouraged to share their views of the service and put forward suggestions for improvements. There are meetings for people living in the home and quality assurance questionnaires are sent every year. The home has recently added a suggestions section to the main notice board to give people another way of putting forward ideas. The home holds small amounts of money for some people. The money is held securely, records are kept of all transactions and receipts are obtained for money spent on peoples behalf. People are given a quarterly written statement with details of the transactions. In their self-assessment the home told us that equipment and installations are serviced and maintained at the required intervals. This makes sure the home continues to provide a safe place for people to live and work. Care Homes for Older People Page 23 of 26 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 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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