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Care Home: Wheaton Aston Care Home

  • Ivetsey Bank Wheaton Aston Stafford Staffs ST19 9QT
  • Tel: 01785840423
  • Fax: 01785841184

Wheaton Aston Court is part of the Four Seasons Health Care Group. It is a purpose built nursing home, providing nursing and social care for up to 36 elderly, physically disabled people, and minimum of 60 years of age. It is situated on the A5 between Gailey and Weston-under-Lizard in Staffordshire, 6 miles from junction 12 of the M6, and 6 miles from junction 2 of the M54. Wheaton Aston village is approximately 2 miles away. The home is single storey and has 30 single bedrooms and 3 double bedrooms. 34 of the rooms have en-suite facilities. There are a number of lounges and a separate dining room. The home is approached via a long drive way and has extensive car parking facilities and garden areas. Wheaton Aston Court is well suited to meet the needs of the stated categories of care, offering excellent facilities throughout. The full range of charges were not detailed in the service`s Statement of Purpose or Service User Guide` documents as routine. The reader may wish to contact the service to obtain more detailed and up to date information about fees.

Residents Needs:
Physical disability

Latest Inspection

This is the latest available inspection report for this service, carried out on 5th August 2008. CSCI found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

For extracts, read the latest CQC inspection for Wheaton Aston Care Home.

What the care home does well We found that Wheaton Aston offers a genuine commitment to care with a highly professional, yet an open and personable approach, which reflected the homeliness of a confident relationship between carer and resident. "I`ve settled in well now, I didn`t realise it would be this nice". Through the process of inspection we considered that the establishment of a professionally accountability towards effective assessment, detailed care planning and review of resident`s needs were meaningful and robust, formulating an excellent standard of care. This highly personable attitude and approach to care is appreciated and welcome by residents and visitors alike. The overall management style demonstrated a professional approach in maintaining an environment conducive to the care of the elderly. We recognised the maintenance of good staffing levels, with in-depth staff training and supervision well established in safeguarding the interests of residents. The support services were found to contribute to the team approach, and are recognised for their efforts. Policies and procedures were found to be reviewed regularly, and we found evidence of a willingness to seek advice from other health professionals in order to maintain a service which encourages best practice. Overall we consider the attitude in meeting caring and organisational demands is commendable, with forward thinking, planning and application contributing to a good service. What has improved since the last inspection? We found that prospective residents are given an opportunity to spend time at the Home prior to admission, and that a communication record is kept in all care files, confirming that relatives are actively involved in the planning of care. We examined and confirmed that care files have been re-organised to provide a more user-friendly working document. Our discussions with staff confirmed an improvement in the standard of the Induction programme. In the course of inspection we established that there have been substantial improvements to the environment, including the provision of profiling beds, and an on-going refurbishment of bedroom areas. What the care home could do better: The achievements in establishing a high standard of care have been recognised, areas of detail outlined through recommendations will continue to play a part in the ongoing development and maintenance of an honest, solid and homely service. CARE HOMES FOR OLDER PEOPLE Wheaton Aston Care Home Ivetsey Bank Wheaton Aston Staffordshire ST19 9QT Lead Inspector Keith Jones Unannounced Inspection 5th August 2008 08:45 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 Wheaton Aston Care Home DS0000068297.V369515.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. Wheaton Aston Care Home DS0000068297.V369515.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wheaton Aston Care Home Address Ivetsey Bank Wheaton Aston Staffordshire ST19 9QT 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) 01785 840423 01785 841184 Four Seasons (No 13) Limited Mrs Lynda Warden Care Home 36 Category(ies) of Physical disability over 65 years of age (36) registration, with number of places Wheaton Aston Care Home DS0000068297.V369515.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. PD (E) - 36 nursing minimum age 60 on admission Date of last inspection 10/08/06 Brief Description of the Service: Wheaton Aston Court is part of the Four Seasons Health Care Group. It is a purpose built nursing home, providing nursing and social care for up to 36 elderly, physically disabled people, and minimum of 60 years of age. It is situated on the A5 between Gailey and Weston-under-Lizard in Staffordshire, 6 miles from junction 12 of the M6, and 6 miles from junction 2 of the M54. Wheaton Aston village is approximately 2 miles away. The home is single storey and has 30 single bedrooms and 3 double bedrooms. 34 of the rooms have en-suite facilities. There are a number of lounges and a separate dining room. The home is approached via a long drive way and has extensive car parking facilities and garden areas. Wheaton Aston Court is well suited to meet the needs of the stated categories of care, offering excellent facilities throughout. The full range of charges were not detailed in the service’s Statement of Purpose or Service User Guide’ documents as routine. The reader may wish to contact the service to obtain more detailed and up to date information about fees. Wheaton Aston Care Home DS0000068297.V369515.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. We conducted this unannounced inspection with the Registered Care Manager and senior nursing staff on duty. Our inspection of the building allowed us free access to all areas and open discussion with people who use the service, relatives and staff. There were 29 people in residence on the day of our inspection. We looked at how care is being arranged and supported for a range of people with health care needs. To do this we looked at (case tracked) four residents’ files from referral to the present time, and four staff files were examined. We also looked at other information such as complaints, incidents, events and other professional reports. We took the opportunity to speak with a number of residents, relatives and members of staff, who took an active role in the inspection process, and contributed to the subsequent report. We acknowledged receipt of the Annual Quality Assurance Assessment (AQAA), and four survey forms returned by residents. We inspected a sample review of administrative procedures, practices and records, confirming consistent good practice and effective management. There followed a report feedback, in which we offered an evaluation of the inspection, indicating those recommendations resulting from the inspection. What the service does well: We found that Wheaton Aston offers a genuine commitment to care with a highly professional, yet an open and personable approach, which reflected the homeliness of a confident relationship between carer and resident. “I’ve settled in well now, I didn’t realise it would be this nice”. Through the process of inspection we considered that the establishment of a professionally accountability towards effective assessment, detailed care planning and review of resident’s needs were meaningful and robust, formulating an excellent standard of care. This highly personable attitude and approach to care is appreciated and welcome by residents and visitors alike. The overall management style demonstrated a professional approach in maintaining an environment conducive to the care of the elderly. We Wheaton Aston Care Home DS0000068297.V369515.R01.S.doc Version 5.2 Page 6 recognised the maintenance of good staffing levels, with in-depth staff training and supervision well established in safeguarding the interests of residents. The support services were found to contribute to the team approach, and are recognised for their efforts. Policies and procedures were found to be reviewed regularly, and we found evidence of a willingness to seek advice from other health professionals in order to maintain a service which encourages best practice. Overall we consider the attitude in meeting caring and organisational demands is commendable, with forward thinking, planning and application contributing to a good service. 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. Wheaton Aston Care Home DS0000068297.V369515.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 Wheaton Aston Care Home DS0000068297.V369515.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): 1,3,4, and 6. The quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The needs of prospective people are appropriately assessed before they are offered a place. They and their relatives can be confident that the service will be able to meet their needs. EVIDENCE: We examined the revised Statement of Purpose and Service User Guide, and found them to provide a very informative description of the Provider’s aims, objectives, and the way the service operated. We were told that an audio version is being prepared to complement the package. It is stated in the AQAA that the Statement of Purpose represents the foundation on which the home Wheaton Aston Care Home DS0000068297.V369515.R01.S.doc Version 5.2 Page 9 operates upon, offering potential residents and their relatives the opportunity to make an informed choice about where to live. We acknowledged that the documents were offered to all enquirers, and a copy placed in each bedroom for people to read. We advised that the Service User Guide be produced in an audio version to compliment the large print version already available. We also asked that fees presented to private applicants are to be included in the Guide. We confirmed that the Home continues to deploy a clear statement of contractual agreement. It was suggested that future contracts would contain information confirming the room allocated to the new person on pre admission visits. Through our case tracking of four residents we clearly identified that the Care Manager, or her deputy, at the point of reference, conducted the preadmission assessment. The documentation identified as a Dependency Assessment Rating was examined, and we found it to a comprehensive, solid foundation for progressive care planning. The objective is for this assessment to be produced with the full involvement of prospective residents and their family, allowing them to influence the direction of care. We found this to be true, and we also recognised that the assessment initiated the process of care, each individual having a plan of care, which included a detailed care plan, risk assessment with longer-term goals and outcomes. During the course of our inspection we had ample opportunity to sit and talk with people who use the service, staff and a couple of visitors. We found evidence that much care had been taken in involving people and their families in the admission process. “I’ve settled in well now, I didn’t realise it would be this nice”. From our discussions with staff and residents it was evident that prospective residents and their relatives are able to visit and assess the quality, facilities and suitability of the Home at any reasonable time, to meet with staff and management. Staff are aware of the special period of personal anxiety that people have under those conditions, a point well illustrated when talking to residents, and examining records on case tracking. No intermediate care took place in the home. Wheaton Aston Care Home DS0000068297.V369515.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, and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A wide range of needs are addressed through the care planning process, meeting personal and health needs with clear principles of respect, dignity and privacy towards people who use the service. Medicine administration systems are safe and secure. EVIDENCE: Our examination of care records and case tracking clearly showed that this standard is well met, maintaining a high quality and robust process of assessment. There was evidence to show that the pre-admission assessment represented the foundation for a well-considered and detailed care planning process, in association with Social Services reports, if available. Wheaton Aston Care Home DS0000068297.V369515.R01.S.doc Version 5.2 Page 11 We found that the profile of the resident’s social, physical and psychological status offered an individual plan of care, based upon dependency assessment and activities of daily living, frequently reviewed. Each resident’s health, personal and social care needs were found to be carefully assessed in an individual plan of care that is reviewed monthly, to reflect their changing needs and adapting care profiles, supported with a substantial and very informative daily progress report, and risk assessments. Established monitoring systems following a process of goals, care and evaluation of high quality care plans, appreciated by residents and relatives alike. Case tracking confirmed to us that specialist support and advice are sought as needed, with each resident having access to a local Doctor, Dentist, Optician, Chiropodist, and Occupational Therapist as required. Through case tracking, our discussions and inspection of records, it was recognised that the home arranges for health professionals should special health care needs are recognised. Care staff maintain all aspects of residents’ personal care, overseen by the trained nurse on a daily basis, with the reintroduction of the key worker system. We were informed that the Care Manager completes a weekly Risk Monitor Report to monitor health variance, accidents, incidents, infection control, complaints, environmental health, and health and safety issues. This was found to be in place, robust and effective as an excellent quality tool. We confirmed that the administration of medicines adhered to procedures to maximise protection for people who use the service. We found that a senior nurse is responsible for overseeing all matters relating to medicines. She has effected a highly developed and smooth process of ordering, receiving, storing, administering and disposing of medicines. Records were seen to be complete and easy to follow through, with no observed breaches in the system. Controlled Drug management was comprehensive. The Homely Medicines arrangements would be further complemented with a full acknowledgement of all the doctors attending residents. It is stated in the service’s Statement of Purpose and the AQAA, that independence, privacy and dignity are encouraged, with the full involvement of family in all matters concerning the well being of residents. This was confirmed, and that relatives and residents meetings had been held on a three monthly basis. We found that bathroom and toilet facilities have notices attached for staff to check occupancy before entering. We looked at bedrooms presented to facilitate privacy for the individual, which included medical examinations and personal care procedures being performed in private. Consideration is to be given to facilitate a suitable bedroom door lock for dementia care situations, to enable selective periods of privacy, without prejudicing safety, to complement available lockable facilities. Wheaton Aston Care Home DS0000068297.V369515.R01.S.doc Version 5.2 Page 12 In our discussions with residents and staff we confirmed that relatives have freedom of visiting, which emphasised the importance of maintaining social contact, and promotes excellent relationships. In our examination of care records we established that a policy and procedure on care of the dying and death had been carefully constructed to meet individual needs, and were in place with the full knowledge of both residents and relatives. Individual spiritual persuasions were seen to be documented and respected at all times. We were informed that relatives are welcome to stay as long as they liked in times of stress, including overnight stay. We were impressed with the confidence and closeness within the Home of staff, residents and visitors, and the mutual respect that prevailed. Wheaton Aston Care Home DS0000068297.V369515.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 and 15 The quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People’s rights to live a meaningful life are central to the homes aims and objectives, and are offered opportunities to exercise choice and control over their lives. People are offered a healthy, well balanced diet, with choices for every meal. EVIDENCE: Our discussions with residents and staff clearly identified a relaxed and informal atmosphere in which the resident’s needs were held in high importance. We observed the daily routine to be flexible and noninstitutionalised, offering choice for meal times, personal and social activities. We inspected four residents’ care notes and confirmed that at pre-admission the person’s personal interests and customs are determined, and where possible accommodated within the routine of the Home. We acknowledged the Wheaton Aston Care Home DS0000068297.V369515.R01.S.doc Version 5.2 Page 14 practice of preparing individual life histories, which are discussed, and used as a basis for personalised social care offering choice and support. We established that the Home employs a part time activity coordinator, who covers ten hours a week to promote social activities as an integral part of care. We were assured by the Care Manager that resources have been made available to increase to twenty hours a week. We found that the activities coordinator seeks the views of the residents when she is planning forthcoming activities within the Home. We also discussed the potential to develop the land around the home to promote a small garden area to enhance outdoor activity facilities. We considered that more variety in indoor activities would be beneficial, especially for residents with dementia and other cognitive impairments. The home continues to operate an established open visiting policy, which was clearly observed during the inspection. Our discussion with relatives and friends present at the time, confirmed that they are encouraged to maintain social links as part of the planning of care. Comments we received from those relatives confirm their appreciation and involvement with the progress of their loved one’s health and social status. Our inspection of residents’ rooms showed a significant influence of personalisation in the inclusion of belongings, furniture and general décor. During the course of the inspection we saw that staff interacted with people in a positive and polite manner. We were informed of regular visits by a lay preacher who has established a popular and recognised presence at Wheaton Aston. Communion is offered every two weeks by a local vicar. A local priest visits Roman Catholic devotees on request. There are no other religious persuasions at the time of inspection. The manager informed us that each individual is encouraged to be independent with regard to financial affairs with the assistance of their relatives. We found this to be true and saw that each resident has a lockable facility available in their rooms if they wished to handle their own accounts. We discussed with the administrator the arrangements for handling small amounts of residents’ monies, and found that they were efficiently handled, regularly audited through the Provider’s office. Both breakfast and lunch was served during inspection and meals were seen to be wholesome and nutritious, with residents agreeing on the quality of preparation and serving. Although off site, we were informed that the cook does meet with residents, frequently oversees the delivery of service, and discusses their individual preferences, including the dietary needs of ethnic groups as and when necessary. We found the dining area homely but very presentable, offering a pleasant ambience for a social meal. Attached to the dining area is a satellite kitchen with snack and drinks being available for residents and family. The centralised kitchen, on an adjacent site, continues to offer a satisfactory service, serving Wheaton Aston Care Home DS0000068297.V369515.R01.S.doc Version 5.2 Page 15 meals from hot food trolleys. Staff were seen to offer discreet assistance to those people who required it. Wheaton Aston Care Home DS0000068297.V369515.R01.S.doc Version 5.2 Page 16 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 and 18 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service has a meaningful complaints policy. People are given opportunities to freely express any concerns, are protected from abuse and their human rights are promoted. EVIDENCE: We found that peoples’ legal rights are protected by the systems in place in the service to safeguard them, including their contract, the continual assessment of care planning and policies in place, for example, the complaints procedure, which we examined. There were a few minor complaints, which we feel would be better dealt with through a ‘record of concerns, complaints and safeguarding’, to record peoples’ and their families’ concerns in a meaningful and effective manner. From our talks with people who use the service, and staff, it was evident that any small matters were handled immediately, discretely and to the satisfaction of all concerned. All people had received information on the procedure to complain, including reference to us. This process was evidenced through the Service User Guide, on examination and case tracking and discussion. We identified that there had been no complaints made to us since the last inspection, and one dealt with internally satisfactorily. We had been informed of one referred safeguarding issue, resolved with no further action considered Wheaton Aston Care Home DS0000068297.V369515.R01.S.doc Version 5.2 Page 17 necessary. Our case tracking confirmed the effectiveness of a Provider, Care Manager and staff sensitive to people’s needs, and a readiness to test the robustness of their information and report structures. We found the policy and procedure for handling issues of abuse (safeguarding) to be effective, and recently updated. We examined four staff records to confirm that staff were suitably checked through Criminal Records Bureau (CRB) and Protection of Vulnerable Adult (POVA) disclosure. We found staff had received training on abuse at induction; this includes the right to ‘Whistle blowing’, consistent with the Public Disclosure Act 1998. POVA training has been completed for all trained and care staff over this year. Wheaton Aston Care Home DS0000068297.V369515.R01.S.doc Version 5.2 Page 18 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): 19,20,24,25 and 26 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Wheaton Aston provides a safe, well-maintained, clean and comfortable environment for the people who use the service. EVIDENCE: We recognise that the location of Wheaton Aston Court is suitable for a care home, purpose-built, situated in a picturesque country setting, conducive to the care of long-term residents. The external state of repair and maintenance is considered to be generally very good. We found the grounds are kept reasonably tidy, safe and are tended Wheaton Aston Care Home DS0000068297.V369515.R01.S.doc Version 5.2 Page 19 regularly, although lacking a garden area which would enhance outdoor facilities attached to the established patio. We were informed that on admission the Care Manager assesses each individual’s needs for equipment and necessary adaptations, we found this to be correct, and saw those facilities available throughout the Home. The interior state of repair is at a high standard; the general layout is acceptable for its stated purpose. We observed that residents had access to all areas, allowing relative freedom, including wheelchair access, in a well maintained, clean and safe environment. We considered that to improve security service areas and storerooms should be secured when not in use. There was evidence to confirm the progressive refurbishment programme presented in the AQAA. We acknowledged that Wheaton Aston provides a range of communal areas for residents to enjoy, with access to three lounges that are furnished in a domestic style, with a comfortable, well-presented dining room. We were informed that social, cultural and religious activities tend to take place in the lounges. Through our inspection we found bedrooms were well appointed, of a good size and equipped to meet the demands of the elderly, with appropriate movement and handling facilities, hand and grab rails, ramps and call alarms. There are a total of nine profiling beds available, with more on order. The Care Manager confirmed to us a willingness on the part of management to meet any reasonable demand for special needs. There is a designated respite care bedroom available, although without en-suite facilities. We tested the effectiveness of the nurse-call alarm system, receiving a positive response, and personal electrical equipment (PAT) were seen to be tested appropriately. We saw a good standard of furnishing complimented with a variety of plentiful personal belongings, and most equipped with a flat screen TV. On our discussion with residents and visitors, we were assured that these arrangements helped to create a sense of belonging, and satisfaction in the quality of life. We recognised the standard of cleanliness to be excellent throughout; there was no evidence of offensive odours in any of the rooms inspected. We were informed that sluices, bathrooms and toilets were cleaned on a routine basis, which we confirmed on inspection, presented a pleasant and hygienic environment. Disposable gloves and aprons were seen in use, and liquid soap and paper towels were evident throughout. The sluices and laundry were found to be well organised and equipped to a good standard, procedures were in place for coping with soiled/infected linen with the provision of alginate bags to minimise handling and cross-infection. We indicated that appropriate laminated information posters (COSHH) would enhance safety in all areas handling chemicals. Wheaton Aston Care Home DS0000068297.V369515.R01.S.doc Version 5.2 Page 20 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 and 30 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels ensure that suitably trained staff are provided to meet the needs of people who use the service. Recruitment, appointment and training processes are consistent and robust, protecting the people who use the service from harm and abuse. EVIDENCE: We found that the service has maintained staffing to consistent levels to ensure equilibrium between numbers, skills and qualifications, with a strong presence of long serving, stable and experienced staff. There were 29 people using the service in the home on the day of the inspection. We examined three weeks of off-duty rotas, in which the daily care staffing showed adequate balance between skills, qualifications and numbers to provide a foundation for a high standard of care. The maintenance, catering, domestic and laundry hours were determined and found to be appropriate for the size of Wheaton Aston Care Home DS0000068297.V369515.R01.S.doc Version 5.2 Page 21 the Home, and the needs of the residents. There is also a part time activity coordinator and a receptionist/administrator. We confirmed the Care Manager works supernumerary, and is supported by a team of experienced Registered Nurses. Agency coverage has been used to support shortages of care staff, in tandem with overtime and flexible rostering. We examined four staff files, each providing satisfactory evidence that the process of appointing new staff were well organised, consistent and contributed in safeguarded the interests of residents. Four staff on duty were interviewed, each having had a statement of terms and conditions. Each member of staff spoke well of the training and supervision offered to them, and of the good working conditions that prevail. Our discussions with staff also confirmed their commitment to providing a quality service, and their awareness of the principles of good practice and Code of conduct. There were no problematic issues raised by the staff. There is a satisfactory staff induction programme, which we found initiated a formal in-house training schedule. The National Vocational Qualification (NVQ) programmes continue, although levels are not maintained due to staff leaving. Consideration should be given to enlarge the availability for care staff to a dementia training programme to meet anticipated needs. We accept the continuing commitment to care education as sustained. The supervision programme is firmly established, which involved establishing a shared aspect of responsibility between staff and trainer, with the involvement of mentor trained staff. Wheaton Aston Care Home DS0000068297.V369515.R01.S.doc Version 5.2 Page 22 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): 31,32,33,34,35, and 38 The quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The care team promote the health, safety and welfare of people using the service, and working practices are safe. People who use the service can be assured that the home is run in their interests. The ethos of the service is based on openness and respect. EVIDENCE: The Registered Care Manager Linda Warden demonstrates a long-term commitment and competence in running Wheaton Aston, in establishing a solid professional policy platform; that has been implemented to achieve a high standard of set aims and objectives. A qualified general Nurse, she has Wheaton Aston Care Home DS0000068297.V369515.R01.S.doc Version 5.2 Page 23 demonstrated to us her wide experience, and is well qualified in meeting the aims and objectives of the service. She has the Registered Managers Award, and has actively promoted, and enhanced the Key worker and Named Nurse team concept. The Registered Providers have demonstrated a high profile and involvement in the smooth running of the Home, and are prepared to delegate a wide range of management responsibility to good effect. We acknowledged the openness and confidence in the observed interactions of staff, relatives and residents. The relationships were seen to be of mutual trust and respect. We found appropriate risk assessments in place for residents, through care planning, review and monitoring, staff selection and the general environment, these were found to be up to date and accurate. Health and safety notices were seen throughout the home. We recognise that quality assurance complements this arrangement, in that we found extensive monitoring in areas as care planning, staff meetings, staff training and residents’ suggestions. Our case tracking reinforced the effectiveness of people’s involvement in their care and environment. The AQAA states that the Manager conducts spot checks through a weekly Risk Monitor Report, including bedrails, wheelchairs, hoist and sling checks, accidents and first impressions. We established this to be true, leading to discussions around establishing a full unit inventory of risk. We saw records of resident and relative meetings that are a regular feature of quality assurance. Comments from those attending included: “I like the activities, would like more outings” “The meals are fine, good breakfasts, more choice needed at lunch, but teatime very happy with the choices and service. Sometimes the bread is a bit thick”. We sampled records and servicing reports and found them to be well maintained, accurate and up to date, ensuring that the people’s’ rights and best interests are safeguarded. The procedures manual was examined, and found to offer a very comprehensive reference. Relevant legislation was discussed and is fully understood by the management, especially the Mental Capacity Act and its implications. Equality and diversity issues were also discussed covering a wide range of issues, including food, religion and staffing. We found that the health and safety of residents and staff are promoted with safe storage of hazardous substances, regular electrical PAT and servicing of electrical and gas appliances and regulation of the water system. The accident book was seen and found to be in order for staff and residents, with a three monthly analysis of trends and frequency. We recognise that the administration and management of the service is efficient, uncomplicated and sensitive to the needs of people who use it. Wheaton Aston Care Home DS0000068297.V369515.R01.S.doc Version 5.2 Page 24 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X 3 3 4 STAFFING Standard No Score 27 4 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 4 3 3 X X 3 Wheaton Aston Care Home DS0000068297.V369515.R01.S.doc Version 5.2 Page 25 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 OP12 OP16 OP20.3 OP26 Good Practice Recommendations That the Service User Guide contains information regarding the up to date fees charged. A Concerns, Complaints and Allegation book be established to more effectively monitor incidents. To consider the provision of a small garden area for the use of residents. That COSHHE laminates be displayed in all areas involving the use of hazardous chemicals, to complement existing procedure sheets. To maintain a training programme to meet NVQ commitments to meet 50 target of all care staff. Ensure access to all service rooms be secure to casual DS0000068297.V369515.R01.S.doc Version 5.2 Page 26 5 6 OP28 OP38 Wheaton Aston Care Home entry by residents, to minimise risk of injury, i.e. laundry and storage areas. Wheaton Aston Care Home DS0000068297.V369515.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection West Midlands 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 Wheaton Aston Care Home DS0000068297.V369515.R01.S.doc Version 5.2 Page 28 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!

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