Care Home: Wilfred Geere House

Similar services:

• Chirnside House
• Keer Sands Residential Home
• Ruskin Lodge
• Bushell House
• Langrigg House
• Parkside
• Dystlegh Grange
• Thornton Lodge

What the care home does well New residents had their needs assessed to establish if the service could provide the right care and support, before a placement in the home was offered. Records showed there was consultation about the level and type of care required. New residents had a `planned admission day`. They were made welcome and received a welcome card and gift. Residents living in the home benefited from the support of a named worker referred to as a Key worker who took responsibility for their personal care. Resident`s also benefited from additional specialist support where needed, such as health and mental healthcare needs. Staff caring for people with dementia had training in this specialist area of work. Healthcare professionals were pleased with the standard of care provided. One GP wrote ``I don`t know what the formula is, but they do it so well`. Wilfred Geere House DS0000031381.V359958.R02.S.doc Version 5.2 Page 6All relatives who provided written comments considered the care and service their relations received as being good. Comments were made, such as, `I feel very lucky my wife is a patient here`. `The quality of care provided for my mother has been excellent. All staff deserves the highest recognition for the difficult work they do`. And `I think the staff at Wilfred Geere provide a very safe, secure and a wonderful warm caring environment for the residents who are at a vulnerable time of life`. `The staff are very friendly and do all they can do to make my mother feel at home`. The level of dignity afforded to residents was commendable. Observations made throughout the inspection showed very good care had been taken with residents` appearance and residents were treated with respect. One relative considered the service did well in `Looking after the patients and keeping them well dressed and clean. Staff to be commended for attention given to residents.` Residents were supported to keep in contact with relatives and friends. Written comments from relatives included `I phone nearly everyday they are very helpful with answers`. And `Staff have very kindly phoned me in on a number of occasions about various issues`. Hospitality for visitors was very good. Food served to residents was good. Choices were offered and the dining room provided a pleasant eating area for residents. One observation from a relatives comment was `a good policy on mealtime`s - regular drinks etc., the food is homemade and excellent.` Adult protection was given a high profile with staff training. Staff knew their responsibility in this area. Comments from the manager demonstrated he manages `zero tolerance` with poor practice. Accommodation for residents was good. The home was tastefully decorated and furnished to a high standard. Aids required to assist people to be independent was provided. The standard of hygiene maintained was excellent. The training provided for staff was very good and the home is commended for the number of care staff having completed a National Vocational Qualification in Care. Staff interviewed showed they had good knowledge in understanding the needs of older people. Relatives` views of staff were, `Some staff have exceptional skills and experience`. `That the girls at Wilfred Geere sing from the same "hymn sheets" in perfect harmony for both family members & residents in care.` Systems were in place to approach residents/relatives to give their view on the quality of services and facilities in the home. Quality Assurance carried out at the home showed professional people considered the staff professional, residents appeared well cared for, and there was a pleasant atmosphere in the home. One relative informed the Commission the home was `First-class like a five star hotel`. What has improved since the last inspection? Information received at the Commission from the manager indicated the home had improved in a number of areas. These improvements includes: Working more closely with our health colleagues in order to ensure a smooth transition for residents coming into the home. Regular meetings are held with health colleagues to support resident care. All relatives, advocates etc. are kept informed of changes in the care needs of that person and are encouraged to participate in reviews. New menus are in place, with guidance taken from "Highlight of the Day" and Catering Code of Practice. There are closer ties with the local community. All staff have an individual personal development plan. What the care home could do better: People using the service must be provided with clear information about the actual level of fees charged and details about the arrangements for paying the fees, within the contract. More detail should be recorded in care planning to ensure residents` needs are consistently met, and residents` abilities are recognised. This is to provide staff with clear information about how best to meet, monitor and respond to these needs and help residents to be cared for as they wish and require. The Manager must ensure residents participate in social and recreational activities suitable to their needs and capabilities. Routines for daily living should be recorded better, and link to personal care needs. This will help residents benefit from a consistent approach to their care by staff. To make sure medication practice is safe, two people should check for accuracy all handwritten additions to medication records. Creams and lotions and eye drops prescribed for residents must be signed for when applied. Medication to be administered `when required` should be recorded in more detail as to the circumstances it would be given, particularly when people are unable to tell someone they need the medication, such as pain relief. Medication no longer required should be returned to the pharmacist and not re ordered. Locks on bedroom doors must be suitable for the residents in the home to use with relative ease. This will help them to keep themselves and their possessions safe.It is recommended staffing levels be reviewed. This will provide residents with the support they need to engage fully in `life in the home` as they would wish. It is recommended management are consistent in their approach to day-to-day management. This will avoid any confusion amongst staff as to `how things should be done`. The systems for communication between management and staff should be reviewed, to prevent essential information not being given. To support staff to develop as professionals and to give job satisfaction, staff supervision and staff meetings should be held more regular. Individual risk assessments of residents for building evacuation should be completed. This will help staff to identify any difficulties they may encounter in an evacuation and know how to keep themselves and residents safe. The Manager must clarify as to whether the home`s fixed electrical wiring certificate is valid and current and notify the CSCI of the findings. CARE HOMES FOR OLDER PEOPLE Wilfred Geere House 310 Highfield Road Farnworth Bolton Lancashire BL4 0PG Lead Inspector Mrs Marie Dickinson Unannounced Inspection 10:00 4 & 6 March 2008 th th 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 Wilfred Geere House DS0000031381.V359958.R02.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. Wilfred Geere House DS0000031381.V359958.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wilfred Geere House Address 310 Highfield Road Farnworth Bolton Lancashire BL4 0PG 01204 337839 01204 337845 rob.crowe@bolton.gov.uk 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) Bolton Metropolitan Borough Council Mr Robert Anthony Crowe Care Home 27 Category(ies) of Dementia - over 65 years of age (27) registration, with number of places Wilfred Geere House DS0000031381.V359958.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The Home is registered for a maximum of 27 service users to include:up to 27 service users in the category of DE(E) (Adults with Dementia over 65 years of age) The service should employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. 15th November 2006 Date of last inspection Brief Description of the Service: Wilfred Geere House is owned by Bolton Council and is run by the Social Services Department. The home can accommodate up to 25 older people with dementia care needs and two respite care beds are also available. The home is situated about two miles from Farnworth town centre and there is limited car parking nearby. All of the bedrooms are single and the residents are actively encouraged to personalise them. The home provides a good choice of lounges and a dining room, which are suitably decorated and furnished, and a separate hairdressing room is also available. The home is located in a residential area and a central sensory garden is presently under construction that will be easily accessible from the main building. There are shops nearby and there is a bus stop near the home, on route to the town centre, as well as easy access to the motorway network. A Service User Guide that describes the home’s services is readily available in the home and the staff gives other information about the home to new and prospective residents and their families verbally. A copy of the latest inspection report, the home’s Statement of Purpose and a copy of the latest quality assurance survey are also displayed in the home. At the time of writing this report the basic charge for accommodation and services is £409:00 per week. Additional charges are made for hairdressing, preferred toiletries, and personal newspapers. Wilfred Geere House DS0000031381.V359958.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 Star. This means the people who use this service experience good quality outcomes. A key unannounced inspection was conducted in respect of Wilfred Geere on the 4th and 6th March 2008. The inspection involved getting information from an Annual Quality Assurance Assessment completed by the manager, staff records, care records and policies and procedures. It also involved talking to residents, staff on duty, the manager, care supervisors, and included an inspection of the premises. Observations were also made of resident’s daily life experience in the home. Written comments from relatives and staff were received giving their view of the service provided and outcomes for residents. Areas that needed to improve from the previous inspection were looked at for progress made. The home was assessed against the National Minimum Standards for Older People. What the service does well: New residents had their needs assessed to establish if the service could provide the right care and support, before a placement in the home was offered. Records showed there was consultation about the level and type of care required. New residents had a ‘planned admission day’. They were made welcome and received a welcome card and gift. Residents living in the home benefited from the support of a named worker referred to as a Key worker who took responsibility for their personal care. Resident’s also benefited from additional specialist support where needed, such as health and mental healthcare needs. Staff caring for people with dementia had training in this specialist area of work. Healthcare professionals were pleased with the standard of care provided. One GP wrote ‘‘I don’t know what the formula is, but they do it so well’. Wilfred Geere House DS0000031381.V359958.R02.S.doc Version 5.2 Page 6 All relatives who provided written comments considered the care and service their relations received as being good. Comments were made, such as, ‘I feel very lucky my wife is a patient here’. ‘The quality of care provided for my mother has been excellent. All staff deserves the highest recognition for the difficult work they do’. And ‘I think the staff at Wilfred Geere provide a very safe, secure and a wonderful warm caring environment for the residents who are at a vulnerable time of life’. ‘The staff are very friendly and do all they can do to make my mother feel at home’. The level of dignity afforded to residents was commendable. Observations made throughout the inspection showed very good care had been taken with residents’ appearance and residents were treated with respect. One relative considered the service did well in ‘Looking after the patients and keeping them well dressed and clean. Staff to be commended for attention given to residents.’ Residents were supported to keep in contact with relatives and friends. Written comments from relatives included ‘I phone nearly everyday they are very helpful with answers’. And ‘Staff have very kindly phoned me in on a number of occasions about various issues’. Hospitality for visitors was very good. Food served to residents was good. Choices were offered and the dining room provided a pleasant eating area for residents. One observation from a relatives comment was ‘a good policy on mealtimes - regular drinks etc., the food is homemade and excellent.’ Adult protection was given a high profile with staff training. Staff knew their responsibility in this area. Comments from the manager demonstrated he manages ‘zero tolerance’ with poor practice. Accommodation for residents was good. The home was tastefully decorated and furnished to a high standard. Aids required to assist people to be independent was provided. The standard of hygiene maintained was excellent. The training provided for staff was very good and the home is commended for the number of care staff having completed a National Vocational Qualification in Care. Staff interviewed showed they had good knowledge in understanding the needs of older people. Relatives’ views of staff were, ‘Some staff have exceptional skills and experience’. ‘That the girls at Wilfred Geere sing from the same hymn sheets in perfect harmony for both family members & residents in care.’ Systems were in place to approach residents/relatives to give their view on the quality of services and facilities in the home. Quality Assurance carried out at the home showed professional people considered the staff professional, residents appeared well cared for, and there was a pleasant atmosphere in the home. One relative informed the Commission the home was ‘First-class like a five star hotel’. Wilfred Geere House DS0000031381.V359958.R02.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: People using the service must be provided with clear information about the actual level of fees charged and details about the arrangements for paying the fees, within the contract. More detail should be recorded in care planning to ensure residents’ needs are consistently met, and residents’ abilities are recognised. This is to provide staff with clear information about how best to meet, monitor and respond to these needs and help residents to be cared for as they wish and require. The Manager must ensure residents participate in social and recreational activities suitable to their needs and capabilities. Routines for daily living should be recorded better, and link to personal care needs. This will help residents benefit from a consistent approach to their care by staff. To make sure medication practice is safe, two people should check for accuracy all handwritten additions to medication records. Creams and lotions and eye drops prescribed for residents must be signed for when applied. Medication to be administered ‘when required’ should be recorded in more detail as to the circumstances it would be given, particularly when people are unable to tell someone they need the medication, such as pain relief. Medication no longer required should be returned to the pharmacist and not re ordered. Locks on bedroom doors must be suitable for the residents in the home to use with relative ease. This will help them to keep themselves and their possessions safe. Wilfred Geere House DS0000031381.V359958.R02.S.doc Version 5.2 Page 8 It is recommended staffing levels be reviewed. This will provide residents with the support they need to engage fully in ‘life in the home’ as they would wish. It is recommended management are consistent in their approach to day-to-day management. This will avoid any confusion amongst staff as to ‘how things should be done’. The systems for communication between management and staff should be reviewed, to prevent essential information not being given. To support staff to develop as professionals and to give job satisfaction, staff supervision and staff meetings should be held more regular. Individual risk assessments of residents for building evacuation should be completed. This will help staff to identify any difficulties they may encounter in an evacuation and know how to keep themselves and residents safe. The Manager must clarify as to whether the home’s fixed electrical wiring certificate is valid and current and notify the CSCI of the findings. 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. Wilfred Geere House DS0000031381.V359958.R02.S.doc Version 5.2 Page 9 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 Wilfred Geere House DS0000031381.V359958.R02.S.doc Version 5.2 Page 10 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): 2,3 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Good admission procedures enabled people to decide if the home could meet their needs and expectations. Contract arrangements were not entirely satisfactory in informing people individually of the cost of their stay. EVIDENCE: The admission procedure followed involves the manager visiting the person in the community. This is to carry out an assessment of their needs and consider if the home has the right facilities, and staff expertise to meet those needs. Since the last inspection there had been a number of admissions. Records completed during the admission process showed how the home managed this. Wilfred Geere House DS0000031381.V359958.R02.S.doc Version 5.2 Page 11 The pre-admission assessment record identified personal, health, and social care needs. This provided information about the person’s circumstances and level of support required to enable them to have the right care. Written information received at the Commission indicated assessments ‘would usually involve a social worker and a community psychiatric nurse. In more complex cases the Care Programme Approach (CPA) is adopted’. This information also stated new residents ‘have a planned admission day’. Efforts were made to help new residents settle in such as allocating a personal carer and giving a welcome card and small gift. Bolton Council, registered provider of this service, deals with contract arrangements. Resident’s files showed people were issued with terms and conditions of residence; however these did not provide an individual contract that included fees payable and method of payment. There was no evidence available to show how privately funded residents contracts met with the requirement of regulation. The range of needs of residents had been considered. Staff training programme-included full induction and essential training for example, moving and handling, and protecting vulnerable adults. Training staff was ongoing as part of staffs development in providing care. Specialist dementia care training was provided. Wilfred Geere House DS0000031381.V359958.R02.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care planning process took into account resident’s health, personal, social, and health care needs, More detail was required however, to ensure the care provided was person centred and took into account the diverse needs and abilities of individuals. Medication was managed relatively safely, however maintaining written records must be improved to reduce the risk of any errors being made. Residents were treated with respect, which supported their right to live with dignity. EVIDENCE: Relatives who provided written comments for this inspection considered the care residents receive to be very good. Comments included, ‘My mother Wilfred Geere House DS0000031381.V359958.R02.S.doc Version 5.2 Page 13 benefits greatly because the care staff understand and meet her needs excellently’. And ‘Takes care of my mother and all her needs very well’. Staff worked to a key worker system, having some responsibility for personalising care for residents. Whilst care plans were written for all residents, and staff interviewed knew how residents should be cared for, care plans were basically written. The manager considered this approach was easier for staff to follow. Completing these for the benefit of residents and staff however, required further development; to make sure personal care was provided in a consistent way. For example statements of ‘requires support or assistance’ should inform the carer what the support would be and level of a persons own dependency skills, self-care and preferences. This would also help people retain existing life skills. Some residents had a night care plan. These were more personalised and clear how care and routine for residents was to be provided. Written comments received from staff said they would like more information, particularly when resident’s needs changed or risk of aggression was known. Reviews of care plans were carried out. Risk assessments had been completed. Healthcare needs were being monitored. Records were kept of visits from residents Doctors, chiropody services, and District nurses attended to clinical procedures in the home such as dressings. Staff also promoted good healthcare, such as continence management and monitoring dietary needs. Pressure care was promoted and pressure-relieving aids were used where need was identified. There was also evidence of the involvement of the Mental Health services in the review of mental health care needs. Written comments from professionals who are involved with residents at Wilfred Geere considered the service to be very good. One comment referred to staff as, ‘Approachable, busy, but always have time for assistance when required’. Another stated ‘‘I don’t know what the formula is, but they do it so well, unlike other places I visit….’ Relatives also commented they were kept informed and consulted about important issues linked to resident care. ‘‘Yes they always consulted me if they have had to seek medical advice and concerning my wife’. Staff responsible for handling, recording and administering medication had been trained. There were policies and procedures and practice guidance, available for them to use. The home operated a monitored dosage system. Medication was dispensed into controlled dose packs by a local pharmacist. Medication records were completed. Better care must be taken however when handwritten additions to residents medication record (MAR sheet) is required to be checked by two people to make sure instructions and doses are accurate. In addition to this creams, lotions and eye drops must be signed for as applied. Medication given as when necessay requires more detail as to when this would be given, particularly when the medication perscribed is for people with Wilfred Geere House DS0000031381.V359958.R02.S.doc Version 5.2 Page 14 dementia. Medication must be reviewed so that unecessary stocks are not ordered and homely remedies are safe to use with perscribed medication. Staff and management are commended for their efforts in maintaining peoples dignity in the home. Observations showed care and attention had been given to resident’s appearance at all times. Continence management was extremely good and residents lived in a clean, odour free environment. Throughout the inspection staff were respectful towards residents in the way they spoke and how they supported them. Written comments from relatives agree with this observation and considered the home did well by, ‘Looking after the patients & keeping them well dressed and clean. Staff to be commended for attention given to residents.’ Wilfred Geere House DS0000031381.V359958.R02.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Residents had some opportunity to take part in activities, and make choices and decisions about their lives. However the differing needs of residents must be considered as to the type of social and recreational activity provided for quality of life experience. Visiting arrangements were very good. Residents were offered a balanced, varied, and nutritious diet that provided for their tastes and choice. EVIDENCE: Although activities were planned, managing activities for people with dementia needs to be developed, and staff numbers sufficient for this to be done successfully. One relative commented ‘It is very difficult to provide for the needs of each individual with the finance and manpower available’. Wilfred Geere House DS0000031381.V359958.R02.S.doc Version 5.2 Page 16 The issue of dealing with activities that meets with residents needs was discussed with the manager. In addition to organised activities, the manager said residents were involved in their own meaningful activities without any restriction being placed against them. For example a resident may want to fold laundry, dust their bedroom or walk about freely whilst chatting to people. A safe outdoor sensory garden area had been created to accommodate resident’s who needs to get out of the home. Observations during inspection showed residents attending the hairdresser, having manicures and there was evidence in the activity room of creative skills being encouraged with Easter bonnets trimmed. One relative commented ‘They interact very well with the residents providing music, quizzes and games which my mother gets involved with and enjoys very much.’ Staff said they would like to do more with residents, but the high dependency needs of residents meant there was not always sufficient time for this. Resident’s lifestyle was centred on them, and residents did not have to conform to any institutional practice such as set times for getting up or going to bed. Residents’ preferences in respect of choice in routine of daily living, could be recorded better. This would help to link individual interests, preference, and capabilities into a plan of care. Night care plans were very good in providing staff with this information by personalising individual night routine. Written comments and comments made by relatives visiting during inspection showed visiting arrangements to be very good. They all felt they could see their relation in private. One relative visiting during inspection said she visited her husband often and had a meal with him at the home. Another visitor said he visited nearly every day and thought the staff were ‘marvellous’. He was always offered a drink and felt he could chat to staff involved in his relatives care. Residents were supported to continue with their chosen religion. One relative wrote, ‘My mum always goes to the religious services and meets the ministers’. Observations made during inspection were, care staff showed sensitivity to the needs of those residents who find it difficult to eat without assistance. The atmosphere in the dining room was relaxed and calm. The dining room provided a pleasant eating area for residents, and individual table settings and centrepieces gave a welcoming touch. Staff were observed being courteous and attentive when serving meals. Meals served were very well presented. Menus seen showed a varied diet was provided and records were kept of meals served. There was a choice of meals offered and portions served were generous. All residents enjoyed their meal and staff sat down with residents who required individual supervision. Wilfred Geere House DS0000031381.V359958.R02.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The complaints procedure was available which helped residents/relatives have confidence to raise any concern they may have. There were policies and procedures, and appropriate training for staff in professional conduct and adult protection issues. This meant residents rights, safety, and welfare was promoted. EVIDENCE: There had been no complaints received at the Commission and no complaints made to the home since the last inspection. The complaints procedure was given to residents when they were admitted to the home. This was in the service user guide. A complaints recording system was in place. Relatives who were consulted said they ‘knew’ how to make a complaint should this be necessary’. And, ‘Have never a reason/s to complain about staff’. Staff interviewed were aware of the difficulty for some residents as they may lack the capacity to make a complaint. However they considered the environment Wilfred Geere House DS0000031381.V359958.R02.S.doc Version 5.2 Page 18 of the home, and an open culture that existed, meant visitors would raise any problems. They knew the procedure. They said it was very unusual to receive a complaint, but minor issues were soon resolved and people were happy with how matters were dealt with. Staff working at the home said they were trained in adult protection and were aware of the abuse policies and procedures, which included whistle blowing. They knew their responsibility in this area and were confident they would ‘report bad practice’ if ever the need arose. There were written policies and procedures covering adult protection and whistle blowing. There was no copy of a staff contract to confirm staff agreement of none acceptance of gifts, wills and bequests. The manager said this was covered during induction. Wilfred Geere House DS0000031381.V359958.R02.S.doc Version 5.2 Page 19 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): 19,22,23,26 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents were provided with a warm, comfortable, clean, environment that suited most of their needs. However door locks fitted on bedroom doors were not suitable for easy use, therefore residents did not always have privacy of space. EVIDENCE: Wilfred Geere is a well maintained, safe enviroment for residents and staff. Residents comfort had been considered and the accommodation was furnished Wilfred Geere House DS0000031381.V359958.R02.S.doc Version 5.2 Page 20 and fitted to a very good standard. The lounges, dining room, and smoking room were pleasant. One relative who was visiting was pleased with the facilities of the smoking room and the comfort it offered his mother. A central sensory garden was near completion and will be a safe place for residents to walk about. When people are admitted to the home, they can bring with them items of furniture and personal effects that can be reasonably accommodated in their bedroom. Bedrooms seen were personalised and furnished and decorated to a good standard. Locks on bedroom doors were not easy for people with dementia to use. This resulted in bedroom doors being left unlocked which meant that people did not have privacy and there is a higher risk of unwanted intrusion by others. Information received at the Commission for this inspection showed contracted engineers checked equipment used in the home. And the building complies fully with the requirements of the fire service and environmental department. Specialist equipment was available to support residents with daily living and aids and adaptations were provided in bedrooms, bathroom and toilets. Written comments from relatives showed they considered the accommodation provided was good. Comments included, ‘The home is extremely clean’, and ‘All facilities at the home are good for the residents’. The standard of hygiene kept throughout the home was very good. One visitor during inspection said, ‘no matter what time I visit, everywhere is clean and I have never smelt any bad odour in the home.’ Wilfred Geere House DS0000031381.V359958.R02.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Staffing levels were mainly satisfactory in aiming to ensure the resident’s needs are effectively and safely met. Recruitment practices were satisfactory in protecting residents. Staff received training, which meant they had the right skills and knowledge to care for residents. EVIDENCE: Information sent to the Commission prior to this inspection showed the home had a near full compliment of staff to cover all essential duties in providing care, and maintaining essential standards in the home such as hygiene and catering. Rotas seen during the inspection showed how staff were deployed throughout the day and night. Relatives were very complementary about staff working in the home. Written comments included ‘Some staff have exceptional skills and experience’. ‘Excellent Staff’, and ‘All staff deserve the highest recognition for the difficult work they do’. Wilfred Geere House DS0000031381.V359958.R02.S.doc Version 5.2 Page 22 There was a general feeling amongst staff that whilst ‘The service looks after people very well’, they struggled at times to meet the needs of residents’. Written comments also included ‘Care assistants need more staff so that they can do their job as it should be done’, one relative commented on the issue of staffing. ‘I think the staff at Wilfred Geere provide a very safe, secure and a wonderful warm caring environment for the residents who are at a vulnerable time of life. It must be a very difficult job especially with the residents’ problems and illnesses when there seems to be less staff than there used to be, they cope wonderfully well’. Observations made during inspection confirmed there were times when due to needs of highly dependent residents, when staff can only deal with personal care needs as the limit of support provided. Staff on duty during inspection were very professional and knowledgeable in the needs of older people with dementia. They considered they were ‘a good team’ and ‘worked well together’. Staff recruitment records are held centrally at the Bolton Local Authoritys head office. A sample of these was looked at in July 2007. Information seen included completed application forms with full employment histories, health information, contracts and criminal record checks. However, whilst proper references were in place for most staff, two had been employed without receipt of a written employment reference, and copies of proof of identity, qualifications and training were not kept. Requirements made have been addressed satisfactorily. Good practice was noted relating to the interview process and induction of new staff. All staff working in the home had received training. The percentage of staff having completed a national vocational qualification in care level 2 and above was excellent. Staff comments on training included, ‘In house training has been given and is far the best way’. And ‘There are always courses available and would also discuss courses during supervision’. To identify training needs staff had completed a personal development plan and information required for organizing training was held electronically. Wilfred Geere House DS0000031381.V359958.R02.S.doc Version 5.2 Page 23 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): 31,32,33,35,36,38 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home was run in the best interests of residents, which meant their health, safety and welfare was promoted enabling them to receive a good standard of care. EVIDENCE: Since the last inspection the home manager (Mr R Crowe) has been registered as manager for Wilfred Geere at the Commission. He has recognised Wilfred Geere House DS0000031381.V359958.R02.S.doc Version 5.2 Page 24 qualifications and extensive experience of working within various residential care settings. Part of his role is to manage within the corporate business plan and budget for the home. Care supervisors support the registered manager in the day to day running of the home, and Bolton Metropolitan Borough Council as Registered Provider have overall responsibility in how the home is managed. Staff who completed questionairres for this inspection considered the home did well by, ‘Tries its utmost to give services users the very best, and is always striving to improve to always be happy and friendly as we were in the past and continue to the future’. Staff considered some areas needed to improve such as communication between shifts, consistency in the management approach. ‘All in all everything is being done to care for service users but more planning with staff who do the job and more understanding needs to take place’. The home sent us their annual quality assurance assessment (AQAA), that gave us information we asked for. For example, how equality and diversity issues were managed. We were informed ‘All staff working in the home receive training and opportunites to gain knowledge/experiences which reflect diversity and equality’. Since the last inspection Quality Assurance had taken place with relatives and professionals linked to the service. The results were published and showed positive outcomes for people living in the home with a 66 response received. Samples from the survey showed, all respondents considered the staff were professional in their manner. All considered they were friendly and helpful. Residents appeared well cared for; telephone calls were answered quickly and politely. There was a pleasant atmosphere in the home, and the home was clean, pleasant, and hygienic. Most respondents considered the home very well managed. The home holds money for a small number of residents for safekeeping. Financial procedures were followed and records kept of transactions made on behalf of people, to provide a clear audit trail. Secure storage was available for the safekeeping of money and of any valuable items. Staff meetings were held, however these were not regular. There was a lack of regular staff supervision to monitor staff and help them develop professionally. The health, safety, and welfare of residents and staff had been considered. The home had a good range of policies and procedures and practice aimed at keeping everyone safe. Risk assessments to support residents with diverse and highly dependent needs, must be completed to take into account planning the care and support required for example in an emergency evacuation. Information received at the Commission showed regular maintenance of the homes fixtures, fitting and equipment, however information recorded showed Wilfred Geere House DS0000031381.V359958.R02.S.doc Version 5.2 Page 25 the fixed electrical systems out of date. The manager said he was sure this had been done and will as a matter of course send verification for this inspection. Staff training records showed essential mandatory training was being given to staff and being renewed periodically. Wilfred Geere House DS0000031381.V359958.R02.S.doc Version 5.2 Page 26 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 X 2 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 4 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 2 X X 4 STAFFING Standard No Score 27 2 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 3 X 3 2 X 2 Wilfred Geere House DS0000031381.V359958.R02.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? YES 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. 1. 2. Standard OP2 OP12 Regulation 5(b)(c) 16 Requirement People using the service must be informed in writing of the cost of staying in the home. The Manager must ensure that when residents participate in social and recreational activities that this is recorded. Previous timescale of 31/12/06 not met. The Manager must clarify as to whether the home’s fixed electrical wiring certificate is valid and current and notify the CSCI of the findings. Previous timescale of 31/12/08 not met. Timescale for action 30/04/08 30/04/08 3. OP38 13 30/04/08 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 Refer to Standard OP7 Good Practice Recommendations More detail should be recorded in care planning to ensure residents’ needs are consistently met, and residents’ DS0000031381.V359958.R02.S.doc Version 5.2 Page 28 Wilfred Geere House 2 3 4 OP9 OP9 OP9 5 6 7 8 9 10 11 12 OP9 OP14 OP23 OP27 OP32 OP32 OP36 OP38 abilities are recognised. Handwritten additions to medication records should be checked by two people for accuracy Creams and lotions and eye drops prescribed for residents must be signed for when applied. Medication to be administered ‘when required’ should be recorded in more detail as to the circumstances it would be given, particularly when people are unable to tell someone they need the medication. Medication no longer required should be returned to the pharmacist and not re ordered. Routines for daily living should be recorded better, and link to personal needs to enable residents to benefit a consistent approach to their care by staff. Locks on bedroom doors should be reviewed so that they are suitable for the residents in the home to use It is recommended staffing levels be reviewed. It is recommended the systems for communication between management and staff be reviewed. It is recommended management are consistent in their approach in day-to-day management. Staff supervision and staff meetings should be held more regular. Individual risk assessments of residents for building evacuation should be completed. Wilfred Geere House DS0000031381.V359958.R02.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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 Wilfred Geere House DS0000031381.V359958.R02.S.doc Version 5.2 Page 30 - 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!