Care Home: Willoughby House

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Willoughby House Willoughby Road Sutton-on-sea Lincs LN12 2NF two star good service The quality rating for this care home is: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Ken Hague Date: 2 6 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Internet address www.csci.org.uk Information about the care home Name of care home: Address: Willoughby House Willoughby Road Sutton-on-sea Lincs LN12 2NF 01507442555 01754811004 boulevardcare@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Boulevard Care Name of registered manager (if applicable) Mr David Meadows Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 8 0 care home 8 learning disability Additional conditions: Date of last inspection A bit about the care home Willoughby House is owned by Boulevard Care, which has a number of care homes within the Skegness area. It provides residential care for 8 residents with a learning disability who are under the age of 65. The home is set just off the seafront of Sutton-on-Sea in Lincolnshire. It is a single storey building surrounded by its own grounds and is within walking distance of all the local amenities and shops. It is very accessible by public transport and there is a large car park at the front of the care home. The home provides minibus transport to enable residents to take part in day activities and there is a local day centre in Orby, which can be attended by residents, if they so wish. There are other activities organised by the home at alternative venues including colleges. Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home How we did our inspection: This is what the inspector did when they were at the care home The inspection took place over 6 hours. The files for three individual residents were read and discussed with the residents and members of staff. Two members of staff were interviewed. The company sent in a form in which they explained how they help the people that live in the home. It tells us how the provider makes sure that they are meeting the Care Home Regulations. Residents were spoken to do during the site visit their opinions can be found within this inspection report. What the care home does well The home provides a comfortable, safe and homely environment for people to live in. There are assessment and care planning processes in place. Residents have detailed care plans, which enables staff to know how residents needs are to be met by the resources of the home. The home offers, a range of social and leisure activities. A balanced and varied diet is provided. Residents can influence the way the service is run. Resident stated that they felt their needs are being addressed by the care home. They said the home is always clean. There is a training plan in place for staff who are well supported by the management of the home, which helps them to provide a good quality of care. What has got better from the last inspection What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Ken Hague 33 Greycoat Street London SW1P 2QF 02079792000 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . New residents receive a full and comprehensive assessment prior to being admitted. This ensures the identified needs of each resident can be met by the resources of the care home. Evidence: The care records for three residents being case tracked were viewed. They all contained a comprehensive detailed assessment which set out the needs of each resident and how they were to be met by the home. Assessments included a risk assessment and where any risk was identified risk management strategies were in place. Assessments were updated and reviewed alongside care plans. Records were signed and dated by the assessor and the resident or relative. The home does not offer a dedicated intermediate risk care service. The individual residents file contains a contract which stated the room to be occupied, the fee which were payable and the terms and conditions of occupancy. Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Care plan instruct staff how they should meet the identified needs of each resident. The companys medication procedure is being followed ensuring the safe administration and storage of medication. Evidence: The care files and records for three individual residents were seen as part of the case tracking process. They all contained a detailed care plan which included a risk management plan when appropriate. The information on the care plan had been obtained at the initial assessment completed prior to the resident entering the home. Residents had been involved in the writing of their individual care plan and had signed their own documents. The care plans set out the choices and wishes and goals of the residents. These were in respect of their social and personal care needs. All care plans had been reviewed in accordance with national guidelines. Staff stated that care plans were easy to understand and ensured residents needs were met. All individual care records were filed in a consistent manner. An index at the front of each file allows the reader to quickly identify where the assessment and care plan can be found in each file. The quality of the recording was good the quality of care records exceeded the national minimum standards. Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home offers a range of activities which meets the needs of residents. The menu provided ensures the dietary needs of residents are met while offering choices. Residents are encouraged to maintain links with family and the community. Evidence: A range of activities are provided by the home. These are detailed in the AQAA supplied by the registered manager. Residents individual care records detail the choices and wishes of the social activities for each individual resident. The “have your say” documents and discussions held during the site visit residents provided evidence that individual choice of activities are being provided. Residents go out into the local community for meals as part of their social lifestyle. Families are encouraged to maintain links with the residents and are invited to social events held at the home. Residents take part in activities held in the community, at the Orby day centre. The managers provide a menu which offers choice and give a balanced diet. Residents confirmed they were satisfied that the quality and choice of food. This judgment was made after discussions held on the day the site visit and from responses found within the have your say documents completed by residents. A resident stated The food here is good we have a choice every day. Staff talk to us and ask is what sort of food we enjoy. We do go out to restaurants for meals sometime to celebrate birthdays. Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The medication policy for the home ensures that the administration and storage of medication is carried out safely. The dignity and privacy of the residents is respected. Health care needs are being met. Evidence: Care plans instruct staff how to provide personal care while preserving the dignity and privacy of the residents. Resident stated that staff respect the privacy and provide help in a sensitive manner. Staff interviewed described the wishes and choices of each resident been case tracked and the levels of support necessary to ensure all of their needs were met. staff were seen to knock at doors before entering. Medication was being taken by a resident who required an injection. The member of staff made sure that the injection by the resident was carried out in the privacy of their room. The home’s updated medication policy ensures that prescribed medication is administered and stored safely. Staff stated that they had been trained in the administration and storage of medication and felt competent to carry out this test. Staff giving out medication, during the site visit was observed to follow this procedure and to complete medication records correctly. There have been no notifications or concerns raised about the administration of medication at this home since the last key inspection. The health care needs of residents are recorded on their individual care plan. The managers ensure that residents can attend GP surgeries and hospital appointments. Resident stated that the health care needs are being met. Recordings in care records supported the statement. Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The managers have in place an updated policy which ensures residents are protected from potential abuse. Residents are able to raise any concerns using the homes complaints procedure. Evidence: The AQAA states of staff have been trained in the recognition and management of abuse. There have been no investigations carried out under the adult protection procedure for this care home. Notifications have been submitted appropriately none have raised concerns. No complaints have been received by the care home or the commission for social care inspection since the last key inspection. Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Residents live in a comfortable well maintained environment. Evidence: An ongoing maintenance program is in place for the care home. Since the last key inspection two bathrooms have been refurbished. A new laundry room has been constructed. A new sleeping room has been established for staff. The managers have purchase new soft furnishing and fitted new carpets in several areas of the home. Rooms have been redecorated including the lounge and bedroom. A new kitchen floor has been fitted. The environment of the care home has been very much improved. The care home was clean and smelt fresh. No health or safety issues were identified at this visit. Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . There are always sufficient numbers of trained staff with appropriate skills on duty to meet the needs of residents. New staff are recruited safely using the updated recruitment procedure of the home. The dignity and privacy of residents is respected. Evidence: The homes managers have an updated recruitment procedure which is being followed by the registered manager. All of the documents set out in the Care Home Regulations were found to be on the files of new staff. This included criminal record bureau checks, two written references, application forms and details of each persons formal interview. Staff records and training records provide evidence that all staff are given both essential training and specialised training courses to ensure residents needs are met. Staff stated that they felt they had been trained to be able to answer the needs of residents. Resident stated in their “have your say” document that they believed their needs will be met by the care home. The AQAA completed by the registered manager provided evidence that staff are taking part in NVQ training in care. The regional manger stated that there is a yearly training plan in place which was written after studying the needs of carers identified in appraisals and formal supervision. Staff stated that in their opinion there were always sufficient staff on duty to meet the needs of residents. The regional manager added that she agreed with these statements. She said if there was a need for additional staffing this was provided. Observations of staff during the site visit provided evidence that they respect the dignity and privacy of the resident and provide support in a sensitive and caring manner. Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The registered manager is monitoring care practice and care records to ensure that the care home regulations are met. No health and safety issues were identified. Evidence: There is an experienced registered manager in post. Staff and residents stated that he is supportive and approachable. Discussions and the inspection of records provided evidence that supervision appraisals of staff meetings are taking place. The quality and detail of care records have improved since the last inspection. A staff training programme is in place to ensure staff obtaining the skills required to meet the needs of residents. No health and safety issues were identified at the site visit. Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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