Care Home: Willow Brook Care Home

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What the care home does well People are assessed before coming into the home and staff make sure that they have suitable equipment and the skills to provide care for them before they come in. People have an allocated named nurse and key worker who knows all about them and communicates with them or their advocates on things they need or concerns they may have. People tell us they are happy at the home and that staff know how to care for them. The home is very clean and well maintained and any repairs are dealt with immediately. There are lots of opportunities for people to be active and take part in social events inside and outside of the home. People are consulted on how they wish to live their lives and what their interests are, enabling staff to plan for each person`s individual likes and interests. Staff are recruited safely by ensuring that anyone who may be unsuitable to work with vulnerable people are not employed. All new staff are supervised and trained and not left to care for people until they are competent to do so. Ongoing training and supervision of staff ensures that people are in safe hands and any gaps in skills are identified and training facilitated. What has improved since the last inspection? There has been significant improvement in how medicines are managed and monitored. People can now be assured that they will receive their medicines at the times they are prescribed and that the practices of storing, ordering and administering medicines are safe. There are more trained staff on duty during weekends which ensures people receive the same level of care and observation throughout the week. Staff induction, supervision and training have been focused on to ensure that people are in safe hands at all times. Care plans are more person centred and a thorough assessment takes place on a regular basis to take account of any changes in a person`s condition that requires more support or referral to external professionals. What the care home could do better: No requirements were made as a result of this inspection. CARE HOMES FOR OLDER PEOPLE Willow Brook Care Home 112 Burton Road Carlton Nottingham Nottinghamshire NG4 3BG Lead Inspector Mary O`Loughlin Unannounced Inspection 09:00 30th July 2008 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 Willow Brook Care Home DS0000026427.V369384.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. Willow Brook Care Home DS0000026427.V369384.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Willow Brook Care Home Address 112 Burton Road Carlton Nottingham Nottinghamshire NG4 3BG 0115 961 3399 0115 940 3848 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) www.bupa.com BUPA Care Homes (AKW) Ltd Vacant Care Home 49 Category(ies) of Old age, not falling within any other category registration, with number (43), Physical disability over 65 years of age of places (3), Terminally ill (3) Willow Brook Care Home DS0000026427.V369384.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Within the total number of beds a maximum of 3 bed maybe used for the category PD(E) Within the total number of beds a maximum of 3 bed maybe used for the category TI Within the total number of beds a maximum of 1 may be used for PD for a named person Within the Total number of beds, a maximum of 43 may be used for the category OP 28th March 2008 Date of last inspection Brief Description of the Service: Willowbrook Care Home is a purpose built property set on the edge of the city of Nottingham. There are grounds to the front and rear of the building with ample parking facilities. The accommodation comprises 49 single rooms all of which have an en-suite facility. All bedrooms are fitted with an Alarm Call System and are suitably furnished. A passenger lift offers access to the first floor and a range of specialist lifting equipment is available for service users with dependent needs. The home has two lounge areas, a quiet room and a designated dining area, providing a variety of comfortable seating and occasional tables. There are six bathrooms, two of which are fitted with an assisted hoist, one with a Parker bath and a shower room. Healthcare professionals will visit the home on request. The current charges are £289 to £600 dependent on whether residential or nursing and the level of care required. There are separate charges for hairdressing and newspapers. The service user guide, statement of purpose and most recent inspection report Willow Brook Care Home DS0000026427.V369384.R01.S.doc Version 5.2 Page 5 are available in the entrance hall and the current Certificate of Registration is also on display. Due to changes of registered manager, and removal of the Terminal Illness category, this certificate requires updating. Willow Brook Care Home DS0000026427.V369384.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people and their views on the service provided. This process considers the provider’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. 2 Inspectors completed this visit over 7hrs. A review of all the information we have received about the home was considered in planning this visit including the Annual Quality Assurance Assessment (AQAA), and this helped decide what areas were looked at. The main method of inspection used was called ‘case tracking’ which involved selecting the care plans of 3 people and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. Members of staff, people who use the service and their relatives were spoken with as part of this visit. A full partial tour was undertaken by the regulation inspectors, which included looking at people bedrooms and communal areas of the home. The quality rating for this service is 2 star this means that people who use the service experience good quality outcomes. What the service does well: People are assessed before coming into the home and staff make sure that they have suitable equipment and the skills to provide care for them before they come in. People have an allocated named nurse and key worker who knows all about them and communicates with them or their advocates on things they need or concerns they may have. People tell us they are happy at the home and that staff know how to care for them. Willow Brook Care Home DS0000026427.V369384.R01.S.doc Version 5.2 Page 7 The home is very clean and well maintained and any repairs are dealt with immediately. There are lots of opportunities for people to be active and take part in social events inside and outside of the home. People are consulted on how they wish to live their lives and what their interests are, enabling staff to plan for each person’s individual likes and interests. Staff are recruited safely by ensuring that anyone who may be unsuitable to work with vulnerable people are not employed. All new staff are supervised and trained and not left to care for people until they are competent to do so. Ongoing training and supervision of staff ensures that people are in safe hands and any gaps in skills are identified and training facilitated. What has improved since the last inspection? There has been significant improvement in how medicines are managed and monitored. People can now be assured that they will receive their medicines at the times they are prescribed and that the practices of storing, ordering and administering medicines are safe. There are more trained staff on duty during weekends which ensures people receive the same level of care and observation throughout the week. Staff induction, supervision and training have been focused on to ensure that people are in safe hands at all times. Care plans are more person centred and a thorough assessment takes place on a regular basis to take account of any changes in a person’s condition that requires more support or referral to external professionals. Willow Brook Care Home DS0000026427.V369384.R01.S.doc Version 5.2 Page 8 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. Willow Brook Care Home DS0000026427.V369384.R01.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 Willow Brook Care Home DS0000026427.V369384.R01.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): 3-6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Admissions to the home are not made until people receive a full assessment of their needs to ensure that the home can make suitable arrangements to provide the care a person needs. Intermediate care is not provided. EVIDENCE: We examined admission records and spoke to people that had recently been admitted to the home. They told us that a trained nurse had visited them and assessed all of their needs before they came to the home. The assessment exceeds what is Willow Brook Care Home DS0000026427.V369384.R01.S.doc Version 5.2 Page 11 required as a minimum standard, ensuring that all the diverse needs of each person have been considered. Within the assessment staff ask questions about language and access interpreters if these are required. The records told us that staff had spent a lot of time ensuring that every aspect of the persons needs were assessed and prepared for within a plan of care and any equipment that was needed to support the person was obtained and in place before the person came to stay. People told us that they had a chance to visit the home or that if they had been too unwell to visit then relatives had viewed the home to ensure that they were happy with the accommodation offered. Willow Brook Care Home DS0000026427.V369384.R01.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. People are involved in planning and agreeing their care and staff ensure people are protected by the home’s policies and procedures with medication. EVIDENCE: We case tracked 3 people and each person had a comprehensive care plan that staff had written through consultation with them or their advocates. We examined the care plans of a person with Diabetes and we found that staff had assessed and planned for any support that the person required, ensuring that the person received daily blood sugar monitoring and referral when necessary to the person’s Doctor. Where people were at risk of falling staff had responded quickly and provided low height beds and crash mats to prevent serious injury occurring. Willow Brook Care Home DS0000026427.V369384.R01.S.doc Version 5.2 Page 13 People were assessed for any risk of them developing a pressure sore and equipment such as pressure relieving mattresses and seat cushions were provided to those needing them to prevent skin damage. Wound care records were not fully completed but staff confirmed that they had been aware of them and provided safe and timely treatment. There were significant improvements in the way medicines were managed, quality audits were being undertaken each day that ensured people were being given their medicines at suitable times and intervals. Staff now ensure that supplies of medicines are obtained in a timely way to make sure that people always have medicines when they need them. A relative told us that she was involved in the care plan reviews, she knew the named nurse and key worker and was confident that she could discuss her fathers care. She told us that she had seen improvements in the home recently and was happy with his care. People told us that they were happy at the home, one person said, “ everyone is kind here and it’s much better than being in hospital” Willow Brook Care Home DS0000026427.V369384.R01.S.doc Version 5.2 Page 14 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 excellent. This judgement has been made using available evidence including a visit to this service. People are able to enjoy a full and stimulating lifestyle with a variety of options to choose from. People’s views and their varied interests are considered when planning the routines of daily living and arranging activities both in the home and the community EVIDENCE: At the inspection of 28th March 2008 we found that activities had improved, with an interesting array of activities, using life maps and individual’s interests to help develop them and relatives and friends were kept informed to help maintain contact and a sense of belonging. At this inspection we received very positive comments from relatives and residents about the activities worker who works very hard even in her own time to organise events and arrange meetings with relatives and residents. We Willow Brook Care Home DS0000026427.V369384.R01.S.doc Version 5.2 Page 15 observed the activities person being very enthusiastic and she had an excellent attitude. The activities Co-ordinator takes a life history of each resident, creating a picture of their personal preferences, religion, culture and wishes, to try to maintain their individuality, and this is used to form part of the home’s plan of activities, which helps with the day to day well-being of residents. There is an information board which is easy to see on the wall, in the reception area for visitors, letting them know what’s going on and also about the relatives’ meetings, and helps them and their families to feel involved in what is happening in the home. The enclosed rear garden had raised beds with vegetables growing, the borders and pots were full of flowers and there was seating and shade for people to sit comfortably. People told us they were very happy with the food being provided and the menu displayed offered choices of main meals. We observed the lunch being served and people were assisted to eat in a sensitive manner. The meals were nicely presented and the dining area spacious and clean. Willow Brook Care Home DS0000026427.V369384.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are listened to, taken seriously and staff training is planned to ensure that people are fully protected from abuse. EVIDENCE: Since the last key inspection in March 2008 we had received notifications regarding a safeguarding investigation, which was being investigated by social services under local protocols, the investigation is now concluded but the report is not finalised. As a result of this safeguarding alert and a complaint received by us we undertook a random inspection on 10/06/08 and found that there were breaches in the regulations and as a result we made requirements under the Care Standards Act to ensure improved outcomes for the people in the home. Since this time the staff at the home have worked very hard to ensure improvements were brought about in a timely fashion. The provider ensured that experienced staff were allocated to work at the home and implement suitable changes including training staff in their personal responsibilities and professional competence. The Commission also received a complaint but this was not upheld. Willow Brook Care Home DS0000026427.V369384.R01.S.doc Version 5.2 Page 17 When we spoke to staff at the home they were aware of the protection of vulnerable adults and confirmed that they were checked prior to employment to ensure that they were suitable to work with vulnerable people. We saw records of training for new staff that show the service has key policies and procedures to protect people from abuse. The local revised policies on safeguarding were not in place but the deputy manager said she would order one that day. Staff spoken with said they had received training in safeguarding people from abuse but where not confident in their role as alerter other than reporting to the senior person on duty. The deputy manager was aware of the shortfall in this training provision and said she is planning further training for all staff. People living at the home told us they knew who to speak to if they had any concerns, they told us that staff always take them seriously and act on what they say. Willow Brook Care Home DS0000026427.V369384.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): 19-26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a safe, well-maintained and comfortable environment, with personal possessions around them. EVIDENCE: The home has a sustained track record in meeting these standards. This inspection found that the home was clean and well maintained throughout. We saw that any repairs or faults are recorded and dealt with immediately. For the people we case tracked we saw that all specialist equipment that they needed to support their disabilities were suitably obtained. Willow Brook Care Home DS0000026427.V369384.R01.S.doc Version 5.2 Page 19 We saw that there was appropriate protective equipment in place to reduce any risk of cross infection and staff training records show us that they are trained both at induction and at intervals of the importance of good hygiene in controlling infection. People told us they liked their rooms and found them comfortable. Willow Brook Care Home DS0000026427.V369384.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): 27-28-29-30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are in safe hands from a trained and competent staff team. EVIDENCE: We found that the levels of trained staff have now increased to ensure that people receive their care in a timely and safe way. Staff files show that a thorough recruitment process is undertaken to ensure that people are protected from anyone that may be unsuitable to work with vulnerable adults. There have been a number of staff recently recruited and they told us they are receiving a thorough induction into their role. The records of staff induction were excellent, we saw the newly implemented induction booklets and saw them being used and signed off as competencies were achieved. New staff confirmed that they had received supervision and mentorship to ensure they were not left to provide care for people until they were suitably competent. Willow Brook Care Home DS0000026427.V369384.R01.S.doc Version 5.2 Page 21 People told us they had seen improvements in the staff numbers and less agency staff are being used. Relatives told us they felt people were in safe hands. Willow Brook Care Home DS0000026427.V369384.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): 31-33-35-36-38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The quality assurance systems and customer service initiatives ensure that the quality of the service provided is improving and in the best interests of the people who use it. EVIDENCE: The registered manager has recently left and the regional manager, another home manager and external quality and compliance teams presently support the deputy manager. Willow Brook Care Home DS0000026427.V369384.R01.S.doc Version 5.2 Page 23 We heard very positive comments from relatives and residents about the deputy manager and people told us that she was very competent and approachable. The service is presently undertaking a recruitment drive to select the right candidate for the post of manager. Since the random inspection in June 2008 a lot of work has been done by the deputy manager, ensuring that the quality of medicine management, staff training, supervision, and care planning have been focused on to improve the lives of those living at the home. All requirements set at the last inspection have been complied with. The Annual Quality Assurance Assessment contained good information which was supported by evidence gathered during the inspection visit, and demonstrates a high level of awareness by explaining the areas still needing improvement and detailing ways in which these improvements can be made. BUPA Care Homes has a Director of Quality and Compliance and has developed a national Quality and Compliance team of experts to support the quality assurance system and annual plan for the home, with resident, family and staff questionnaires continuing to form part of the process. The Regional quality manager was at the home during this inspection and completing an audit on medication. The staff have clearly worked tirelessly and have become more responsive and organised in the daily management of the home. Relatives and residents told us that things have improved and everyone feels that the activities person excels in her role ensuring that peoples personal preferences and views are considered and inform how the home runs. There are quality audits being undertaken regularly, these include recording all accidents and incidents and records tell us that any risks to the people at the home prompt staff to take steps to reduce risks or eliminate them if possible. Staff are trained in how to move people safely and we observed good practice when people were supported to move. We looked at the records of fire prevention and saw suitable regular adherence to checking all fire equipment, emergency lighting and escape routes along with checking the alarm weekly. We looked at how personal monies were held and found that the home are not the appointee for any resident but do hold cash sums if requested to do so. The accounts were seen, each person has money deposited into an individual Willow Brook Care Home DS0000026427.V369384.R01.S.doc Version 5.2 Page 24 interest bearing account and statements are provided monthly. All expenditure is recorded and receipted appropriately. Willow Brook Care Home DS0000026427.V369384.R01.S.doc Version 5.2 Page 25 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 X 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 3 X 3 Willow Brook Care Home DS0000026427.V369384.R01.S.doc Version 5.2 Page 26 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 OP3 OP8 OP9 OP18 Good Practice Recommendations Ensure that care plans reflect clearly who is responsible for the provision of nursing type care. Ensure that all wounds have a suitable record of dressing treatments and changes. Ensure that records of dressings on medicine record sheets are suitably signed for. Ensure that progress is achieved with updating the training and policies on Safeguarding Adults to ensure staff are fully up to date in protecting people. Willow Brook Care Home DS0000026427.V369384.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Willow Brook Care Home DS0000026427.V369384.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. 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