Care Home: Wilson Lodge

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What the care home does well This is a random inspection and therefore not all the standards were assessed. People told the expert: "It`s fantastic here, the foods brilliant, especially Sunday dinners, they`re lovely." "They really look after us here." " I can do anything I want, someone will always take me, I`m really lucky." "I`ve never been so well, it`s wonderful here." "It`s great, I can do the things I want and get lots of independence." People said they get on well with the staff and the managers. One person said, "The Manager would do anything for me, he really looks after us." Another person said, "I like living here and I like the staff." The expert said, " The rapport seemed friendly between staff and residents." The expert said, " The residents were alert and interacting, whether they were just sitting quietly or chatting in their groups, everyone looked perfectly relaxed." People said that staff helped them to attend health care appointments, which helped them to feel more relaxed and less anxious. What the care home could do better: This is a random inspection and therefore not all the standards were assessed. The requirements from our last inspection had been complied with. Staff should monitor the weight of all the people living there to ensure their health needs are being met. People should be given more choice about the furniture and decoration of their bedrooms so these reflect their personal tastes and interests. Records of qualified nursing staff should show they are currently registered with the Nursing and Midwifery Council (NMC) to show they are `fit` to practice. Reports of the providers monthly visits should be available in the home. This will help staff know what they need to do to ensure they are meeting the standards and make improvements to the home to benefit the people living there. Staff should receive the training they need so they know how to support the people living there to meet their needs. Random inspection report Care homes for adults (18-65 years) Name: Address: Wilson Lodge 16 Augusta Road East Moseley Birmingham West Midlands B13 8AJ one star adequate service 11/06/2009 The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Sarah Bennett Date: 2 3 0 6 2 0 1 0 Information about the care home Name of care home: Address: Wilson Lodge 16 Augusta Road East Moseley Birmingham West Midlands B13 8AJ 01214491841 01214492926 wilsoncare@btconnect.com www.wilson-care.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Malcolm Wright Type of registration: Number of places registered: Conditions of registration: Category(ies) : Wilson Care Resources Ltd care home 36 Number of places (if applicable): Under 65 Over 65 0 0 learning disability mental disorder, excluding learning disability or dementia Conditions of registration: 36 36 The maximum number of service users who can be accommodated is: 36 The registered person may provide the following category of service only: Care Home with Nursing (Code N); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) 36, Mental disorder, excluding learning disability or dementia (MD) 36 Date of last inspection 1 1 0 6 2 0 0 9 Care Homes for Adults (18-65 years) Page 2 of 11 Brief description of the care home Wilson Lodge provides nursing care for up to 36 adults suffering from mental health problems. People living there may also have a learning disability but mental health illness is the primary reason for admission. As well as the registered manager the home employs a nurse manager. The ethos of the home is encouraging and supporting independence of the people living there. The home is situated within a residential area, close to the city centre and within walking distance of local shops and other amenities. The building is located at the end of a cul de sac. There is no off road parking for visitors. Car parking facilities for staff are situated at the rear of the property. The home has ramped access, which enables disabled people or visitors to easily access the premises and a passenger lift is available inside the home. Accommodation is spread over two floors offering a mixture of single and shared rooms. One bedroom has an en suite toilet. Communal areas are on the ground floor and include two lounges, a dining room, a smoking room and two small secluded gardens. The home has two baths and three showers, which meet the needs of the people living in the home. There are dedicated kitchen and laundry facilities on the premises. Corridors are wide and have handrails to enable the people living there to mobilise independently. A hoist and a stand aid are available and pressure relieving equipment is available for people living there who may require this equipment to prevent skin sores. Copies of previous inspection reports are available from the office and a notice is displayed to inform the people living there and their representatives that these are available. The reader is advised to contact the home for details of current charges to live there. Care Homes for Adults (18-65 years) Page 3 of 11 What we found: The focus of inspections undertaken by the Care Quality Commission (CQC) is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. The last key inspection of this service was on the 11th June 2009. This random visit was undertaken by one inspector over six hours. There were thirty three people living there. The home did not know that we would be visiting that day. The reason for this visit was to check compliance with the requirements made at the last key inspection and to review the outcomes for the people living there. During this visit we looked at two care files and the medication records for two people, fire and health and safety records, three staff records and reports of visits by a representative of the provider. We spoke to the people living there, the manager and the staff on duty. We were assisted by an Expert by Experience (in this report known as the expert). This is someone with personal experience of using care services. Experts by Experience observe what happens in the home and talk to people to obtain their views about what it is like to live there. The expert produced a report based on their findings and details of this are included in this report. These are our findings: Care plans included more detail about how staff should support people to meet their needs and achieve their goals. They had been regularly reviewed. Staff reviewing them had included some detailed information about how the persons needs had changed where appropriate and how staff needed to support the individual. The home had purchased a computer program called Care Doc and staff had begun inputting information about individuals into this. This gave a detailed assessment on each person about several aspects of them as a person including their mental health, physical health, hobbies and interests, their rights, mental capacity and how much control they have over their environment. At the front of the persons records it gave an overview of the level of risk for each of the areas. Where this was highlighted as a high risk there was a more detailed assessment, which staff could access, so that they would know how to support the person. When all the information is inputted for individuals this will give staff very detailed information about how to support people. The program can be inputted with information as peoples needs change or further assessments are done. Staff showed and said that it was an easy system to use and useful in providing staff with the information they need to support each person living there safely. The expert spoke to people living there about the activities they do. An activity worker was employed at the home until recently, but has now left. People told the expert, The activity staff got me going swimming, I had not done this since I was little, I go every week now. I go to the pub and go shopping. Staff have helped us get Passport to Leisure cards so we can get cheap entrance at leisure centres. We can attend church if we want to. People said that although the activity staff had left they can still go Care Homes for Adults (18-65 years) Page 4 of 11 swimming, as a nurse takes them. One person however said that a lot of things had stopped since the activity worker left. The expert said, On the whole, Wilson Lodge appeared to be offering a wonderful quality of life to its residents with plenty of options and good care. The deputy manager said that they were discussing with staff how they would support people in activities as part of their role and this was already happening with nurses taking people swimming. One persons records showed that they had not been weighed for two months, despite their records indicating that they were at risk of not getting the nutrition they needed to be well. Previous records had indicated that the reading may not be correct as the person had moved when on the scales. The deputy manager said they had identified that an alternative way of monitoring the persons weight was needed. They said they would write guidelines for staff on measuring the persons arm so their loss or gain of weight could be monitored. The new computer program includes records of peoples weight. A graph is produced when data is inputted so that staff can easily monitor weight loss or gain. The persons Body Mass Index (BMI) is also automatically calculated. This is important, as a significant loss or gain of weight can be an indicator of an underlying health need. Records sampled included more information about how peoples health needs are met and what health appointments they have attended. It was easier to see how peoples health needs were being met and if any follow up advice or appointments were needed to ensure the persons well being. Medication records showed that where people are prescribed PRN (as required) medication a protocol is in place. This states when, why and how much of the medication should be given to the person. This ensures that the medication is used only when the person needs it to meet their health needs. We did not do an audit of the medication, as the local pharmacist was visiting to do an audit that afternoon. They do this quarterly. The manager said that staff audit the medication monthly to ensure it is being given as prescribed. Medication records sampled had been signed appropriately by staff, indicating that medication is given as prescribed. When we last visited the temperature in the medication room was very hot and we were concerned that this may have affected how effective the medication was. The manager said they had consulted the pharmacist about this. They said as the medication is not stored there for several months it should not be affected, unless the temperature is higher than 40 degrees Celsius. The skylight to the medication room is going to be covered and blacked out to help reduce the temperature in this room. At the time of our visit the lift had been removed and a new one was to be installed. The manager told us after our visit that the new lift had been installed. During the time without the lift one person had moved to a vacant ground floor bedroom, other people were able to use the stairs. The expert said, The home smelt really fresh. At our last visit we made recommendations relating to redecoration of the home and providing new beds and flooring in bedrooms. Recommendations made relating to bedrooms had not been met. The manager said this was because there were plans to extend the home. This would involve refurbishment of all the bedrooms. This will help to improve the quality of life for Care Homes for Adults (18-65 years) Page 5 of 11 the people living there. The expert said, One persons room was very basic and shared with another resident. They said they liked sharing and the other person was their best friend. Another persons bedroom was really crammed with furniture. I feel more effort could be put into giving residents more choices in their individual rooms. Staff records sampled included the required records to ensure that suitable people are employed. This included a satisfactory Criminal Records Bureau (CRB) check. Two of the three records sampled were for registered nurses. A copy of their registration with the Nursing and Midwifery Council (NMC) was in their records. However, both of these had expired so it was not clear that they continued to be fit to practise. The manager said he had seen evidence that all nurses working there are currently registered with the NMC but had not taken copies of these. Staff records included training records. These showed that most staff had completed updated training in safeguarding the people living there from abuse. Eight staff still needed to do this but the manager said this had been arranged. The majority of staff had received training in the Mental Capacity Act and the Deprivation of Liberty Safeguards that accompany this legislation. This is needed so that staff are aware of this legislation and how it may affect the people living there. When we last visited we found that some water temperatures were too hot, which could have put people at risk of scalding. Valves were to be fitted to taps soon after our last visit to regulate the temperature of the water from the tap to reduce this risk. Staff then needed to monitor this, so the valves could be adjusted when necessary. The manager was not able to find these records, as the maintenance staff who does these was off that day. We left an immediate requirement for a sample of these to be forwarded to us. The manager met this and forwarded these to us. These showed that water temperatures are tested regularly. Where they are too hot, the valve has been adjusted and the water temperature retested to ensure that people are not at risk of being scalded. When we last visited there was a hole in the door to the smoking room, where the lock had been removed. This could have been a risk to the people living there, if there were a fire. The manager said this was repaired soon after our last visit. We recommended at our last visit that there be regular fire drills so that staff and the people living there could practise what to do if there was a fire. Records showed that there had not been a fire drill since November 2009. The homes fire risk assessment had recently been reviewed. This stated that there should be fire drills about every three to four months. The manager said they had not had one during the winter months, as it was too cold for some people to go out, but they would be doing one in the next few days. Following our visit they told us that a fire drill had taken place. When we last visited we did not see any reports of visits from the provider to audit how the home is meeting the standards. Staff told us that these visits are done but reports were not available. At this inspection we were told that reports were still not available in the home, so it was not possible for staff to know what to do to make any improvements needed. We asked for a sample of these to be sent to us. This was done. Reports showed that the provider asks the views of the people living there and staff. They comment on any issues that need addressing and check these at the next visit. These should be available in the home so that staff know what improvements are needed and can action these. Care Homes for Adults (18-65 years) Page 6 of 11 What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Adults (18-65 years) Page 7 of 11 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 8 of 11 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 1 The information for the people living there about the home should be updated so they have the information they need. Not assessed at this inspection. The statement of purpose should be updated so that people have the information they need to make a choice as to whether or not they want to live there. Not assessed at this inspection. Individuals weight should be monitored to ensure that their health needs are met so ensuring their well being. The complaints policy should be updated to ensure that people have the information they need so they know their views will be listened to and acted on. Not assessed at this inspection. The complaints log should include a record of all complaints made to ensure that people know their views are listened to and acted on. Not assessed at this inspection. People should be provided with a standard price flooring type of their choice in their bedroom so it is homely and Page 9 of 11 2 1 3 4 19 22 5 22 6 26 Care Homes for Adults (18-65 years) 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 comfortable for them. Previous recommendation. 7 26 Consideration should be given to replacing the beds with a type that is more homely and comfortable for people. Previous recommendation. Staff meeting minutes should be available in the home so that staff who are not able to attend can read them and be updated with any changes to the needs of the people living there. Not assessed at this inspection. Records of registered nurses employed there should show that they are currently registered with the Nursing and Midwifery Council (NMC) to show they are fit to practice and support the people living there. Staff should receive the training they need so they know how to support the people living there to meet their needs. Previous recommendation. Reports of monthly visits by a representative of the owner should be available in the home. This will ensure that the home is regularly audited to ensure the needs of the people living there are met. Previous recommendation. 8 33 9 34 10 35 11 39 Care Homes for Adults (18-65 years) Page 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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