Care Home: Wimbledon Beaumont

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What the care home does well Activities offered by the home and mealtimes are tailored to individual`s needs and wishes. Care is taken to make sure that the activities programme is inclusive of all interests and hobbies, as well as developing new ones. Mealtimes are a social occasion and provide an opportunity for people to dine in a pleasant environment. The general manager is inclusive in his approach to the running of the home and strives to make sure that `the person` is at the centre of any changes or alterations. The home recognises the importance of making sure that people are included in the care planning process and assessments reflect their individual needs. People who live in Wimbledon Beaumont expressed their satisfaction with the care received and were complimentary about the staff team. The staff of Wimbledon Beaumont have worked hard to become an excellent service provider. Staff are continuing to take `ownership` of the work they are doing, whilst making sure that care is person centred. What has improved since the last inspection? Requirements relating to staff training, protection of a person`s dignity and care planning have been met. The home acknowledges in its AQAA that more work is needed on these areas, to make sure that the changes are consistent. What the care home could do better: Care is needed to make sure that the use of bed rails is accurately documented and there is a clear indication of why rails are in place. CARE HOMES FOR OLDER PEOPLE Wimbledon Beaumont 35 Arterberry Road Wimbledon London SW20 8AG Lead Inspector Janet Pitt Unannounced Inspection 3rd September 2008 13:40 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 Wimbledon Beaumont DS0000069471.V372258.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. Wimbledon Beaumont DS0000069471.V372258.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wimbledon Beaumont Address 35 Arterberry Road Wimbledon London SW20 8AG 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) 020 8944 8299 020 8879 7399 wimbledon@barchester.net www.barchester.com Barchester Healthcare Homes Ltd Paul Raymond Hart Care Home 49 Category(ies) of Dementia (49), Old age, not falling within any registration, with number other category (49), Physical disability (49) of places Wimbledon Beaumont DS0000069471.V372258.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing (CRH - N) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE 2. Physical disability - Code PD The maximum number of service users who can be accommodated is: 49 5th September 2007 Date of last inspection Brief Description of the Service: The Wimbledon Beaumont is situated in a residential area of Wimbledon, close to public transport. The home provides nursing care for up to forty-nine people who may have dementia. Accommodation is provided over three floors. All rooms are single apart from one shared room. All rooms have en suite facilities. Each floor has its own lounge and there is an accessible garden for individuals to use. Dining facilities are situated on the ground floor. A variety of activities are offered including outings and shopping trips in the home’s minibus. Information about the home is available in the Statement of Purpose and Service User Guide. Fees for this service start at £1000 per week. Wimbledon Beaumont DS0000069471.V372258.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 three stars. This means the people who use this service experience excellent quality outcomes. One inspector undertook this unannounced inspection. Two site visits were made on 3rd and 9th September 2008 that lasted a total of seven and a half hours. Records relating to care and medications were examined. The inspector was able to observe one musical activity. Staff members spoken with included the manager, activities co-ordinator, maintenance person and the clinical nurse lead. The home provided an Annual Quality Assurance Assessment (AQAA) and information from this was used in this report. Five people who live at Wimbledon Beaumont were spoken to during the site visits. What the service does well: What has improved since the last inspection? Wimbledon Beaumont DS0000069471.V372258.R02.S.doc Version 5.2 Page 6 Requirements relating to staff training, protection of a person’s dignity and care planning have been met. The home acknowledges in its AQAA that more work is needed on these areas, to make sure that the changes are consistent. 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. Wimbledon Beaumont DS0000069471.V372258.R02.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Wimbledon Beaumont DS0000069471.V372258.R02.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 People who use this service receive good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People can be confident that all their needs will be assessed prior to admission to the home. They are actively involved in this process and their views are listened to. EVIDENCE: People’s care plans were sampled. Each person had been assessed prior to and on admission. It was noted that an individuals views were documented on what their needs were. People or their representatives had signed the document. There was a clear indication of the people’s health needs and who should be involved in making sure that they are met, such as optician and dieticians. Assessments of need indicated the persons preferred form of address and whether they wished to have same gender care. Mobility assessments included the type of hoist and sling size that was needed. Wimbledon Beaumont DS0000069471.V372258.R02.S.doc Version 5.2 Page 9 A relative of a person who was deciding whether to come to the Wimbledon Beaumont to live spoke with the inspector. This person said that staff had been welcoming and had taken time to discuss the needs of their relative. This person had been advised by the manager to visit unannounced to make sure that this approach by the staff was consistent. The manager made sure that a copy of the most recent inspection report was provided to assist in the decision making process. Wimbledon Beaumont DS0000069471.V372258.R02.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11 People who use this service receive good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are treated as individuals and their privacy and dignity is generally respected, however use of bed rails should be risk assessed and documented. Care plans are being develop to make sure that they are person centred. Further work is needed to make sure that language use in plans is appropriate. Individuals can be confident that spiritual needs and end of life wishes will be respected. EVIDENCE: The staff have worked hard to develop care plans to make sure that they are person centred. There is evidence within the plans of people’s preferences being documented, such as the brand of toothpaste they like or the number of pillows a person wants. People’s religious and spiritual needs are documented and carried out. One person who chose not to practice their religion formally had the following Wimbledon Beaumont DS0000069471.V372258.R02.S.doc Version 5.2 Page 11 detailed on their plan: ‘Does not practise [their] religion but [they] feel comfortable saying a few words of prayer.’ Some attention is needed to make sure the language used in care documentation is appropriate. This was discussed with the clinical lead. One plan had used the word ‘feed’ when indicating what assistance a person needed with eating and drinking. However, the same plan stated that ‘plenty of time to chew and swallow’ was needed. This shows a good understanding of an individual’s ability. Carers are able to detail their input into meeting needs and the home acknowledge that skills in written English need monitoring to make sure that records are easily understood. The home’s AQAA states that care documentation is audited every six months and work is progressing in making sure the person or their representative is involved in the planning process and further reviews. New documentation has been introduced to assist staff in making sure that plans are person centred. Medications within the home are safely handled and administered. A sample of records was inspected. The records contained details of when the medication was due and whether it had been given, as well as directions for usage. A separate chart showed the amount of any variable dose medications that had been given. There were no issues with storage of medications. End of life wishes had been discussed with people who live in the home and were documented sensitively. Care is needed to make sure that when beds rails are used there is a clear reason for this. This issue had been highlighted in an audit of care plans undertaken by the company, but at the time of the site visit had not been actioned. Wimbledon Beaumont DS0000069471.V372258.R02.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use this service receive excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home offers a wide range of activities that are suitable and age appropriate. Staff are more aware of the importance of making sure that those who do not wish to participate in organised activities are able to continue with their own interests. Mealtimes are a social occasion and the variety and quality of food on the menu is high. Individuals are able to welcome their visitors into the home and staff make sure that these contacts are maintained. EVIDENCE: We found that the home is continuing to develop the range of activities it offers to people who live there. During the site visits a musician came to play a short concert. We observed that people were able to sit and enjoy the music and staff did not try to force people to engage. At the end of the concert we noticed that the majority of Wimbledon Beaumont DS0000069471.V372258.R02.S.doc Version 5.2 Page 13 people were singing to themselves, tapping their feet and moving their hands in time to the music being played. The atmosphere was relaxed and enjoyment was evident. We spoke with the activities co-ordinator who is involved in asking people what hobbies and interests they have and tailors activities offered accordingly. The home has recently started a watercolour painting group, which is co-ordinated by the maintenance person. He said that the primary aim of the group was to socialise and hopefully develop a new or existing skill. The budding artists are encouraged to display their works. One individual was very proud of the landscape painting they had produced. We observed a conversation between people in the group relating to their differing techniques. The activities person stated that more emphasis is now being placed on making sure that those people that chose not to be involved in the main activities are given one-to-one attention. The manager said that the home has an active knitting circle and use has been made of the computer to download new knitting patterns. Individuals are able to watch films and television on a large screen. This is also use for a Wii player. Plans are in place to purchased further games for the Wii Player, one of which involves trying out virtual sport. The home currently has a Brain Training game. A portable DVD player is available so that that an individual can watch a film of their choice in private. The documentation to record a person’s life history and interests could be improved in order that the focus is on what they would like to do, rather than their medical background. Observations and feedback received indicated that people are supported to maintain contact with their family and friends. Visitors were seen to be welcomed into the home. Mealtimes continue to be a social occasion with a good variety of food on offer. People who live in the home said that if they change their mind about a choice of food then this is accommodated. One concern raised was that of timing of the meals and when people were able to go into the dining room. This was discussed and a clock was provided in the sitting room to make sure that those who liked routine were aware of what the time was. The clinical lead said that she would explain the importance to staff of making sure that reasons were given if a meal was delayed to make sure that no one became anxious. Mealtimes are flexible in the home, but the needs of those who prefer routine also need to be met. Wimbledon Beaumont DS0000069471.V372258.R02.S.doc Version 5.2 Page 14 Special dietary needs can be catered for and care had been taken to make sure tables were attractively laid. People who needed assistance with eating were supported by staff and not hurried over their meal. Wimbledon Beaumont DS0000069471.V372258.R02.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use this service receive good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Individuals who chose to live at Wimbledon Beaumont can be confident that Safeguarding is a high priority in the home and staff have received suitable training to make sure that people are protected from abuse. The home welcomes comments on the running of the home and takes action if necessary. EVIDENCE: We have not received any complaints or concerns regarding Wimbledon Beaumont. The manager reported that no complaints have been made since the previous inspection. The AQAA indicates that staff need further training on complaint handling and this has been planned for. The aim is to make sure that staff are aware of factors that might trigger a complaint. There has been no change to making sure that all staff are aware of the importance of Safeguarding Adults and training has been given to make sure that staff are up to date with current guidance. Wimbledon Beaumont DS0000069471.V372258.R02.S.doc Version 5.2 Page 16 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 and 26 People who use this service receive good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There is an ongoing major refurbishment programme in place; this will make sure that individuals can be confident that the home is well maintained. Care is taken to make sure that the home is clean and tidy and there are not risks to the people that live there. EVIDENCE: The home’s AQAA states that their housekeeping department has introduced a regular schedule for cleaning of carpets and curtains. The activity area has been refurbished. A new nurse call system has been installed that monitored call bell response times and alerts staff to people at the front door, particularly ‘out of hours’. Wimbledon Beaumont DS0000069471.V372258.R02.S.doc Version 5.2 Page 17 We noticed on the site visits that major refurbishment has been undertaken in the home. People’s rooms are being redecorated and refurbished and there are plans to refit some bathrooms this year. There is a choice available of decorative schemes and individuals are consulted on their preferences. We noted that the home was clean and tidy at the time of the site visit. Wimbledon Beaumont DS0000069471.V372258.R02.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use this service receive good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There is an appropriate number and skill mix of staff on duty to make sure that needs are met. Training has been focused on developing staff’s ability to care for persons who have dementia and this has started to be put into practice. Procedures make sure that staff are safely recruited. EVIDENCE: The manager reported that no new staff have been employed since the previous inspection. Information we hold indicates that staff recruitment procedures are satisfactory and all necessary checks are carried out. Therefore staff files were not inspected on this occasion. Eighty percent of staff have receive training in dementia care and the remaining members of staff are due to attend this training. The manager said that he has started to notice a change in practice and more staff awareness of caring for persons with dementia. Wimbledon Beaumont DS0000069471.V372258.R02.S.doc Version 5.2 Page 19 The AQAA shows that staff turnover at Wimbledon Beaumont is low and there are a number of members who have been working at the home for over ten years. The manager is proactive in empowering staff to develop their roles and take on responsibility. He told us he encourages ideas from staff in how the home can continue to develop. Wimbledon Beaumont DS0000069471.V372258.R02.S.doc Version 5.2 Page 20 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 and 38 People who use this service receive excellent quality outcomes in this area This judgement has been made using available evidence including a visit to this service. People live in a home that is well managed and their views are important to the running of Wimbledon Beaumont. Quality Assurance systems in place make sure that individuals can make their views known. The health and safety of people is promoted and appropriate checks are carried out to make sure that they are protected. EVIDENCE: The AQAA shows that there are appropriate procedures in place for quality monitoring within the home. Monthly visits under regulation 26 are carried out and we are supplied with copies of these. Monthly audits are also carried out Wimbledon Beaumont DS0000069471.V372258.R02.S.doc Version 5.2 Page 21 on aspects of care practices within the home. The clinical lead reported that audits had been carried out on medication and care planning. Support is provided to the general manager at regional and national level and he said that these resources have been useful for discussing the way forward for the Wimbledon Beaumont. We found that regular meetings are held where staff are encouraged to offer suggestions on how to develop the home. Care is also taken to make sure that people who live in the home and their representatives are surveys on their views. A recent survey showed a high level of satisfaction with the home. ‘Mystery shoppers’ are used by the company to monitor responses to enquiries and staff attitude. The manager considers that a more approachable management style has ‘created a greater sense of belonging amongst staff’. The manager is now registered with CSCI and has the support of an experienced nurse to lead on clinical issues, as he is not a Registered Nurse. We consider that the manager is proactive in his approach and is primarily concerned with the welfare of people that live in the home. He recognises the importance of making sure that the Wimbledon Beaumont is a persons ‘home’. No issues with health and safety were identified at the time of the inspection and there are good procedures in place to protect the people that live there, such as regular fire alarm testing and first aid training. Wimbledon Beaumont DS0000069471.V372258.R02.S.doc Version 5.2 Page 22 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 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 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 4 X 4 X 3 X X 3 Wimbledon Beaumont DS0000069471.V372258.R02.S.doc Version 5.2 Page 23 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. 1 Standard OP10 Regulation 13 (7) Requirement Use of bed rails must be within a risk assessed framework, which clearly demonstrates the needs for them. This will make sure that the use of rails is not deemed to be a form of restraint. Timescale for action 30/11/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Wimbledon Beaumont DS0000069471.V372258.R02.S.doc Version 5.2 Page 24 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Wimbledon Beaumont DS0000069471.V372258.R02.S.doc Version 5.2 Page 25 - 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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