Care Home: Windsor Court Care Home

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What the care home does well There are good procedures in place to make sure that people are properly assessed and receive good information about the home before moving in. This helps in making sure that people know about the care and services on offer at the home before making a decision about moving in and also ensures that people are only admitted to the home if their needs can be met. People are encouraged to be independent and to make their own decisions about their daily routines where this is possible. This helps people to have control over their lives. People said that they enjoyed the food that is fresh and home cooked. One person said, "I always enjoy the meals" and another person said, "The meals are fantastic". People living at the home said that staff always listen to what they have to say and act on this. This helps in making people feel safe. The environment is very clean and well maintained. This makes it a pleasant, comfortable and safe place for people to live in. People who live at the home say that the staff are very good to them and treat them well. They commented that staff are "lovely, wonderful, kind and friendly". One person said, "I am lucky to be in such a lovely place and have lovely people looking after me". Another person said, "I would not want to live anywhere else, the staff are so cheerful". The home encourages people to tell them what they think about their service. This helps to provide the home with information so that know what they are doing well and areas where they can improve on. What has improved since the last inspection? Further work has been done to develop care plans so that they contain more individual information about each person. This will help in making sure that people receive support to suit their personal needs in the way they prefer. There have been improvements in the number of staff who have achieved or who are undertaking the National Vocational Qualification (NVQ) programme. This will help in developing a more knowledgeable and skilled workforce. People`s nutritional needs are better monitored and acted on. This helps in making sure that any areas of concerns are referred to health care specialists at an early stage so that any health needs can be dealt with promptly. The manager or deputy manager carry out monthly checks of the medication systems to make sure medicines are managed safely and proper procedures are being followed. This helps to make sure that safe standards are maintained and people are not put at risk. Parts of the home have been re-decorated to maintain a comfortable and pleasant environment for people who live at the home. There are systems in place to make sure that accidents are followed up so that any health and safety issues can be identified and addressed and to make sure people receive the appropriate health care when they need it. The organisation has developed new financial systems so that people`s monies are kept in individual accounts. This makes it easier to account for people`s monies and protects their interests. What the care home could do better: Arrangements could be put in place to make sure that changes to people`s health care needs are better monitored at all times so that any areas of concern can be quickly identified and acted on. This will help in making sure that people`s receive the appropriate health care support when they need it. The home could review the range of activities that are on offer at the home and take any necessary actions from this to make sure that they are meeting the social and recreational needs of all the people living at the home. CARE HOMES FOR OLDER PEOPLE Windsor Court Care Home Bartholomew Avenue Goole East Yorkshire DN14 6YN Lead Inspector David White Key Unannounced Inspection 29th January 2008 08:30 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 Windsor Court Care Home DS0000000962.V357136.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. Windsor Court Care Home DS0000000962.V357136.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Windsor Court Care Home Address Bartholomew Avenue Goole East Yorkshire DN14 6YN 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) 01405 763749 01405 765590 windsorcourt@schealthcare.co.uk www.schealthcare.co.uk Southern Cross Care Homes No 3 Limited Position Vacant Care Home 77 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (52), of places Physical disability over 65 years of age (52) Windsor Court Care Home DS0000000962.V357136.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To admit one named service user with Dementia who is under 65 years of age. 27th June 2006 Date of last inspection Brief Description of the Service: Windsor Court is a modern, purpose built care home situated close to Goole town centre. The home has two floors and a safe courtyard garden. There are pleasant, well maintained gardens. There is a local health centre a short distance from the home. The home offers residential care in three units: the ground floor (Balmoral unit) provides residential care. People with dementia are cared for in a unit on the second floor (Buckingham), and, adjacent to this is a unit for people with higher dependency needs (Sandringham). A passenger lift is available to enable access to all floors. The weekly fees for the home at the time of the site visit on 29th January 2008 ranged from £310.80 to £475. Additional charges are made for chiropody, hairdressing, toiletries and newspapers. Current information about services provided at Windsor Court in the form of a statement of purpose, service user guide and the most recent inspection report published by the Commission for Social Care Inspection are available by contacting the home. Windsor Court Care Home DS0000000962.V357136.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The Commission for Social Care Inspection inspects homes at a frequency determined by how the home has been risk assessed. The inspection process has now become a cycle of activity rather than a series of one-off events. Information is gathered from a variety of sources, one being a site visit. More information about the inspection process can be found on our website www.csci.org.uk We went to the home without telling them that we were going to visit. This report follows the visit that took place on the 29th January 2008. The visit lasted for 8 hours. The purpose of the visit was to make sure that the home was operating and being managed in the best interests of people living there. Information has been used from different sources for this report. These sources include: • • • Reviewing information that has been received about the home since the last inspection. Information provided by the manager on an Annual Quality Assurance Assessment questionnaire. Surveys returned by eleven people who live at the home, two relatives and two health and social care professionals who have contact with the home. During the visit a number of documents and records were looked at and some areas of the home used by the people living there were visited. Some time was spent with people who live at the home, talking to them and observing how they interacted with staff. Discussion was had with a relative and health care professional that were visiting the home at the time of the site visit. Time was also spent talking to staff including the administrator, cook, the manager and operations manager for the service. This all helped in gaining an insight into what life is like for people living in the home. The manager was available throughout the site visit and the findings were discussed with her and the operations manager at the end of the inspection. Windsor Court Care Home DS0000000962.V357136.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Further work has been done to develop care plans so that they contain more individual information about each person. This will help in making sure that people receive support to suit their personal needs in the way they prefer. There have been improvements in the number of staff who have achieved or who are undertaking the National Vocational Qualification (NVQ) programme. This will help in developing a more knowledgeable and skilled workforce. People’s nutritional needs are better monitored and acted on. This helps in making sure that any areas of concerns are referred to health care specialists at an early stage so that any health needs can be dealt with promptly. The manager or deputy manager carry out monthly checks of the medication systems to make sure medicines are managed safely and proper procedures Windsor Court Care Home DS0000000962.V357136.R01.S.doc Version 5.2 Page 7 are being followed. This helps to make sure that safe standards are maintained and people are not put at risk. Parts of the home have been re-decorated to maintain a comfortable and pleasant environment for people who live at the home. There are systems in place to make sure that accidents are followed up so that any health and safety issues can be identified and addressed and to make sure people receive the appropriate health care when they need it. The organisation has developed new financial systems so that people’s monies are kept in individual accounts. This makes it easier to account for people’s monies and protects their interests. 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. Windsor Court Care Home DS0000000962.V357136.R01.S.doc Version 5.2 Page 8 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 Windsor Court Care Home DS0000000962.V357136.R01.S.doc Version 5.2 Page 9 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): 1, 3 and 6 People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. People who use the service can be sure that the home will meet their needs following assessment. A good range of information is available to help people decide whether the home is suitable for their needs. EVIDENCE: People living in the home and relatives who returned surveys said that enough information had been provided about the service before any decision was made about moving in. The statement of purpose, which provides information about the care and services on offer at the home, is currently being updated to include information about the new manager and any other changes to the home. Windsor Court Care Home DS0000000962.V357136.R01.S.doc Version 5.2 Page 10 The records showed that the home carries out very good assessments before people move into the home. The assessment information has recently been updated so that it provides a very detailed account of people’s needs and abilities. The manager or her deputy carries out the pre-admission assessment that also considers any risks to the person or to other people who are living in the home. All this information is then used to develop a care plan. Where possible people who use the service are involved in the assessment process. The person carrying out the assessment visits the person and gets information from relatives and other professionals to help them decide if they will be able to meet people’s needs before a place is offered. People are then offered the opportunity to visit the home to meet people and have a look around. Once an assessment has been completed and it has been agreed that someone is suitable to be admitted to the home and they want to move in, a review is carried out six weeks following admission to discuss progress. Care plan reviews take place on a regular basis and it was evident that alternative placements had been found for people whose needs the home were unable to meet. At the time of the visit there was no person staying for intermediate care. However, in the past thorough assessments have been carried out to assess people’s intermediate care needs so that staff could plan the most appropriate type of care to enable people to return home. Windsor Court Care Home DS0000000962.V357136.R01.S.doc Version 5.2 Page 11 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 and 10 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Overall people’s personal and health care needs are well met with one exception. People are treated in a way that respects their privacy and dignity. EVIDENCE: People living in the home were complimentary about the care they receive. One said, “It’s a pleasant place, staff are smashing and kind. I wouldn’t want to live anywhere else, staff are so cheerful”. Another person said, “Staff are very good, you only have to ask and they take notice and see to it”. One person described the staff as “wonderful”. A survey returned by a relative commented “The home looks after people well”. Care planning systems have been developed so that the information is more person centred to people’s individual needs. People said that they are encouraged to be independent and make their own choices. Windsor Court Care Home DS0000000962.V357136.R01.S.doc Version 5.2 Page 12 Each person has a care plan that is based on a thorough assessment of people’s needs. The care plans set out how care and support is to be given so that personal and health care needs are met. The plans include information about people’s likes, dislikes and preferences. There was information in the care records about activities that had been undertaken by people. Care plans are regularly reviewed and involve where possible people who are living in the home, relatives and others who are involved in their care. The home has a key worker system that enables staff to spend time with people on an individual basis. Key workers produce reports to care professionals about people’s progress to help with the care review process, although a survey returned by a care professional indicated that sometimes these could be more up to date. The care records had details of any health professionals that people see. These included the GP (General Practitioner), specialist nurses, psychiatrist, physiotherapist and chiropodist. Records are kept of any health appointments and their outcome. People were supported in attending appointments and health care specialists made visits to the home on request. Staff receive training in a number of aspects of health such as nutrition, pressure care and dementia care. Two health professionals commented that the home communicated well with them and ‘sought their advice when appropriate’. In most cases staff acted promptly to address people’s health needs properly, however, in one particular situation this had not happened. One person had developed skin problems and this was referred to the GP who prescribed some treatment. However the care records showed that staff did not monitor this properly and so were not aware that the skin problem was deteriorating and this led to the person being admitted into hospital. The manager told us that lessons had been learned from this and that actions had been put in place such as additional staff training to prevent any re-occurrence. Each care plan includes a range of risk assessments that are reviewed regularly. A risk assessment has been carried out about fire evacuation for a person who is cared for mostly in bed. Information about the pressure care management of this person was very good and regular reviews were taking place to make sure that any changing needs were being met. Health care specialists undertake assessments of people who use wheelchairs in order to maintain their independence and mobility and other specialist advice is sought when needed. Weight is regularly monitored and the manager audits this so that any weight loss is identified immediately and referred to the local GP where appropriate. In any areas where people were assessed as being at risk, care plans were in place to outline actions that needed to be taken to manage this. One complaint had been made to the Commission for Social Care Inspection since the last inspection of the home. Part of the complaint alleged that the home had not responded properly when a person had fallen. The accident and care records showed that appropriate actions had been taken following any falls. The manager carries out monthly audits of any falls so that she can monitor any patterns emerging. This enables any problems to be Windsor Court Care Home DS0000000962.V357136.R01.S.doc Version 5.2 Page 13 identified at an early stage and triggers referrals to the GP and falls clinic so that appropriate action can be taken to minimise any risks to people. Part of the complaint also alleged that medication that was being given to a person living at the home did not correspond with what the GP had prescribed before the person had been admitted to the home. The registered providers investigated the matter, and have informed the Commission that medication is only administered as directed by the GP. The medication systems were looked at and a random check of the medication records tallied with what had been prescribed by the GP. Information received in the complaint alleged that the person’s relative had been prescribed too much medication when living in the home. The registered providers investigated the matter, and have informed the Commission that medication is only given as prescribed by the GP. The home uses a monitored dosage pre-packed system for medicines and has stock supplies of some medications to make sure that people receive the medication they are prescribed when they need it. Staff said that the local chemist is notified about any medication changes or issues that affect medication supplies. The manager said that medication reviews take place every six months with GP’s to discuss the need for medication and whether any medication changes are needed. The manager undertakes monthly audits of the medication systems to make sure medicines are managed safely and if necessary takes action to deal with any shortfalls. No one in the home is able to manage his or her own medicines. The medication administration record (MAR) sheets were checked and showed no errors. The home is following procedures for the safekeeping, administration and recording of Controlled Drugs. All staff that are responsible for the administration of medication have been trained to do so. Staff were observed to be kind and respectful to people who they appeared to know well. Most people require some kind of support with bathing. Those spoken to said that support was always given in a sensitive way that did not embarrass them. People said that they saw their GP and other social and health care professionals privately when they came to see them. People said that they have a bath on a regular basis and when they wanted one. Windsor Court Care Home DS0000000962.V357136.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 and 15 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. People live in a homely environment where they can make their own choices about their daily lives. Activities are on offer and people have involvement with the local community. It would benefit people if these areas were developed further to provide more opportunities for people in meeting their social and recreational needs. EVIDENCE: Whilst some people were not able to express their preferences about how they live their daily lives, those who were said that they could plan their daily routines as they wanted. There is information in each person’s care records about their personal interests and hobbies. This information had been obtained from the person and other sources where possible. The home employs an activities organiser who shares her work between the three units and works around 20 hours a week. At the time of the site visit she was seen supporting people to plant some seeds for the garden. The home has it’s own pub that is decorated in 1950’s style and people spent time in there Windsor Court Care Home DS0000000962.V357136.R01.S.doc Version 5.2 Page 15 enjoying a drink after their lunch and this is monitored by the staff team. Comments from surveys returned by people who live in the home mostly indicated that there are usually activities they could take part in. One person commented “I have been on one outing and there are a few concerts, nothing special”; another said “I enjoy going to the pub for lunch”. People did say that they did not go out much although some people said they were not bothered about this and preferred to stay in. The local library visits every six weeks and church and religious services are organised to accommodate people living at the home. Entertainers visit the home every month. The activities person does not work on an evening and at weekends. Whilst people are able to watch television and listen to music at these times other activities need to be considered including more opportunity to spend time out of the home. The manager said she would look at possible ways of addressing this. The home encourages family and friends to be involved, as they want to be. One relative said, “I am always made to feel welcome and am kept well up to date about my relative’s care”. There is a separate visitors room if people wish to use it for extra privacy when seeing family and friends. People said that they enjoyed the food that was provided. One said, “I always enjoy the meals, the food is always good”. Another person said, “The meals are fantastic”. The cook explained that fresh produce is bought from local suppliers and then home cooked. Two people needed soft diets and these were prepared individually. The cook was aware that one person needed a specialist diet and had information from the dietician about ways of improving people’s nutritional intake through food supplements. The lunchtime was relaxed and unhurried and people were given support as they needed it in a discreet manner. People were seen receiving regular drinks and snacks in between mealtimes and the care records showed that staff regularly supplied fluids to people who were bedfast. Windsor Court Care Home DS0000000962.V357136.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): 16 and 18 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. People’s concerns are listened to and acted on. Proper procedures are in place and followed to safeguard people from possible harm. EVIDENCE: The home has a complaints procedure that is on display in the hallway. Every survey returned by people who live in the home said that staff listened to and acted on what they said. People knew who they needed to speak to if they had concerns and were “confident” that any matters would be properly dealt with. One person said, “Staff are good at listening and sorting things out”. The Commission for Social Care Inspection received one complaint about the service that the registered providers were asked to investigate. This complaint remains ongoing and is now being dealt with by a senior person in the organisation after the person making the complaint expressed dissatisfaction with the outcomes from one aspect of the initial investigation. There have been two adult safeguarding issues since the last inspection. The home and organisation responded properly to these by referring these matters to the appropriate agencies so that appropriate actions could be taken to safeguard people from possible harm. All the staff have received training in the protection of vulnerable adults. They were able to say what action they would Windsor Court Care Home DS0000000962.V357136.R01.S.doc Version 5.2 Page 17 take if they suspected abuse or had an allegation of abuse made about them. They were also able to describe the different types of abuse. In care planning records risks assessments have been carried out on people who can be aggressive and actions put in place to minimise risks to the person and others from their behaviour. Most staff have received training on how to deal with people whose behaviour challenges services. Windsor Court Care Home DS0000000962.V357136.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 and 26 People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. People live in a very clean and comfortable environment that is suitable to meeting their needs. EVIDENCE: The home is purpose built so is designed to meet the specific needs of people who live there including an enclosed courtyard area that can be accessed by everyone who is living in the home. Accommodation is over two floors and can be accessed via a passenger lift and there is level access to the home so it is suitable for people with mobility problems. All the bedrooms are single with ensuite facilities and are decorated to a high standard. Specialist aids, adaptations and equipment are available to help people with their mobility and independence such as a bath with an electrical hoist and a shower (wet room). Windsor Court Care Home DS0000000962.V357136.R01.S.doc Version 5.2 Page 19 On the day of the site visit the home was very clean and did not have any unpleasant odours. All the surveys returned by people who live at the home commented that the home is always clean and fresh. One person said, “my bedroom is always clean and tidy” and another “I am lucky to be in such a nice place and to have such lovely people looking after you”. Bedrooms are personalised to suit individuals and their interests. People are able to have a bedroom key if they want and keypads are used to help in promoting people’s privacy and safety. Some parts of the home have recently been re-decorated. Furnishings and fittings were of a good standard, clean and well maintained. A maintenance worker is employed to attend to any work promptly and there is ongoing refurbishment work. There is signage on doors, and the bedroom doors were painted in different colours to help people who are confused with their orientation. Call bells were accessible in all personal and communal areas so that staff could access people if they were able to do so. Each person spoken to said that call bells were always answered promptly. The home employs laundry assistants to attend to people’s personal clothing and bedding. Suitable systems were in place for preventing the spread of infection and staff had received training about this. The home has used the Department of Health “Essential Steps” guidance to assess their infection control management procedures and maintain good standards. Windsor Court Care Home DS0000000962.V357136.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 and 30 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. People receive care from a settled and well-trained staff team. Shortfalls in staffing levels in one unit and in one aspect of the recruitment procedures were immediately addressed. This will help in making sure that all people’s needs are fully met by suitable staff. EVIDENCE: Information passed onto the Commission by a relative suggested that staffing levels were inadequate in the Buckingham unit. A survey returned by a health professional commented that ‘there are sometimes staffing problems’ and a relative survey also told us ‘more staff are needed’. The home has three separate units to accommodate people with different needs. Overall staffing turnover is low and this helps people to receive consistent care from people who have a good understanding of their needs. People who live in the home referred to the staff as ‘lovely girls who are polite and helpful’. In two of the units (Balmoral and Sandringham) the staffing levels were satisfactory and people said that their care needs were being well met. The duty rosters also supported this. Staff commented that they felt staffing levels Windsor Court Care Home DS0000000962.V357136.R01.S.doc Version 5.2 Page 21 were sufficient in these areas and care was being provided in an unhurried way. In the Buckingham unit the duty rotas showed that there are normally two staff on duty throughout the day between 7.30am and 7.30pm with an additional member of staff used between 9am and 1.30pm. Three of the people on the Buckingham unit need support with some personal cares from two staff. Two people need assistance with eating and one person needs a member of staff to give them their food. Another person has had a number of falls and needs observing. Whilst people’s needs were being met, staff were observed to be working under pressure with people whose needs were complex. Staff said that when there are three people on duty at all times throughout the day this made it easier in making sure that all people’s needs were met. The staffing levels on the Buckingham unit were discussed with the manager and operations manager for the organisation at the time of the visit. They agreed to immediately increase the staffing numbers in the Balmoral unit so that there were at least three care on duty at all times between the hours of 7.30am and 7.30pm and gave assurances that they would keep the staffing levels under review. The staffing levels at night were satisfactory. At night there are three staff on the Balmoral unit and two staff on each of the other two units. The organisation has introduced a ‘Care block system’. This involves the use of a remote control device that scans bedroom doors to indicate when a member of night staff is entering someone’s bedroom and attending to them during the night. Staff also use the device to record what kind of support they have provided. The management said that this helps to monitor activity through the night and is used alongside other documentation to record what type of care and support is being offered. This information is then stored on a database. The management confirmed that the system was not intrusive and did not impinge on people’s privacy and dignity. The organisation has recruitment procedures that had been mostly followed by the management of the home. This includes obtaining the necessary police checks before new staff start work at the home. However, in two staff files seen there was only one written reference. In both cases the second reference was a verbal one and whilst information about this had been written down, the management has not followed this up by obtaining the reference in writing to confirm the details that had been provided verbally. This was discussed with the manager and operations manager who gave assurances that these would be obtained as soon as possible and that in future any verbal references would be followed up in writing. The operations director informed us the day after the site visit that requests had been sent off to the two people who had provided verbal references for their references to be given in writing. This will help to confirm that the details provided in the verbal reference are accurate and helps to protect people who are using the service from workers who may be unsuitable to care for them. Windsor Court Care Home DS0000000962.V357136.R01.S.doc Version 5.2 Page 22 A complaint made to the Commission alleged that staff did not understand the needs of people with dementia. The registered providers investigated the matter and informed the Commission that staff did receive appropriate training. Staff spoken to had a good understanding of the needs of people in the home and knew them well. Ninety-two per cent of staff have attended training on dementia care and challenging behaviour. The senior team leader has done some specialist dementia training and another senior team member is also due to do the same training. They will then be expected to roll out this training on to other staff. The manager said that the home has a DVD about dementia, which they sit down and go through with relatives who may want to know more about it. People living in the home said that their needs were being met and were complimentary about the abilities of the staff team. A survey returned by a social care professional commented ‘staff are helpful and friendly’. Staff receive a good range of training that starts at the point of induction for new staff. The home was having a problem in accessing the National Vocational Qualification (NVQ) for some staff but this has now been rectified and the home now has an ongoing NVQ programme for all staff. Training is provided in safe working practices such as moving and handling, food hygiene and fire safety as well as specialist training. The manager has developed a training matrix that is held on a database and this alerts her as to when staff are in need of training updates. Staff said, “The training is good and supports us to do our jobs properly”. Staff said that they have individual supervision sessions on a regular basis and found them to be useful. They also have regular staff meetings to discuss various aspects of the home. Windsor Court Care Home DS0000000962.V357136.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 People who use the 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 is well managed in the best interests of people who live there and proper attention is given to their health and safety. EVIDENCE: The home manager has worked for several years at the home as a carer and senior carer before being appointed as manager in August 2007. She has recently completed the Registered Manager’s Award and following her application to be registered as the manager of the home with the Commission, is currently awaiting an interview date. Staff said that they feel well supported by the manager. People who live at the home said she is “approachable and Windsor Court Care Home DS0000000962.V357136.R01.S.doc Version 5.2 Page 24 friendly”. Two care professionals who have involvement with the home commented ‘over the last few months the home has seen changes for the better’. The home has good quality systems in place to seek the views of others about how services can be improved. Questionnaires are sent out to people living at the home, relatives, staff and professionals who have contact with the home. Information from this was available at the home on the day of the visit and most of the comments seen provided positive feedback about the care and services provided. Information from these questionnaires are evaluated and then acted on. As a result of some comments different foods have been provided to suit people’s preferred tastes. A number of audit systems were in place to monitor different aspects of care so that any issues could be addressed quickly and improvements could be made. Meetings take place with people living at the home and relatives. A relative said, “I try and get to the meetings to keep up to date with things”. Staff said that they are encouraged to give their opinions in staff meetings. The operations manager undertakes monthly visits to the home and makes a report from their findings of actions to be taken to improve the service. The home has recently introduced a new system for looking after people’s monies. This means that the home has a bank account that is sub divided into individual accounts for people who live in the home. Records of and receipts from any incoming or outgoing monies are kept. Any cheques are paid directly into each person’s personal account and the administrator keeps details of individual accounts on a database. People can have access to their monies at any time. The self-assessment form completed by the home before the site visit indicated that all the necessary health and safety checks were up to date and the records looked at confirmed this. Previous recommendations from a fire officer visit had been acted on and the kitchen is to be re-tiled in February 2008 following a recommendation made at a recent food hygiene inspection visit. Fire safety checks were carried out as necessary and a visit from the fire officer in August 2007 found that all aspects of fire safety in the home were satisfactory. Windsor Court Care Home DS0000000962.V357136.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 3 X 4 X X 4 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 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 3 X 3 X 3 X X 3 Windsor Court Care Home DS0000000962.V357136.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. 1. Standard OP8 Regulation 12 (1) (b) Requirement Arrangements must be put in place to make sure that identified health needs are properly monitored at all times so that any changing needs can be acted on. This will help in making sure that people receive the necessary health care to have their needs met. Timescale for action 29/03/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP12 Good Practice Recommendations The range of activities that are offer should be reviewed to make sure they are meeting all people’s social and recreational needs. Windsor Court Care Home DS0000000962.V357136.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Windsor Court Care Home DS0000000962.V357136.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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