Care Home: Winslow House

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What the care home does well At the last inspection in April 2007 we found the following: The homes Statement of Purpose and Service Users Guide provide people living at the home, and proposed people, with the information about the services provided. A number of staff have worked at the home for a long time and this results in consistency for the people living at the home. The continued investment in the home ensures people live in a pleasant environment that is comfortable and safe. Feedback received from visitors to the home praised the high standard of the environment. The home has exceeded the recommended 50% of care staff trained in NVQ level 2. Safe recruitment procedures are in place to reduce any risks to people living at the home. The home regularly reviews aspects of its performance through a programme of self-review and consultations, which include seeking the views of people living at the home, their relatives and staff. Since this last random inspection visit we have no reason to believe that this has changed. During this visit people living in the home told us; `I like it here the staff are very good to me and very friendly`, `I have the newsletter from my local church and go to the homes monthly service`, `I like the food`, `the staff are very kind and helpful and the manager and deputy are very good`, `I join in with the activities I like and will go down to a piano recital`, and `the food is very good. Comments from the surveys people completed included the following; `the home is very good I have no complaints`, `I am happy with everything and I have no complaints at all`, `I am perfectly contented here and we all get on together`, `everything seems to run smoothly thanks to the staff`, and `I have my own room, which is very pleasant and I am very happy here`. One relative told us that her mother is very well cared for and that she had no concerns about the home. What the care home could do better: Medication audits could be improved to include `spot check` tablet counts, and protocols for some `as required` medication must be completed. The ceiling in the upstairs dining room needs some maintenance where there was a water leak. We recommend that interview notes are kept in the recruitment records, particularly where any gaps in employment have been discussed. Random inspection report Care homes for older people Name: Address: Winslow House Winslow House Springhill Nailsworth Glos GL6 0LS three star excellent service 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: Kathryn Silvey Date: 2 8 0 4 2 0 1 0 Information about the care home Name of care home: Address: Winslow House Winslow House Springhill Nailsworth Glos GL6 0LS 01453832269 01453836423 winslowhouse@invictawiz.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Jean Ellen Walker Type of registration: Number of places registered: Conditions of registration: Category(ies) : Winslow House Ltd care home 35 Number of places (if applicable): Under 65 Over 65 35 old age, not falling within any other category Conditions of registration: Date of last inspection Brief description of the care home 0 Winslow House is a Victorian property, which has been converted and extended to provide attractive accommodation for older people who require personal care. The Home has been equipped with a shaft lift and a number of adaptations to assist older people. The communal areas consist of a large lounge/dining room on the first floor, and a lounge, dining room and a large conservatory/dining room on the ground floor. The gardens are attractively laid out and well maintained. Winslow House is situated within walking distance of Nailsworth town centre and has Care Homes for Older People Page 2 of 10 Brief description of the care home the benefit of attractive views of the surrounding countryside. The accommodation fees range from 450 to 850 pounds per week and extras that are not included in the fees include newspapers, chiropody and hairdressing. Both the Statement of Purpose and Service Users Guide are available in the main entrance to the home and this includes a copy of the last inspection report. Care Homes for Older People Page 3 of 10 What we found: This random inspection took place on 28th April 2010 and included a visit to the home. The registered manager was present throughout. The manager had completed a Annual Quality Assurance Assessment (AQAA) as part of the inspection, providing considerable information about the service and plans for further improvement. The AQAA also included numerical information about the service (DataSet). We The Care Quality Commission (CQC) received completed surveys from ten people living in the home, one relative and eight members of staff. This random inspection focused on looking at two care plans in detail and speaking to the people, medication management, the environment and recruitment practices. The recommendations we made at the last inspection were complete. We looked at two care plans in detail, and one plan for a person recently admitted to the home. We also spoke to four people, including the person recently admitted, and three relatives who were visiting the home. We found that the pre-admission assessments were detailed and comprehensive. Risk assessments were well recorded to include for example; manual handling and the use of a hoist, falls prevention and urinary catheter care. The care plans were very detailed and recorded peoples individual needs, the required intervention, the aim and the outcome. The care plans were reviewed monthly and any changes were recorded and a new care plan produced to support the changes. Some people had signed that their care plan was correct, and all plans were easily accessible in peoples bedrooms. Nutritional assessments are completed for people at risk of malnutrition and regular reviews are completed to promote their health and wellbeing. Weekly and daily records were well recorded, and healthcare professional visits were highlighted. The record included visits from a district nurse, a doctor, an ophthalmologist and an audiologist. People and their relatives told us they were satisfied with the care provided and that they liked the staff. The manager completes a weekly assessment of each persons dependency, low, medium or high, to help ensure that there are sufficient staff available to meet peoples needs. One person told us that concerns are dealt with swiftly and efficiently. Activities completed were recorded daily in individual care plans, and there was a two weekly programme posted for people to choose what activities they would like to take part in. We looked at some of the crafts people had made and the homes newsletter, which provided information about people and what had been happening in the home. Medication was safely stored and administration records were complete. There were no Controlled Drugs. Not all as required medication had a protocol so that staff made consistent decisions when administering them. We also recommend that the regular medication audit completed by the manager should include a spot check tablet count for medication not on the monitored dosage system, as we found an error. There was a homely remedy procedure and doctors are aware of what medication may be given to their patients. The home had a year 2010 medication reference for the staff to use. Medication fridge temperatures were recorded. The spacious medication storage room Care Homes for Older People Page 4 of 10 was cool therefore the temperature of the room was not recorded. We looked around the home which was clean and free from offensive odours. People also told us that the home was always clean. The requirements made by the Environmental Health Officer in October 2009 had been met, and the manager told us that the home was subsequently rated five star. Improvements were being completed in the kitchen. The gardens were also being improved with additional raised borders for people to use in the extensive well tended gardens. The home was well maintained and improvements are continually made to ensure that people have a safe and comfortable home. Equipment and systems are regularly serviced, and the home has an individual fire risk assessment to aid evacuation with regard to peoples mobility. We looked at four recruitment records and all were complete. The staff do not start work without a Criminal Records Bureau (CRB) check and portable CRBs are not accepted by the provider. We recommend that interview notes are kept, particularly where any gaps in employment may have been discussed. The manager provided us with a comprehensive record of the training completed by the staff during the last year. What the care home does well: What they could do better: Care Homes for Older People Page 5 of 10 Medication audits could be improved to include spot check tablet counts, and protocols for some as required medication must be completed. The ceiling in the upstairs dining room needs some maintenance where there was a water leak. We recommend that interview notes are kept in the recruitment records, particularly where any gaps in employment have been discussed. 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 Older People Page 6 of 10 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 Older People Page 7 of 10 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 1 9 18 Review medicine records and 11/06/2010 care plans for people living in the home to ensure that for all medicines prescribed with a direction as required or with a variable dose there is always clear, up to date and detailed written guidance for staff on how to reach decisions to administer the medicine and at a particular dose, taking into account the provisions of the Mental Capacity Act 2005. This will help to ensure that people living in the home receive the correct amounts of medication in a consistent way in line with planned actions. 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 19 We recommend that the ceiling in the upstairs dining room Page 8 of 10 Care Homes for Older People 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 is repaired as it looks unsightly. 2 29 We recommend that recruitment interview records are kept for reference. Care Homes for Older People Page 9 of 10 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 Older People 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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