Care Home: Wispington House

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What the care home does well The home provides a comfortable, safe and homely environment for people to live in. There are assessment and care planning processes in place. Residents have detailed care plans, which enables staff to know how residents needs are to be met by the resources of the home. Regular residents meetings and care reviews are held where residents comment on the services provided at the home. The home offers, a wide range of social and leisure activities. A balanced and varied diet is provided. Residents are encouraged to make their own choices; and they, their relatives and other visitors to the home are encouraged to give their views and opinions of the service, which means that they can influence the way the service is run. Resident stated that they felt their needs were being addressed by the care home. They said staff are kind. The home is always clean. We are very satisfied with the service being provided to us. There is a training plan in place for staff who are well supported by the management of the home, which helps them to provide a good quality of care. What has improved since the last inspection? The requirements identified at the last key inspection have been met. The registered manager stated that the home is endeavouring to ensure that the regulation requirements continue to be met. All of the home`s policies and procedures have been reviewed. Residents stated at the site visit that they did not know of any way the home could be improved What the care home could do better: The registered manager has begun the process to identify resources, to enable her to ensure staff are familiarised and trained in the Mental Incapacity Act 2007. This is new legislation, part of which came into force in October 2007. CARE HOMES FOR OLDER PEOPLE Wispington House 41 Mill Lane Saxilby Lincoln Lincs LN1 2QD Lead Inspector Ken Hague Unannounced Inspection 14th April 2008 09:00 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 Wispington House DS0000002480.V362262.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. Wispington House DS0000002480.V362262.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wispington House Address 41 Mill Lane Saxilby Lincoln Lincs LN1 2QD 01522 703012 01522 704547 trevor.brock@eurotelonline.com 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) Mr Trevor William Brock Mrs Heather May Brock Mrs Heather May Brock Mr Trevor William Brock Care Home 26 Category(ies) of Dementia (3), Old age, not falling within any registration, with number other category (26) of places Wispington House DS0000002480.V362262.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to provide personal care for service users of both sexes whose primary needs fall within the following category:Old age, not falling within any other category (OP) - 26 Dementia - over 65 years of age (DE(E)) - 3 The maximum number of service users to be accomodated is 26. 2. Date of last inspection 17th April 2007 Brief Description of the Service: Wispington House is a detached property, a former farmhouse, adapted to provided accommodation and care for up to 26 older people. The home is situated in large grounds set back from the main road of the village of Saxilby, which has local facilities within walking distance for the more able residents. The City of Lincoln is approximately four miles away. This homes brochure states our aim is to enhance your quality of life by helping you to lead a full and active life as you would expect living in your own home. The home is managed by the proprietors and operates as a family run business, with the proprietor’s son in law also involved in the management of the home. Accommodation is provided on the ground floor and the first floor with a chair lift available to residents accessing this floor. There are twenty single rooms two with en-suite facilities and three double bedrooms provided, one is a flat with its own lounge, kitchen and en-suite facility. Both owners, one of whom is the registered care manager, have daily involvement in the running of this home. At the time of the inspection the home confirmed that the weekly fees ranged from £499 - £450 depending on the residents assessed needs. Additional charges are made for services such as chiropody, hairdressing and toiletries. Information about these costs as well as the day-to-day operation of the home, can be found in the home’s statement of purpose and service user guide. These documents are available in the reception area. An additional copy is kept in the home’s office. These documents are made available to all new potential residents. The care home does not offer a dedicated intermediate care service. Wispington House DS0000002480.V362262.R01.S.doc Version 5.2 Page 5 Wispington House DS0000002480.V362262.R01.S.doc Version 5.2 Page 6 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 inspection took place over 5 hours. The registered manager and the provider were given feedback at the end of the inspection. The main method of inspection used was called ‘case tracking’ which involved selecting three residents and tracking the care they receive through the checking of their records, discussion with them and the staff, and where more appropriate observation of interaction between staff and residents and related care practices. A sample of care records was inspected. Two members of staff were interviewed and the opinions of three residents were sought. An (AQAA) Annual quality assurance assessment was completed by the care home and sent to the Commission for Social Care Inspection prior to this report being completed. This is a self- assessment document completed by the providers of the care home. It sets out evidence from the provider to demonstrate that they are meeting the Care Home Regulations. It is normal procedure to obtain written feedback from residents prior to the site visit using a document called “have your say”. This was not possible on this occasion due to time constraints. However residents were spoken to do during the site visit. Their opinions are reflected within the inspection report. What the service does well: The home provides a comfortable, safe and homely environment for people to live in. There are assessment and care planning processes in place. Residents have detailed care plans, which enables staff to know how residents needs are to be met by the resources of the home. Regular residents meetings and care reviews are held where residents comment on the services provided at the home. The home offers, a wide range of social and leisure activities. A balanced and varied diet is provided. Residents are encouraged to make their own choices; and they, their relatives and other visitors to the home are encouraged to give their views and opinions of the service, which means that they can influence the way the service is run. Resident stated that they felt their needs were being addressed by the care home. They said staff are kind. The home is always clean. We are very satisfied with the service being provided to us. Wispington House DS0000002480.V362262.R01.S.doc Version 5.2 Page 7 There is a training plan in place for staff who are well supported by the management of the home, which helps them to provide a good quality of care. What has improved since the last inspection? 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. Wispington House DS0000002480.V362262.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 Wispington House DS0000002480.V362262.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): Standards 3 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are robust and updated procedures in place which are used for the assessment of new residents to the service. This ensures that all of their personal care, health care and social needs are met. A dedicated intermediate care service is not provided by the home. EVIDENCE: The files of three new residents were examined as part of the case tracking process. They all contained a full assessment including a risk assessment for each individual resident caried out prior to their addminsion to the home. Where a risk had been identified a management strategy for that risk was set out in the assessment and care plan. All care documents are being revealed in line with National Guidelines. The assessments set out the care needs, social needs and health needs of each individual resident. Residents confirmed that they have been involved in the Wispington House DS0000002480.V362262.R01.S.doc Version 5.2 Page 10 writing of their initial assessment. Members of staff interviewed confirmed that assessments are always carried out prior to residents being admitted. The three residents being case tracked all confirmed that they received an assessment prior to being admitted to the home. The registered manager stated that an individual copy of the service users guide is given to all new residents when they are addmitted to the home. A copy of the service users guide is kept in each of the resident individual bedroom. Assessments were detailed, easy to read and understand. Standard forms were used for each assessment. Their quality of recording was consistent for both short-term and long-term residents. Wispington House DS0000002480.V362262.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): Standards 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individual needs are reflected in clear, comprehensive and up to date care plans; and the privacy and dignity of residents is maintained. EVIDENCE: The individual care plans for the residents being case tracked all contained a comprehensive care assessment including an individual care plan. The needs identified at the initial assessment have been transferred onto care plans which identify the resources of the care home and meet the individual residents needs. Care plans were personalised for each resident. Care plans are reviewed on a monthly basis. There is a schedule of dates available that shows when reviews are due for each resident. There was evidence of the skin condition of the residents being monitored and recorded. Pressure area relief routines were being followed in line with care plans. Specialised equipment and mattresses will be provided when identified within care plans. Wispington House DS0000002480.V362262.R01.S.doc Version 5.2 Page 12 Residents confirmed that they could request a bath or shower at any time. The bathing of residents was recorded within care records including their choice of bath or shower. In addition the manner in which care was provided and their choice of toiletries were found in each care plan. Residents and relatives made comments such as ‘staff are very helpful. ‘They come to help you very quickly if I ring my call bell.’ ‘Staff make sure that I have my privacy when I want it’. Pre inspection information (AQAA) shows that there is a policy available regarding privacy, dignity, choice and independence. The care home has a policy for the Administration and storage of medication. The registered manager provided evidence that all staff have being trained to administer prescribed medication in a safe manner. The records for the administration of controlled drugs were discussed with the staff on duty. The evidence from these discussions and the inspection of records is that medication is being managed in accordance with the procedures of the care home. Records show that residents have access to support services provided such as chiropody and an optician. Physiotherapy, Occupational Therapy and Dietician services are available by referral to the appropriate service. Staff were observed to treat residents with dignity and spoke to them in sensitive manner. Staff were seen to knock at bedroom doors before entering therefore acknowledging the right of privacy of each resident. Wispington House DS0000002480.V362262.R01.S.doc Version 5.2 Page 13 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): Standards 12,13,14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are enough suitable activities provided for residents that are in accordance with their needs and wishes. Residents receive a healthy and balanced diet that is based on their likes and dislikes. The staff enable nresidents to maintain control over their lives. EVIDENCE: An events file is kept at the home, which shows that activities such as bingo, coffee mornings and outside entertainers are provided for residents. An activity organiser is in post. Records are also kept as to who joins in the activities and whether they like them or not. Residents said that activities are provided and they have been asked what sort of things they would like to do. Information on the residents notice board and discussions with staff provided evidence that residents are provided with outings. One recent outing was to Skegness. A new patio area has been provided by the home to allow residents to sit outside in the summer period. This area is secured with a small fence. Care records provide evidence that residents can go to local shops and visit local churches or community events. Wispington House DS0000002480.V362262.R01.S.doc Version 5.2 Page 14 Residents said that they are helped to attend churches, hairdressers and outside social groups. One resident said that they get lots of visits from family members and staff make them welcome when they come. Menus are available and follow a varied and balanced plan. Residents said that the food is very good and they get lots of choice. Residents spoken to during the site visit confirmed that their dietary needs are being met by the care home Residents said that they are able to make their own minds up about everything they do, and they are able to have their own furniture brought in to the home. Staff were seen to provide information and support to help residents make their choices and decisions. Choice, fulfilment and independence are referred to in the home’s statement of values, and in all care records. The registered manager said that literature is available to staff about recent legislation regarding decision-making (Mental Capacity Act, 2007). She also said that she plans to discuss the legislation with staff at the next team meeting. Wispington House DS0000002480.V362262.R01.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): Standards 18 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected by clear policies and procedures; and staff who are trained and knowledgeable. EVIDENCE: The evidence from the inspection of the complaint procedures, records at the home and discussion with staff and residents is that the complaints procedure is accessible to all residents. This ensures residents can raise concerns or make a formal complaint. Only one complaint has been received since the last key inspection. The complaint was resolved to the satisfaction of the complainant. Residents stated they were confident in being able to raise concerns with staff and the manager of the home. Residents and staff interviewed during the site visit stated the management are very approachable and would act immediately if any complaints or concerns were raised with them. There have been no notifications since the last key inspection that have raised any concerns. There has been no Adult protection enquiries held at the home since the last key inspection. The inspection of training records and discussion with staff provided evidence that staff have received training in the identification and prevention of abuse. Wispington House DS0000002480.V362262.R01.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): Standards 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a clean well maintained care home, which provides them with safe comfortable accommodation. The up-to-date infection control policy is followed and a safe environment is maintained. EVIDENCE: A tour was made of the care home. All areas of the home was found to be clean and smelt fresh. All of the rooms were decorated to a good standard. The rooms viewed had been personalised by the individual residents. The residents confirmed their satisfaction with the environment of the care home and their own individual bedroom. A new patio area has been created at the front of the care home allowing residents to sit out in the summer weather in safe surroundings. Wispington House DS0000002480.V362262.R01.S.doc Version 5.2 Page 17 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): Standards 27,28,29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s needs are met by appropriately trained staff; and they are safeguarded by robust recruitment procedures. EVIDENCE: During the site visit a relaxed atmosphere was evident, call bells were answered promptly, and staff demonstrated efficient management of residents needs. Staff said that there are enough people on duty to meet needs, and if shortages occur through sickness, there are staff to call upon to fill any gaps. The staff stated that if resident’s needs increased additional staffing was provided. Records show that staff have received training in areas such as moving and handling, fire safety, health and safety, optical awareness, diabetes, and dementia. There is also evidence that induction training is provided in line with a nationally recognised induction process; and training for a nationally recognised qualification is available. The AQAA states that 65 of staff hold a NVQ level 2 certificate in care. Staff confirmed this and said that access to training is very good and they received a good induction process. The registered manager states in the AQAA that extensive training courses are provided to all staff. Wispington House DS0000002480.V362262.R01.S.doc Version 5.2 Page 18 Staff stated that they feel safe working in the care home they fear well supported by all management. They described teamwork has good and morale been very high. Agency staff are not used in the home. New staff, recruited since the last key inspection, showed that the home’s policies and procedures had been followed and all checks had been made before staff started employment. Wispington House DS0000002480.V362262.R01.S.doc Version 5.2 Page 19 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): Standards 31,33,35 &38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed in the best interests of the residents, and there are quality assurance systems enabling residents to contribute to the development of the service. EVIDENCE: The registered manager has worked at the home for a number of years in various roles such as care worker and deputy manager. She has recently applied to undertake the Registered Managers Award, and already holds nationally recognised care qualifications at various levels. Staff said that she is approachable and they feel confident to go to her with any issues or concerns that they may have. Residents said that she is always around for them to speak to and always helps them when they need anything. Wispington House DS0000002480.V362262.R01.S.doc Version 5.2 Page 20 Pre inspection information shows that regular residents meetings are held and quality assurance surveys are carried out. Minutes of meetings were seen and demonstrated that residents QA Surveys showed that they are generally happy with the services they receive. The registered manager and staff said that supervision sessions are held. Staff confirmed that the registered manager supports them in their work and helps them to develop their skills. There are financial procedures in place to ensure that resident’s financial interests are safeguarded and protected. No health and safety issues were identified at this key inspection. Wispington House DS0000002480.V362262.R01.S.doc Version 5.2 Page 21 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 N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 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 3 X 3 X X 3 Wispington House DS0000002480.V362262.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Wispington House DS0000002480.V362262.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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