Care Home: Wrottesley House

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What the care home does well Information about the service is provided in two documents, the statement of purpose and service user guide. The documents have recently been revised and reviewed, are readily available and user friendly. The fees for the service are included in the documents and range from 359.00 - 420.00 pounds per week. An assessment of a person`s care needs are obtained prior to offering a placement at the home, this ensures that staff have the information to meet those needs. Each person is treated as an individual and the care home is responsive to his or her health, personal and social care needs. Wrottesley House is well maintained, well decorated and furnished and provides a quality environment in which to live. People spoken with expressed a satisfaction with their accommodation. The manager and staff have a good knowledge of the individual care needs of people living at the home, and provide a high standard of care. People living at the home stated that the staff were very good, attentive and friendly. the food was `always lovely` and they had sufficient social and recreational activities to meet their needs. What has improved since the last inspection? Information on the activities arranged during the month are now included in the monthly newsletter and a programme of events is displayed around the home. The redecoration and replacement of the fabric has continued, with areas receiving attention when needed. Staff have received training in dementia awareness and the protection of vulnerable adults, in addition to the mandatory topics and other areas relevant to the service. This ensures that people are cared for by well trained and competent staff. What the care home could do better: No requirements or recommendations have been made following this inspection. All evidence points to a service that has developed systems to provide good quality outcomes for people living at the home. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Wrottesley House 46 Wrottesley Road Tettenhall Wolverhampton West Midlands WV6 8SF     The quality rating for this care home is:   three star excellent service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Joy Hoelzel     Date: 2 4 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Wrottesley House 46 Wrottesley Road Tettenhall Wolverhampton West Midlands WV6 8SF 01902744609 01902744609 wrottesley.house@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Wrottesley House Ltd care home 18 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: All DE category service users must be accommodated on the ground floor. The agreed staffing levels are: 8am - 9pm Senior Carer 2 care staff Night staffing 2 waking care staff Care Manager hours are supernumerary Separate catering/domestic/laundry staff/activity organiser must be provided in addition to care hours. These are minimum staffing levels and must be increased in the event of any increase in dependency of service users accommodated. CSCI will continue to monitor the staffing levels and may require levels to be increased should CSCI feel that care needs are not being met. Date of last inspection Brief description of the care home The home is situated in a residential area of Tettenhall about half of a mile from Tettenhall Green, and approximately three miles from Wolverhampton City Centre. The home is in close proximity to a main arterial road. The home was built over 26 years ago as a large, detached private dwelling and has since been adapted and extended to accommodate 18 service users. Six of the bedrooms have an en-suite facility. At the Care Homes for Older People Page 4 of 24 Over 65 5 18 0 0 Brief description of the care home front of the premises there is a parking area together with flowerbeds and shrubs. The rear garden is well laid out with lawns and borders. There is one double bedroom and the remaining 16 bedrooms are single. The home has adequate bathrooms/showers and WCs. There are two lounges, a dining room, laundry room, an office and a staff room. Information of the home and the provision of the service are available in the statement of purpose and service user guide, both documents have recently been revised and are readily available. Commission for Social Care Inspection reports for this service are available from the provider or can be obtained from www.csci.org.uk Care Homes for Older People Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The previous key inspection was completed 4th September 2006, with an annual service review carried out on 7th April 2007. This unannounced inspection took place over four hours on Monday 24th November 2008. The registered manager was in charge of the home, supported by care and ancillary staff. A look around the home took place, which included a number of bedrooms as well as communal areas. The care documents of a number of people using the service were viewed including care plans, daily records and risk assessments. Other documents seen included medication records, service records, some policies and procedures and Care Homes for Older People Page 6 of 24 staffing records. Discussions were held with people living, visiting and working at the home. Some people were unable to fully comment about their experience of life at the home. Observations were made of how they spent the day and of the interactions offered by staff in an attempt to obtain an overview of how they may be feeling. Prior to this inspection an Annual Quality Assurance Assessment (AQAA) document was posted to the home for completion. The AQAA is a self-assessment and a dataset that is filled in once a year by all providers. It informs us about how providers are meeting outcomes for people using their service and is an opportunity for providers to share with us the areas that they believe they are doing well. It is a legal requirement that the AQAA is completed and returned to us within a given timescale. The acting manager completed this document and returned it the commission. Comments from the AQAA are included within this inspection report What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 24 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this 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 can be confident that the care home can meet their individual care needs. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. Evidence: Information of the service provision is detailed in the statement of purpose and service user guide. Both documents have been revised this year and are available upon request at the home. The service user guide specifies the weekly fees for the service, from 359:00 to 420:00 pounds per week, and what is and what is not included in the fee. The case file of the person who recently moved into the home was looked at to see if information had been sought regarding this persons needs prior to moving in. Care Homes for Older People Page 10 of 24 Evidence: Information had been gathered from the previous health care setting and a pre admission assessment was completed by the service. The manager confirms that a member of staff always visits the person prior to offering a place at the home and whenever possible visits to the home are arranged. This person discussed the admission process and stated that she is very satisfied with all aspects of the service but nothing is quite like your own home. Other case files looked at included a pre admission assessment by the home in addition to social worker reviews, assessments from Primary Care Trusts and community care services. This gathering of information ensures that the service can be confident of meeting a persons care needs. The home does not provide an intermediate care service. Care Homes for Older People Page 11 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this 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 plan is person centered and focuses on the individuals strengths and personal preferences. The delivery of personal care is individual and is flexible, consistent, reliable, and person centered. Staff respect privacy and dignity and are sensitive to changing needs. Evidence: All people have a plan of care that is initially generated from the assessments obtained prior to the person moving into the home. Three plans were selected for inspection with people being at the home for varying lengths of time. The plans evidenced that the person and/or their representative is fully involved in the care planning and review process. Each plan contained assessments for maintaining a persons safety and when a risk is identified it is linked with a corresponding plan of care. For example one person is currently at risk of developing pressure areas due to a specific condition, the care plan indicates the pressure relieving equipment to be used and the regular interventions needed by staff to reduce the risk. Another person experiences episodes of anxiety and distress due to a specific condition. A care plan has been developed Care Homes for Older People Page 12 of 24 Evidence: with details for staff of what the possible triggers are to these periods and the action needed to reduce the distress. Staff discussed the care needs and described the way they helped this person. The Annual Quality Assurance Assessment completed by the manager discusses how the health and personal care needs of people are met by - Each service user has an individual plan of care and actively contributes at reviews and helps to set realistic goals. The care workers are trained to give a high standard of personal care and to allow choice in daily routine and decision making; for example choice of clothes, meals The aqaa acknowledges that it could do better by Improving the aspects of care planning to ensure that it remains person centered Medication is administered to people by the senior care staff using a monitored dose system with additional boxes and bottles of medicines. The procedures were looked at, staff explained the processes and all evidence points to good arrangements being in place for the safe administration of medications. Staff were observed throughout the day to be assisting people with care needs in a discreet and respectful way. People were offered choices at every opportunity be it the television programme, selection of drinks or help with personal care. Care Homes for Older People Page 13 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this 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 are involved in daytime activities of their own choice and according to their individual interests, diverse needs and capabilities. The meals are balanced and nutritious and cater for the dietary needs of individuals. Care staff are sensitive to the needs of people who find it difficult to eat and give assistance with feeding. Evidence: Social, leisure and recreational activities within the home and in the community are arranged by the care staff. People living at the home described the recent entertainment within home and stated how very much they enjoyed this event. Other activities outside of the home have been arranged through out the summer months with people saying they enjoyed going out. The statement of purpose includes details of maintaining contact with family and friends. People living at the home confirmed regular visits from family at all times during the day to suit the individual. The Annual Quality Assurance Assessment details the improvements made during the past twelve months Allocated specific times for supervised recreational activities. Developed a News Letter and a monthly activity planner Involved senior carers in planning an activities programme. Listened to what our service users want. Care Homes for Older People Page 14 of 24 Evidence: The main front door is kept locked for security reasons, entry to the home is gained by staff answering the door. A number keypad is used for exiting the premises. No other doors were locked with the exception of storage cupboards; people have unrestricted access to areas around the home and the rear garden. Should people wish to obtain advice from the advocacy service, contact details are displayed of the local service at the entrance to the home. The dining area is prepared in advance of meals with people being encouraged to sit at the table, but people are able to have their meals in their preferred place. People spoken with stated that they enjoyed the meals provided, had plenty to eat and a good variety. One person confirmed that she had been offered a choice for the main meal but couldnt remember what she had ordered. That was alright as the food is always good. Staff were observed to be sitting with people who required help to eat and drink and were very patient, discreet and encouraging. Care Homes for Older People Page 15 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and others involved with the service say that they are satisfied with the service provided and know what action to take if they have concerns. Evidence: The statement of purpose and service user guide both offer clear concise details of how to raise a concern or complaint about the service. The procedure is also displayed on the notice board in the home. Four people discussed the action they would take if they had any concerns and would in the first instance speak with their family who would then talk with the manager. All were very confident that it would quickly be sorted out. The manager confirmed that no concerns, complaints or safeguarding issues have been raised with her during the last twelve months. We, the commission have not received any correspondence in this area The home offers a facility for residents to deposit personal monies for safekeeping; records relating to this were seen. All transactions are recorded on individual balance sheets with invoices and receipts kept. Care Homes for Older People Page 16 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this 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 provides a physical environment that is satisfactory to the specific needs of the people who live there. It is well furnished, comfortable and has a programme for the maintenance and redecoration of the premises. Evidence: Wrottesley House is situated in a quiet area of Tettenhall, Wolverhampton. It is a two storey building providing accommodation for up to 18 people. The redecoration and replacement of the fittings and fixtures occurs as the need arises. The communal areas are well furnished, comfortable and warm. All of the bedrooms reflect the individuality of the occupant, many personal items and possessions were seen. One person spoken with said that although nowhere is quite like your own home she is satisfied with the accommodation. Other people expressed similar comments. The Environmental Health Officer and Fire Safety Officer have both visited, the manager stating any recommendations they made have been complied with. An infection control audit by the primary care trust was completed in August resulting in an overall score of 85 this being a good standard. During the tour of the premises all areas of the home were clean and hygienic. Care Homes for Older People Page 17 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has plentiful staff available at all times to support the needs, activities and aspirations of residents in an individualised and person centered way. Evidence: A duty rota is maintained on a weekly basis to identify the members of staff in the home at any one time. During the morning of the inspection the registered manager confirmed that seventeen people were in residence and were being cared for by a staff team consisting of three care staff and ancillary personnel. People living at the home stated that the staff are very good, friendly will do anything for you, staff are kind and look after me very well. General observations and discussion with staff confirmed that staffing numbers and skill mix enable a service provision, which meets the care needs of the people living at the home. Care staff spoken with confirmed that there is opportunity for training at National Vocational Qualification in care levels 2&3. One member of staff is planning to begin the National Vocational Qualification level 4 in care early in the New Year. The Annual Quality Assurance Assessment indicates that 85 of care staff hold an NVQ Care Homes for Older People Page 18 of 24 Evidence: qualification. Two staff files were selected for inspection, each contained details of the checks necessary to ensure that suitable people are employed by the service. Staff have their training and development needs identified through the appraisal and supervision processes held throughout the year. Staff discussed the sessions and courses that have been available and includes dementia awareness, first aid, food hygiene and fire safety awareness. Care Homes for Older People Page 19 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager communicates a clear sense of direction, is able to evidence a sound understanding and application of best practice operational systems, particularly in relation to continuous improvement, customer satisfaction, and quality assurance. Evidence: Mrs Anne Younger is the registered manager for the service and has the experience and knowledge to successfully manage the home on a day-to-day basis. Throughout this inspection Mrs Younger offered a clear understanding of the key principles and focus of the service, discussed the improvements made recently and the plans for the future. People living and working at the home offered positive comments about her style of management and commented that they would have no hesitation but to see her if they felt unhappy about anything. The AQAA contains excellent information that is fully supported by appropriate evidence. It includes a high level of understanding about the importance of equality Care Homes for Older People Page 20 of 24 Evidence: and diversity and a wide range of evidence showing how they have listened to residents. The home demonstrates a high level of self-awareness and recognises the areas that it still needs to improve, and has clearly detailed the ways in which they are planning to do this. The service has an effective quality assurance and monitoring system that makes certain the home is operating as it states it does and meets its stated aims and objectives. Satisfaction surveys are sent to residents and their families, staff and to other health care professionals that are involved with the home. The results of the surveys are then considered and actioned. The home offers a facility for residents to deposit personal monies for safekeeping; records relating to this have been maintained and fully receipted. Records, documents and certificates are available for inspection to ensure that the weekly, monthly and annual health and safety checks are being carried out. Care Homes for Older People Page 21 of 24 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, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 24 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, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 23 of 24 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 24 of 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!