Care Home: Wychdene

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What the care home does well The service provides all the information a person considering living in the home would want to know about facilities and what living in the home would be like. The service gathers information about the individuals` requirements and preferences prior to admission, not only to meet the diverse needs of the individual but to also ensure the home is able to meet their needs in a manner acceptable to the person. The service focuses on involving residents in all areas of their life, and actively promotes the rights of individuals to make informed choices. This includes developing and maintaining family and personal relationships. There are a range of activities that people living in the home are encouraged to participate in and they are encouraged to express their views and suggestions around their interests. People living in the home benefit from living in a safe, well-maintained environment with ample personal and communal space to meet their needs. The service ensures that all members of staff receive relevant training that includes induction and external qualifications that is targeted and focused on improving outcomes for people living in the home. What has improved since the last inspection? Care plans have been revised to give more comprehensive information and guidance to staff delivering care requirements. Since the last inspection the home has invested in the refurbishment of several areas of the home and there is a maintenance plan in place to gradually refurbish the remaining rooms. Items of furniture,carpets and soft furnishings have been replaced as and when required. The kitchen area has been revamped and a wet room/shower room installed for the benefit of residents. What the care home could do better: There are no requirements arising from this inspection and we are of the opinion that the service is providing good quality outcomes for people living in the home. Key inspection report Care homes for older people Name: Address: Wychdene 19 Callis Court Road Broadstairs Kent CT10 3AF     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Paul Stibbons     Date: 1 7 0 5 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. that people have said are important to them: They reflect the things 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. Care Homes for Older People Page 2 of 25 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Wychdene 19 Callis Court Road Broadstairs Kent CT10 3AF 01843865282 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mylan Ltd Name of registered manager (if applicable) Miss Lisa Robinson Type of registration: Number of places registered: care home 28 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 28 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - OP Date of last inspection Brief description of the care home Wychdene residential home is owned by a private company. It is a large detached property situated close to the town of Broadstairs. At the present time two of the bedrooms are being used as a double and all other bedrooms are used as singles. Seven of the bedrooms have ensuite facilities. The home has a lift facility. The home is located in close proximity to local amenities. Wychdene is registered to provide personal care and support for up to 28 older people, who require varying degrees of Care Homes for Older People Page 4 of 25 Over 65 28 0 2 0 0 7 2 0 0 9 Brief description of the care home assistance. The home has a registered manager. Care Homes for Older People Page 5 of 25 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: two star good 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 last inspection on this service was completed on the 20th July 2009. This Key unannounced inspection visit was conducted on the 17th May 2010 Prior to this inspection visit we assessed any information that we have received about the home and the information the service submitted in their Annual Quality Assurance Assessment that we had requested. The Annual Quality Assurance Assessment is a self-assessment by the service that focuses on how well outcomes are being met for people using the service. Care services are judged against outcome groups. They allow us to judge how well a provider delivers outcomes for the people using the service, rating them as Excellent, Good, Adequate or Poor. One overall judgment is made for each of the outcome areas. Care Homes for Older People Page 6 of 25 This judgment is based on the standards looked at during the inspection process. Further information about how we make our judgments on outcome groups can be found in the KLORA (Key Lines of Regulatory Assessment) publication on the commissions website. The Registered manager was not present during the inspection. The deputy manager assisted with the inspection and a number of residents were seen and spoken with before the conclusion of the visit as were four members of staff. Discussions were held with those present and a variety of documents and records that included Statement of purpose, Service user guide, pre-admission assessments of need, care plans, health plans, risk assessments, activity records, recruitment and training records, medication records and health and safety records were examined. A tour around the premises was undertaken to assess whether the facilities and quality of the environment met the needs of people who live there. The interactions between staff, management and residents were observed and noted. Care Homes for Older People Page 7 of 25 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our Care Homes for Older People Page 8 of 25 order line 0870 240 7535. Care Homes for Older People Page 9 of 25 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 10 of 25 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. Prospective residents have sufficient information on which to make an informed decision as to whether the home can meet their needs. A trial period and full assessment of needs is conducted before a permanent placement and written contract of terms and conditions is offered to prospective residents. Evidence: We wanted to look at the information available to people who may be considering using the service and whether it was sufficient and detailed enough to be able to make an informed decision as to whether the home would meet their requirements. We also wanted to see whether the home gathered sufficient information about prospective residents to be confident that they are able to meet the diverse needs of individuals in a manner that is acceptable to them. Significant time and effort is spent Care Homes for Older People Page 11 of 25 Evidence: planning to make admission to the home personal and well managed and prospective residents and their families are treated as individuals and with dignity and respect for the life-changing decisions they need to make. There is a high value on responding to individual needs for information, reassurance and support. The home has developed a Service users guide for residents and relatives giving information about the home and facilities. Three pre-admission assessments were viewed and it was evident that all new residents receive a comprehensive needs assessment before admission. The service obtains a summary of any assessment undertaken through care management arrangements, and insists on receiving a copy of the care plan before admission. Responses to surveys sent out confirmed that residents or their representatives were involved in the assessment process and their views were sought. Information is gathered from a range of sources including medical history information and life history. The assessment focuses on achieving positive outcomes for people and this includes ensuring that the facilities, staffing and specialist services provided by the home meet the ethnic and diversity needs of the individual. Before agreeing admission the service carefully considers the needs assessment for each individual prospective person and the capacity of the home to meet their needs. Care Homes for Older People Page 12 of 25 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. People living in the home have an individual plan of care that sets out how their health, personal and social care needs will be fully met. People living in the home are protected by the homes policies and procedures for dealing with medication. People living in the home are treated with respect and their right to privacy is upheld. Evidence: We wanted to know whether residents receive effective personal and health care support using a person centred approach with support provided based upon the rights of dignity, equality, fairness, autonomy and respect. We looked at three care plans and they clearly record peoples personal and health care needs and detail how they will be delivered. Care plans included a client care profile, medication requirements, mobility, nutrition and individual preferences. Risk assessments are in place for the security and safety of individuals. Care Homes for Older People Page 13 of 25 Evidence: Four residents were spoken with about the care they received and their comments demonstrated that staff members respond appropriately and sensitively in all situations involving personal care. Time was spent talking to residents in the lounge and the interaction between staff and residents was friendly, caring and mutually respectful. Residents spoken with had nothing but positive comments about the home, staff and care provided. The health care needs of residents unable to leave the home are managed by visits from local health care services. Residents have the aids and equipment they need and these are well maintained to support them and staff in daily living. The home has an efficient medication policy supported by procedures and practice guidance, which staff understand and follow. Medication records are fully completed, contain required entries, and are signed by appropriate staff. All staff administering medication have received training in the management of medication. Care Homes for Older People Page 14 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home have the opportunity to participate in a range of activities People living in the home enjoy a healthy and varied diet that is of their choosing. Evidence: The service actively encourages and provides varied opportunities for people using the service to maintain social, emotional, communication and independent living skills where appropriate. The service focuses on involving residents in all areas of their life, and actively promotes the rights of individuals to make informed choices. This includes developing and maintaining family and personal relationships. During the visit a member of staff tried to encourage residents to participate in some activities. One gentleman played a board game with staff but others were more interested in watching a cowboy film on television. The AQAA states that the home provides a selection of daily newspapers and magazines and some residents said they were happy just to read and mix socially. Care Homes for Older People Page 15 of 25 Evidence: The home keeps a record of activities that each individual has participated in and the benefits derived from taking part. Menus are changed frequently to accommodate residents wishes and survey responses from residents was generally positive about the food provided. Care Homes for Older People Page 16 of 25 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. People living in the home can be confident that their views will be listened to, taken seriously and acted upon. People living in the home are protected from abuse. Evidence: The home has a complaints procedure that is provided to all residents. Complaints records were examined and all complaints recorded had a written response to the complaint held on file. Responses from surveys sent to residents indicated that they are satisfied with the service, feel safe and well supported. All staff working at the service have been trained to know the importance of taking the views of residents seriously, and of listening to and responding to issues raised. All staff members have received safeguarding of vulnerable adults training. Personnel files viewed evidenced that recruitment procedures included all the relevant checks and references to ensure only appropriate staff are employed. Care Homes for Older People Page 17 of 25 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. Residents benefit from living in a safe, well-maintained environment with ample personal and communal space to meet their needs. Evidence: The provider and manager have ensured that the physical environment of the home provides for the individual requirements of the people who use the service who live there. The living environment is appropriate for the particular lifestyle and needs of the residents and is homely, well maintained, clean, safe and comfortable. The AQAA states that since the last inspection several bedrooms have been refurbished and several items of furniture and carpets have been replaced. Communal areas have been decorated and curtains purchased. There has been a library area created with books for the residents enjoyment. Three bedrooms were viewed and they all had personal possessions and photographs of friends and family on display. Hot water taps were sampled during the visit and appeared to be at an acceptable temperature for the safety of residents. The home is very homely, clean, tidy and free of any offensive odours. The Annual Care Homes for Older People Page 18 of 25 Evidence: Quality Assurance Assessment states that members of staff have received training in infection control, there are assessments in place for the Control of Substances Hazardous to Health. Care Homes for Older People Page 19 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are in safe hands at all times supported by a trained staff team in adequate numbers. People living in the home are protected by robust recruitment policies and procedures. Evidence: The service ensures that all members of staff receive relevant training that includes induction that is targeted and focused on improving outcomes for residents. Two staff members spoken with were of the opinion that training was excellent and that they felt they received all the necessary training to be competent in their job role. The home funds staff to undertake NVQ qualifications and are committed to having 100 NVQ trained staff. The home has robust recruitment policies and practices in place and the deputy manager confirmed that all the required checks are carried out prior to employment of any individual. Care Homes for Older People Page 20 of 25 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 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 run in the best interests of the residents and their health, safety and welfare is promoted and protected. Evidence: The registration certificate for the home is on display and is accurate in the detail. The manager is qualified and competent and registered with the commission. Comments in the AQAA and from some staff members spoken with indicated that relationships between Directors, manager and staff are not entirely harmonious. Evidence was seen that resident meetings, staff meetings and supervision sessions are regular. Notes and action points are taken of meetings and sessions, and progress is regularly reviewed. The home has efficient systems to ensure effective safeguarding and management of residents money and valuables, including record keeping. Care Homes for Older People Page 21 of 25 Evidence: Record keeping is of a good standard. Records are kept securely and staff member induction training ensures they are aware of the requirements of the Data Protection Act. The home conducts internal health and safety checks and the AQAA indicates that the homes equipment and installations have been serviced and tested as recommended There is evidence of regular monitoring by the providers and written records of these visits are retained at the home. Care Homes for Older People Page 22 of 25 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 23 of 25 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 24 of 25 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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