Care Home: Wychwood

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What the care home does well Wychwood continues to provide a busy and stimulating environment with organised activities that provide opportunities for learning, personal development and pleasure. The Manager is experienced and dedicated to providing high standards of care to service users meeting individuals differing religious, racial, physical and cultural needs. There is an open and friendly atmosphere with good communication between service users, staff and other interested parties. Staff are well supported, enjoy working at the home and have a real commitment to the service users. They are encouraged to undertake regular training and updates. Service users` personal needs are well supported and choice, privacy and dignity are seen as very important. What has improved since the last inspection? Service users are offered a wider range of activities. A new television is in place in the lounge. A new induction programme has been introduced and more training is available to staff. What the care home could do better: Access to the garden and laundry should be made easier for people who use wheelchairs. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Wychwood 38 London Road Southborough Tunbridge Wells Kent TN4 0PX     The quality rating for this care home is:   two star good 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: Gary Bartlett     Date: 1 1 0 3 2 0 0 9 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. 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. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) 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 Adults (18-65 years) Page 2 of 25 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.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 25 Information about the care home Name of care home: Address: Wychwood 38 London Road Southborough Tunbridge Wells Kent TN4 0PX 01892535623 Telephone number: Fax number: Email address: Provider web address: www.pepenbury.info Name of registered provider(s): Type of registration: Number of places registered: Larkfield Hall Ltd care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 4 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: Learning disability - LD Date of last inspection Brief description of the care home Wychwood was registered in May 2005 as a respite service for four service users with learning disability, one bedroom is equipped to meet the needs of service users with a physical disability, a fifth bedroom is available for very short term emergency or trial stays. The house is detached and set back from the main road through Southborough, it has a large garden and a patio area. Four bedrooms are on the first floor; the fifth room that is suitable for a wheelchair user is on the ground floor. Service users who Care Homes for Adults (18-65 years) Page 4 of 25 Over 65 0 4 Brief description of the care home stay at Wychwood access day care facilities during the week, a variety of activities are offered during evenings and weekends. Local facilities are within easy reach and the centre of Tunbridge Wells is approximately two miles away. The fees structure is complex and is decided by the Local Authority. Levels of fees can be obtained by application to the provider or to Kent County Council. Care Homes for Adults (18-65 years) 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This key unannounced inspection was conducted by Gary Bartlett, Regulatory Inspector, who was in Wychwood on 10th March 2009 from 8.45 a.m. until 11.45 a.m. A further visit was made on 11th March from 7.15 a.m. until 10.15 a.m. Judgements about quality of life and choices were taken from direct observation and by discussion with the Manager, service users and staff. Some records and parts of the building and grounds were inspected. An Annual Quality Assurance Assessment had been completed, from which information was used to inform the inspection process. The Inspector would like to thank everyone involved for their contribution to the inspection. Care Homes for Adults (18-65 years) Page 6 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 set out 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 order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 25 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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. Service users can be confident they will have an assessment of their needs before they move in to Wychwood and benefit from having the opportunity of a trial stay. Evidence: When a referral has been received, the Manager undertakes an assessment of the persons needs. The Manager described how she intends to broaden this to include assessments of prospective service users religious and cultural needs. She is also wanting commissioners to provide more information about service users family and social backgrounds so staff at the home have a good understanding of these when people arrive at Wychwood. Prospective service users are given the opportunity to visit the home and have introductory stays of a night or two. Discussion with staff indicates they are sensitive to learning new service users needs and individual preferences and in helping them to settle in. Care Homes for Adults (18-65 years) Page 9 of 25 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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 who use the service can be confident their needs will be met and that they will be consulted about how this will be achieved. Risk management systems promote their safety and independence. Evidence: The judgment for this outcome group has taken into account the quality of life for all the service users. It also includes an assessment of the level of knowledge and understanding displayed by staff when providing care. Comments made by service users and staff, observation during the site visit and the previous inspection report, all indicate the standard of care provided is good. Service users say that staff are fully aware of their needs. Staff are aware of far more information than is recorded in care plans and a lot of information is shared verbally. The Manager described how she will be introducing a more detailed system of care planning. The three care plans sampled included information about individual preferences regarding personal care, interests and activities. Risk assessments are in place relating to a range of activities. Care Homes for Adults (18-65 years) Page 10 of 25 Evidence: Service users have regular opportunities to contribute their views and ideas with regard to activities and menus and are very well supported in this. It is clear that service users have confidence in the staff team and observed interaction was warm and friendly. Wychwood has policies and procedures in place in respect of data protection and confidentiality of information. The Manager is aware of these, as is demonstrated by her having ordered a new filing cabinet for the safekeeping of records when they are not in use. Care Homes for Adults (18-65 years) Page 11 of 25 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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. Service users enjoy individual lifestyles and are supported to develop their life skills. They have the opportunity to experience a variety of social and leisure activities. Evidence: Whilst staying at the home, service users are encouraged to continue to attend their usual daily activity venues. If other transport is not available, staff take service users to their day care in the homes minibus. Service users are treated as individuals and are consulted about their different interests and activities are provided accordingly. Service users spoken with clearly enjoy the activities they participate in. The home is in the centre of the town where there are shops, pubs and restaurants and records show that service users are encouraged and supported to use these local community facilities. Care Homes for Adults (18-65 years) Page 12 of 25 Evidence: Service users participate in planning the menus and they enjoy a variety and choice of meals. They have the opportunity to go shopping with staff. Packed lunches are taken to day care centres. Care Homes for Adults (18-65 years) Page 13 of 25 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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. Service users benefit from sensitive and flexible support that meets their individual needs and preferences. Evidence: Discussion with staff clearly shows they are aware of the type and nature of the support required for individuals care needs. Staff have a very good understanding of the preferred routines and varying requirements of each person. They provide flexible support to service users based on individual choice and personal care is provided in private to promote their dignity. Through discussion with the staff and service users and assessing the three care plans, it is evident service users have ready access to health and social care professionals. Service users are supported with any routine and specialist appointments. The Manager said she is reviewing the current facilities for the storage of medicines to ensure they fully comply with the latest guidelines from the Royal Pharmaceutical Society. The Medication Record Administration Record (MAR) sheets are completed Care Homes for Adults (18-65 years) Page 14 of 25 Evidence: appropriately. Medications are only administered by staff authorised to do so. One service user currently staying at Wychwood manages her own medicines and there are risk assessments in place for this. Care Homes for Adults (18-65 years) Page 15 of 25 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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 who use the service are protected by clear policies and procedures. They are encouraged to offer comment or complaints. Evidence: The complaints procedure is readily available to people who use the service. They say they feel confident they are listened to and any necessary action is taken. The home keeps a record of all complaints received by them, the result of the investigation and how the complaint has been resolved. The AQAA indicates the home has not received any complaints in the last twelve months and the Commission has not directly received any information regarding complaints about the home since the last inspection. There are procedures for responding to suspicion or evidence of abuse or neglect to ensure the safety and protection of residents. The staff spoken with have a sound understanding of safeguarding vulnerable adults procedures and of the need to be mindful of individuals needs. A senior staff member stated any allegation of abuse would be referred to the concerned agencies without delay. There have not been any safeguarding alerts. Care Homes for Adults (18-65 years) Page 16 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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. Service users live in a generally comfortable and clean home. Evidence: Wychwood offers a clean and comfortable environment for people to stay in. The Manager described how she is planning to make it more homely with pictures and a possible change in the layout of the seating in the lounge. The lounge is of a good size and a large screen television has been put on one wall. The dining room is partitioned so the areas used for eating and relaxation are separate. One bedroom is on the ground floor, is wheelchair accessible and has an en suite adapted shower room. The other bedrooms are on the first floor and are equipped with wash basins. Service users say they find the bedrooms comfortable and the bathroom and toilet facilities are adequate for their purposes. There is a large garden with a patio. Wheelchair users can gain access to the patio via a side entrance to the garden as there are steps from the rear of the house. There has been talk in the past of addressing this so all service users can gain access to the garden equally but, to date, without result. Consequently, there remains a restriction Care Homes for Adults (18-65 years) Page 17 of 25 Evidence: to the activities that wheelchair users can participate in outside and could make those less physically able feel different and precluded. Likewise, the laundry can only be accessed via steps. It is unlikely expensive work will be carried out given that the accommodation is temporary with plans for a purpose built house in the future. As service users are accommodated for short stays up to a maximum of 14 days, it would seem unreasonable to insist on major alterations to outside areas at this stage. Care Homes for Adults (18-65 years) Page 18 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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 benefit from the support of enthusiastic and committed staff, who demonstrate a good understanding of service users individual needs and preferences. Evidence: Robust recruitment processes are followed to ensure only properly checked people work at the home. People applying to work at the home have to complete an application form, provide two references, have POVA and Criminal Records Bureau (CRB) checks and attend an interview. From observation and discussion, it is clear the staff are very focussed on the needs of the people living in the home and work closely with them. Service users like the staff and find them approachable, friendly and kind. Throughout the site visit there was evidence of good relationships between staff and service users. Staff mentioned how much they enjoy working with the service users and this is reflected in the way care and support is given. Staff obviously know the service users well and how best to put them at ease. There is an induction programme in place for new staff and there is ongoing training for all staff. Staff speak of regular training and there are certificates on their files. The Care Homes for Adults (18-65 years) Page 19 of 25 Evidence: Manager acknowledges the training matrix needs updating to give a management overview of courses attended and those booked. Care Homes for Adults (18-65 years) Page 20 of 25 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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 Manager is committed to providing a good service and the home is well run in the best interests of service users. There is an open and friendly atmosphere. Evidence: The Manager has been in post for a short time and demonstrates a commitment to providing a high quality service tailored to the individual needs and preferences of the service users. She holds an NVQ level 3 in care and has fourteen years experience of working with people with learning disabilities. She is currently completing the Diploma in Learning Disability Management and is intending to submit an application to be registered as Manager of Wychwood. Service users and staff find the Manager approachable and supporting. A quality assurance process is in place, which elicits views from service users and other people involved with the home. There are records of fire systems checks and fire drills and training. Staff and service users spoken with have a good understanding of emergency procedures. The records Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: of maintenance and safety checks seen are up to date. Care Homes for Adults (18-65 years) 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 Adults (18-65 years) 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 1 24 Access to the garden and laundry should be made easier for people who use wheelchairs. Care Homes for Adults (18-65 years) Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or 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. 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 Adults (18-65 years) Page 25 of 25 - 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!