Care Home: Wyvern Lodge - WSM

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What the care home does well Residents receive a caring service and their needs are being well met. The staff are helpful and work hard to meet the residents care needs. Care plans have a satisfactory amount of information in them to show how residents are being helped and supported. Residents are provided with a well cooked and well served diet. Staff engage with residents and there is a a relaxed and homely atmosphere at the home. Complaints are dealt with properly by Mrs Ferguson. Mrs Ferguson aims to run the home in the best interests of the residents. What has improved since the last inspection? The systems for handling residents money are safer and money is only spent by them or on their behalf. What the care home could do better: Ensure all residents medication charts clearly state the dose and time on the instructions part. Provide a more effective way to dry residents laundry. This requirement relates to the tumble dryer not working. Ensure staff are up to date in training on health and safety subjects and on matters relevant to the needs of the residents. Hold more regular staff meetings to ensure staff have opportunities to make their views known in the home. Key inspection report Care homes for older people Name: Address: Wyvern Lodge - WSM 154 Milton Road Weston Super Mare North Somerset BS23 2UZ     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: Melanie Edwards     Date: 2 0 0 9 2 0 0 9 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) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. 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: Wyvern Lodge - WSM 154 Milton Road Weston Super Mare North Somerset BS23 2UZ 01934413388 01934413388 wyvern_lodge.wsm@virgin.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Pauline Ann Johnson,Mr Brian Edwin Johnson care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: May accommodate one named person under 65 years for respite care. This condition is specific to one person and will lapse when the person reaches 65 or leaves the home. Date of last inspection Brief description of the care home Wyvern Lodge is registered for up to 16 older people. It is situated in a residential area, near accessible local amenities. The bus stop to the town centre and sea front is just outside the home. Wyvern Lodge provides day care for up to 5 people each day. Most of the accommodation is in the original part of the building but some rooms are in a ground floor wing at the rear. The home has a passenger lift. There is a small, secluded garden with seating to the rear of the home. The fees to stay at the home are around 400 pounds a week. 0 3 1 2 2 0 0 8 0 Over 65 16 Care Homes for Older People Page 4 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: We were able to meet nine of the ten residents living at the home. We spoke to the registered manager Mrs Ferguson, two care assistants and a cook about roles, responsibilities, training needs and the way that they help residents. We saw staff help residents with their needs. We had lunch with the residents. We saw a selection of records relating to the running and management of the home. The records we saw included the statement of purpose, the service user guide, two care plans, six medication charts, menu records, the record of complaints, staff training records the staff duty record, three staff employment files, residents survey information, the fire book, the accident book and three residents finance records. Care Homes for Older People Page 5 of 25 We saw most of the environment and the only parts we did not check were a small number of bedrooms. We found the home was operating within the required conditions of registration which we impose. The conditions of registration detail the type of care and the needs of residents and the numbers of residents who may stay at the home. Care Homes for Older People 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 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 Older People Page 7 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 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 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home properly plan how to support and care for residents before they move in. There is information available for people to find out about the service provided at the home. The home does not provide intermediate care for residents. Evidence: To find out more about what sort of information there is for people to find out about the home, we read a copy of the service users guide and the statement of purpose. We were told that residents are given their own copy of the guide so they have information about the home. We read in the statement of purpose and the service users guide up to date information about the service provided, the qualifications of the staff employed and the type of accommodation. We also read about the philosophy of the home and the way that the service aims to meet residents needs. The complaints Care Homes for Older People Page 9 of 25 Evidence: procedure is in each service users guide so residents know how to complain if they need to. We looked at two of the residents assessment records to see how well needs are identified and how the care they need is then planned. We found the assessment records we read were satisfactorily informative and they set out the residents range of physical mental and social needs. We also saw that the actions taken to support the person had also been recorded in the assessment records. The assessment records we saw were being regularly reviewed and updated. The residents who we met told us that staff are very,attentive when helping them with their needs. We were also told that the staff, will do anything that I ask. These are good examples of how residents feel their needs are being well met . The home does not provide intermediate care for residents. Care Homes for Older People Page 10 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. Residents care plans show in enough detail the help and support that people need. Residents health needs are met. Residents are treated properly and with politeness. Residents medication is handled and given to them in a generally safe way. However action must be taken to ensure all handwritten medication charts are written properly to ensure medication is given out safely. Evidence: The residents who we met made some really positive comments about how the staff help and support them, for example one person said, of course Im looked after very well, another person told us, the staff are very, very attentive. This is really good evidence that residents needs are met at the home. To find out how the home identify what sort of care and support residents need,we Care Homes for Older People Page 11 of 25 Evidence: read two care plans. We found that the care plans were reasonably informative and they showed how to meet the residents needs. The care plans set out what to do to help the resident to meet their needs. We could see in the care plans that staff look at them regularly and update them with new information when needed. This is done to show that the home keeps a really close eye on residents needs to make sure they can still meet them. The care plans we read had a satisfactory level of information in them. They showed that the staff had worked out with the residents what sort of help and care they need. The care plans also showed the ways the home could help them to meet their different range of physical, mental and social needs. We saw information that showed us that staff are making sure they know in good detail, what sort of help, care and support people need. We saw the care staff helping residents in a kind and friendly way. We noticed that staff knocked on bedroom doors before they went in to them. This shows staff aim to respect residents and their right to privacy. We saw up to date written information in care plans that showed us residents are well supported with their physical health care needs by the GPs., the dentist, and the chiropodist. We met a district nurse who came to the home to help residents with nursing needs. We were told that the staff communicate effectively with the district nurses about residents needs. We looked at how residents medication is looked after to find out if the home has safe ways of handling medication. We looked at six medication administration charts in detail. We saw a photo of each resident kept with his or her administration chart to help staff give out medication safely. However we checked two residents handwritten medication records where there was no amount, or the correct time written directly on the instructions part of the chart. This information guides staff to make sure they give out the right amount of medication at the right time. We found that medication stock was generally satisfactorily organised and administration charts were being kept up to date. There was a satisfactory system for ordering and receiving medication and the records were up to date. Medication stock was stored in a metal cupboard which is kept locked. Care Homes for Older People Page 12 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. Residents are well supported to do a variety of different activities that they enjoy. Residents are offered a well cooked range of meals. Residents can receive visits from family friends and people who matter to them. Residents are supported to maintain some control in their day to day lives. Evidence: There are a variety of organised social activities for residents to take part in and these include bingo, gentle exercise sessions and occasional trips to areas of interest in the community. We saw photos in the home of residents and staff engaged in a range of social activities during the past year. We witnessed a staff and residents games session in the afternoon. The residents we saw were enjoying this activity. We saw residents receiving visitors during the morning. We were told that the home have a very relaxed visiting policy and people can come to the home when they like. Visitors may also have a meal at the home, this is a really positive way for residents to stay in touch with people who matter to them. Care Homes for Older People Page 13 of 25 Evidence: One resident has two cats and this is a really good example of how the home support people with things in their life that matter to them. We saw residents walking around the home and they were talking with the staff, they looked really relaxed and settled. We also saw residents got up at different times during the morning. This tells us residents can make choices in their daily lives. The home has its own hairdresser who attends to hair and who cuts and perms hair while residents are at the home. We ate a portion of the lunchtime meal. The lunch was roast beef, roast and boiled potatoes and three fresh cooked vegetables. There was a choice of three homemade desserts. We found the meal was tasty and well presented. We saw the staff offer residents a choice of juices or a glass of wine with their lunch. This is a really good way to make meal times a social event and to promote residents choices. The residents we met told us staff ask them the day before what meals are on offer the next day and what would they like the next day. The residents menu choices looked well balanced and traditional. Residents can make a choice of what meal they would like to have. The residents who we met spoke positively about the quality of the meals that are provided. Care Homes for Older People Page 14 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. Residents are able to make their views known and to make complaints if they need to. Residents are protected from the risk of abuse and harm. Evidence: We saw a copy of the complaints procedure in the reception area. The procedure includes our up to date contact details for anyone who wishes to contact us. The contact details of North Somerset Council are available as well if people wish to contact them directly to make a complaint. The residents we met told us they would make a complaint to Mrs Ferguson or the owners of the home. They said they felt they are interested in their concerns and complaints. This helps to demonstrate the home welcomes and responds positively to complaints. We looked at the complaints record to see how well complaints are dealt with. There had been no complaints received since the last inspection. We saw in the staff training records that the staff do training to ensure they are up to date in their understanding of the principle of safeguarding residents from abuse. We were also told by care staff that they study the subject of abuse as part of their National Vocational in care qualifications . Care Homes for Older People Page 15 of 25 Evidence: We saw a policy in place relating to the issue of protection of vulnerable adults from abuse. The staff knew of the policy and the actions they must take to protect the residents. Care Homes for Older People 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, 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a homely relaxed environment . However improvements must be made to the laundry processes in the home. Evidence: We have quoted parts of this section of the report from the last inspection report as it is still applicable. Wyvern Lodge Care Home is a large house built over three floors which can be accessed by stairs or lift. The building is an older residential property located in Weston Super mare. It is situated close to Worle village to local shops a church and a park. There is a small patio garden towards the back of the home. Residents use either a main lounge leading onto a sun lounge and dining room. We saw that residents looked relaxed and also very comfortable in their surroundings. Residents bedrooms are for single use. Rooms are satisfactorily decorated and maintained. Residents have personalised their bedrooms with photographs mementos and small items of furniture. The standard of furniture and fittings is satisfactory. The residents we asked said they liked the environment and setting of the home. Care Homes for Older People Page 17 of 25 Evidence: There is a toilet and bathroom on each floor and three of the bedrooms have an en suite toilet. We saw there are radiator covers fitted to all radiators and every window is fitted with a restrictor. This is to protect peoples health and safety and stop them burning themselves. We saw that the environment is well ventilated and warm and there is plenty of natural light. The environment was adequately clean and satisfactorily maintained in parts of the home. We saw specialist equipment and adaptations throughout the home to assist residents and visitors who may have reduced mobility. There was soap and hand towels available in the toilets and bathrooms to minimise the risk of cross infection in the home. However we noticed that the tumble dryer is not working. We saw laundry hanging outside to dry. We also saw two baskets of bed linen waiting to be hung up to dry but there was no room. We advised that a more suitable way to dry laundry must be found. This is because laundry building up, waiting to be washed may be an infection control risk. Care Homes for Older People 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 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are being helped and supported by enough staff. Staff training is not fully up to date and this could impact on residents. The home follows safe recruitment practices when employing new staff and this helps protects the residents. Evidence: We checked the numbers of staff on duty for the last two weeks to see if residents are cared for by enough staff. For the current number of ten residents there are a minimum of two care staff on duty as well as Mrs Ferguson during the day in the week. There are two care staff on duty at night and on call support if needed. We did not check the number of catering and domestic staff however we saw staff carrying out their duties during the inspection. We saw staff help and talk to the residents in a courteous and polite manner. Residents were positive about how the staff help them. One resident said,the staff are very attentive I only have to ask for something and they are there on the spot, another comment made was, the staff are very,very good. Care Homes for Older People Page 19 of 25 Evidence: We observed staff demonstrate in the way that they helped residents, a good understanding of their care needs. We checked the training files of the staff team to see if staff are keeping up to date in their knowledge of the needs of residents. We saw evidence that staff had attended training sessions and updating. However we saw that for five of the care staff they had not done recent training in health and safety subjects, including first aid, manual handling and safe food handling. The majority of staff have done National Vocational Qualification in care award training or are in the processof working towards completing it. We checked recruitment records of three new staff, to see if the home carries out employment safety checks on staff before they start work. We saw that recruitment procedures are safe and protect residents. We saw confirmation that all new staff have a criminal records bureau check undertaken to confirm that they are suitable to work with vulnerable people. We also saw two references for each new member of staff. 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. Residents live in a home that is run in their best interests. Residents finances are looked after safely. Residents and staff health and safety is mostly adequately protected. Evidence: Mrs Carol Ferguson is the registered manager. She has been working at the home for over eighteen months. She has years of experience caring for people with a range of needs. Before this job she worked at another care home caring for residents. This helps to demonstrate she is fit and competent to be a manager. We were told by the residents that they see Mrs Ferguson regularly, one resident told us,shes very kind. We discussed with Mrs Ferguson how often she runs staff meetings for the staff team. She told us that recently this had been infrequent. We strongly recommended that she Care Homes for Older People Page 21 of 25 Evidence: holds regular staff meetings. This can be really helpful for staff as a way to make their views known. Mrs Ferguson has been carrying out a survey involving the residents and their families to check the quality of the care and the service. Mrs. Ferguson said she would review and audit the care and the service based on the results of the questionnaires from residents and relatives. We looked at two residents finance records to see if money is looked after by the home safely. The records we looked at were up to date and satisfactorily maintained. There is a secure safe to keep residents money and valuables in. Residents records were generally satisfactorily maintained up to date legible and in order. The records relating to the management of the home were satisfactorily maintained and in order. Individual records and the homes records are kept secure and are available to staff when needed. Other records are referenced elsewhere in the report. The environment looked generally satisfactorily maintained. See the comments written in the last section of the report in relation to staff health and safety training. The fire logbook record showed fire alarm tests and drills are being done regularly. The kitchen was clean and tidy and in order. The kitchen staff do regular food hygiene training to ensure they have a good understanding of safe practices for preparing and cooking food. 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 1 9 13 Handwritten Medication administration records must state the amount of medication and the time it must be given Health and wellbeing. 22/09/2009 2 26 15 There must be a suitable way 21/10/2009 to dry all laundry in the home. Health,safety and well being. 3 27 18 Staff must do relevant health 21/12/2009 and safety training. Health and safety. 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 32 Hold regular staff meetings for the staff team. 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. Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. 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