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Inspection on 05/03/09 for Westport Care Centre

Also see our care home review for Westport Care Centre for more information

This is the latest available inspection report for this service, carried out on 5th March 2009.

CSCI found this care home to be providing an Adequate service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

On the files inspected we noted that care plans comprehensively recorded the needs of residents and had been updated, also risk assessments were in place, were up to date and reflected the needs of residents. There was evidence that the home has done significant work on recording the afterlife wishes of residents, on their files. The file for resident A evidenced that a `Not for Resuscitation` form has been developed. The manager stated that this will be discussed and completed with the resident and her son. She stated that these forms will only be used for people who do not wish to be resuscitated and in their absence it will be assumed that people do wish to be resuscitated. We also saw two end of life forms which have been developed, one had been completed and one had some information which needed to be expanded. On the file of resident B there was a `Thinking Ahead and Planning Discussion` record, which had been signed by her and stated her funeral wishes. An `After Death` form had also been completed, but not signed or dated. The manager explained that 7 staff undertook Death and Dying training with one of the Tower Hamlets safeguarding officers, and that this included the fact that decisions on whether life is extinct cannot be made by senior care assistants or carers. We saw a protocol for medical emergencies, a good resuscitation instruction chart, and policy, an Expected Deaths policy and an Unexpected Deaths policy. It was noted that the cordless phones which are to be used in emergencies, are already available in the home. The home uses the Braden scale which is a risk assessment for dependency. We noted that there is no explanation of the range, although there is a comment that the lower the score the higher the risk. The manager, during the course of the inspection added a line to the assessment to explain the scoring system. We saw evidence of referrals to health specialists. We saw writing from the district nurse in her book, and recording from the occupational therapist in the professional visits section of a file. We also saw evidence of optical tests with prescriptions being issued. The manager stated that these are filled by the optician who delivers the spectacles to the home.We viewed the arrangements for the administration of medication. We noted specimen signatures, and photographs of residents. We checked the Medication Administration Record (MAR) sheets for the residents we were case tracking. We discovered one error, where there was one tablet too many in stock. We checked the storage of controlled drugs and the record book which is satisfactorily kept. We noted that returned drugs are signed for by the pharmacist and regular audits done by the manager and senior carers, who also check drugs into the home. We observed that more tray tables have been provided and saw one in the room of a resident who was eating on his lap at the previous key inspection. We visited the kitchen and noted that it was clean and the cook and her assistant were both wearing clean aprons. We discussed with the manager the issue of residents being supported to access the community. She said that the home has increased the hours of the activities coordinator and offers residents the opportunity to go out. She stated however that many residents do not want to go out. She showed us an invitation to attend a television studio with all transport laid on. She had had to pass this to another home because no-one wanted to take it up. We read in the notes of one resident of her having a shopping trip into the community. We feel that the importance of community presence has been raised with the manager, and she is trying to offer this as often as possible. We looked at the activities folder which evidences the provision of many sessions of activity of one kind or another. We observed the activities co-ordinator at work with a group of residents. We have interviewed this member of staff in the past and feel she is very well suited to the role. We ate lunch with the residents and observed that there were new clear glass salt and pepper pots, clean and filled. We saw no more tea pots without knobs. We did find however that lunch was rather disappointing. The meal eaten was smoked haddock with tomato, mixed vegetables and mashed potatoes, followed by fruit salad. The fish was quite small and the mashed potatoes were thin and watery. The mixed vegetables included celery, swede, carrot and onion, not suitable to serve with fish. The fruit salad was canned and served without custard or cream or any other topping. This was reported to the manager who spoke to the cook. She agreed to order a different variety of potatoes. We noted that thicker mattresses had replaced some thin ones. We spoke to two residents who still prefer the thin mattresses and expressed this to us. We visited room 37 and noted that the carpet had been renewed. We also noted that the radiators now have individual thermostats, the ceiling tiles in the staff room have been replaced and there were no unpleasant odours in the communal areas of the home. We saw evidence that seven carers have undertaken first aid training and some staff have undertaken the four day course. The staffing level has been increased by one full time post. We checked supervision records and noted dates. There is a very clear chart of when supervision is due and the manager checks with those who supervise, who has been supervised, and enters it on the chart. The level of supervision now appears to be regular and sufficient.

What the care home could do better:

No new requirements were issued as a result of this inspection. We would like to commend the manager for the energetic and thorough way she has approached compliance with the previous requirements, which are now met.

Inspecting for better lives Random inspection report Care homes for older people Name: Address: Westport Care Centre 24-26 Westport Street Stepney London E1 0RA one star adequate service 27/10/2008 The quality rating for this care home is: The rating was made on: 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. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Anne Chamberlain Date: 0 5 0 3 2 0 0 9 Information about the care home Name of care home: Address: Westport Care Centre 24-26 Westport Street Stepney London E1 0RA 02077901222 02074239701 susan.lawlor@excelcareholdings.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Ferrolake Ltd care home 44 Number of places (if applicable): Under 65 Over 65 0 44 dementia old age, not falling within any other category Conditions of registration: 44 0 The maximum number of service users who can be accommodated is: 44 The registered person may provide the following categories of service only: Care home only - Code 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 - Code OP Dementia - Code DE Date of last inspection Brief description of the care home Westport Care Centre is a registered residential care home which caters for 40 older people of both gender who require care and support. It also offers respite services dependant on the availability of beds. The premises are a purpose built three-storied building. All bedrooms have en-suite toilet and shower facilities. A range of communal areas including a smoking room and a patio garden are available. Parking spaces are available underneath the building. Care Homes for Older People Page 2 of 9 2 7 1 0 2 0 0 8 Brief description of the care home The home is conveniently situated close to public transport links and other local amenities. The Registered Provider is Ferrolake Ltd. The fees are between #511.56 and 527.80 weekly. Care Homes for Older People Page 3 of 9 What we found: The inspection was undertaken on behalf of The Commission for Social Care Inspection (CSCI) and the terms we and us will be used throughout. The aim of the inspection was to test compliance with the requirements from the key inspection undertaken in October 2008. We interviewed the manager, viewed files for three residents, and checked a number of issues around the building. We ate lunch with the residents and visited the kitchen. What the care home does well: On the files inspected we noted that care plans comprehensively recorded the needs of residents and had been updated, also risk assessments were in place, were up to date and reflected the needs of residents. There was evidence that the home has done significant work on recording the afterlife wishes of residents, on their files. The file for resident A evidenced that a Not for Resuscitation form has been developed. The manager stated that this will be discussed and completed with the resident and her son. She stated that these forms will only be used for people who do not wish to be resuscitated and in their absence it will be assumed that people do wish to be resuscitated. We also saw two end of life forms which have been developed, one had been completed and one had some information which needed to be expanded. On the file of resident B there was a Thinking Ahead and Planning Discussion record, which had been signed by her and stated her funeral wishes. An After Death form had also been completed, but not signed or dated. The manager explained that 7 staff undertook Death and Dying training with one of the Tower Hamlets safeguarding officers, and that this included the fact that decisions on whether life is extinct cannot be made by senior care assistants or carers. We saw a protocol for medical emergencies, a good resuscitation instruction chart, and policy, an Expected Deaths policy and an Unexpected Deaths policy. It was noted that the cordless phones which are to be used in emergencies, are already available in the home. The home uses the Braden scale which is a risk assessment for dependency. We noted that there is no explanation of the range, although there is a comment that the lower the score the higher the risk. The manager, during the course of the inspection added a line to the assessment to explain the scoring system. We saw evidence of referrals to health specialists. We saw writing from the district nurse in her book, and recording from the occupational therapist in the professional visits section of a file. We also saw evidence of optical tests with prescriptions being issued. The manager stated that these are filled by the optician who delivers the spectacles to the home. Care Homes for Older People Page 4 of 9 We viewed the arrangements for the administration of medication. We noted specimen signatures, and photographs of residents. We checked the Medication Administration Record (MAR) sheets for the residents we were case tracking. We discovered one error, where there was one tablet too many in stock. We checked the storage of controlled drugs and the record book which is satisfactorily kept. We noted that returned drugs are signed for by the pharmacist and regular audits done by the manager and senior carers, who also check drugs into the home. We observed that more tray tables have been provided and saw one in the room of a resident who was eating on his lap at the previous key inspection. We visited the kitchen and noted that it was clean and the cook and her assistant were both wearing clean aprons. We discussed with the manager the issue of residents being supported to access the community. She said that the home has increased the hours of the activities coordinator and offers residents the opportunity to go out. She stated however that many residents do not want to go out. She showed us an invitation to attend a television studio with all transport laid on. She had had to pass this to another home because no-one wanted to take it up. We read in the notes of one resident of her having a shopping trip into the community. We feel that the importance of community presence has been raised with the manager, and she is trying to offer this as often as possible. We looked at the activities folder which evidences the provision of many sessions of activity of one kind or another. We observed the activities co-ordinator at work with a group of residents. We have interviewed this member of staff in the past and feel she is very well suited to the role. We ate lunch with the residents and observed that there were new clear glass salt and pepper pots, clean and filled. We saw no more tea pots without knobs. We did find however that lunch was rather disappointing. The meal eaten was smoked haddock with tomato, mixed vegetables and mashed potatoes, followed by fruit salad. The fish was quite small and the mashed potatoes were thin and watery. The mixed vegetables included celery, swede, carrot and onion, not suitable to serve with fish. The fruit salad was canned and served without custard or cream or any other topping. This was reported to the manager who spoke to the cook. She agreed to order a different variety of potatoes. We noted that thicker mattresses had replaced some thin ones. We spoke to two residents who still prefer the thin mattresses and expressed this to us. We visited room 37 and noted that the carpet had been renewed. We also noted that the radiators now have individual thermostats, the ceiling tiles in the staff room have been replaced and there were no unpleasant odours in the communal areas of the home. We saw evidence that seven carers have undertaken first aid training and some staff have undertaken the four day course. The staffing level has been increased by one full time post. We checked supervision records and noted dates. There is a very clear chart of when supervision is due and the manager checks with those who supervise, who has Care Homes for Older People Page 5 of 9 been supervised, and enters it on the chart. The level of supervision now appears to be regular and sufficient. 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 2. Care Homes for Older People Page 6 of 9 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 9 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, 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 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 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). 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