Inspection on 30/10/08 for Westside Home

This is the latest available inspection report for this service, carried out on 30th October 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

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Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Westside Home 32 Scarle Road Wembley Middlesex HA0 4SN     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Tony Lawrence     Date: 3 0 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for 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 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Westside Home 32 Scarle Road Wembley Middlesex HA0 4SN 02087821516 02087821516 west_sidehomes@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Kemi A Beckley Type of registration: Number of places registered: Mr John Femi Beckley,Mrs Kemi A Beckley care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 3 The registered person may provide the following category 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: Mental Disorder, excluding learning disability or dementia - Code MD Date of last inspection Brief description of the care home Westside Home is a home for three residents with mental health problems. The home is located in a street close to Wembley High Road with shops, amenities and transport connections. There are several parks close by. There is off street parking for two cars. There are three spacious bedrooms for residents including a staff room/sleeping-inroom. There is a shower room with toilet on the ground floor and one bathroom on the 3 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 27 Brief description of the care home first floor. Fees are approximately £996.00 per week depending of complexity of needs. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home 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 unannounced key inspection took place on Thursday 30th October 2008 from 09:30 - 15:00. During this visit we reviewed all of the key National Minimum Standards for care homes for adults. We did this by talking with residents, staff and the homes manager. We also looked at care records kept in the home and saw all private and communal parts of the home. We would like to thank the residents, staff and manager for their help with this inspection. Care Homes for Adults (18-65 years) Page 6 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 27 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 27 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. People living in the home know that their care needs have been assessed and they have been involved in the assessment. Potential residents are supported to plan their own move into the home, at a pace that suits them. Evidence: I looked at two other places, but this was the best. Comment from a resident. The staff want you to visit before you move in. I visited 3 or 4 times and stayed overnight. Comment from a resident. During this visit we talked to one person who had lived in the home for more than 2 years and another person who was visiting before making a decision about moving in. Both people were very positive about the way they were supported to visit the home to meet other residents and staff. The provider told us that all potential residents were expected to visit and spend a minimum of three overnight stays in the home as part of the referral and admission procedures agreed with other agencies. Residents told us Care Homes for Adults (18-65 years) Page 9 of 27 Evidence: that this arrangement was helpful and had helped them to settle in to the home more easily. We also checked the care plan file for one person living in the home. The file included detailed assessments and reports from social and health care professionals. We saw evidence that the homes manager had visited the person in hospital as part of the admission process, to complete the homes own care needs assessment. One resident told us that he had been fully involved in the assessment and planning his own transition programme. Care Homes for Adults (18-65 years) Page 10 of 27 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 living in the home know that their care needs will be recorded in a plan and risk assessment that are regularly reviewed. People know that they will be fully involved in agreeing their own care plan and risk assessment. Evidence: We have a meeting every 4-6 weeks with all the staff and the residents to talk about how the home is run. Comment from a resident. During this visit we looked at one persons care plan file, with their agreement. The care plan file was well organised, but staff should consider removing some duplicated information. For example, the file we checked had numerous copies of letters detailing security arrangements during hospital visits. Only the latest copy was needed and this would make information easier to find in care plan files. The file we checked included evidence that the resident and staff from the home were fully involved in regular reviews with the multi-disciplinary team responsible for the persons care. Review Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: meetings had been held in January and June 2008 and a third meeting was planned for December 2008. The resident told us that he had been involved in the reviews and staff had supported him each time. We also saw that the home received copies of detailed reports after each meeting, with a summary of agreed actions. The care plan file also included a copy of the homes own care plan. The resident told us that he had worked on the care plan with his key worker and had agreed the goals that were included. We saw that the plan summarised the persons personal and health care needs and how these would be met in the home. There was evidence that the plan was last reviewed in March 2008, with the residents full involvement. Staff who spoke to us during this visit were very aware of potential risks to residents and other people and how these would be minimised. We also saw that a detailed risk assessment was completed as part of each multi-disciplinary review. The assessment detailed actions agreed by the multi-disciplinary team to reduce known risks and included clear guidance for staff, including agreed emergency procedures. Care Homes for Adults (18-65 years) Page 12 of 27 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. People are supported to maintain existing skills and develop new ones. Residents are supported to maintain contact with other people and any restrictions are known to resident and staff. Evidence: I go to college three times a week. Its 2 different colleges and I do computing and literacy. Its really helped me. Comment from a resident. I enjoy cooking and the staff help me to try new things. Comment from a resident. Two people living in the home who spoke to us during this visit said that staff supported them to plan and access education, employment and leisure activities. We saw from the care plan that we checked that one resident had been supported to enrol Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: for adult college classes and staff had also worked with him to consider voluntary work. Another resident also told us that he went to adult college classes that he had chosen, with staff support. Both resident told us that they could take part in appropriate leisure activities, in the home and the local community. Both people were aware of restrictions that had been agreed with the multi-disciplinary teams responsible for their care, and the reasons for these. We saw that any restrictions had been clearly recorded as part of peoples care plans. The care plans also included contact details for each persons relatives, friends and other significant people. Again, we saw that any limitations on contact were clearly recorded and explained to the residents. Staff who spoke with us during this visit were aware of restrictions on individual residents and the reasons for these. One resident told us that he had not cooked his own meals when he first moved in to the home, but with staff support he was now cooking four or five times each week. He said that he enjoyed trying new foods and staff encouraged him to experiment. He said that he was aware of the need to eat more healthily and could only do this because of the counselling and support he had received from staff in the home. The homes menus showed that residents prepared their own meals, with support from staff if needed. Meals were varied and nutritious, individuals cultural needs were well recorded and halal meat was always provided for one resident. Care Homes for Adults (18-65 years) Page 14 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be confident that their personal and healthcare needs will be well assessed and recorded. Residents will get the help and support they need to become more independent and prescribed medication will be managed safely in the home. Evidence: Staff have really helped me to look after myself. I wasnt too good when I came here, but I look after myself much better now. Comment from a resident. I see my CPN every 3 weeks and I arrange to see my GP when I need to. Staff will help me with hospital appointments, if I want them to. Comment from a resident. During this visit we reviewed the care plan file of one of the two people living in the home, with his agreement. We saw the persons personal care needs and preferences were well recorded in his care plan. He told us that agreeing goals with staff had helped him to develop routines, maintaining and developing his independence. We also saw that the care plan included an excellent record of every health care appointment and contact with clinicians. Copies of medical reports and reviews were included in the Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: care plan file, with clear guidance for staff working in the home on how the person should be supported to achieve agreed goals. This was good evidence of excellent joint work with other health and social care agencies. We saw that all prescribed medication was securely stored in a lockable metal cabinet in the locked office / staff sleep in room. No controlled medication was kept in the home when we visited. The home used a monitored dosage system provided by Boots and all prescribed medication was delivered every four weeks. We checked the medication administration records and these were well completed by staff, with no errors or omissions. We saw that the home had clear policies and procedures to support residents to manage their own medication, as part of their preparation to move on to more independent living. One resident told us that he found this support very helpful, but it could be frustrating when any changes had to be agreed with the multi-disciplinary team responsible for his care. Care Homes for Adults (18-65 years) Page 16 of 27 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 living in the home are cared for safely and they can be confident that any complaints will be dealt with appropriately. Evidence: We have disagreements but we sort them out in house meetings. If I was unhappy about something Id talk to the staff or the manager. Comment from a resident. Following a requirement that we made at our last visit in November 2006, we saw that the owner / manager had obtained a copy of the local authoritys safeguarding adults policies and procedures and these were available in the homes office for staff reference. Staff who spoke to us were clear about the procedures for reporting any concerns. The manager confirmed that there had been no safeguarding referrals or investigations since our last inspection. A resident who spoke with us was clear about the homes complaints procedure and said that this had been explained to him when he moved into the home. There have been no formal complaints recorded since our last inspection. Care Homes for Adults (18-65 years) Page 17 of 27 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 excellent 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 excellent standards of private and communal accommodation. Evidence: I really like my room - Ive got everything I need and Ive bought some of my own furniture for when I move into my own place. Comment from a resident. Westside is a large terraced house in a residential street, close to the shops and transport links in Wembley High Road. There are three large bedrooms for residents, one on the ground floor and two on the first floor. There is a shower room / toilet on the ground floor and a bath / shower room and toilet on the first floor. The communal lounge, kitchen and laundry room are on the ground floor. There is a staff office and separate office / sleep in room o the first floor. There is a large rear garden and parking for 2 cars at the front of the home. During this visit we saw all three residents bedrooms and all communal parts of the home. All parts of the home were well decorated and comfortably furnished. Residents bedroom were spacious, well decorated and very individual. There was a sufficient number of bathrooms and toilets for residents use. Westside provided excellent Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: standards of private and communal accommodation. Residents told us that the standard of accommodation was far better than other homes they had lived in. During this visit all parts of the home were clean and hygienic. Care Homes for Adults (18-65 years) Page 19 of 27 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. The home is well staffed to meet residents care needs. Staff are well supervised and trained. Evidence: The staff are very supportive. They counsel you and help you prepare to move on. There are always enough staff on duty to help me. Comment from a resident. When we arrived for this inspection, one member of staff was on duty in the home, supporting the two residents. The homes manager arrived later in the morning and also helped with the inspection. To make sure that staff, residents and other people know about the managers availability each day, it is a requirement of this report that she records the hours she works each day on the homes rota. A third member of staff arrived to work at 2:00 pm. The homes rota showed that there was usually one member of staff on duty at all times, with one person available in the home at night. Staff who spoke with us during this visit said that they had regular supervision with the homes manager and access to relevant training. Staff said that they found the supervision and training very helpful. The homes manager confirmed that three staff were also completing their National Vocational Qualification (NVQ) Level 2 training. Care Homes for Adults (18-65 years) Page 20 of 27 Evidence: Completion of this training will enable the home to exceed the target for 50 . We checked the personnel files for two people working in the home. Each file included an application form, two written references, training and supervision records and a Criminal Records Bureau (CRB) check. The manager should make sure that the induction training record is completed for staff working in the home. The manager should also make sure that one member of staff provides current evidence of leave to remain and work in the UK. During this visit we saw that the manager and both staff worked well together to make sure that residents care needs were met. Care Homes for Adults (18-65 years) Page 21 of 27 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 home is well managed and residents are consulted about and involved in the running of the home. There is a need to improve one aspect of the homes fire safety standards. Evidence: The manager told us that she is also the joint owner / registered provider of the home with her husband. The manager told us she is a qualified social worker who also worked as an Approved Social Worker for four years before opening the home in 2006. The manager is suitably qualified and experienced and we have registered her as a fit person to manage a care home. It is a recommendation of this report that the manager completes her NVQ Registered Managers Award. During this inspection the manager demonstrated a clear understanding of current best practise and a commitment to providing the best possible service for people living in the home. The manager told us that annual quality assurance questionnaires were given to residents, their relatives, health and social care professionals. The results of the Care Homes for Adults (18-65 years) Page 22 of 27 Evidence: surveys were used to write a development plan to improve services offered in the home. Residents also told us that staff asked them regularly for their views on the running of the home, during individual counselling sessions and at regular house meetings. One resident also told us that they were consulted about the admission of new residents. The manager told us that she also planned to involve residents in the recruitment of staff to work at Westside and a second residential project planned by the provider. During this visit we reviewed a selection of records kept by staff in the home, including care plans, risk assessments, medication records and daily care notes. Standards of record keeping in the home were good. During this visit we discussed one health and safety issue with the manager. We saw that a number of fire doors throughout the home were propped or wedged open. If there is a need to keep fire doors open, they must be fitted with self closing devices activated by the homes fire alarm system. Care Homes for Adults (18-65 years) Page 23 of 27 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 24 of 27 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 1 31 18 The manager must make sure that she records the hours she works on the homes rota. This will make sure that residents, staff and other people know about the managers availability each day. 31/12/2008 2 42 23 Fire doors must not be wedged or propped open. If fire doors need to be kept open, they must be fitted with a self-closing device activated by the fire alarm system. This will reduce risks to residents, staff and other people if there is a fire in the home. 15/12/2008 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 Adults (18-65 years) Page 25 of 27 1 6 Staff should review residents care plan files to remove duplicated information and correspondence. This would make it easier to find important information. The manager should make sure that the induction training record is completed for all staff working in the home. The manager should make sure that one member of staff provides current evidence of leave to remain and work in the UK. The manager should make arrangements to complete her NVQ Level 4 Registered Managers Award. 2 3 34 34 4 37 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) 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. 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