CARE HOMES FOR OLDER PEOPLE
The Westcliff Residential Care Home The Westcliff Residential Home 51 Leopold Road Felixstowe Suffolk IP11 7NR Lead Inspector
Mike Usher Unannounced Inspection 24th November 2005 11:30 X10015.doc Version 1.40 Page 1 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 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address DS0000052323.V272396.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DS0000052323.V272396.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service The Westcliff Residential Care Home Address The Westcliff Residential Home 51 Leopold Road Felixstowe Suffolk IP11 7NR 01394 285910 01394 271154 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Hazelwood Care Limited Mrs Margaret Jean Crowley Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33) of places DS0000052323.V272396.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 26th August 2005 Brief Description of the Service: The Westcliff is registered as a care home for older people. The Home comprises two Victorian houses, situated on parallel roads in the town of Felixstowe and close to the seafront. The town facilities are close by and include various shops, a library, post office and Doctors surgery. Initially the two houses were linked by a single storey extension, however an extension linking both houses at first floor level was completed in September 2001. The second floor is reached by shaft lift on the West wing and by stair lift on the East wing. There is a small patio area leading from the dining room. There is limited parking at both ends of the property. The Home was first registered in 1972. Mrs Crowley became Manager in June 2001 and Hazelwood Care Limited purchased the home in October 2003. Mr Singh is the Responsible Individual acting on behalf of the company. The Home is registered for 33 older people with 29 single bedrooms and two shared rooms. DS0000052323.V272396.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was the second statutory inspection of the home during the current annual cycle of inspection. It follows the first inspection, which was announced, that took place on 26th August. The current inspection focused on previous requirements and recommendations, recent developments, and core standards not covered by the first inspection. The home continues to provide a good standard of care, with a high degree of compliance with the national minimum standards, and the staff and management are to be congratulated on achieving such a good standard of service. What the service does well: What has improved since the last inspection? What they could do better:
Within the scope of this inspection, the home achieved a good standard of care with no requirement or recommendations arising. A requirement from the previous inspection relating to the laundry equipment is being actioned within the stated timescale and is carried forward, as is the recommendation regarding obtaining further advice on adapting the environment to provide an improved service to service users with dementia. DS0000052323.V272396.R01.S.doc Version 5.0 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. DS0000052323.V272396.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000052323.V272396.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards will be looked at in more detail in future inspections. EVIDENCE: DS0000052323.V272396.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 8, 9, 10 Service users are well cared for. EVIDENCE: Service users spoken with during the inspection felt that hey were very well cared for. They described staff as friendly, kind, polite and respectful, and also that most had a good sense of humour, which was much appreciated. The familiarity of carers was also felt to be an important factor in the good standard of care provided. Although a number of carers come from abroad, and so speak English as a second language, the service users reported that there were no problems with communication. Staff were observed to interact very positively and warmly with service users throughout the inspection. Their approach was respectful, but informal and supportive. An examination of the home’s medication arrangements confirmed that these are satisfactory. Stocks of medications and controlled drugs are kept secure, and the current medications are kept in a metal medications trolley that is secured to the wall in the dining room. The home uses the Monitored Dosage
DS0000052323.V272396.R01.S.doc Version 5.0 Page 10 system, and the supplying pharmacist also provides training to staff, and carries out a regular audit. Records kept were clear and concise and being well maintained. DS0000052323.V272396.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 - 15 Everyday routines are suited to service users needs and preferences. EVIDENCE: Service users spoken with confirmed that the food provided was to their liking, and menus were displayed in the entrance halls, indicating a good variety of food was provided, with a choice of main meals. Various entertainments have been planned leading up to Christmas, and the arrangements were posted on notice boards. Service users felt that there was a good choice of seating areas, and that they were able to freely move between their own rooms - where they might watch TV, read, rest or keep their own company – and the communal areas where they could socialise. Routines were described as relaxed and suited to their individual needs and preferences. Visitors were always welcomed and service users felt that they were well looked after. DS0000052323.V272396.R01.S.doc Version 5.0 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 - 18 The home provides a safe and secure environment for service users. EVIDENCE: The home has a suitable complaint procedure that is displayed prominently within the home. Service users consulted during the inspection said that they felt safe and secure living in the home, and were confident that any concerns they did have would be acted upon. There was a clear confidence in the staff and management that helps create a relaxed and inclusive atmosphere. DS0000052323.V272396.R01.S.doc Version 5.0 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 - 26 Service users live in a comfortable and well-maintained home that is well adapted to their needs. EVIDENCE: On the day of the inspection the home was found to be clean, tidy, and in good order throughout. The building is being well maintained and there was no odour. Furniture and furnishings are of a good standard, and the home was comfortable and warm. There have been no significant developments in the environment since the last inspection, but plans have been drawn up to adapt some of the accommodation to provide more specialist care to a small number of service users with dementia. Plans are also in hand to upgrade the laundry equipment, as reported in the previous inspection, and this is still within the agreed timescale.
DS0000052323.V272396.R01.S.doc Version 5.0 Page 14 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28, 30 The home is well staffed by competent carers. EVIDENCE: The home continues to maintain an adequate staffing level, with the Deputy Manager and 5 carers on duty on the morning of the inspection, supported by a Cook, Kitchen Assistant, Domestic, and Maintenance worker. In the afternoon there were 4 carers, with the Cook returning to prepare the evening meal with the help of a Kitchen Assistant. An examination of the staff rota confirmed that this level of staffing is maintained consistently, and includes two waking night staff. The Deputy Manager reported that the staff group has been stable over the past months, and turnover continues to remain at a low level. This ensures a good continuity of staff and therefore a more consistent and knowledgeable level of care for service users. A Fire Safety training session is planned for December, one of two sessions per year that ensure that all staff receive refresher training at least once per year. Service users felt that staff were well trained and good at their job. Staff were observed to assist service users in an attentive and helpful manner. DS0000052323.V272396.R01.S.doc Version 5.0 Page 15 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 35, 37, 38 Service users are safeguarded, and the home run in their best interests. EVIDENCE: The home assists a number of service users with looking after their immediate financial matters, and the arrangements were examined and found to be satisfactory. Records were in good order, and an occasional audit was carried out. A spot check confirmed that money safeguarded for service users was correct and properly accounted for. Discussions with the Deputy Manager confirmed that a recent incident had been appropriately dealt with, although she was reminded that such matters must be reported to the Commission. It was confirmed that all service users have secure storage in their rooms, and that their bedrooms doors are lockable and keys freely available.
DS0000052323.V272396.R01.S.doc Version 5.0 Page 16 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 2 STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X 3 3 DS0000052323.V272396.R01.S.doc Version 5.0 Page 17 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP26 Regulation 13(3)(4) 16(2)(J) Requirement Laundry equipment must be able to properly deal with soiled articles, to modern hygiene standards. Timescale for action 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard 19, 22 Good Practice Recommendations Further consideration should be given as to how the environment can be appropriately adapted to meet the needs of people with dementia. Advice should be sought from an appropriately qualified advisor. DS0000052323.V272396.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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