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Inspection on 26/08/05 for The Westcliff Residential Care Home

Also see our care home review for The Westcliff Residential Care Home for more information

This inspection was carried out on 26th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

The home provides a comfortable and homely environment for service users, that is well adapted to meet their needs. There is an effective management structure and a competent staff team. Service users and relatives consulted during the inspection were very satisfied with the standard of care provided. Staff were described as kind and friendly. The following comments were typical of those made during the inspection: "I am very satisfied with my father`s care" "I think my mum is very well looked after" The home has achieved a very high level of compliance with the National Minimum Standards and the staff and management are to be congratulated on providing such a high standard of care.

What has improved since the last inspection?

The environment continues to be well maintained and the bathing facilities improved with the provision of a shower room on the first floor. A suitable training programme has been put in place to prepare the staff to provide the more specialist care required for people with dementia. Similarly, plans are being drawn up to further adapt the environment to this end.

What the care home could do better:

Laundry equipment must be able to properly deal with soiled articles, to modern hygiene standards. Further consideration should be given as to how the environment can be positively adapted to provide care for people with dementia. This process would benefit from the advice of a suitably qualified consultant.

CARE HOMES FOR OLDER PEOPLE The Westcliff Residential Care Home 51 Leopold Road Felixstowe Suffolk IP11 7NR Lead Inspector Mike Usher Announced 26 August 2005 th 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 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. The Westcliff Residential Care Home I54-I04 S52323 Westcliff V235823 050826 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Westcliff Residential Care Home Address 51 Leopold Road, Felixstowe, Suffolk, IP11 7NR Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0207 3725167 Hazelwood Care Ltd Mrs Margaret Jean Crowley Care Home 33 Category(ies) of Old Age (OP) 33 registration, with number of places The Westcliff Residential Care Home I54-I04 S52323 Westcliff V235823 050826 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 17/03/05 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. The Westcliff Residential Care Home I54-I04 S52323 Westcliff V235823 050826 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection focused on progress regarding previous requirements and recommendations, significant developments, and management issues. It also looked at issues arising from the owners request for registration to provide care for a small number of people with dementia. The inspection used observation, examination of records and other documents, discussions with management, staff, and residents, and made use of information provided by the home prior to the inspection visit. In addition, a number of survey forms were returned by service users (8), relatives (9) and staff(1), giving their views on aspects of the home’s operation. The inspection was assisted by the manager, Mrs Crowley, and a Director of the company, Mr Ramana. What the service does well: What has improved since the last inspection? The environment continues to be well maintained and the bathing facilities improved with the provision of a shower room on the first floor. A suitable training programme has been put in place to prepare the staff to provide the more specialist care required for people with dementia. Similarly, plans are being drawn up to further adapt the environment to this end. The Westcliff Residential Care Home I54-I04 S52323 Westcliff V235823 050826 Stage 4.doc Version 1.40 Page 6 What they could do better: 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. The Westcliff Residential Care Home I54-I04 S52323 Westcliff V235823 050826 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection The Westcliff Residential Care Home I54-I04 S52323 Westcliff V235823 050826 Stage 4.doc Version 1.40 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 standard(s) These standards were not looked at in detail on this inspection. EVIDENCE: N/A. The Westcliff Residential Care Home I54-I04 S52323 Westcliff V235823 050826 Stage 4.doc Version 1.40 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 standard(s) 7, 8, 10 The health and personal care needs of service users are well met. EVIDENCE: Care plans are informative, containing a good level of information, including moving and handling assessments. It is suggested that if the home is to care for people with dementia, care planning will need to be developed to offer a more person-centred, therapeutic approach. Service users spoken with during the inspection confirmed that they were satisfied that their privacy and dignity was respected, including during the provision of personal care. They also agreed that carers addressed them in their preferred manner (e.g. on first name basis) and they were able to receive visitors in private, either in one of the lounges or in their own room. Staff were seen to knock on bedroom doors and await a reply before entering. One incident during the day in which a staff member did not deliver care in a particularly sensitive manner was discussed with the manager who agreed to rectify this particular practice. The Westcliff Residential Care Home I54-I04 S52323 Westcliff V235823 050826 Stage 4.doc Version 1.40 Page 10 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 standard(s) 12 - 15 The home provides a supportive environment for service users with relaxed and flexible routines. EVIDENCE: A range of activities and entertainments are offered, and information on these events is posted on notice-boards throughout the home. On the day of the inspection there was a session of gentle exercise offered in the main lounge. Service users are encouraged to retain control over their daily lives, and this was illustrated by a resident choosing to go out, and letting staff know where she was going and when she expected to return. Residents are offered a key to their room when they move in and so are able to lock it if they wish. Bedrooms are personalised and residents are encouraged to bring in their own furniture and possessions. The inspectors were able to take lunch with the residents, and this was a relaxed and sociable affair. The dining room is comfortable with tables decorated with cloths and flowers. Individually plated meals are served, and the food was nicely presented and with good-sized portions. Extra servings were offered, and service users were assisted appropriately by staff. The Westcliff Residential Care Home I54-I04 S52323 Westcliff V235823 050826 Stage 4.doc Version 1.40 Page 11 Service users have a choice of meals, which is discussed each day with them individually, for the following day’s meals. Routines were described as relaxed, with breakfast served in service users’ own room (though one service user spoken with felt that it was offered too early and would wish for it to be available later – they were encouraged to speak to the manager on this point). The Cook has been in post for 5 years and draws up the menus in consultation with the manager and service users, and is able to cater for special diets. Fresh fruit and vegetables are purchased locally and meals are freshly cooked in the kitchen. The Westcliff Residential Care Home I54-I04 S52323 Westcliff V235823 050826 Stage 4.doc Version 1.40 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 standard(s) 16 Service users feel safe and secure. EVIDENCE: Service users spoken with during the inspection said that they felt safe and secure living in the home. They thought that staff were kind properly trained, and were confident that any concerns that they may have would be listened to and addressed. The Westcliff Residential Care Home I54-I04 S52323 Westcliff V235823 050826 Stage 4.doc Version 1.40 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 standard(s) 19 - 26 The environment is comfortable and pleasant and provides a good standard of accommodation. EVIDENCE: On the day of the inspection the home was clean, tidy and in good decorative order throughout. The new shower room on the first floor has been finished. The laundry is a good size the procedure for dealing with soiled articles is appropriate, making use of sealed plastic bags that open in the wash. However, the current domestic washing machines used are not suitable for dealing with soiled laundry and should be replaced with machines that have a specific sluice cycle, and gravity drainage. The ground floor of the East wing is being considered as a separate unit for people with dementia. It is planned to provide an easy-access, secure garden to the side, and during the inspection it was possible to discuss further ways in which the environment could be conducted to provide more suitable accommodation. To this end it is considered to change the entry to the The Westcliff Residential Care Home I54-I04 S52323 Westcliff V235823 050826 Stage 4.doc Version 1.40 Page 14 laundry to the outside of the building, and site a new WC near to the communal room, which will serve as a dining room and lounge whilst the initial number of people with dementia to be cared for is small (around 5 places). In addition, it is recommended that the door to the cellar should be inaccessible to residents. The Westcliff Residential Care Home I54-I04 S52323 Westcliff V235823 050826 Stage 4.doc Version 1.40 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 - 30 Staffing levels are adequate and staff are trained and competent to carry out their duties. EVIDENCE: On the day of the inspection there were 6 carers on duty in the morning, 5 from 11am and 4 in the afternoon and evening (plus Cook and Kitchen Assistant). The staff handover session focused on relevant issues of concern and keeping up-to-date with developments, including important information about a service user admitted that day. The home has recently started to recruit care staff from abroad, and a specialist recruitment agency is being used for this purpose. The owners then interview prospective candidates, and check language skills to ensure that these are adequate, and also assist with finding appropriate accommodation. A sample of staff records for recently employed carers were examined and found to be satisfactory, with the appropriate checks and references being carried out. Staff turnover is low, and this provides a good level of continuity for service users. A good programme of training is in place. All new staff undertake Induction training provided by Suffolk Social Care Services which includes Moving and Handling. Other training provided recently includes Fire Safety, Health & Safety, Food Hygiene, and First Aid. Training courses are certificated, and it was discussed that some Moving and Handling certificates were marked as The Westcliff Residential Care Home I54-I04 S52323 Westcliff V235823 050826 Stage 4.doc Version 1.40 Page 16 valid for 3 years. Mr Ramana agreed that this was not desirable, and confirmed that another company is now used for refresher training and this will be annually, which is felt to be more appropriate. In preparation for providing care to people with dementia, the manager and deputy manager have completed an intensive 2-day course run by Dementia Care Matters, who have also provided a one-day training course for staff (which is being repeated to catch any staff who were unable to attend first one). The Westcliff Residential Care Home I54-I04 S52323 Westcliff V235823 050826 Stage 4.doc Version 1.40 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 37, 38 The home is managed so as to meet the needs of service users in a satisfactory manner. EVIDENCE: The manager continues to run the home is a satisfactory manner. The owners are discharging their obligations to visit the home on a regular basis and compile a report of that visit, a copy of which is sent to the commission. Quarterly Residents’ Meetings are held, and the minutes of these meetings are displayed on notice boards, as are forthcoming events, menus, the Complaint Procedure, copies of the Service User Guide, statement of purpose, and the most recent inspection report from the commission. Records examined were up-to-date and adequate policies and procedures are maintained. The home has been inspected by both the local Fire Service and The Westcliff Residential Care Home I54-I04 S52323 Westcliff V235823 050826 Stage 4.doc Version 1.40 Page 18 Environmental Health Service in the last 12 months, and Mrs Crowley confirmed that there were no outstanding requirements or recommendations from these visits. Documentation provided by the home confirms that appropriate checks and maintenance is carried out on essential equipment and services at regular intervals. The Westcliff Residential Care Home I54-I04 S52323 Westcliff V235823 050826 Stage 4.doc Version 1.40 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 3 3 x x x 3 3 The Westcliff Residential Care Home I54-I04 S52323 Westcliff V235823 050826 Stage 4.doc Version 1.40 Page 20 No Are there any outstanding requirements from the last inspection? 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 26 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. 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