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Inspection on 01/11/05 for West Eaton House Nursing & Residential Home

Also see our care home review for West Eaton House Nursing & Residential Home for more information

This inspection was carried out on 1st November 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 is clean and odour free, bedrooms are personalised and communal areas are like `home from home`. Residents are well cared for and staff are kind and have the training and knowledge to ensure they are kept safe. Residents are assessed prior to admission and the registered manager always ensures their physical needs can be met before admission.

What has improved since the last inspection?

The requirements from the last report had been addressed and the inspector acknowledges the work undertaken to ensure documentation is up to date and relevant to individual care needs. Care plans had been updated and there was evidence of monthly reviews and changes if necessary were noted in care plans. Medication records had improved.

What the care home could do better:

The home continues to try and recruit a social activities co-ordinator, the registered manager and his staff team are aware of this shortfall.

CARE HOMES FOR OLDER PEOPLE West Eaton House Nursing & Residential Home Worcester Road Leominster Herefordshire HR6 8QJ Lead Inspector C Presley Unannounced Inspection 1st November 2005 10:15 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 West Eaton House Nursing & Residential Home DS0000027693.V257551.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. West Eaton House Nursing & Residential Home DS0000027693.V257551.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service West Eaton House Nursing & Residential Home Address Worcester Road Leominster Herefordshire HR6 8QJ 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) 01568 610395 01568 614407 graeme@frontsouth.co.uk Frontsouth Limited Graeme Millar Beedie Care Home 33 Category(ies) of Dementia - over 65 years of age (33), Old age, registration, with number not falling within any other category (33), of places Physical disability over 65 years of age (33) West Eaton House Nursing & Residential Home DS0000027693.V257551.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th August 2005 Brief Description of the Service: West Eaton House is situated in a rural setting close to the town of Leominster. The two-storey building is suitable for its purpose and is in attractive grounds. The providers Front South Limited also own homes in other areas of the country. The home has thirty-three beds and provides care for older people who either require nursing care or personal care. Residents who have additional physical disabilities or dementia can be accommodated. None of the single rooms are twelve square meters so an assessment of equipment and space requirements for those residents with physical disabilities is essential prior to admission. West Eaton House Nursing & Residential Home DS0000027693.V257551.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place during the morning period and over lunchtime. Time was spent with the registered manager discussing outcomes following the last report and progress from shortfalls identified at the last visit. The premises were briefly inspected; as were care plan documents and policies and procedures. Comments received in the form of letters from families included;‘My Mother was looked after by the home for a number of years, she was loved and respected and treated with great dignity and care to the day she died’. ‘I have been hugely impressed by the level of care and kindness that they have shown my parents’. What the service does well: What has improved since the last inspection? What they could do better: The home continues to try and recruit a social activities co-ordinator, the registered manager and his staff team are aware of this shortfall. West Eaton House Nursing & Residential Home DS0000027693.V257551.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. West Eaton House Nursing & Residential Home DS0000027693.V257551.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 West Eaton House Nursing & Residential Home DS0000027693.V257551.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): 3 Residents are assessed prior to admission to ensure their needs can be met. EVIDENCE: Assessment of need documents were inspected and although the registered manager felt these could be more detailed he said they contained enough information to formulate a care plan, particularly in one instance where the admission was an emergency. West Eaton House Nursing & Residential Home DS0000027693.V257551.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): 7&9 Care plans reflected current care needs of residents and medication policies and procedures and medication records ensured medication was handled safely. EVIDENCE: Care plans had improved since the last inspection and now reflected current care needs and had been updated at least monthly or as needs had changed. Residents were weighed monthly in kilograms one month and pounds and ounces the next; the registered manager recognised this was confusing when weights were audited, it was suggested these were converted into one or other. The home has a number of pressure relieving mattresses and residents are monitored for any signs of pressure sores. Medication recording when medication was administered was excellent. West Eaton House Nursing & Residential Home DS0000027693.V257551.R01.S.doc Version 5.0 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 the following standard(s): 12, 13 & 14 Residents are encouraged to maintain independence within their limitations and staff spend time socially interacting with them. EVIDENCE: The home continues to try and recruit a social carer to spend time talking with residents, organising activities and outings if this is felt to be appropriate. The local Church visits the home monthly to perform Holy Communion. The home is not located on a local bus route and is at least a twenty minute walk from Leominster the home offers a service whereby visitors can be picked up to visit to ensure residents maintain contact with family and friends. A member of staff escorts residents to out patient appointments and the home has a car for this purpose. The home does not take care of resident’s finances; extras are invoiced directly to the resident or the next of kin. Residents are risk assessed for lockable space in their bedrooms. West Eaton House Nursing & Residential Home DS0000027693.V257551.R01.S.doc Version 5.0 Page 11 Lunch looked appetising on the day of inspection and residents were being assisted to eat by staff in a quiet and efficient manner that ensured privacy and dignity. The registered manager said all food was now being heat probed before serving and records were kept. The fire door leading from the kitchen to the corridor had been adjusted so it closed on its rebates. West Eaton House Nursing & Residential Home DS0000027693.V257551.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 complaints procedure is clear and staff are aware of their responsibilities with regard to caring for the vulnerable adult and have received training in this field. EVIDENCE: The complaints procedure is clear and has set time scales for dealing with a complaint. There have been no complaints to the home or the Commission for Social Care Inspection since the last inspection. The home uses the Herefordshire Multi-agency procedures for the protection of the vulnerable adult. Staff spoken to during the inspection were aware of their responsibilities in protection, which included ‘Whistle-blowing’. Staff had received training in this field and more awareness training was planned in the future. West Eaton House Nursing & Residential Home DS0000027693.V257551.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 Environmental risks are recognised and addressed and the home is safe for residents who have a tendency to wander. EVIDENCE: A number of environmental issues were raised at the last inspection these have been addressed and the environment and any safety issues are kept under review. A fire risk assessment has been carried out and further fire doors to partition parts of the ground floor are on order. West Eaton House Nursing & Residential Home DS0000027693.V257551.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): 28,29 & 30 Recruitment procedures are robust and ensure staff working with vulnerable adults are safe to do so; staff receive training which ensures they have the knowledge and expertise to care for residents. EVIDENCE: The home has a stable workforce and care staff have either attained an NVQ qualification in direct care or are working towards one. Adaptation nurses who are qualified nurses in their own country, work in the home as carers whilst awaiting registration with the Nursing and Midwifery Council in the United Kingdom. The training matrix evidenced staff received up to date training in all aspects of care, including the safe handling of residents. The registered manager said there were enough staff to meet the needs of residents and this was kept under review. Recruitment files inspected evidenced a robust recruitment procedure and all staff had a POVA first check and an enhanced criminal record check before commencing work in the home, this included volunteers. West Eaton House Nursing & Residential Home DS0000027693.V257551.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 There is a quality assurance programme, which continues to be developed; and residents financial interests are safeguarded at all times. EVIDENCE: The registered manager continues to develop a quality assurance programme, which can be collated into an annual report and involves all parties including members of the multidisciplinary team. The home does not act as appointee for any resident and does not have the facility to keep personal monies secure, residents or their next of kin are invoiced for extras. West Eaton House Nursing & Residential Home DS0000027693.V257551.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 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x x STAFFING Standard No Score 27 x 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 2 x 3 x x x West Eaton House Nursing & Residential Home DS0000027693.V257551.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 OP33 Regulation 24 Requirement A quality assurance programme must be introduced in accordance with the requirements of Regulation 24 and Standard 33 Timescale for action 30/03/06 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 OP7 Good Practice Recommendations It is recommended weights are recorded continually in either kilograms or pounds. West Eaton House Nursing & Residential Home DS0000027693.V257551.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 West Eaton House Nursing & Residential Home DS0000027693.V257551.R01.S.doc Version 5.0 Page 19 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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