Inspection on 22/04/05 for West Haven

This inspection was carried out on 22nd April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.

Other inspections for this house

West Haven 25/01/07

West Haven 22/11/06

West Haven 23/11/05

West Haven 08/09/04

West Haven 15/04/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 West Haven 146 Huddersfield Road Dewsbury West Yorkshire WF13 2RW Lead Inspector Jim Leyland Unannounced 22 April 2005 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 Haven J51J01_s26332_West Haven_V220492_ 220405.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service West Haven Address 146 Huddersfield Road Dewsbury WF13 2RW 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) 01924 461720 Catholic Care (Diocese of Leeds) Mr Peter Simmons Care Home 7 Category(ies) of 6 x Learning Disability 1 x Learning Disability registration, with number over 65 years of places West Haven J51J01_s26332_West Haven_V220492_ 220405.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Conditions of this registration are listed on the Registration Certificate displayed at the service. Date of last inspection 8 September 2004 Brief Description of the Service: Westhaven is a home for up to 7 adults who have learning disabilities. The home is owned by Catholic Care. At the time of the inspection all seven places were occupied. At present all the people who reside at the home are aged 40 years and above and they are involved in the decision-making process and supported through person centred planning. Westhaven is set back from the main Huddersfield Road. It is located within close proximity to public transport links and local shops and is a short walk from the centre of Dewsbury with all its amenities. The home has ample communal space where people who receive services are able to spend time, including three lounges and a dining room. The home has a large, private garden, providing a safe environment for people living at Westhaven. West Haven J51J01_s26332_West Haven_V220492_ 220405.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector arrived at Westhaven at 10.30 am and left at 4.00 pm. A tour of the home took place with the manager and four care plans, three staff files, medication, health and safety, complaints and training records were looked at. Six of the seven people who live at the home spoke with the inspector and three members of staff and the manager were also spoken to. People who receive services said that they liked living at Westhaven and felt that staff were helpful. One person enjoyed helping in the garden, another was looking forward to their holiday. People living in the home said that they feel safe and that they could speak to staff if they had any concerns. Several requirements are made as a result of the inspection visit. These are discussed below and relate to care planning, risk assessments, recording of complaints, recruitment procedure and health and safety. Additionally there are some good practice recommendations. The inspector would like to thank the people living at the home, staff and the manager for their help at the inspection visit. What the service does well: What has improved since the last inspection? Progress has been made at the home and the inspector is aware of the hard work that has gone into meeting the requirements made at the last inspection. The statement of purpose, service user guide and contract of terms and conditions have been updated to provide user-friendly information to people living at Westhaven and anyone considering living there in the future. Personcentred plans are being completed, involving people who receive services in setting out preferences, choice and goals. West Haven J51J01_s26332_West Haven_V220492_ 220405.doc Version 1.30 Page 6 Training profiles have been updated for staff and there is evidence that staff have attended or are due to attend adult protection training. The medication system has been improved and recording is accurate and storage is less cluttered and easier to use. Fire drills are now taking place more frequently and the names of staff who have participated in them is noted. 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. West Haven J51J01_s26332_West Haven_V220492_ 220405.doc Version 1.30 Page 7 DETAILS OF INSPECTOR 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) Scoring of Standards Statutory Requirements Identified During the Inspection West Haven J51J01_s26332_West Haven_V220492_ 220405.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 2 and 5 The statement of purpose and service user guide at Westhaven have been completely revised. Relevant information to prospective service users and their families is available. Some gaps relating to emergency placements and around the obligations of people living at the home and the organisation are noted. EVIDENCE: The manager explained that the statement of purpose has been updated. The document provides a user friendly guide, setting out clearly the aims and objectives of the home, the experience and qualifications of staff and a summary of the fire procedure. The service user guide makes use of symbols and pictures to explain the complaint’s procedure to people living in the home. There have been three new staff appointed over the past six months and their details should be included in the statement of purpose. A second recommendation is that, although the home does not take emergency placements, information should be provided that explains this. It is suggested that the complaint’s procedure in the service user guide refer to the Commission for Social Care Inspection. There have been no new people admitted to the home since the last inspection. People who receive services are assessed comprehensively and Community Care Assessments were seen at the inspection. Any new people West Haven J51J01_s26332_West Haven_V220492_ 220405.doc Version 1.30 Page 9 referred to Westhaven are assessed via head office to determine whether their needs can be met at the home. One of the main areas of progress has been the inclusive contract of terms and conditions between the home and people receiving services. Two case files seen included the user-friendly booklets, setting out the relevant information set out in the standard. Both had been signed by the respective person living at Westhaven and the manager. One recommendation is made that the contract include a section on the rights and responsibilities of both parties and who is liable if there is a breach in contract. West Haven J51J01_s26332_West Haven_V220492_ 220405.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 7 and 9 People who receive services at Westhaven are being involved in completing person-centred plans, promoting inclusion and choice. There is evidence that people living in the home are involved in making decisions about their lives. There are areas for improvement: notably in terms of devising more detailed care plans and risk assessments for people who’s needs have changed significantly. EVIDENCE: Four care plans were examined and all four included person-centred plans at various stages of completion. One person explained that they had worked with a member of staff on the computer when drawing up their plan. The plan was written in the first person and clearly sets out preferences and goals and areas where support from staff is needed. Conversely the needs of two other people living at Westhaven have changed significantly. The person-centred approach is useful in gauging the views of the people receiving services, including their wishes and choices. However both of these individuals must have detailed care plans about specific aspects if their care and detail how these needs are to be met. West Haven J51J01_s26332_West Haven_V220492_ 220405.doc Version 1.30 Page 11 The monthly summaries are of particular merit. They set out a succinct overview of the person who receives services, relating to their health, social and emotional needs. The key worker system promotes effective communication with people living in the home and daily records and monthly summaries are up to date and clearly written. Residents’ meetings take place regularly. Minutes from these meetings show that people who receive services are actively engaged in making decisions about living at Westhaven, for example planning holidays, menus and discussing their feelings and concerns. The manager explained that Advocacy services have been used and are being considered to support people who receive services, to voice their opinions and make choices. Two risk assessments for people living at Westhaven were examined. One has been completely revised, following a multi-disciplinary meeting with the individual, staff and manager from the home and social services. The risk assessment is based on providing safeguards, whilst promoting some independence and will be reviewed on a regular basis. The second file explained that several risks have been identified. One concerned self-travel and there is clear evidence that the occupational therapist has completed a comprehensive assessment. A requirement is made, however, as no formal risk assessment has been formulated around one individual’s mental health needs, following several incidents, which have resulted in a complaint and harm to other service users (See standards 22 and 23). West Haven J51J01_s26332_West Haven_V220492_ 220405.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 15 16 and 17 People living at the home are actively involved in appropriate educational and fulfilling activities. Links with family and friends are promoted and people who receive services have their own responsibilities and have their rights respected. Mealtimes are often a social occasion, promoting choice, inclusion and participation with preparation. EVIDENCE: All people who receive services at Westhaven are engaged in age and peer appropriate activities. Two people said that they had been to work at a local farm on the day of the inspection; one had been involved in a local environment project. Another person said that they had been to college where they participate in courses such as computing, cooking and sewing. One person who receives services explained that they had commenced a music course at a local college; in line with a goal set out in their person-centred plan. Another person explained to the inspector that although they do not participate in any formal activities, they have a responsibility helping in the garden, growing fruit and vegetables. West Haven J51J01_s26332_West Haven_V220492_ 220405.doc Version 1.30 Page 13 Staff explained that people living at Westhaven help out with food shopping, domestic chores and cooking. On arrival at the home one person was busy hanging out the washing, with support from a member of staff. People living at the house confirmed that they had their own keys to their home and bedroom and also that they receive their mail unopened. The manager said that family links are maintained and one person living at the home confirmed that they saw their relative regularly. Families are kept informed of relevant events, meetings and changes, based on the consent of the person who receives services at the home. On the day of the inspection people living at Westhaven spoke with staff to change the evening meal menu and an alternative was chosen. People participate in menu planning each week. One person’s care plan examined set out their dietary requirements clearly. Two people spoken to said that they prepared their own breakfast and one was observed to prepare a sandwich for lunch. Where there had been an issue where a person living in the home had been hungry during the night, staff had worked with them to set up a snack box to take to their room. West Haven J51J01_s26332_West Haven_V220492_ 220405.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 19 20 and 21 The person-centred approach followed by staff at Westhaven allows persons living in the home to receive personal support in the way they prefer. There is clear evidence that the physical and emotional health needs of people are assessed and that the relevant agencies are referred to and included, taking into consideration the ageing of service users and their changing needs. The home has a satisfactory medication system and recording and storage of medication was accurate on the day of the inspection. EVIDENCE: Where people who receive services have personal support needs, staff are aware of the appropriate checks and prompts from the individual personal plans or the newer person-centred plans. People living at Westhaven are referred to appropriate agencies, for example physiotherapists, social workers and the Royal National Institute for the Blind to consider specialist equipment and mobility aids to assist people. The individual care plans now contain separate medical appointment sheets. The manager pointed out that details of these appointments are also written up in more detail, highlighting any changes in medication or concerning their health needs. Two people living at the home have experienced changes to their health and there is clear evidence that the staff and the manager are able to support these people effectively. Daily records show that one person had West Haven J51J01_s26332_West Haven_V220492_ 220405.doc Version 1.30 Page 15 complained of having a sore toe and that person attended a chiropody appointment within seven days. Where someone’s mental health needs have changed, the appropriate agencies have been contacted, notably the hospital consultant, GP, social worker and occupational therapist. All people who receive services have access to a GP. Where guidance is given to record blood sugar levels, evidence was seen that this is followed appropriately. Staff at the home who administer medication have all received Monitored Dosage System training from Boots. Two persons’ medication was checked at the inspection and their medication was stored and recorded appropriately. A recent incident where the wrong person’s medication was delivered to the home was dealt with efficiently, staff were responsive to contacting the pharmacy and recording the details clearly. Appropriate codes and explanations are recorded on the Medication Administration Record sheet. One of the most difficult areas to discuss with people in the home concerns seeking their final wishes. Minutes from a resident’s meeting show that bereavement issues and making wills has been discussed openly. One member of staff pointed out that people who receive services are to be spoken to by the key worker to determine their thoughts and discuss their final wishes. Appropriate support and counselling has been given to people living at the home who have experienced loss and staff are to be commended for their sensitive and respectful approach. West Haven J51J01_s26332_West Haven_V220492_ 220405.doc Version 1.30 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 There is evidence that people living at Westhaven are listened to and able to make complaints. One area for improvement concerns the logging of complaints and notifying the complainant about any outcomes. People receiving services at the home are protected from harm and abuse, however this would be improved further through updating care plans and risk assessments. EVIDENCE: Records show that the one complaint made was by a person living at the home. The complaint was logged in the complaint’s book. However the complainant did not receive a formal response of the outcome in the 28-day timescale. The complaint’s procedure points out that the appointed officer will notify the complainant of any decision in writing, this has not been undertaken. Secondly the outcome of the complaint was not logged either. Therefore a requirement is made to ensure that complaints are acted upon appropriately. Progress has been made since the last inspection, in that the manager and most members of staff have attended recent training on Adult Protection Awareness. The manager explained that new staff have also been put forward to do this training. Incident records show that one service user has alleged to has hit other service users. Appropriate documentation has been completed and referrals have also been made to social services and health professionals, to assess the individual’s behaviour. A recommendation is made that as a result of these incidents, that care plans (standard 6) and risk assessments (standard 9) are updated/devised to respond to these changing circumstances. One member of staff said that they were aware of how to diffuse situations and there are policies in place relating to physical and verbal aggression. West Haven J51J01_s26332_West Haven_V220492_ 220405.doc Version 1.30 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 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 assessed at the inspection visit. However the smoke lounge has been tastefully decorated since the last inspection and one service user was looking at colour charts as they said that their bedroom would be decorated. EVIDENCE: West Haven J51J01_s26332_West Haven_V220492_ 220405.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34 and 35 Although a thorough recruitment procedure is followed at Westhaven; there were some gaps in the documentation required. Staff receive a comprehensive induction to working in the home and are put forward to undertake courses relevant to the work they perform. EVIDENCE: The files of the three newest staff were examined at the inspection. All contained confirmation that a satisfactory Criminal Records Bureau check has been received, including a check relating to the Protection of Vulnerable Adults Register. A requirement is made as two of these files did not include a recent photograph of the member of staff and one only had one written reference. In order to protect people residing at the home, all relevant documentation must be available for inspection. One member of staff showed the inspector that they had almost completed their formal induction. The induction meets the Skills for Care criteria, including the principles of care practice. Staff have attended other relevant training courses to assist their work including: ‘Managing Challenging Behaviour’ and ‘Focus on Anxiety and Depression’. Each member of staff has an individual training plan, which has been updated, following a previous recommendation. West Haven J51J01_s26332_West Haven_V220492_ 220405.doc Version 1.30 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 and 42 The home has an informal quality assurance system and the views of people who receive services are listened to and acted upon. A more formal system is being developed by the providers. Progress has been made in promoting the health and safety of staff and people living at Westhaven, through mandatory training and fire drills and practices. EVIDENCE: At present people receiving services are able to voice any issues both informally and through regular resident’s meetings. It is recommended that in order to promote effective quality monitoring and ensure that the aims and objectives of the home are met; that any comments received from people receiving services and other stakeholders should be logged and used to provide outcomes for people living at the home. Established staff are up to date with their mandatory health and safety training and this was highlighted on the updated staff training profiles. Newer staff, who have completed some training before being employed by the home, have been put forward to undertake relevant refresher courses in moving and West Haven J51J01_s26332_West Haven_V220492_ 220405.doc Version 1.30 Page 20 handling and first aid. One member of staff has completed the 4-day first aid course and the manager explained that more staff would be considered for this. Portable appliance and electrical installation inspections are up to date. A requirement is made that the servicing of gas boilers and central heating systems be undertaken as a matter of urgency, as the Corgi certificate was several months out of date. Following the inspection visit the deputy manager said that a gas inspection has now been planned. Following a previous requirement fire drills now take place on a regular basis and the names of the staff who have participated is recorded. West Haven J51J01_s26332_West Haven_V220492_ 220405.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 x x 2 Standard No 22 23 ENVIRONMENT Score 1 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 1 3 x 1 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 x 3 x x 3 3 3 Standard No 31 32 33 34 35 36 Score x x x 1 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 West Haven Score 3 4 3 3 Standard No 37 38 39 40 41 42 43 Score x x 2 x x 1 x J51J01_s26332_West Haven_V220492_ 220405.doc Version 1.30 Page 22 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 6 Regulation 15(2) Requirement The registered person must keep the service user plans under review and in consultation with the service user revise the plan to determine how their needs will be met. The registered person must ensure that unnecessary risks to the health and safety of service users are identified: Risk assessments must be devised in order to prevent service users from being harmed or abused. The registered person must respond in writing to the complainant within 28 days and notify them of any actions taken, in response to the complaint. The registered person must maintain the records set out in Schedule 4 of the Care Home Regulations: Staff records must include two written references and a recent photograph. The registered person must ensure that all parts of the home to which service users have access are free from hazards to their safety: An up to date Corgi accredited gas certificate must be obtained. Timescale for action 31st May 2005 2. 9 13(4) 13(6) 31st May 2005 3. 22 22(4) 31st May 2005 4. 34 17(2) Schedule 4 31st May 2005 5. 42 13(4) 29th April 2005 West Haven J51J01_s26332_West Haven_V220492_ 220405.doc Version 1.30 Page 23 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. 2. Refer to Standard 1 5 Good Practice Recommendations The statement of purpose should include up to date staffing details and pay reference to not taking emergency placements. It is recommended that the contract of terms and conditions set out the rights, responsibilities and obligations of both the person living at the home and the home and who is liable if there is a breach of contract. Information gathered from service users in reseidents meetings and informal discussions and comments from other stakeholders should be recorded and used as a basis for meeting the aims and objectives of the home and outcomes for people who receive services. 3. 4. 39 West Haven J51J01_s26332_West Haven_V220492_ 220405.doc Version 1.30 Page 24 Commission for Social Care Inspection Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB 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. 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