Inspection on 18/12/08 for West Heanton Ltd - Residential Home

This inspection was carried out on 18th December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

West Heanton Ltd - Residential... 18/12/06

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 10/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: West Heanton Ltd - Residential Home West Heanton House West Heanton Buckland Filleigh, Shebbear Beaworthy Devon EX21 5PJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Susan Taylor     Date: 1 8 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: West Heanton Ltd - Residential Home West Heanton West Heanton House Buckland Filleigh, Shebbear Beaworthy Devon EX21 5PJ 01409281754 01409281585 tom@westheanton.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): West Heanton Ltd Name of registered manager (if applicable) Thomas Geoffrey Bond Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home West Heanton is an older style property which has been converted into a residential care home for up to 22 elderly people. The home is situated in a rural area in its own well maintained grounds. The home has various lounge areas and a separate dining room. All areas can be accessed either by stairs or by use of a chair lift. The cost of care ranges from £294 to £390 per week depending on individual needs. Additional costs, not covered in the fees, include chiropody, hairdressing, and personal items such as toiletries and newspapers. People funded through the Local Authority have a financial assessment carried out in accordance with Fair Access to Care Services procedures. Local Authority or Primary Care Trust charges are determined by individual Care Homes for Older People Page 4 of 30 care home 22 Over 65 22 0 Brief description of the care home need and circumstances. General information about fees and fair terms of contracts can be accessed from the Office of Fair Trading web site at www.oft.gov.uk. Current information about the service, including CSCI reports, is available to prospective residents, relatives and others who may have an interest such as care managers. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is Two stars. This means the people who use this service experience GOOD quality outcomes. This was a key inspection of West Heanton Residential Home under the Inspecting for better lives arrangements. We were at the home with people for 9 hours. We looked at key standards covering: choice of home, individual needs and choices, lifestyle, personal and healthcare support, concerns, complaints and protection, environment, staffing and conduct and management of the home. We looked at records, policies and procedures in the office. We walked around the home and met 10 people. We observed how people are looked after and how much say Care Homes for Older People Page 6 of 30 they have about their lives at West Heanton. We also met 8 staff. We talked to them about their experience, support and training to find out whether it met the needs of people living at the home. Their comments and our observations are in the report. In December 2008, the fees ranged between 294 and 390 pounds per week for personal care. People funded through the Local Authority have a financial assessment carried out in accordance with Fair Access to Care Services procedures. Local Authority or Primary Care Trust charges are determined by individual need and circumstances. General information about fees and fair terms of contracts can be accessed from the Office of Fair Trading web site at www.oft.gov.uk What the care home does well: What has improved since the last inspection? What they could do better: People that lack capacity are not always fully represented when decisions about their care needs are made, for example when an alarm has been fitted that alerts staff when a person leaves their room, and this needs to be improved. The assessment should clearly highlight who will be involved in the process and the issues that need to be Care Homes for Older People Page 8 of 30 addressed for the individual and carefully considered with the persons advocate and other health and social care professionals supporting them. The way medicines are given out does not follow best practice and therefore does not eliminate the risk to people of being given the wrong medication. We have made a legal requirement about this. Activities need to be more person centred and therefore appropriate for each individuals needs and capabilities to ensure that everyone is engaged and stimulated. People should be confident that the staff that care for them are consistently following best practice by getting regular support and guidance in a more formal way. This will ensure that people always receive the best possible care from knowledgeable and experienced staff. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 30 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information is gathered from a range of sources to ensure that individuals needs are met. People that lack capacity are not always fully represented when decisions about their care needs are made and this needs to be improved. The home does not offer intermediate care; therefore no judgement has been made about this. Evidence: The manager verified that information about funding has been produced to accompany the service users guide and is given to potential residents. 90 percent of people responding to our survey verified that they received enough information about the home before they moved in so that they could decide whether it was the right place for them. Similarly, everyone that responded in the survey had received a contract. They made comments like the home came highly recommended and when I visited I felt very welcome. We casetracked a person that had only recently moved into the home. The individual said that the information about the home was detailed and gave a very Care Homes for Older People Page 11 of 30 Evidence: good picture of what the service provides. Therefore, people have sufficient information with which to make a decision about whether they want to move into the home and know what to expect when they live there. The manager told us that people are assessed in their current setting. The pre admission form seen included information about their current abilities, medication, next of kin and equipment required. We examined 4 care files (hard copy and computerised) and tracked the needs of the individuals concerned. All 4 people had had their needs assessed. The team had established any risks for an individual about their tissue viability, falls, and nutritional status. In one persons file a mental health risk assessment highlighted that the person was at risk of wandering, particularly at night. Records demonstrated that a pressure mat was used as a measure to reduce the risks highlighted from occurring. The persons mental capacity had not been assessed. Such measures might be considered to be forms of restraint without careful assessment and agreement from all stakeholders, including the individuals advocate. We discussed this with the manager who is aware of requirements in the Mental Capacity Act 2005 for there to be ongoing assessment of an individuals capacity at an exact moment about a particular decision and or issue. They verified that policies and procedures covering this aspect of care were in the process of development. These will also incorporate the local authority procedures that come into effect in April 2009. The manager verified that intermediate care is currently not provided at West Heanton. Care Homes for Older People Page 12 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive effective personal and healthcare support that is person centred and is based upon the rights of dignity, equality, fairness, autonomy and respect. Current procedures do not ensure that medicines are handled safely for people living in the home. Evidence: We casetracked 4 people by speaking to them and also observing the care they were given. We read their care plans and concluded that individual personal preferences, routines and social activities were well known by staff and had been documented. This has ensure that all staff have a good understanding of how each person prefers their care and support to be delivered. We looked at 4 care files, which demonstrated that the home has good professional relationships with general practitioners, nurse specialists and the consultant psychiatrist. For example, a person with dementia had been visited at the home by the consultant psychiatrist and their medication had been reviewed and changed. In Care Homes for Older People Page 13 of 30 Evidence: addition to this there are good links with the mental health and social services teams. Letters seen on files indicate good communication and partnership working that ensures that people living in the home receive appropriate care. The home had clear policies and procedures about risk assessment and management, which had been robustly implemented. All of the care files had guidance on action to be taken to minimise identified risks with regard to tissue viability, falls, manual handling, and continence. All of the assessments had been regularly reviewed. Where a high risk of development of pressure ulcers had been highlighted, we read similiar entries in the persons care plan and saw that the individual was sitting on pressurerelieving equipment and had no pressure ulcers. The manager told us that they had tried to obtain this equipment from the community resources but had been unable to do so and had purchased the equipment instead to prevent the persons skin breaking down. There was a high standard of information to ensure that care and health needs were assessed and monitored. Verbal information and feedback in respect of individuals personal and health care needs is given to staff at the start of each shift. This process was observed at the beginning of the afternoon shift. This handover also gave staff time to ask questions and give their view about how an individual was doing. The home uses a monitored dosage system. Senior staff are responsible for stock taking. Records of ordered drugs and a register of controlled drugs were seen and tallied with those being stored. The system was easy to audit and we tracked medication given to 4 people. Records accurately reflected medication having been given as prescribed by the GP. We observed medicines being put into pots, with the individuals name on it. We discussed the practice of secondary dispensing with the member of staff and told them that this was unsafe. If the care worker giving the medicines does not have the container with the label they cannot be sure that each person receives the right dose of the right medicine at the right time, as prescribed. Additionally, they do not have access to information about how the medicine should be taken that is on the container. Best practice guidance is available on our website at: http:/www.csci.org.uk/professional/default.aspx. We discussed our observations with the manager who said that the procedure would be reviewed immediately and made safe. One persons care file highlighted that there were risks associated to medicines because the person had poor eyesight and sometimes tended to spit their medicines on the floor when given them. We observed that when this person was given their Care Homes for Older People Page 14 of 30 Evidence: medicines staff did this by taking account of the individuals disability and also carefully monitored that they had swallowed the tablets. All medication was kept in a secure place; controlled drugs were stored in accordance with legislation(Misuse of Drugs Safe Custody Regulations 1973). We observed that staff always knocked on doors before entering bedrooms. People told us that care was always done in the privacy of their room and that staff treated them with respect and kindness. One person commented they all treat you nicely. Care Homes for Older People Page 15 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Routines and activities are flexible for people and they are listened to regarding the choice of daily activity. These could be individualized further to take account of the diverse needs of people living there to ensure that everyone leads a full and stimulating life. People are encouraged to maintain contact with friends and family in the community, which emonstrates a commitment to the principles of inclusion. Evidence: Information provided by the manager verified that 100 percent of people living at West Heanton are of christian faith. The home has stong connections with the Church of England congregation in Shebbear and the Methodist circuit. Additionly, 2 people are visited regularly by the Roman Catholic priest from Torrington. During the afternoon, a carol service took place that was well attended and people enjoyed getting into festive spirit. According to information sent to the Commission, 7 people currently living at West Heanton have dementia. We wanted to establish how peoples needs were met with regard to meaningful activity. An hour was spent in the lounges observing how staff interacted with the people. This highlighted examples of good practice. During the Care Homes for Older People Page 16 of 30 Evidence: period of observation, staff engaged with people continuously at the right speed and demonstrated genuine warmth and attention, which people appeared to respond to and enjoy. We asked staff what they did to help these people pass the time. Staff said that it was difficult to sometimes know what people could actually do or wanted to do. We were told that one person, whose care we tracked, was known to like classical music and had classic fm on in the background when we met them. The manager verified that staff tended to act on instinct and information obtained from families rather than on assessed knowledge. Activities were group based and did not always reflect the level of ability that the person had given the stage of their dementia. To illustrate this point, some people might be more responsive to sensory activities such as painting or aromatherapy. Alternatively other people might be more responsive to cognitively based activities, such as a reminiscence quiz. We discussed specific tools that might be useful to gain in depth information about individual capability and interest such as the Pool Activity level instrument. This would also ensure that activities are person centred and pitched at the right level for people. The Home has a menu that rotates on a weekly basis. The home displays a copy of the weeks menu choices on notice boards. Each day there is a choice of two meals at lunchtime however the kitchen will prepare alternatives if neither are acceptable. On the day of inspection there was a roast lunch with a choice of either chicken or beef. We observed people being asked whether they would like a sherry or other alcoholic beverage before lunch. One person confirmed that they often have a meal that is different from the advertised meals. Another person said that the kitchen would often prepare them meals that met their cultural needs. A well balanced and varied menu is available. All of the people who were spoken with during the course of the inspection made positive comments about the quality of meals such as excellent food and all home cooked. One person told us that they had recently had a birthday. A cake had been made for the person and they were encouraged to invite any visitors they wished to to their celebration. Meals are either served in the dining room, but people can have their meals in their rooms if this is preferred. The dining tables are set out hotel-style, are covered with linen tablecloths, with place settings and condiments at each table. One person said I like to go to the dining room normally but if I am not feeling too good, they bring my meal to me. Care Homes for Older People Page 17 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. West Heantons policies ensure that people are protected and able to voice their concerns, safe in the knowledge that these will be acted upon. Evidence: Information sent to us by the manager tells us that complaint procedure has been improved to ensure that complaints are consistently recorded and acted upon. Similarly, people are also encourage to make suggestions about how the service can be improved. In surveys, 100 percent of people living in the home tell us that they are satisfied that the home listens to them and deals with any concerns in a timely way. The Commission received no complaints before or during the inspection. We saw a copy of the Alerters guide. The home also had a whistle blowing policy, which all of the staff we spoke to understand. Kind and caring interactions were observed throughout the day between staff and people living in the home. Staff engaged positively with people who had dementia and demonstrated genuine warmth when engaging those individuals. A relative told us that the staffs were kind and caring. Another visitor commented that their relative was very content. Information sent by the provider told us that 52 percent of the staff holds an NVQ in care, part of which is about safeguarding people. 2 staffs are in the process of doing the award. Staff told us that policies and procedures are discussed with them. We Care Homes for Older People Page 18 of 30 Evidence: looked at training records and saw that Safeguarding Adults training had been provided for staff. Information sent to us by the manager verified that no safeguarding or POVA referrals had been made since the last inspection. We observed that people are treated with respect and encouraged to see West Heanton as their home. A relative in a survey commented that their mother is happy here and the care is excellent and I would certainly recommend it to anyone. A person living in the home wrote nothing is too much trouble when remarking about how the staff treat them. Care Homes for Older People Page 19 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean, well maintained environment which meets their needs. Evidence: We toured the premises and saw that radiator guards were in place throughout the building. Fire exits were clear and accessible. We looked at a selection of bedrooms occupied by the people whose experience we tracked, which were clean, individual and comfortably furnished. People living in the home told us that there is always a housekeeper on duty. All of the wcs and bathrooms had locks on the doors. Communal areas were comfortable and homely. People told us that many parts of the home had been decorated, which looked fresh and bright. Maintenance certificates were seen for assisted baths, electrical installation, and central heating and fire alarm systems. Surveys from people living in the home and relatives verified that the home is kept fresh and clean. Information sent to the Commission by the manager verified an audit using the department of health guidance had been carried out and there is an action plan in place to prvent and control the spread of infection. 39 percent of staff had received training about the prevention of infection and management of infection control. The manager showed us a training programme run by the local college that covered infection control, which the service has signed up to and will enable all of the staff to Care Homes for Older People Page 20 of 30 Evidence: update their knowledge and experience in this area. Hand towels and soap dispensers were seen in wcs, bathrooms and bedrooms. Good hand washing practices were observed as staff were seen to deliver care to people. The laundry was clean and well organised. We observed good infection control measures being followed when staff were dealing with soiled linen and staff had access to gloves and aprons. As a result of these measures, none of the people have been unwell other than with normal seasonal colds. Care Homes for Older People Page 21 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Recruitment practices at West Heanton are robust and therefore protect the people living there. The training and development programme ensures that competent and knowledgeable staff cares for people. Evidence: In a survey 100 percent of people tell us that staff are always available when they need them. One person wrote they always come when I need them. Similarly, staff verified that there are usually enough staff to meet the individual needs of people who use the service. We examined duty rosters for four weeks up to the week of the inspection. On the day of the inspection there was three carers, the deputy manager, manager on duty during the day till 9pm and two waking staff at night. Additionally, there were 3 cleaners, a kitchen assistant and cook on duty. Staff we spoke to told us that they were busier in the mornings but did not feel rushed. Maintenance staff had also been employed. We observed that people were attended to promptly and appeared relaxed. We examined the files of three of the newest staff. Two satisfactory written references had been obtained for all of the staff prior to employment. Pova checks had been undertaken and criminal records bureau certificates had been obtained also before Care Homes for Older People Page 22 of 30 Evidence: employment commenced. The home had a written procedure about recruitment and retention of staff and it was clear that these had been followed to protect the people living in the home. Information that the manager had sent us verified that a wide range of training had been provided over the last 12 months. Records demonstrated that 52 percent of the care staff had achieved the NVQ level 2 award in care or above. We saw individual training files, which contained further evidence of specialist training having been provided, for example, dementia awareness. Induction records seen demonstrated that training meets the appropriate standards set out by the Skills for Care. We spoke to staff about their experience and training opportunities in the home and people verified that this was regularly offered to them. The training and development plan for the home contained information for the period 2008-9 and reflected the needs of people currently living in the home so would ensure that staff have the knowledge and understanding to meet these needs. Care Homes for Older People Page 23 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well run home, where their views count and improvements are made. Health and safety is promoted and ensures that people living and working in the home are protected. Evidence: The Registered Manager has nearly 4 years experience in running the home. Since the last inspection, he has achieved the NVQ level 4 in care and management. He told us that he uses the internet extensively, in particular the Commissions professional website, to keep up to date thus ensuring that the care delivered is best practice. He had recently downloaded and shared with staff the Commissions publication See me, not just my dementia. Additionally, The manager showed us written confirmation of places booked on a mental capacity act training course for himself and the assistant manager. Throughout the inspection we found that he had a clear understanding of his role in meeting the stated aims and objectives of the home. Similarly, he provided the Commission with a lot of information in a document entitled AQAA (Annual Quality Care Homes for Older People Page 24 of 30 Evidence: Assurance Assessment). In it he outlined what the home could do better to improve the quality of life of people living there and how it would be done, in addition to explaining what had been improved. Our main concern at the inspection has been that the management of medication is not as safe as it could be and therefore the risk of the wrong medication being given to people is not eliminated. However, we are confident that this will have been addressed as the manager immediately took steps to change the way medication is given out before we left the home. We observed that there are clear lines of accountability within the home. People told us that the registered provider is also very much hands on. We observed people being asked for feedback about lunch, their care and activities during the inspection. There is an open door policy that also allows people living there, visitors and staff to speak with the Registered Manager whenever they wish to. A monthly newsletter is published and there is a residents forum that takes place every 8 weeks. People told us that West Heanton is well run and they liked to call it home. An internal survey entitled Your views count had been done, which the manager had used to identify areas for improvement. We toured the premises and saw that the certificate of registration was displayed in a prominent position where people living in the home and visitors could see it. People living in the home, some supported by relatives, had sent the Commission survey forms and made comments like: the care is excellent and I would certainly recommend it to anyone nothing is too much trouble my mother made a visit before deciding to come...she was fully involved in the choice of room They always come when I need them we get a choice Since coming here I am much better in myself For people who are unable to look after their own money, West Heanton holds a small float of money for people whose relatives are unable to do this for them. The money is kept in secure facilities. People we spoke to verified this and told us that either they managed their own money or relatives did this for them. We saw records that the home kept and checked balances which were correct. Appraisal records were seen in the staff files we looked at. Staff told us that the manager and provider were always approachable. We looked at 4 records and none of the staff had had a 1:1 with the manager in the last 12 months. Information sent to the Commission verified that the manager works alongside staff every day and this was also borne out in what people told us on the day. A more formal approach to supervision had been identified as an area for improvement. This will ensure that staff Care Homes for Older People Page 25 of 30 Evidence: consistently follow best practice when caring for people and also have the opportunity to reflect and identify any gaps in their knowledge and experience. Comprehensive Health and Safety policies and procedures were seen, including a poster stating who was responsible for implementing and reviewing these. In information sent to the Commission, the manager verified that risk assessments are carried out. We saw various examples of this with regard to audits done, which included medicines, fire safety and first aid equipment. As we toured the building we observed cleaning materials were stored securely and used with by staff wearing gloves. Data sheets were in place and staff spoken to understand the risks and strategies to minimise those risks from chemicals used in the building mainly for cleaning and infection control purposes. Records of accidents were kept and showed that appropriate action had been taken. The fire log was examined and demonstrated that fire drills, had taken place regularly. Similarly, the fire alarm had also been regularly checked. People living in the home, and staff told us that the alarm was regularly. A certificate verified that an engineer had checked the fire equipment. First aid equipment was clearly labelled. Nearly all of the staff on duty held a current first aid qualification. Risk assessments for the environment had been reviewed since the last inspection. Maintenance certificates were seen for the heating, electrical and fire alarm systems. The manager had verified in information sent to the Commission that portable electrical appliance checks had been done and we were told by people living there that an electrician had looked at their appliances. Therefore, we concluded that the health and safety of people living, working and visiting the home is maintained. Care Homes for Older People Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 The registered person must 31/05/2009 ensure that medication procedures are safe and eliminate the potential risks to people living in the home. People living in the home need to be confident that staff responsible for giving out medicines always follow safe procedures so that they receive the right medication at the right time. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 3 Peoples mental capacity should be assessed so that the team are clear about whether a person is able to make decisions about their care and life at West Heanton. If they are unable to do so, the assessment should clearly highlight who will be involved in the process and the issues that need to be addressed for the individual. In particular, restricting access to bedrooms, use of keypads or mats linked to the call bell system need to be carefully considered and agreed by all stakeholders. Page 28 of 30 Care Homes for Older People 2 9 People living in the home need to be confident that staff responsible for giving out medicines always follow safe procedures so that they receive the right medication at the right time. The diverse needs of people are taken into account when organising individual and group activities so that everyone leads a full and stimulating life. For example, use an assessment tool like the Pool Activity level instrument to establish exactly what individuals are able to do and indentify suitable activities accordingly. Staff should receive 1:1 supervision six times a year and a record be kept of it. This will ensure that staff follow best practice and are supported when caring for people living in the home. 3 12 4 36 Care Homes for Older People Page 29 of 30 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 30 of 30 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!