Inspection on 09/07/07 for West Heath House

This inspection was carried out on 9th July 2007.

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.

Other inspections for this house

West Heath House 04/09/06

West Heath House 15/03/06

West Heath House 07/11/05

West Heath House 23/03/05

West Heath House 18/08/04

West Heath House 19/02/04

West Heath House 03/09/03

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE West Heath House 90 Alvechurch Road West Heath Birmingham B31 3QW Lead Inspector Monica Heaselgrave Key Unannounced Inspection 12:30 9th July 2007 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 Heath House DS0000033605.V343443.R01.S.doc Version 5.2 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 Heath House DS0000033605.V343443.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service West Heath House Address 90 Alvechurch Road West Heath Birmingham B31 3QW 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) 0121 475 3614 0121 478 0130 Not known Birmingham City Council (S) Mrs Imelda Walley Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places West Heath House DS0000033605.V343443.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. That home is registered to accommodate 26 people over 65 years who are in need of care for reasons of old age which may include mild dementia. Registration category will be 26 (OP) That minimum staffing levels are maintained at 3 care staff throughout the waking day of 14.5 hours. That additional to above minimum staffing levels there must be two waking night care staff. 4th September 2006 Date of last inspection Brief Description of the Service: West Heath House is a large purpose built two-storey building, located on the Alvechurch Road in West Heath. It is situated at the top of the road overlooking the main road with views all around the immediate area. The home is opposite a church and parade of shops; a number of bus routes to the city and surrounding area are within walking distance. The building is approached via a drive to the front with some off road parking. West Heath House offers accommodation to twenty-six older adults. All bedrooms are single with a wash hand basin facility, and emergency call system. Bedrooms are located on the ground and first floor, with access via a passenger lift. There are two lounges, a separate smoking room, a dining room, main kitchen, office and medical room. The laundry is situated on the first floor. Toilets and bathrooms are situated on both floors these have facilities suited to those people who require assistance. There is level access for wheelchair users to the front entrance and throughout the home. Corridors are wide and spacious and allow people to move around the home freely and safely. The home has hoisting equipment available for those people who have decreased mobility. An accessible well maintained garden area with outdoor seating is provided. Inside the home, the reception area has notice boards, which display information about forthcoming events and other articles that may be of interest. West Heath House DS0000033605.V343443.R01.S.doc Version 5.2 Page 5 The current charge for living at the home is £64.65 per week low rate, £136.00 higher rate for respite care. Additional charges include chiropody, hairdressing, and outings, which are partially subsidised from donations and budget. West Heath House DS0000033605.V343443.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out between 12:30 and 8:30 p.m. The inspection included a tour of the building, talking to people who live in the home, relatives, staff and the Manager. A review of records including information forwarded by the Manager before the inspection and survey comment cards that were completed by people who live in the home and their relatives was also included. Care records were reviewed as part of the “case tracking” of three people who live at the home. West Heath House was last inspected in September 2006 at that time the manager was required to address seven requirements to improve the care of the people living at the home. All of these have been addressed. No new requirement was made as a result of this inspection. What the service does well: There is comprehensive information about the service the home offers and this is presented in many ways to ensure people who live at the home have the information they need before making a decision to move in. Health concerns are identified quickly through the good records maintained, meaning the needs of the people who live in the home are addressed in a timely manner. Staff relate well to the people who they care for, and showed some skill in engaging those who had dementia. This ensures an inclusive approach for those people who find it difficult to initiate activities or conversations by themselves. People appeared well cared for with personal care needs met in a positive manner. Staff had a clear understanding of the need to protect people from potential abuse and know what to do when they have concerns. There are good systems in place to manage complaints this gives people who live in the home confidence to use procedures. There are good arrangements for managing peoples’ finances ensuring these are safeguarded. West Heath House provides a clean, friendly, welcoming, well-maintained and comfortable environment for the people who live there. West Heath House DS0000033605.V343443.R01.S.doc Version 5.2 Page 7 Training opportunities have ensured staff have the skills to meet the particular needs of the people who live in the home, this has included dementia care training which is specific to current people in the home. An experienced manager provides effective and competent leadership for her staff. There is qualified team of care staff who provide continuity of care. What has improved since the last inspection? What they could do better: Improvements at the home have been consistent over the last two years. The manager has ensured that any shortfalls with the service have been rectified within agreed timescales. The number of requirements has decreased from 14 to none at this visit. This indicates that the quality of the service continues to improve and move forward for the benefit of the people who live at the home. West Heath House DS0000033605.V343443.R01.S.doc Version 5.2 Page 8 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. West Heath House DS0000033605.V343443.R01.S.doc Version 5.2 Page 9 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 Heath House DS0000033605.V343443.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Comprehensive assessment procedures ensured the needs of the people being admitted were known and could be met by staff. People moving into the home were able to visit prior to admission if they wished and were being issued with a contract that detailed the terms and conditions of their stay. EVIDENCE: It was pleasing to note that there has been significant improvements in carrying out home visits to prospective clients, and ensuring that all the necessary records and assessment of needs are in place, prior to a person moving in. Thorough assessment of need ensures that the manager has the information necessary in forming a judgement as to whether they can be certain to meet the assessed needs of a person. The files for three people admitted to the home since the last inspection, were sampled. All the files included copies of comprehensive assessments undertaken by the manager of the home prior to the admission of the West Heath House DS0000033605.V343443.R01.S.doc Version 5.2 Page 11 individuals. Areas looked at during the assessment were health, abilities, needs in relation to personal care and memory. The assessment also included a summary of more personal routines and preferences which were detailed in a booklet called ‘All About Me.’ This had details such as; Please tell me what’s on my plate as I’m partially sighted,’ ‘Read my bingo cards’, ‘Brush my hair and put my slippers on, cream my legs and clean my glasses.’ These gave very good personal detail to the carer as to the care the person preferred. It was particularly nice to see that these had been produced in pictorial format and large print making it easier for the individual to read information about them. The inspector spoke with the family of one person recently admitted, their comments were positive, ‘Before mom came here she had a visit from the manager in hospital and we then had several visits, unannounced, to see the home. The staff was professional and polite we had lots of information about what the home offers before we made the decision. When she moved in we helped to describe her routines and preferences so that staff could look after her the way she likes. Mom also had a larger room offered to her when the staff realised that this was more in keeping with her needs. We are really pleased, mom loves the home she is well looked after.’ The systems in place now have all the key elements of good practice, which in turn, helps staff to support individuals right at the start of their stay. All three files sampled included signed copies of the terms and conditions of residence at the home. ‘Have Your Say’ surveys completed by people who live in the home, and their relatives indicated that they had enough information about the home to help them make a decision. West Heath House DS0000033605.V343443.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good care planning has meant that the people who live in the home receive individualised care and identified risks are minimised. The management of medication is good and ensures people receive their medication in a timely and safe manner. People are treated with respect and are clearly happy in the company of staff. EVIDENCE: People who live at the home have a plan of care that identifies their needs and gives staff instructions how to meet their needs. These are called Individual Service Statements, (I.S.S.). The three files examined had a plan of care generated from the initial assessment. The I.S.S. seen covered all required areas including, personal care, medical needs, dietary requirements and social needs. It was nice to see a record of what people are able to do for themselves and what assistance they require. Individual likes, dislikes and preferences were also included. The files of those people case tracked showed that there were a variety of health care needs which included; the management of West Heath House DS0000033605.V343443.R01.S.doc Version 5.2 Page 13 continence, weight monitoring, ulcerated legs, risk of falls, poor tissue viability, impaired vision, Epilepsy, and mobility. The care records seen, included numerous risk assessments for nutritional and tissue viability, mental health and falls assessments. There are risk assessments that identify how people are moved safely. All risk assessments are reviewed and updated monthly to ensure they are in line with the persons’ changing needs. For example one file showed that a manual handling risk assessment was in place, this gave specific details as to the hoist to be used, the sling size and how many staff were required. A second file had specific details relating to tissue viability. This identified the risk of developing pressure sores. This was linked to the care plan, which identified depression and spending lengthy periods in bed. A risk assessment relating to food intake was evident and identified the steps staff take to ensure nutritional needs, for instance weighing the person weekly, ordering food supplements, and recording the food the person is eating to ensure they have a sufficient diet. The care plan also included an overview of each person’s day which gave staff details about their preferred rising and retiring times, what times and where they liked to eat, where they liked to sit and how they liked to spend their days. It was positive to see that an ‘additional information section’ is completed where there are specific concerns or things that staff need to be aware of, this is good because it highlights important information, for instance one seen made it quite clear that one individual is a private person preferring only the company of his family. He enjoys his own privacy spending time in his room; he has been offered a T.V. and radio, which was refused. This information ensures that staff has good insight into an individuals desires and that staff have the information to respect this. It was pleasing to note that the requirements made following the last inspection in relation to updating care plans and risk assessments have been met this ensures that staff have the information they need to ensure risks are minimised and the care is individualised. All the files sampled included separate health care records, these gave an overview of visiting professionals. It was very clear from these that health care needs of the people living in the home were met. There was evidence of visits from G.P.’s, district nurses, medication reviews, visits to outpatient clinics, telephone conversations with doctors as result of hospital visits and visits from the continence advisor, dentist and optician. Where necessary the advice of more specialised health care professionals was sought, for example, community psychiatric nurses. The daily records detailed any concerns with individual peoples’ health that care staff had noted and this was then followed up and monitored. The daily records were looked at, these had more detail in relation to the general well West Heath House DS0000033605.V343443.R01.S.doc Version 5.2 Page 14 being of and the care given to the people living in the home, making it much easier to determine if needs were being met. The medication administration records (MAR) were kept well. There were no gaps in signing for medication. There was a photograph of person to assist with identification. The storage of medication was secure making it safe for people who live in the home. A daily audit is carried out between shifts to ensure that all medication is given out correctly and signed for this ensures that any errors made can be picked up quickly and rectified. Staff who administer medication have received appropriate training to do so. The medication round was observed and medicines were seen to be administered safely. The people living in the home raised no concerns about their privacy or dignity. Staff addressed people appropriately, and personal care was offered discreetly. Male staff have been recruited which means where some people have a preference as to who supports them with their personal care routine there is now some choice around this. There was a cordless telephone available for the use of individuals so that they could make or receive calls in private. All bedroom doors were lockable with keys available. The returned surveys indicated that staff is available when people need help. One family offered the following comments: ’She has the equipment she needs such as her wheelchair and zimmer frame, and her larger bedroom means she has the room she needs to move around safely. She eats really well, loves her food particularly a supply of sweets, staff are approachable and the personal care is very good.’ Call bells were within reach for those that were in their bedroom and this ensures that they call for help when needed. The lounge and communal areas were staffed consistently through the inspection ensuring people who are vulnerable to falls, or confused had the support they needed to keep them safe and comfortable. Staff spoken with had good knowledge of the care routines of people, and observations showed that staff know who needs assistance and in what areas. There was good support to people moving around the home, and accessing the toilet areas. Staff spoke to people in a kind and friendly, and supported their introduction to the inspector In summary care records set out in detail the action that needed to be taken by care staff to ensure all aspects of the health, personal and social care needs of the person are met. There are good dementia care guidelines, which looked at both the strengths and weaknesses of a person. Social or background profiles detailed the values, preferences, and lifestyle of the person so that staff can plan their daily routines in a positive manner. West Heath House DS0000033605.V343443.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Activities meet the expectations, and interests of the people who live in the home. There has been a good improvement in exploring and planning for the needs and interests of people who have dementia, they have the support and assistance to engage in stimulating activities that promote their individuality. The dietary needs of people are well met, they benefit from meals that are well presented, wholesome and varied. EVIDENCE: There was a range of activities being offered to people, quiz’s, card games, musical instruments, visiting entertainer, mobile library, movement and music sessions, keyboard sessions, knitting, skittles and planned visiting entertainers and trips. People spoken with indicated that they enjoy what is on offer. Comments received were; ‘The staff are really nice, they take me shopping, I’ve played bingo.’ A relative said, ‘She likes books and being read to, the staff are ordering some audio tapes for her which is nice.’ One person said ‘We’re going to Twycross zoo, last year we went to Weston which was nice. Sometimes we go to Northfield on the bus, or out for lunch, and I have my hair done over the road.’ West Heath House DS0000033605.V343443.R01.S.doc Version 5.2 Page 16 The surveys asked whether activities are arranged that people can take part in. Five people had ticked ‘always’ ‘four had ticked ‘usually’. An activities list is posted on the notice board to advise people of coming events. Staff spoken with said ‘It’s changed for the better, we have more one to one time with people especially those who need help to take part.’ It was positive to see that the daily records had improved. These now show what people have taken part in and meet with their initial plan. For instance one plan said that the person enjoyed reading, music, bingo, the daily records showed that she had taken part in these on a regular basis. There was good written information to guide staff in supporting people with their social needs. People are helped to exercise choices and make decisions, especially those people who have dementia or memory loss. For example; ‘put clothes out to let her dress independently, cognitive impairments mean she needs prompting and will need direction to the dining room, toilet or lounge. Often becomes anxious in the afternoon staff need to reassure her’. The guidance to staff included specialist dementia care guidelines designed to lesson the distress and disorientation. It is positive to see that the daily notes have improved in detail and now enable staff to monitor whether these things were being offered or taken up by people in the home. Staff said that some of the people currently cared for have dementia but they feel they have more time to spend with them and support them in the things they enjoy, and that the records now give them a clearer picture of the persons’ character and previous preferences which helps them to plan activities around this. The home positively demonstrates how the individuals social activity needs are met. People stated they are able to go to bed and get up when they chose and spend their time as they chose. Some have personalised their rooms to their choosing as seen during the tour of the home. Several people said they made their own decisions this included what they wore, what they ate, activities and attending church or other community amenities. The menus provided by the home were good and varied and comprised a fourweek rolling menu. People said, “The food is good ”. One relative also stated that the meals provided are of good quality and plentiful. Staff was observed talking directly with people to establish their meal choices. The arrangements in place for some people who require monitoring of their food or fluid intake ensures that their nutritional needs are met. This information was clear in their care plan and showed what measures are being taken to address these needs. The mealtime occasion was relaxed and sociable with assistance from staff on hand. West Heath House DS0000033605.V343443.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 17 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints procedures are available in a format suited to the needs of the people who live in the home, ensuring that people are fully informed of the complaints process. Staff are trained in procedures designed to protect the vulnerable people in their care. EVIDENCE: The Commission has not received any complaints about this service. People who live in the home were clear that they would speak to the manager if there was a problem. Surveys returned from relatives and those relatives spoken with at the time of the visit, indicated that they were generally happy with the relationship they had with the manager and staff team and were confident that any concerns they had would be listened to and acted upon. People who live in the home are given a copy of the complaints procedure within their “Service User Guide” when they come to live at the home. The complaints procedure is also displayed in the hall. An Information folder was seen which gave comprehensive information about the home, policies and procedures such as the complaints procedure. Some information is available in large print and pictorial form making it easier for people to access. Minutes of house meetings were looked at and indicated that people have the opportunity to raise any concerns they may have. Overall the staff has worked hard to ensure that procedures that affect people in the home are given a high West Heath House DS0000033605.V343443.R01.S.doc Version 5.2 Page 18 profile. This is particularly important for those who have dementia or memory loss and may have difficultly in advocating for themselves. There has been progress on tightening up the recording of complaints. The complaints records were viewed and showed that a record of the investigation and outcome is maintained, and made known to the complainant in writing. This ensures the complainant has the opportunity to say whether they are satisfied or not with the action taken. There were many compliments in the ‘compliments book’, which indicated that the home had acted to improve outcomes for individuals. The monthly regulation 26 visit records showed that compliments and complaints are audited, this is a good means of quality assurance and another means of the service being able to obtain the views of people in order to make any improvements. The AQAA completed by the manager prior to the inspection visit stated that staff had received training in Adult Protection Procedures, and discussion with individual staff showed a good understanding of how to keep people safe. The training records showed that most staff had received training in how to recognise abusive situations and how to respond to them in order to safeguard people in their care. It was particularly pleasing to note that staff have recently received training in dementia care which means staff have a better understanding of how to protect and promote peoples’ rights. The financial records of three people were seen and showed that a record is maintained of incoming money, and expenditures. Receipts are maintained and a running total kept. No discrepancies were found. Where able to, people had signed to say they had received their money. People told the inspector they had access to their money as needed. West Heath House DS0000033605.V343443.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Continued improvements have been made which have significantly improved the facilities and comfort for the people who live in the home. West Heath House provides a comfortable and safe environment for those living there. EVIDENCE: The location of the home is lovely, set at the top of the road overlooking the church and local shops with pleasant views from all aspects. West heath House is a well-maintained comfortable and pleasant environment, which meets with the needs of the people who live there. There is level access to and from the home. The rear garden is mainly laid to lawn and fairly level, some people were observed in the garden and said they come out every day for a walk. The manager said that they have recently secured a grant to provide a paved walkway across the lawn and a pagoda, this will enable more people to access the garden, some of whom presently use wheelchairs and can’t negotiate the incline at the lawn border. The garden is West Heath House DS0000033605.V343443.R01.S.doc Version 5.2 Page 20 well maintained, some of the people who live there told the inspector that that they had planted up container pots for the patio, these were beautiful. The home arranges many garden fetes and fundraising events so the garden is well utilised. There is ample garden furniture, shaded areas, and seating. A partial tour of building found that the home was clean and fresh. All areas of the home are appropriately decorated and furnishings and lighting were domestic in character. The manager has been undertaking a programme of redecoration and refurbishment, in the last year a number of improvements had been made, all three lounges and the dining room have been redecorated, fitted with new lighting and new curtains. The upstairs carpet in the corridor has been replaced, as have two bedroom carpets. Bedrooms have all been redecorated. The people who live in the home commented on the many improvements made, one family were very pleased that there is some flexibility with the accommodation. Her relative was provided with a larger room to allow more space for the zimmer frame, and her own personal furniture. A variety of aids were seen to include a hoist for lifting people, zimmer frames for mobility, raised chair legs to enable more independence by the individual in seating themselves and standing up themselves. It was evident that the layout of bedrooms was thoughtful, ensuring that no items of furniture could potentially be an obstacle. The space in the rooms allowed furniture to be placed in a manner that would minimise the risk of falls. This was in line with the risk assessment seen for a person at risk of falling, and it was positive that staff try to minimise this risk as much as possible. There are adequate bathing and toilet facilities to meet the current needs of people who live in the home. Modernisation of the toilets has improved privacy and accessibility. Corridor areas are spacious and it was observed that staff had sufficient room to support those people moving around the home with zimmer frames. Domestic staff are responsible for the general cleaning, and all areas viewed on the day of the visit were clean, and hygienic. The arrangements in place for infection control were good staff were observed using protective clothing, and lidded waste bins were in toilet areas. A contract for the collection of clinical waste was in place. Systems were in place to deal with soiled linen, lessening the risk of cross infection. Surveys returned by the people who live in the home and their visitors were positive about the facilities and standards of cleanliness. All said that the home was ‘always’ fresh and clean. One stated, ‘They keep the home clean and tidy.’ The manager has identified environmental improvements but is mindful of the viability of these. Currently the home is in the second phase of decommissioning, this means they are preparing for the future closure of the unit and the future provision of services for older people. West Heath House DS0000033605.V343443.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are sufficient numbers of trained staff to meet the needs of the people who live in the home. Recruitment procedures have improved and provide robust safeguards for vulnerable people. Staff training opportunities ensure staff can meet the needs of the people in their care. EVIDENCE: At the previous visit in September 2006 the high dependency levels of some people being cared for did impact on the availability of staff to meet needs. Since that time referrals have been made for some people to be reassessed, and currently no one is described as having high dependency needs. This has had a positive impact, both people who live in the home and the staff who care for them have commented favourably on the change this has had. ‘It’s much better now, more time to help people to do activities or have a chat.’ ‘We have been able to take people out more often such as to the local shops.’ ‘There is so much more time now to just be with people, read to them take them out or help them with bingo or other activities.’ Comments from people who live at the home included; ‘Staff are really nice, they do spend time with us, take us out to the shops and do activities’. ‘If I need staff they are always there for me, really nice to me and we enjoy their company.’ The surveys returned by people who live in the home and their relatives indicated that staff is available when they need them. Discussion with the West Heath House DS0000033605.V343443.R01.S.doc Version 5.2 Page 22 manager and individual staff showed that the improvements in the assessment information means that they are in a better position to judge if they can meet a persons’ needs before they are admitted, and this ensures they do not compromise the needs of the people already living in the home. Staff spoken with during the visit were enthusiastic about their job roles and had a good knowledge of the individual care needs of people. The gender mix of staff did reflect the gender mix of people currently living at the Home. Male care staff within the staff team has met some preferences in respect of the gender of staff assisting with their personal care needs. Agency staff are at times, used to cover vacancies, it was pleasing that the manager strives to use the same agency staff members in order to promote continuity of care for the people being cared for. There has consistently been very little staff turnover at the home, which provides good continuity of care for the people who live there. There was evidence on the files that were sampled for care staff that they had received induction training in line with skills for care specifications. Information provided to the Commission prior to the inspection indicated that approximately just over 60 of staff, that is 15 of the 22 permanent care staff had National Vocational level 2 qualification (NVQ) or equivalent. Staff had completed training in Infection Control, Safe Food Handling, and Health and Safety. All staff had completed statutory training. The records looked at in the home showed that staff had undertaken training in Fire Procedures, Tissue Viability, Challenging Behaviour, Adult Protection, Manual Handling, and Dementia care. This ensures that a competent and appropriately skilled staff team supports people. Recruitment and selection procedures have improved since the last visit to the home. These are now robust and protect the people who live there with all the required checks in place before the new employee commences work. West Heath House DS0000033605.V343443.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Home is run in the best interests of the people living there. Systems are in place to continuously monitor the service on offer, and there has been a continuous improvement in ensuring that the needs of the people living at the home are met safely. The health and safety of the staff and the people living in the home was well managed. EVIDENCE: The manager is experienced in the conditions that affect older people. She holds the NVQ level 4 in management and care and the Registered Managers Award. She has several years of experience in caring for older persons, and managing a staff team, this ensures she has the relevant skills to manage the care home. West Heath House DS0000033605.V343443.R01.S.doc Version 5.2 Page 24 There are lots of platforms to encourage the inclusion of people in how the home is run; regular house meetings are held, regular audits are carried out, both by the manager, team manager and cross homes audits which consists of a manager from another home calling unannounced and auditing the practice. Audits have included, cleanliness and safety of rooms, water temperatures, fire doors, emergency call bells, care plans and medication. Surveys were sent out to staff, people who live in the home, relatives and visiting professionals and have been analysed and actions required identified. Reports of these showed the views of people who live in the home, or visit are sought as to their experiences, the majority of these have been positive. A compliments book is available with many positive comments as to the efforts of the manager and her team in meeting the needs of people who live in the home. The manager is keen to improve the home and has a programme of continuous improvements. Robust arrangements are in place for managing the finances held at the home, this provides good safeguards for those who need support in this area. Planned supervision for all staff is now more consistent providing staff with a regular platform in which to review their practice. There are appropriate arrangements to ensure the health and safety of both people who live and work in the home. Appropriate maintenance and inspection certificates for all appliances were seen. Required checks on the fire system take place including staff training to ensure that they know what actions they should take in the event of a fire. Risk assessments for fire and food were also available. There are comprehensive reports of accident and incident and it was positive to see that the manager undertakes ongoing audits of accidents to ascertain patterns in the frequency, times and places that people fall, this has resulted in some positive initiatives in how peoples’ bedrooms are furnished and the room they require. There has been a substantial improvement in including the outcome of risk assessments in peoples’ care plans. This has meant staff are more aware of the risks, and have written instruction as to how to minimise it ensuring the person cared for is protected as far as possible. The management of the home is good, and focused on positive outcomes for people who live in the home. There were a number of requirements made at the previous visit which the manager has positively met. These mainly related to the management plans for identified risks. There needed to be improvements to ensure the overall safety of people being cared for. The plan for daily living had little correlation to the assessment information, and lacked significant key points. Plans did not in all cases set out in detail the action that needed to be taken by care staff to ensure all aspects of the health, personal and social care needs of the person are met. West Heath House DS0000033605.V343443.R01.S.doc Version 5.2 Page 25 The current records now clearly address these shortfalls, it is evident a lot of work has taken place and the outcome for the people who live in the home is good. West Heath House DS0000033605.V343443.R01.S.doc Version 5.2 Page 26 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 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 3 West Heath House DS0000033605.V343443.R01.S.doc Version 5.2 Page 27 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations West Heath House DS0000033605.V343443.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Heath House DS0000033605.V343443.R01.S.doc Version 5.2 Page 29 - 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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