Inspection on 21/06/06 for West House Care Home

This inspection was carried out on 21st June 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

West House Care Home 26/11/08

West House Care Home 04/12/07

West House Care Home 08/02/06

West House Care Home 28/09/05

West House Care Home 01/03/05

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE West House Care Home Waldridge Road Chester Le Street Durham DH2 3AA Lead Inspector Mrs Tanya Newton Unannounced Inspection 10:00 21 June and 4th July 2006 st 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 House Care Home DS0000062946.V298928.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 House Care Home DS0000062946.V298928.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service West House Care Home Address Waldridge Road Chester Le Street Durham DH2 3AA 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) 0191 387 1533 Roundview Properties Ltd Mrs Barbara Sally Stubbs Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30), Terminally ill (3) of places West House Care Home DS0000062946.V298928.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th February 2006 Brief Description of the Service: West House is a home owned by Roundview properties Ltd. It is registered to provide nursing and residential care for up to 30 older persons. The home offers single and double room accommodation, with communal sitting/dining areas. Bathrooms are located throughout the home, some of which have aids to support service users during personal care. West House is situated in Chester-le street, a town near to Durham and Newcastle. Mrs Barbera Stubbs manages the home. Fees within the home range from £359.00 and £412.00. Fees do not include hairdressing and chiropody. West House Care Home DS0000062946.V298928.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced. The visit to the home took place on the 21st June between the hours of 10am and 5pm. Feedback was given to the manager on the 4th July. All of the key national minimum standards were inspected. The inspector spoke to most people who use the service, relatives, staff and the manager and inspected some of the records in the home. Prior to the inspection the manager had completed a self-assessment document which provides the Commission with information to aid the inspection. Some service users had also completed comment cards on what they thought about the service at the home. On the whole service users were happy with the service they were receiving What the service does well: What has improved since the last inspection? The contract and complaints policy were updated following requirements in the last inspection report for the home. Care plans now contain a section on resident’s finances to support residents in managing their own money. Staff files have also been updated and most now contain the information needed to protect residents. West House Care Home DS0000062946.V298928.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. West House Care Home DS0000062946.V298928.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection West House Care Home DS0000062946.V298928.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each resident is provided with a contract, which provides them with clear information about their fees and the terms and conditions of residence. Assessments are provided before admission. Only service users whose needs can be met are admitted to the home. The home does not provide intermediate care. EVIDENCE: Each service user is provided with a contract which they sign. The contract tells them what is included within the fees and what may be additionally charged for. West House Care Home DS0000062946.V298928.R01.S.doc Version 5.2 Page 9 The home carries out its own assessments meeting people either in hospital, their own homes or at West House. Service users are invited to visit the home prior to admission. The home also requests a copy of the care management assessment for service users funded by the local authority. Assessments contained detailed information. The home does not admit service users whose needs cannot be met. Comments from residents included “I had a look around the home before I moved in” and “my daughter looked around for me”. The home does not admit residents for intermediate care although respite (short stay) care is provided. West House Care Home DS0000062946.V298928.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 & 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each service user has a care plan, which reflects their changing needs. Some areas of the care plan need extending where assessments have identified risks. The personal and health care needs of the service users accommodated are being met. Standards of care within the home are very good. The systems for dispensing medication are good and protect residents. Privacy is maintained and service users are respected. The home provides care to those who are dying in a sensitive, caring and respectful manner. West House Care Home DS0000062946.V298928.R01.S.doc Version 5.2 Page 11 EVIDENCE: Each resident has a care plan, which provides staff with information about how their needs should be met. Some of the assessments within care plans identified risks, these included pressure care, falls and nutrition. A care plan should be put in place where a risk has been identified showing how the home will minimise that risk. Reviews are carried out reguarly on care plans, this helps staff to monitor changes in a resident’s health. Residents have access to GPs, dentists, community nurses and opticians. The practice of involving residents/relatives within the care planning process should be encouraged. Residents comments included “I haven’t seen or heard of my care plan” and “I don’t know what a care plan is”. Comments from G.Ps, Care Managers and other health and social care professions were received. The following are some of their comments “an excellent home, I’d be happy if my mum lived there”(from a G.P), “calls to district nursing services are always relevant to patients needs, staff are friendly and welcoming, they know their patients well and respect their privacy and dignity”, “I have been placing clients in West House since 1993 and have found the care to be consistently very good”. Comments from residents and their relatives included “I’m well cared for, the nurses look after me”, “I’m well looked after” and “the medical care is good here”. Medication records are up to date for each resident and medicines received, administered and disposed of are recorded. A qualified nurse gives all medication. The home is carrying out regular audits of medication to check that systems are running smoothly. There are no service users who administer their own medication. The home makes sure that particular attention is given to supporting resident’s privacy and dignity when delivering personal care. Residents confirmed this in discussion making the following comments “staff are nice they treat you with respect” and “we are treated well here”. The home deals with death and dying in a sensitive manner. Relatives of a resident who had recently passed away said “the care was excellent, mam was looked after properly and nothing was a trouble. They really couldn’t have done any more”. Some staff had attained training in palliative care. West House Care Home DS0000062946.V298928.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The activities being provided were poor and do not provide sufficient stimulation and interest for people living at the home. Family feel welcome and can visit the home at any time. The routines of the home meet the choices and wishes of the residents. Menus are varied and service users are given a choice. EVIDENCE: Comments from residents and their relatives regarding the activities were poor and included “There’s nothing to do here and we don’t go out”, “I like quizzes and stuff but there’s nothing going on” and “socially there’s nothing, its sleepy valley after lunch, there’s no conversation which can be difficult. I’d like to see more going on here”. West House Care Home DS0000062946.V298928.R01.S.doc Version 5.2 Page 13 The manager said that an activities co-ordinator post had been advertised for some time now and agreed that until the role could be filled that an additional staff member would be working during the afternoon to provide some stimulation to residents. Residents should be asked what type of activities they would like to participate in and this should be recorded in their care plan. The home has open visiting arrangements and residents know that they can entertain their visitors in their own room. If they prefer they can use community areas of the home to talk to visitors. A group of residents were asked if they felt that they could make choices, their responses included “we get choices about most things, we get up and go to bed when we want and we choose what meals we want”. Comments regarding the food were mainly positive and included “the meals are decent and we usually get a choice” and “the foods not bad although there’s not always a choice”. Most residents felt that the meals had improved and the owner regularly purchases individual items for service users to ensure that individual choices are catered for. West House Care Home DS0000062946.V298928.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are dealt with appropriately and systems to protect people from abuse are in place. EVIDENCE: There are adequate written policies and procedures in place to deal with complaints and care staff said they were aware of these. Written records of complaints and the outcomes are kept at the home. Service users said they would complain to the manager if they were at all unhappy. Staff training has taken place in the protection of vulnerable adults in abuse. Staff recruitment procedures were adequate and staff were employed following appropriate CRB and POVA checks. The manager and staff team were clear and confident in the protection of vulnerable adult procedures. West House Care Home DS0000062946.V298928.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home was clean, tidy and free from odour during the inspection. EVIDENCE: As highlighted in the last inspection, the owner of West House is trying to gain planning permission to extend the premises. The home has started to undergo a programme of redecoration and the areas that have been decorated look much improved. The dining room chairs need replacing as they are in poor condition and do not enable staff to easily manoeuvre residents to and from the table. The radiator covers in the dining area are tatty and stained and the room generally should be made more welcoming. The carpets in the hallways corridors, small dining area, entrance and lounges of the home need to be replaced and service users require new bedding, quilts and curtains in their bedrooms. West House Care Home DS0000062946.V298928.R01.S.doc Version 5.2 Page 16 Comments from service users, relatives and visitors included “The home is lovely, very well kept”, “the accommodation is ok”, “the home is kept clean carpets get done every night” and “the environment is not wonderful is it”. Staff said, “the environment is improving, slowly” and “the hoist we have is a hand pump one, we used to have an electric one which was much better”. A visiting professional said “the corridors and bedroom doors are a bit small, it can be difficult to enter bedrooms if residents are on a stretcher or using the hoist”. The treatment room is extremely warm and very uncomfortable to work in. Some of the toilets are very small and difficult to access particularly for service users in wheelchairs. One service user said, “I’ve had my head bumped twice today when trying to get into the toilet”. The home also needs a designated smoking area for residents. At present smokers use the main lounge. Some of the non-smoking residents have said that they do not like this. This was raised in the last inspection report and should now be addressed. West House Care Home DS0000062946.V298928.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The number of staff on duty seems in the main to be meeting the needs of the service users living within West House. Staff files had been updated and included most of the required information, including a record of any training. EVIDENCE: There is a registered nurse on duty at all times in West House and there are four carers on duty on a morning and three on an afternoon. The manager’s hours are in addition to these. Some staff felt that the number of staff on an afternoon should be increased, as there is no activities co-ordinator at present. There is a clear commitment to providing staff with training and 55 of care staff had achieved an NVQ level 2. Mandatory training is provided for all staff. Most staff had recently completed training in health and safety and were going to start an infection control course. Three staff files were checked during the inspection, all contained the required information, which helps to protect residents living at the home. Residents were complimentary about staff and commented “Staff are alright. I get on with them all. Staff are a good help I like it here as far as these places go”. West House Care Home DS0000062946.V298928.R01.S.doc Version 5.2 Page 18 Two staff were spoken to during the inspection both said that they were well supported by the manager and that they had seen improvements in the service being provided. Morale is high and there is a good rapport between the staff and the residents accomodated. This was observed throughout the inspection. One staff member said “the staff work hard to provide a good standard of care here”. Two comment cards were received which said “responsible, caring and knowledgeable staff who work well with the primary care team” and “we have a very good relationship with the staff at West House, they contact us for advice if necessary and they are always polite and curteous”. West House Care Home DS0000062946.V298928.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a registered manager in post who is able to provide the home with a clear sense of leadership and direction. Basic quality assurance systems are in place to seek improvements in the service being provided. Financial procedures have been updated and protect service users. There are clear health and safety systems in place to protect service users and staff. West House Care Home DS0000062946.V298928.R01.S.doc Version 5.2 Page 20 EVIDENCE: The manager has the required qualifications and experience to run the home. She supports a strong staff team to provide a good standard of care and support to the service users living within West House. One health professional said “I find the manager very professional, she always acts in the best interests of clients”. Comments from staff regarding the management were positive and included “the manager and nurses are very good”. Morale is high and there is a good rapport between the staff and the service users accomodated; this was observed throughout the inspection. Feedback is gained through staff meetings, residents meetings and day-to-day contact with service users and their relatives. Questionnaires have also been given to relatives. Feedback should also be sought from other professionals. The owner carries out regular visits to the home these must be formalised. A report must be written regarding these visits on a monthly basis. This information helps to improve the service being provided to residents. The owner agreed to do this. Three service users monies were audited; systems to manage residents monies had improved following the requirement made in the last inspection. The manager confirmed that the home carries out regular Health and Safety checks and some of these records were looked at during the inspection. West House Care Home DS0000062946.V298928.R01.S.doc Version 5.2 Page 21 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 X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X 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 X 3 X 3 X X 3 West House Care Home DS0000062946.V298928.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? YES 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 OP12 Regulation 16(2)(m) (n) Requirement Activities must be made available to service users based on their individual interests and needs. Previous timescale of 31/03/06 not met. Timescale for action 31/07/06 2. OP19 OP38 13(4) c The home needs to review the 31/07/06 arrangements for smoking taking into account risks to service users and staff and advice should be sought from the Fire Officer. The dining room chairs need replacing. The carpets in the hallways corridors, small dining area, entrance and lounges of the home need to be replaced and service users require new bedding, quilts and curtains in their bedrooms. 30/11/06 3. OP19 23(2) b West House Care Home DS0000062946.V298928.R01.S.doc Version 5.2 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. 3. 4. 5. Refer to Standard OP7 OP9 OP19 OP33 OP38 Good Practice Recommendations Care plans should be updated where risks are identified. The temperature in the treatment room should be monitored to ensure it remains at 25 degrees or below. The radiator covers in the dining area are tatty and stained and the room generally should be made more welcoming. Feedback from other professionals should be sought to support the homes quality assurance systems. Door guards or automatic door closers should be fitted where a service users requires their door to be open. West House Care Home DS0000062946.V298928.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI West House Care Home DS0000062946.V298928.R01.S.doc Version 5.2 Page 25 - 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. 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