Inspection on 20/02/08 for West View

This inspection was carried out on 20th February 2008.

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

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 View 27/07/06

West View 03/01/06

West View 19/07/05

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE West View Plummers Lane Tenterden Kent TN30 6TX Lead Inspector Mary Cochrane Unannounced Inspection 20th February 2008 10:00 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 View DS0000063680.V358369.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 View DS0000063680.V358369.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service West View Address Plummers Lane Tenterden Kent TN30 6TX 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) 01580 261500 mandy.brown@kent.gov.uk http/www.kent.gov.uk/SocialCare/children/fost ering/ Kent County Council Mrs Mandy Kathleen Brown Care Home 60 Category(ies) of Dementia (0), Old age, not falling within any registration, with number other category (0) of places West View DS0000063680.V358369.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home with nursing only - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) - nursing 20 Old age, not falling within any other category (OP) - 25 2. Dementia (DE) - 15. The maximum number of service users to be accommodated is 60. Date of last inspection 27th July 2006 Brief Description of the Service: West View is an innovative service, registered in April 2005. It is run by Kent County Council and provides a range of services to meet both the health and social care needs of 60 male and female residents aged 55 and over. Accommodation is on two floors each providing care for 30 residents. Nursing care and recuperative care is provided in the 15-bedded Benenden East and 15-bedded Benenden West units on the first floor accessed by two passenger lifts. The ground floor comprises two units: The Lindens and Wittersham. Long term residential care for 15 residents and up to 5 places for short stay respite care is provided in the Lindens. Wittersham provides long term dementia care for 15 residents and up to 4 of these may be used for shortterm respite care. West View Integrated Care Centre is newly built and situated in Plummer Lane. It offers magnificent views of rural countryside and provides ample car parking. There is a secure garden as well as other gardens, walkways and a pond to the front of the building. The market town of Tenterden with bus services, railway station and other amenities is nearby. The town of Ashford is approximately 15 miles away. The maximum current weekly fee is £364.79 A copy of the last inspection report is available to view at the reception area. West View DS0000063680.V358369.R01.S.doc Version 5.2 Page 5 West View DS0000063680.V358369.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This visit to the service was an unannounced “Key Inspection” which took place over one day. All the core standards were looked at during the visit. This visit forms part of the key inspection. The registered manager and deputy manager were both available to assist during the site visit. The people living at the home and the staff on duty were helpful and cooperative throughout the visit. The following methods of inspection and information gathering were used: At the time of the site visit there was one-to-one discussion with people who use the service, care staff and management. Staff interactions with residents, care interventions and activities were observed. Individual support plans risk assessments were looked at and discussed. Selected policies, medication charts, training matrix and training programmes and financial arrangements were looked at. A partial tour of the building was undertaken. Information received from the home since the last inspection was used in the report. An annual service assurance assessment (AQAA) was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. The information in the AQAA needs to developed and expanded to give a better picture about what the service is offering and how it plans to improve the standard of care for people who stay at West View. We also looked at information we have about concerns and complaints and how these have been managed. We also took into account the things that have happened in the service, these are called ‘notifications’ and are a legal requirement. In November 2007 a safeguarding adults alert was raised at the home. The local adult protection team is still investigating this. The home are waiting a date for a meeting to discuss the issues raised. Policies and procedures are being followed by the service. West View DS0000063680.V358369.R01.S.doc Version 5.2 Page 7 A thematic inspection was undertaken at the home in January 2007. This was a short, focused inspection that looks in detail at a specific theme. This inspection looked at the quality of information given to people about the care home and whether people experience open and fair conditions of care. Shortfalls that were highlighted at this inspection were looked during the site visit. What the service does well: People who wish to stay at the home have access to information, which tells them about the service and the care they will receive if they decide to spend time at the home. As a lot of people come straight from the William Harvey Hospital where information about the service is available on the wards. The staff make sure that peoples needs have been fully assessed before they come to stay. This will ensure that the service can give them the support and care they need. The home provides a friendly, homely atmosphere. Each of the residents has their own rooms with en-suite facilities. If people want to they can bring in personalised effects, which make them, feel more comfortable and ‘at home’. Individual tastes and choices are catered for. The people living at Westview appear relaxed and content in their environment. Residents said the staff are very kind both as individuals and collectively. Good interactions were observed during the inspection, as was the caring attitude of the staff. Residents confirmed they feel their privacy and dignity is respected. The choice menu provides residents with appetising and nutritious meals in pleasant surroundings, which are enjoyed by all. Residents said the food was very good and they always have a choice of meals. Family and friends are welcome at the home. People living at the home can be sure that their views will be taken into consideration and acted on. The Home has a Quality Assurance System in place for the benefit of the residents. One resident said ‘I was in hell and now I am in Paradise’. A staff member said ‘everyone works well together. We have a good team’. West View DS0000063680.V358369.R01.S.doc Version 5.2 Page 8 What has improved since the last inspection? What they could do better: The service needs to make sure that care plans contain the information needed to meet the needs of the residents. They need to be accessible to the staff at all times. Information needs to be recorded in so that it is easy to follow and any health or care problems need to be easily identified. The staff need to be able to see what they action have to take or what interventions may have already taken place to meet the needs of the residents. The plans need to give a picture of the whole person. They need to look at what the person can do for themselves and not what needs to be done for them. Daily records need written about how the person has spent their day and not what tasks have taken place. The home needs to develop a person centred approach to care. The service needs to make sure that all the health care needs of the residents have been identified and met and that risks are kept to a minimum at all times. There needs to be evidence in place to support this. On the day of the visit all the staff spoken to reported they are finding the care planning system on the computer difficult to work with and it was not ‘user friendly’. They felt information was lost on the system and that it was unreliable. Important information which affects the care and lives of the people living at the home is being missed or is not available to staff. The medication practises and procedures need to be adhered to make sure that the residents take their medication safely and effects are being monitored. Terms and conditions/Contracts need to tell people who are staying in recuperative/intermediate beds about what happens after if they still need care after 6 weeks. The service told us this the maximum time a person is allowed to stay in places and after time the situation is reviewed. West View DS0000063680.V358369.R01.S.doc Version 5.2 Page 9 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 View DS0000063680.V358369.R01.S.doc Version 5.2 Page 10 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 View DS0000063680.V358369.R01.S.doc Version 5.2 Page 11 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): 1,2,3 and 6. People who use the service experience good outcomes in this area Prospective residents have the information they need to make an informed choice about living in the home; their needs are assessed; and they will only be admitted if the home are confident of meeting these needs. Resident’s places are protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The statement of purpose and service users guide contains all the necessary information to assist residents their representatives to make an informed decision as to whether the home is suitable and able to meet their needs. West View DS0000063680.V358369.R01.S.doc Version 5.2 Page 12 The statement of purpose is kept in the reception area of the home. Residents have a copy of the service users guide in their bedrooms. This is kept up to date to reflect the present situation in the unit. The service users guide is well presented and well written. It includes information on how to make a complaint. The service told us that Kent County Council (KCC)is working on putting this infromation into other formats which will make more accessible for people who wish to use the service. Everyone who uses the service has a terms and conditions/ contract in place. Which explains what the service provides for the money paid. The terms and conditions/contracts are kept in the individual rooms of the resdidents or in their main file. They are signed by the person receiving care or their representative and the manager of the home. People receiving intermediate/ recuperative care are only guareenteed a place at the home for a maximum of 6 weeks. The service told us that their contracts are reviewed on a weekly basis and resigned. The home needs to make it clear in their terms and conditions/contracts what the procedures are after this period of time has elapsed. Some residents are concerned about what would happen if they were not well enough to return home after the 6 weeks. The centre has different procedures for admission depending on the type of care needed. The home offers long stay, intermediate and nursing care. Some people are assessed from home by the local care management team. A trained person at the William Harvey Hospital assesses others. For intermediate care, a flow chart identifies the process. The registered manager said if they are not sure they will be able to meet someone’s needs from the assessment then she or the deputy manager will do an independent assessment. All referrals are looked at carefully to make sure the service will be able to meet individual needs. The centre has dedicated rehabilitation facilities, which include equipment for therapy and treatment. Specialist services from relevant professions including physiotherapists and occupational therapists are provided to meet the assessed need of those residents admitted for rehabilitation. One lady said ‘ I am getting back on my feet again. I will be going home soon’. West View DS0000063680.V358369.R01.S.doc Version 5.2 Page 13 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. People who use the service experience adequate outcomes in this area Residents cannot be sure that all their identified needs will be met and that all risks will be minimised. Action needs to be taken to ensure that the homes medication policies and procedures are adhered to and fully protect the safety of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service uses a computer system to plan the care of the people who come to stay. Each of the 4 units has its own computer terminal where staff are supposed to enter all the information about residents and how they are going to meet their individual assessed needs. It was evidence on the day of the visit that the system is not working in the best interests of the residents and it is West View DS0000063680.V358369.R01.S.doc Version 5.2 Page 14 leaving people at risk. The system is not being used as a daily working tool to meet the needs of the residents. Samples of plans were looked in each unit of the centre and shortfalls were identified in all the units. The system is set up in such a way that it is difficult to get a full picture of a person who needs many different aspects of care. Information did not flow and is fragmented. Information is getting lost and could not be trailed to find out outcomes of care interventions. A specialist nurse was due to visit a resident but there was nothing documented about whether the visit had taken place, the outcome of the visit. The care plan had not been updated to reflect the changes in the care and support needed. Another person had a pressure area and was receiving care from the district nursing team. This was not identified on the care plan. There was nothing to say when his dressing was changed whether the area was improving and how often the visits were taking place. There were no district nurses notes available. There was no evidence in to show whether people had seen the chiropodist. Other people been identified with needs such as epilepsy and diabetes but the care plans did not give the staff the direction and guidance on how to meet these needs. Some staff spoken to knew what to do but others didn’t. Care plans were scant on information on how to meet individual needs. Staff said that they were finding the system difficult to work with. They said that it was not ‘user friendly’. Only one terminal per unit meant that they could not put information in when they needed to as often the system ‘locked them out’. The registered manager of the home was concerned that information was being missed and has decided to hand write the daily records. These are written are a format where it is difficult to find information easily. They did not give a clear picture about how residents spent their time, they mainly said that people are washed, dressed had their meals and are taken to the bathroom. They did not relate to the individual care plans. Some of the care plans are not being reviewed and up-dated when care needs have changed. There are some risk assessments in place but these need to be further developed more individualised to ensure that all risks have been identified and kept to a minimum. It was also identified information about medical needs of residents was being entered on assessments but staff did not know what the conditions were. This potentially leaves people at risk. The home does need to develop a more person centred approach to care. Key working needs to be further developed and promoted. Some needs are met in a task orientated way. Plans focussed on what residents could not do instead of promoting independence and self-esteem. West View DS0000063680.V358369.R01.S.doc Version 5.2 Page 15 The Intermediate Care Team comprises physiotherapists, occupational therapists and community district nurse and provides care and support to those residents admitted for recuperative care. The centre employs its own physiotherapist. All staff are trained to treat and prevent the development of pressure ulcers and to promote continence. Residents have access to dental and chiropody services. The service told us that GP are contacted when necessary. The home is being pro-active and is seeking advice and in-put from specialist services in addressing issues about anti-coagulant treatment. Since the last inspection the service has improved its access to medication. The pharmacy now delivers twice a day and stays open late. This means prescribed medication is more readily available for the residents who come to the home at short notice or via the hospital system. Residents usually get the medication they need when they need it. The staff told us that on occasions they still do have problems especially with controlled drugs. But they are being pro-active in trying to resolve the issues with the hospitals, doctors and pharmacy. A sample of prescription sheets were seen. There was evidence to show that on some occasions staff had not signed the prescription sheets when they had given the medication, this does need to be addressed. However because pill counts were done at regular interval this indicated that the medication had been given to the resident. The recording and administration of controlled drugs was undertaken according to requirements. Medication policies and procedures are in place. When possible medication is stored safely in the rooms of the residents otherwise it is stored in the medication room. All staff who administer medication have received training and their competency are regularly assessed. Some of the people staying at the home are prescribed medication (this includes topical creams) on a ‘when required’ basis. It is recommended that medication prescribed ‘when required’ needs have written instructions and guidance for staff to ensure that the medication is administered consistently and can be monitored. This needs to be documented in residents care plans. It also needs to be ensured that the effect of analgesia for pain is monitored. Some people are receiving high doses of pain relief and there is no evidence available to show whether it is effective or not. At the time of the visit some of the residents were self-medicating. There was no risk assessment available for one resident although staff thought it had been done but were unable to locate it. Another resident was now selfmedicating having been at the home for some time but there was no reassessment done to evidence how this decision had been made. Supply of medicines for self-administration was not recorded and also there was no evidence available to show that people were being checked at regular intervals to ensure they were taking their medication as prescribed. West View DS0000063680.V358369.R01.S.doc Version 5.2 Page 16 Through observation and talking to the residents and staff there was evidence to show that privacy and dignity is upheld. Observations of staff offering personal support were good. People were spoken to discreetly and with respect Staff were observed assisting the residents in a caring and supportive manner and were seen treating them with respect and understanding. Staff were observed demonstrating good body language and communication skills when interacting with the residents. Members of staff spoken to confirmed an understanding and commitment to this aspect of care. A resident said ‘ The staff are very good, they will do anything you ask’. West View DS0000063680.V358369.R01.S.doc Version 5.2 Page 17 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. People who use the service experience good outcomes in this area. Residents are enabled to exercise choice and control over their lives. There are opportunities to participate in social and recreational activities. There is varied, healthy diet provided which offers choices at every meal. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home does provide some activities for residents. These include various board games, bingo, dominoes jigsaws and arts and crafts. The home also arranges for musical entertainers to visit. The service works closely with local charities to provide funding for trips out. Trips are organised for small groups of people and have included visits to garden centres, the theatre and shopping trips. The manager did say that she is discussing the possibility of holidays for the permanent residents. There is a short life history included in residents’ care plans providing staff information about their interests and activities. There was West View DS0000063680.V358369.R01.S.doc Version 5.2 Page 18 no evidence to indicate that activities happen on regular basis. Staff said they usually take place in the afternoon if there is enough staff and if they have time. The home would benefit from a dedicated activities co-ordinator and an activities programme. This would give staff the guidance and direction to provide activities on a regular basis. From looking at the recent daily records s there was little evidence to indicate that any activities had taken place and if people had participated and whether or not they had enjoyed it. A reminiscence room has been set up but there is nothing to show how this room is used. There is also a fully operational sensory room with a variety of “snoozelam” equipment. A resident said ‘I would like to do more, its very boring at times, I enjoy going into the garden when it is warm’. Another said ‘The staff do try and organise a game of bingo, but no-one is interested, they prefer to stay in their rooms’. Residents are encouraged to retain their independence as much as possible, and to be able to decide their lifestyle on a day-to-day basis. All residents are invited to attend residents meetings, which are held at regular intervals. The meetings give people the opportunity to express their views and make suggestions regarding their care at Westview and also to make any suggestions on how the service can be improved in any way. Suggestions are listened to and acted on. Residents are encouraged to maintain contact with family and friends. Residents are able to receive visitors in the privacy of their own room if they wish or they can make use of quiet areas in the home. The staff were observed making visitors welcome and involved. There is the facility to receive telephone calls in private. The service told us if a resident expressed a wish not to see or speak to a particular person, this would be respected and recorded as their preference. One visitor said ‘you are made to feel welcome. The staff always offer you a cup of tea. They are polite and treat people with respect and courtesy’. Residents are enabled to practice their religion. Communion services are organised as well as a Baptist service every month. The service told us that Shaw Health Care provides the catering arrangements at West View and the kitchen is well equipped and staffed. Residents complete menu cards and choose what they wish to eat. The majority of residents spoken to said they enjoy the meals. Three meals a day are provided as well as a snack meal in the evening if required. The kitchen was not visited at this time. A lunchtime meal was observed; this was relaxed and unhurried with residents able to take their time to enjoy the food. Staff were observed assisting residents to eat in a respectful way. The meals served were well West View DS0000063680.V358369.R01.S.doc Version 5.2 Page 19 presented and special diets are catered for. Residents said that the food was very good and there was always plenty. They said they could have drinks or snacks whenever they wanted. West View DS0000063680.V358369.R01.S.doc Version 5.2 Page 20 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): 16 and 17 People who use the service experience good outcomes in this area. The people who use the service can be sure that their complaints will be dealt with. The staff have the skills and knowledge to keep residents as safe as possible. People are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints procedure is displayed in prominent places throughout the home. A copy of this procedure is also contained in the information folder available in all bedrooms. The service has systems in place to ensure residents or their representatives can raise any concerns about the home. Residents indicated that they could speak to the staff if they had any concerns. West View has received some complaints since the last inspection. These had clear documentation, with copies of letters sent in response to complainants, and the outcomes of complaints. All concerns and complaints are taken seriously, and dealt with appropriately. It was clear that the manager and staff use any complaints as an opportunity to learn how to do things more effectively, and action is taken to prevent similar occurrences from happening in the future. West View DS0000063680.V358369.R01.S.doc Version 5.2 Page 21 In November 2007 a safeguarding adults alert was raised at the home. The local adult protection team is investigating this and policies and procedures are being adhered to by the service. They are waiting the date of a meeting to discuss the issues that have been raised. At the time of writing the report the alert remains open. Staff are aware of what constitutes abuse and reported that they would have no problem whistle blowing if the need arose. The service told us that all staff have received training in safeguarding adults and in the Mental Capacity Act. Records supported this. West View DS0000063680.V358369.R01.S.doc Version 5.2 Page 22 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 and 26. People who use the service experience good outcomes in this area Resident’s benefit from a well-maintained, comfortable and homely environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The centre provides a pleasant environment for its residents with single ensuite facilities and all rooms (including en suites) have an emergency call bell. It is appropriate to the specific needs of the people who live there. Permanent residents are encouraged to personalise their bedrooms. The service promotes privacy and dignity of the residents. There is a good range of specialist equipment and aids available for those who need them. West View DS0000063680.V358369.R01.S.doc Version 5.2 Page 23 Shaw Health care is responsible for maintaining the building both in respect of routine maintenance and renewal of fabric and decoration. On the day of the visit the home was clean and free from any offensive odours. Residents and staff said that the home is always fresh and cleaned to a high standard. The grounds and gardens are attractive and accessible to residents. There is a passenger lift between the ground and first floor. The responsibility of the domestic and laundry provision is with Shaw Health Care. Residents said that the laundry service was very good and they had no complaints. An infection control policy and procedures are in place and staff training is provided. West View DS0000063680.V358369.R01.S.doc Version 5.2 Page 24 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 People who use the service experience good outcomes in this area. There are adequate numbers of staff with sufficient training and experience to meet he needs of the residents. The staff have a good understanding of the service users and positive relationships have been formed. Recruitment practices are thorough ensure the service users are fully protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a stable core staff team. Staff reported that they all work well together. One member of staff said ‘We respect and accept each others skills and knowledge and we use this to the benefit of the residents’. From looking at the duty rotas and from speaking to staff there was evidence to show that generally there was enough staff with the necessary qualifications, knowledge and skills on each unit to meet the needs of the West View DS0000063680.V358369.R01.S.doc Version 5.2 Page 25 residents. The service told us it is in the process of recruiting and employing more qualified nursing staff. They also said they have obtained funding for health care assistants and for administration support. The centre offers day care and is registered to provide residential, dementia and nursing care. In respect of nursing care, registered nurses and health care workers are employed on a secondment basis by the local PCT. The centre has been accredited to provide placements for student nurses. The home does have thorough recruitment practises. The sample of staff files looked at contain all the necessary information and safety checks to ensure that the residents are protected. A list of PIN numbers/expiry dates and evidence of completed CRB checks are now available at the centre. The service needs to make sure they have an update photograph of staff on their files. The deputy manager has delegated responsibility for induction and other training. The induction programme is thorough and is linked with Skills for Care standards. New staff spend 2 weeks completed their induction training before they are allowed to work with residents. The registered manager and deputy have put together a information pack for all new staff this contains all the information they need to assist them in working successfully within the centre. Each member of staff has an individual training profile and development programme. Staff have received up-to date specialist training and mandatory training to ensure all the needs of the residents are met. Training is on going. Staff spoken to are eager, enthusiastic and motivated to learn. They were keen to improve the standard of care given to the residents. Competencies are checked at regular intervals. The registered manager stated training and competency issues identified at the inspection with regards meeting the health care needs of the residents will be addressed. The nurses working within the unit keep up-to date with their training. Each nurse specialises in a specific are e.g. tissue viability, diabetes, moving and handling. Their expertise and knowledge is then passed to others to improve care practises for the people who live at the home. More than 50 of staff have achieved NVQ level 2 or above. West View DS0000063680.V358369.R01.S.doc Version 5.2 Page 26 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): 31,33,35 and 38 People who use the service experience good outcomes in this area. The home is well run and in the best interest of the people who live there. The health, safety and welfare of the residents is promoted and protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager is a Registered Nurse and Social Worker with Management Qualification. She has the skills, competencies and positive attitude to run the home and meet its stated purpose, aims and objectives. The staff and the residents reported that they were well supported and West View DS0000063680.V358369.R01.S.doc Version 5.2 Page 27 responded in a positive, relaxed manner in the presence of the manager. Opportunities for change and development are on going. West View has quality assurance systems in place. There are opportunities for the residents, staff, relatives and other stakeholder to put forward their views about the home and the standard of care that is offered. This is done using annual questionnaires. Feedback from the quality assurance has been collated and is available to read. This details how the service is monitored and feedback from consultations with the residents. The registered manager will be analysing the feedback and acting on any identified shortfalls. It should be ensured that this information is fully accessible for residents and their representatives to reference. Regular quality assurance visits by a representative of KCC are completed and recorded to meet the requirement. All incidents that are reportable under regulation 37 of the care standards act are reported to the appropriate agencies. Accident forms are completed when necessary. The home employs a facilities manager who is responsible for the safety of the premises. Regular checks are made of equipment and the premises. There are systems in place for monitoring health and safety. All checks seen were in order and well recorded. Fire checks were undertaken at the necessary intervals and water temperatures were within safety limits. Staff are trained in all areas relating to health and safety during their induction. Mandatory training is kept up –to date and is on-going. All staff have 4 to 6 weekly formal supervision. Staff said they benefit from this 1 to 1 time. Arrangements are in place for clinical supervision for nurses and health care staff. The centre’s arrangement for dealing with residents’ personal finances was discussed. Some residents make use of the centre’s Personal Property Accounts (PPA’s), which feeds into and out of a KCC account set up with a major bank. This system has been introduced for residents’ convenience and the amounts banked and withdrawn are small. This system protects the monies of the residents. West View DS0000063680.V358369.R01.S.doc Version 5.2 Page 28 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 3 3 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 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 3 X 3 West View DS0000063680.V358369.R01.S.doc Version 5.2 Page 29 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 OP7 Regulation 15(1) Requirement The manager develops and agrees with all residents user/representative an individual support/care plan, which includes all the health, social and personal care required, describing the services and facilities to be provided by the home, and how these services will meet current and changing needs and aspirations. The plan needs to be implemented and updated to reflect the changing needs of the residents. Daily records need to contain relevant information about the day of the residents and written in a format that is easy to follow. Previous timescale 07/02/06 and 31/01/07 not met 2. OP8 12(1)(a) The registered manager needs to make sure all the health care needs of the residents are met. There needs to clear evidence in place to show how this has been done by the service. The service needs to make sure DS0000063680.V358369.R01.S.doc Timescale for action 31/05/08 31/03/08 2. OP9 13 (2) 31/03/08 Page 30 West View Version 5.2 • • • • • All staff sign the prescription sheets when they administer medication. There needs to be individual guidelines in place for residents prescribed ‘when required’ medication. The effects of pain relief need to be monitored. All residents who self medicate need to have a risk assessment in place, which is reviewed at regular intervals. People who self medicate need to be monitored at regular intervals to ensure they taking their medication as prescribed. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP1 Good Practice Recommendations Stating the availability of other versions of the home’s information for prospective service users including the service user guide, statement of purpose and other information would enhance the current provision. Thematic visit 9 January 2007 refers Terms and condition of placement should clearly reflect the individual care services provided by West View. Thematic visit 9 January 2007 refers. The residents need to be involved in meaningful daytime activities of their own choice and according their interests DS0000063680.V358369.R01.S.doc Version 5.2 Page 31 2. OP2 3 OP12 West View and capabilities. West View DS0000063680.V358369.R01.S.doc Version 5.2 Page 32 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 View DS0000063680.V358369.R01.S.doc Version 5.2 Page 33 - 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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