CARE HOME ADULTS 18-65
West View House Killingworth Road Killingworth Newcastle Upon Tyne NE12 7BR Lead Inspector
Jim Lamb Key Unannounced Inspection 29th May 2007 09:30 West View House DS0000000333.V337994.R01.S.doc Version 5.2 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 House DS0000000333.V337994.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 Adults 18-65. 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 House DS0000000333.V337994.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service West View House Address Killingworth Road Killingworth Newcastle Upon Tyne NE12 7BR 0191 2685768 0191 2685768 susan.keeney@nhs.net 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) Northumberland, Tyne & Wear NHS Trust Anne Rosenthal Care Home 5 Category(ies) of Learning disability (4), Learning disability over registration, with number 65 years of age (1) of places West View House DS0000000333.V337994.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 19th December 2005 Brief Description of the Service: West View House is a large two-storey house that provides personal care and accommodation for five male service users with learning disabilities. The home is located in a residential area of Forest Hall and is within walking distance of all the local amenities and transport links. The property consists of five single bedrooms; there is a lounge, dining room and a small sunroom. There are secluded landscaped gardens to the rear with seating for service users. The home has its own transport. Fees for the home range from £952 to £987. West View House DS0000000333.V337994.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Summary: How the inspection was carried out Before the visit: We looked at: • Information we have received since the last visit. • How the service dealt with any complaints & concerns since the last visit. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service & their relatives and staff. The Visit: An unannounced visit was made on 29.5.07. During the visit we: • • • • • • Talked with people who use the service, and the staff. Looked at information about the people who use the service & how well their needs are met, Looked at other records which must be kept, Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, Looked around the building to make sure it was clean, safe & comfortable, Checked what improvements had been made since the last inspection visit. We told the provider what we found. What the service does well:
Service users where able, described good relationships with the staff and said they were always polite and helpful. The two support workers and the one enabler on duty were friendly and relaxed and showed a good understanding of service users needs. Arrangements to maintain contact with their family and friends are good. A variety of social activities were available providing service users with varied and interesting days, both inside and outside the home. The service users have enjoyed holidays this year: Amsterdam, Spain, York.
West View House DS0000000333.V337994.R01.S.doc Version 5.2 Page 6 Meals are varied and well balanced, offering good choice and nutritious food at all meals. All of the service users spoken to were pleased with the quality and choice available. Meals were seen as a relaxed and social occasion. Hygiene practices were good protecting the health of service users and staff. The home is well staffed with a skilled, consistent and trained staff team giving security to service users. The staff recruitment and vetting process helps protect service users. The staff have a good understanding of each individual needs. More than fifty percent of staff is qualified to National Vocational Qualification in Care level 2 (NVQ) or above providing a trained, skilled staff team. The service users were very complimentary about the staff. Service users spoke very positively about the standard of the service. Comments included: “I’m very happy with the care I receive, there is always something to do”. “I am always well cared for here”, I have just had a great holiday abroad. “I am very happy living here”. “I like the food”. “Yes, I can see my family, they come to see me a lot, and I have no complaints”. The assessment form encourages staff to explore issues relating to equality and diversity as if refers to: gender, ethnicity, and religious/spirituality. Educational and social histories, preferred daily routine, and preferences. It also looks at mood, speech, behaviour, mental health, risks, and daily living skills. The staff is balanced to enable choice of male or female staff, according to needs and wishes. Plans are in place to deliver training, which includes equality and diversity. What has improved since the last inspection?
The home continues to provide high standards of care. All service users care records have recently been up-dated and reviewed. West View House DS0000000333.V337994.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. West View House DS0000000333.V337994.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection West View House DS0000000333.V337994.R01.S.doc Version 5.2 Page 9 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 2 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users are provided with enough information about the service to enable them to make a choice about where they want to live. All service users are appropriately assessed prior to admission into the home; this provides staff with the information they need to meet the service users needs. All are provided with a written contract explaining their terms and conditions with the home. EVIDENCE: Details of the extra charges and what these are for, are in the contract given to service users and are agreed prior to their admission. Two service users’ files were checked and each included a full needs assessment. The service users and their representatives are involved in drawing up both these initial assessments and the home’s subsequent service user plans.
West View House DS0000000333.V337994.R01.S.doc Version 5.2 Page 10 The homes statement of purpose and service users guide is available in pictorial formats, and information is available on audiotape. The service user plans checked by the inspector were comprehensive, and listed details of service user’s needs and actions taken by the staff to meet these needs. The service users feedback cards all showed their needs were met and they were happy with the care offered to them. Two care plans were checked and staff interviewed, which confirmed that a range of specialist services was provided to service users. Staff interviewed had had a range of relevant training and experience. West View House DS0000000333.V337994.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6 7 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The care planning system is clear enough to ensure that staff has the information they need to meet the assessed needs of the service users. Service users are supported to make decisions about their lives, and take risks to promote their independence. EVIDENCE: There are comprehensive assessments in the service users’ care plans. There is also a comprehensive risk assessment of service users. There are advocacy arrangements, as well as family input, to represent service users. Each service user has an allocated key worker.
West View House DS0000000333.V337994.R01.S.doc Version 5.2 Page 12 Care plans are drawn up with service users, they clearly identify each individuals care needs and how staff will meet them. Plans are amended and reviewed on a regular basis. There are systems in place that will ensure that the placement and the service users plans are reviewed six monthly/annually. These involve the care managers and the service users representatives. Any service users rights that maybe restricted are linked to risk assessments, and action is taken to minimise identified risks and hazards. Service users continue to have access to a range of health care professionals. Service users’ feedback cards all showed that they are able to make decisions for themselves, and that they are happy with all aspects of the care that they receive. West View House DS0000000333.V337994.R01.S.doc Version 5.2 Page 13 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11 12 13 14 15 16 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The meals in the home are good; offering choice and variety, the supper options should be included on the main menus. The service users have opportunities for personal development and leisure activities. They are supported to maintain very good links with the community and their relatives and friends. EVIDENCE: Each service user has a full needs assessment carried out, including activities of daily living skills. These are reviewed and updated on a regular basis. All service users participate in this process. West View House DS0000000333.V337994.R01.S.doc Version 5.2 Page 14 Service users can access a range of community-based services. They are supported and encouraged to be in control of their own lives, to enjoy their own interests and hobbies inside and outside the home. The service has its own transport. All service users are supported to maintain very close links with their families. They can choose who they want to see and when. Daily routines promote independence, choice and freedom of movement. Some service users are involved in light housekeeping tasks, such as setting tables, keeping their rooms tidy, cooking and helping with the washing up. On day of the inspection, one-service user was making homemade bread. The Home’s menus are based on the known likes and dislikes of the service users. At least two hot meals are provided each day, and service users help with the food shopping. The staff consults with the service users regarding meals and knows all their likes and dislikes. Service users, who are able, have access to the kitchen and can prepare snacks/drinks for themselves if they wish. West View House DS0000000333.V337994.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The health care of the service users is met and there is good multi disciplinary working taking place. The promotion of health care needs is taken seriously. Medication systems are well managed. Personal support is always provided in the way that service users prefer. EVIDENCE: Service users need minimal help with their personal care tasks, such as bathing and dressing. Privacy and dignity are respected at all times. The need to respect service users privacy and dignity when delivering health and personal care is a key principle of the homes aims and objectives.
West View House DS0000000333.V337994.R01.S.doc Version 5.2 Page 16 The homes policies, procedures and guidance support and inform practice. Induction training also covers privacy and dignity. Service users care records showed that they have access to external health care services. G.Ps visit when necessary. Service users are referred for specialist health care if appropriate. All service users receive regular health care checks. District nurses’ provide very good support and they maintain their own health care records, and they ensure that the service has appropriate aids and equipment in place. The medication systems were examined for ordering, receiving, administering and disposal. These systems are managed well. All staff that administers medications has had accredited medication training. Controlled drugs are not currently prescribed. Should this change; appropriate systems and procedures will be put in place. There is a medication policy which is accessible to staff. The dispensing pharmacist offers good support and advice, following a pharmacist audit, recommendations made have been implemented. West View House DS0000000333.V337994.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a good, clear, user-friendly complaints system and service user’s views are listened to and acted upon. Procedures are in place to protect service users from harm, and these are followed. EVIDENCE: There is a complaints procedure. It contains details of how to contact the CSCI to make a complaint, if complainants are not happy with the homes investigation and response. The complaints procedures are available on audiotape, for service users with reading difficulties. Service users said that staff listened to their concerns and dealt with them fairly. The home keeps a record of complaints. During the last twelve months there has been no complaints received. The home has a Whistle Blowing policy and the Local Authorities Vulnerable Adults procedures. The Home keeps detailed financial records on behalf of the service users.
West View House DS0000000333.V337994.R01.S.doc Version 5.2 Page 18 Receipts of personal spending are kept. The Trust provides Service users with substantial clothing allowances for clothes, holidays etc. This is good practice. West View House DS0000000333.V337994.R01.S.doc Version 5.2 Page 19 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 25 26 27 28 29 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable and safe environment for those living there. The standard and decoration within the home is generally very good. Communal areas and bedrooms are large, and meet the service users needs. All areas within the home are well maintained, clean, tidy and free from offensive odours. EVIDENCE: The home was clean, well decorated and well maintained. The grounds were tidy, safe, attractive and accessible. West View House DS0000000333.V337994.R01.S.doc Version 5.2 Page 20 The home has an appropriate amount of sitting, recreational and dining space. There are enough rooms for a variety of activities to take place. Service users can see visitors in private in their own rooms. Furnishings and fittings were domestic in design and in good condition. Lighting was also bright and domestic in design. Service users’ bedrooms have opening windows. The rooms were centrally heated and the heating level could be controlled within each bedroom. All rooms are highly personalised and well furnished. Water is stored at over 60°C. Valves at water outlets ensure water is provided close to 43°C to prevent scalding. A record of water temperatures is kept. The home was clean and free from offensive odours. The laundry facilities are well organised. West View House DS0000000333.V337994.R01.S.doc Version 5.2 Page 21 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32 34 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a good match of well-qualified staff offering consistency of care within the home. There are robust procedures in place for the recruitment and selection of new staff, which helps to protect service users. The staff team receive supervision and this provides them with a good understanding of the service users support needs. EVIDENCE: Staff levels on the day of the inspection continue to meet the agreed level. Samples of 4 weeks’ rotas showed the required numbers of staff were on duty: In addition to the manager, there are 3/4 staff between 8am and 9pm, and one waking nightstaff between 9pm and 8am. Staff said that staffing levels were appropriate.
West View House DS0000000333.V337994.R01.S.doc Version 5.2 Page 22 All the staff were over 18 years of age and those left in charge were at least 21. Training needs of staff continue to be identified in supervision and appraisal sessions. The staff said that the Trust asks them annually what type of training they would like. The training programme meets The National Training Organisation requirements for the first six months. There is a good staff training and development programme in place. All new staff undertakes LADAF training. To provide staff with a greater understanding of the ageing process, they should be provided with; ageing, illness, palliative and death training. Training should include service users, religious and cultural customs. An inspector recently examined the staff recruitment records. The Trust has a rigorous staff recruitment and selection process to ensure that all appropriate checks and references are in place prior to employment. The staff present on the day of the inspection confirmed that rigorous checks are always carried out. West View House DS0000000333.V337994.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37 39 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The manager is supported by the organisation in providing clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities. The systems for service users’ consultation are good, and service user’s views are both sought and acted upon. The health and safety of the service users is promoted. The service is aware of equality and diversity and its implications. West View House DS0000000333.V337994.R01.S.doc Version 5.2 Page 24 EVIDENCE: The manager has the appropriate qualifications, experience and skills necessary to manage the service. She has NVQ level 4 in management, as well as a diploma in higher education in Learning Disabilities Studies. Service users are told when inspections take place and they are shown inspection reports. Copies are available for relatives and others to see. The records inspected were found to be appropriately completed. These included the fire log book, accident records, personal allowance records, quality assurance, and the Health and Safey manual. There are appropriate maintenance contracts for the home. A sample of personal finances records was examined. Transactions were appropriately recorded. There was plenty of evidence of personal spending. Receipts are obtained for purchases and are cross-reference to the transaction. There is a health and safety policy and range of associated procedures. All staff receives training in health and safety and safe working practices (fire safety, moving and handling, first aid, food hygiene, and infection control). Servicing and maintenance agreements are in place for facilities and equipment. Risks in the environment and tasks, including safe working practices are assessed and reviewed. All fire safety checks; tests and instructions to staff are conducted at the required frequency and recorded. A system continues to operate monitor the quality of the service provided, this involves gaining feedback from service users, relatives and professionals involved with the home. (Tell Us What You Think!) leaflets are also circulated to service users, as part of the Trusts quality assurance system. Water storage tanks, gas and electrics are checked annually. West View House DS0000000333.V337994.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 4 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 4 26 4 27 4 28 4 29 4 30 4 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 X LIFESTYLES Standard No Score 11 4 12 4 13 4 14 4 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 4 2 4 X 4 X X 4 X West View House DS0000000333.V337994.R01.S.doc Version 5.2 Page 26 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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. 1. Refer to Standard YA21 Good Practice Recommendations Staff requires; ageing, illness/palliative and death care training. West View House DS0000000333.V337994.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 House DS0000000333.V337994.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!