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Inspection on 27/02/06 for Westacre Nursing Home

Also see our care home review for Westacre Nursing Home for more information

This inspection was carried out on 27th February 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The manager and deputy have worked on information giving to staff, there is an open atmosphere and staff feel able to ask questions and challenge. The manger and deputy carry pout regular supervision and team meetings in the home. They have found that this helps with the communication and in meeting the needs of those that live there.

What has improved since the last inspection?

The care plans have improved since the last inspection. It was apparent in one care plan for example that staff are now using a common language and understanding the needs of the residents and this has improved their interaction with the residents in the home. The recording of when medication is given has also improved and the home has started regular reviewing of several of its process including medication to assist with keeping to standards. The deputy and manager have arranged several training courses for staff, the deputy has been on a training course and has arranged courses in the home in areas such as dementia.

What the care home could do better:

There continues to be improvement in all areas the home. The opportunity is for maintenance of standards so far achieved.

CARE HOMES FOR OLDER PEOPLE Westacre Nursing Home Sleepers Hill Winchester Hampshire SO22 4NE Lead Inspector Val Sevier Unannounced Inspection 27th February 2006 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 Westacre Nursing Home DS0000011657.V278913.R01.S.doc Version 5.1 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. Westacre Nursing Home DS0000011657.V278913.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Westacre Nursing Home Address Sleepers Hill Winchester Hampshire SO22 4NE 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) 01962 855188 01962 866284 watsonsue@btconnect.com Nursing Home Services Mrs Lesley Margaret Russell Bell Care Home 33 Category(ies) of Dementia - over 65 years of age (33), Old age, registration, with number not falling within any other category (33) of places Westacre Nursing Home DS0000011657.V278913.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th June 2005 Brief Description of the Service: Westacre Nursing Home is located in a quiet residential area, within easy reach of the centre of Winchester. The home offers nursing care for older people over the age of 65 years. The house has many original features and has been altered in order that the needs of older people can be met. Work is nearing completion on extending the home and refurbishing existing areas. Westacre Nursing Home DS0000011657.V278913.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and tool place over three and half hours. The registered manager and deputy were available to assist. The inspector was able to speak with four residents and several staff. The visit is the second one of this inspection year; the standards not seen previously were looked at along with the areas that needed action from the last visit. All action asked for had been carried out and the home has made improvements in several areas. The inspector was able to see the extension and refurbished area, it is hoped that this will be ready for occupation soon. The previous report should be read in conjunction with this report for the reader to have a full picture of the service. What the service does well: What has improved since the last inspection? The care plans have improved since the last inspection. It was apparent in one care plan for example that staff are now using a common language and understanding the needs of the residents and this has improved their interaction with the residents in the home. The recording of when medication is given has also improved and the home has started regular reviewing of several of its process including medication to assist with keeping to standards. The deputy and manager have arranged several training courses for staff, the deputy has been on a training course and has arranged courses in the home in areas such as dementia. Westacre Nursing Home DS0000011657.V278913.R01.S.doc Version 5.1 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. Westacre Nursing Home DS0000011657.V278913.R01.S.doc Version 5.1 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 Westacre Nursing Home DS0000011657.V278913.R01.S.doc Version 5.1 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): 1, 2 The statement of purpose and service users guide are good providing prospective residents and existing residents with detailed information about the home enabling an informed decision to be made. EVIDENCE: The information contained in the service users guide and statement of purpose gives readable and full information on the home, how it offers it services and support to residents and relatives. It contains the last report and a copy of a contract so that prospective persons can see what the home offers and their part of the contractual agreement. The document gives a lot of information so that readers are able to use it to decide if the home is for them or not. Westacre Nursing Home DS0000011657.V278913.R01.S.doc Version 5.1 Page 9 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): 8, 9 and 11 There has been an improvement in how staff meet mental health needs of residents. There has been an improvement in the systems for the administration of medication, which are now clear and ensure that resident’s medication needs are met. The arrangements for understanding an individual’s needs in their final weeks give a very clear guidance for staff in caring for those who are dying. EVIDENCE: The inspector sampled four care plans, it was noted that the care pans now reflect how staff can communicate and interact with individuals that have dementia. In one case they have adopted the terminology used by the individual in identifying her room and how to get there the lift is a train, and the bedroom is home. They have found that using the same language has benefited the resident who does not get upset now. Staff spoken with felt that the training that has been offered in understanding dementia has been beneficial and also the fact that is ongoing means they can relate it people they care for. Westacre Nursing Home DS0000011657.V278913.R01.S.doc Version 5.1 Page 10 The medication records were sampled; the local pharmacist has been out to the home 9th February 2006, and has carried out an audit of procedures and records. There was no action needed by the home. There was evidence that since the last inspection the manager undertakes a monthly audit of medication records to ensure that resident’s needs are met. The staff have recently undertaken an update in this area. The manager and deputy were asked how resident’s final days were managed, the home has a policy that addresses all issue and the manager explained that there is ongoing communication with the family and doctor as individuals become frailer. Family are enabled to spend time with their relatives and staff are reminded each time of what should be place to make the time comfortable for all concerned. Staff spoken with felt that the updating at the time is beneficial as it is also supportive. Westacre Nursing Home DS0000011657.V278913.R01.S.doc Version 5.1 Page 11 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 and 15 There has been an improvement in how the home can meet individual preferences in lifestyle. The meals in the home are good offering choice and variety. EVIDENCE: The home has looked at the social needs of the residents in conjunction with the new information gained from the training in dementia. It was seen that improvements have been made in addressing individual needs. The menu was on display in the foyer and residents have a choice at lunch and supper. The deputy has been concerned about some residents and their weight, and has asked for a dietician to visit (March 17th) to speak with staff including the cooks about the nutrition and dietary needs of the residents and how they can be met. Westacre Nursing Home DS0000011657.V278913.R01.S.doc Version 5.1 Page 12 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 and 18 The manager has established a sense of openness at the home so that relatives and residents can voice their concerns. EVIDENCE: There have been no complaints made since the last inspection to either the home or to the CSCI. Relatives were aware of how to complain and said they felt comfortable in speaking with the manager or deputy about any issues. There have been no allegations regarding adult protection at the home. The manager undertakes training the staff in this area, and staff spoken with were aware of the whistle blowing policy and the training. Westacre Nursing Home DS0000011657.V278913.R01.S.doc Version 5.1 Page 13 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, 20, 21, 22, 23, 24, 25 and 26 The standard of the décor at the home is very good providing residents with an attractive and homely place to live. EVIDENCE: The inspector walked around the home sampling some rooms. There was evidence that residents had been able to personalise their rooms with furniture and personal possessions. Many had televisions and radios and some had their own telephones. The home is homey and well maintained. There was equipment available to assist staff in the safe moving of residents. There are specialist baths in addition to the ensuite facilities at the home. The refurbishment is near competition with only outside work needed to be finished. A brief tour of the new area was carried out and it is hoped that it will be ready for occupation soon. Westacre Nursing Home DS0000011657.V278913.R01.S.doc Version 5.1 Page 14 There are plans to refurbish and extend the laundry and kitchen, to accommodate the increase in numbers at the home. The laundress and cook were pleased that their work areas were to be altered and were looking forward to the change. Westacre Nursing Home DS0000011657.V278913.R01.S.doc Version 5.1 Page 15 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): 28 and 30 The home provides and assists staff with a good training programme in order to meet resident’s needs. EVIDENCE: The home assists staff in applying for an NVQ qualification that is suitable for them and offers support in the home. Training is planned throughout the year to cover both mandatory and issues related to needs of residents. For example assessment methods of mental health, downs syndrome and dementia and writing care plans. The deputy has attended a Hampshire Social Services course in training staff and dementia, from which any additional information or ideas will be added to the homes training in this area. Westacre Nursing Home DS0000011657.V278913.R01.S.doc Version 5.1 Page 16 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): 37 and 38 There was evidence that health and safety is attended to protecting the well being of all at the home. EVIDENCE: Where necessary the inspector has received regular notification of incidents at the home. The proprietor also carries out a regular monthly visit and sends a report to the commission about that visit. The fire records and training for manual handling, food hygiene and first aid were seen, and all were in date. Westacre Nursing Home DS0000011657.V278913.R01.S.doc Version 5.1 Page 17 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 3 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 X 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X 3 3 Westacre Nursing Home DS0000011657.V278913.R01.S.doc Version 5.1 Page 18 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Westacre Nursing Home DS0000011657.V278913.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Westacre Nursing Home DS0000011657.V278913.R01.S.doc Version 5.1 Page 20 - 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!