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Inspection on 12/10/05 for Westbank Nursing Home

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

This inspection was carried out on 12th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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 home provides a warm, comfortable and homely environment for service users. Support is provided by a caring staff team in a way that offers service users choice, protects their privacy and dignity and promotes independence. Activities and entertainment are organised by enthusiastic staff and health is promoted and monitored by qualified nursing staff.

What has improved since the last inspection?

The laundry has been refitted to further protect service users from risk of infection. New induction training has been introduced to ensure that service users are cared for by staff who are competent to carry out all the tasks that they undertake

What the care home could do better:

Some improvement is needed to provide additional help to those with a sensory impairment, this includes specific training for staff in this area. Complaints records must include detail of the investigation process and some improvement is needed in the quality assurance system to provide a report for the commission in line with the regulations. Service users who wander must be protected by ensuring that they cannot leave the home without the knowledge and supervision where necessary, of staff.

CARE HOMES FOR OLDER PEOPLE Westbank Nursing Home 64 Sevenoaks Road Borough Green Kent TN15 8AP Lead Inspector Ruth Burnham Announced 12 October 2005 09:30 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 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. Westbank Nursing Home H56-H06 S26213 Westbank Nursing Home V242726 121005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Westbank Nursing Home Address 64 Sevenoaks Road Borough Green Kent TN15 8AP 01732 780066 01732 780054 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) New Century Care (Borough Green) Limited Mr Martyn Hales CRH Care Home 40 Category(ies) of Old age (40) registration, with number Physical dis - over 65 (5) of places Terminally ill (5) Westbank Nursing Home H56-H06 S26213 Westbank Nursing Home V242726 121005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Care of two service users is restricted to two persons whose dates of birth are 16/08/1959 and 24/07/1942. Date of last inspection 24 May 2005 Brief Description of the Service: Westbank is a care home providing nursing, personal care and accommodation for older people with a percentage of service users who may have a physical disability or terminal illness. The home is located in a village, close to shops, pubs, a post office and other amenities. Accommodation is arranged on one level. The premises are detached and purpose built. All bedrooms are single and there is one large communal room used as a dining room/lounge, there is also a small private visitors room. The home is set in beautiful grounds with views extending across magnificent countryside. There is ample parking available. The home employs full time and part time care staff and registered nurses who work a rota which includes waking night duty. In addition to the care staff there are domestic, catering, maintenance and administrative staff. The home also employs an enthusiastic activities co-ordinator. Westbank Nursing Home H56-H06 S26213 Westbank Nursing Home V242726 121005 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, carried out by one inspector who was in the home from 09.30 to 13.30, during which time the manager and the area manager were spoken with, staff and service users were seen and spoken with around the home, a tour of the premises was made and some records were examined. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. Westbank Nursing Home H56-H06 S26213 Westbank Nursing Home V242726 121005 Stage 4.doc Version 1.40 Page 6 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Westbank Nursing Home H56-H06 S26213 Westbank Nursing Home V242726 121005 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Westbank Nursing Home H56-H06 S26213 Westbank Nursing Home V242726 121005 Stage 4.doc Version 1.40 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 standard(s) 2&4 (6 does not apply) Prospective service users considering moving into the home can be sure that their needs will be met however, some improvement is needed to provide additional to help those with a sensory impairment. EVIDENCE: Service users entering the home are made clear about the services that are provided and of their rights and responsibilities via information contained within the service users guide. All service users are provided with a statement of terms and conditions, which is signed by all parties. Where service users are funded by the Local Authority, the level of fees was not included as recommended in the standard. Assessments carried out prior to inspection ensured that the home only admitted service users whose needs could be met. Some discussion took place about the need to provide additional services for service users who have a sensory impairment in addition to their nursing needs, the manager agreed to access specialist advice and training in this area. Westbank Nursing Home H56-H06 S26213 Westbank Nursing Home V242726 121005 Stage 4.doc Version 1.40 Page 9 Westbank Nursing Home H56-H06 S26213 Westbank Nursing Home V242726 121005 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 9 People who live in the home are protected from harm through effective risk management processes. EVIDENCE: People who live in the home are protected from harm through effective risk management processes, which include comprehensive risk assessment within the care planning system. Individual risk assessments are placed in each resident’s room. Westbank Nursing Home H56-H06 S26213 Westbank Nursing Home V242726 121005 Stage 4.doc Version 1.40 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 standard(s) These standards were not inspected on this occasion, therefore no judgement has been made. EVIDENCE: Westbank Nursing Home H56-H06 S26213 Westbank Nursing Home V242726 121005 Stage 4.doc Version 1.40 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 standard(s) 16, 17 & 18 People living in the home are free to offer comment or complaint, although some improvement is needed to the complaints records. There are effective systems in the home to protect the people living there from abuse. EVIDENCE: People who live in the home are free to make comment or complaint through contact with staff and free access to the manager, there is a clear complaints procedure and regular surveys are carried out. When complaints are received a record is kept, however, it was not possible to see the process of investigation, as the recording process is inadequate. The legal rights of people living in the home are upheld and they are enabled to participate in the civic and political process should they wish to do so. Where residents have no relatives or friends to act for them, access is facilitated to advocacy services. People who live in the home are protected from abuse through an adult protection procedure and through recruitment procedures, which ensure that staff are checked by the criminal records bureau. Westbank Nursing Home H56-H06 S26213 Westbank Nursing Home V242726 121005 Stage 4.doc Version 1.40 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 standard(s) These standards were not inspected on this occasion, therefore no judgement has been made. EVIDENCE: Westbank Nursing Home H56-H06 S26213 Westbank Nursing Home V242726 121005 Stage 4.doc Version 1.40 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 30 People who live in the home can be confident that care and nursing staff are well trained, although residents with sensory impairment may not be so well supported with their specialist needs. EVIDENCE: A new induction training system is being introduced and company training facilities are provided to support all care staff trough the NVQ process. Trained nurses are supported to continue their professional development to ensure that people who live in the home are cared for by suitably qualified and competent staff. It was identified during the inspection that current training does not include the specific skills required to support residents who have a sensory impairment, the manager agreed that training would be accessed as soon as possible to supplement the current training programme Westbank Nursing Home H56-H06 S26213 Westbank Nursing Home V242726 121005 Stage 4.doc Version 1.40 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 - 38 The quality of life and safety of people in the home is maintained through good business management, however some improvement is needed in the quality assurance system and security of the home. EVIDENCE: People who live in the home can be confident that it is well managed by the registered manager who has 12 years experience in a management capacity in this home. He is a qualified nurse and has completed the registered managers award in line with the requirements of the care standards. He communicates a clear sense of direction and leadership to ensure that the home is managed with the best interests of service users in mind. The home is run in the best interests of service users through forward planning via an annual development plan for the home. Some discussion took place about the need to show that the quality assurance system in place is based on planning-action-review and produces a report to the Commission that Westbank Nursing Home H56-H06 S26213 Westbank Nursing Home V242726 121005 Stage 4.doc Version 1.40 Page 16 demonstrates continuous improvement in the quality of life for people living in the home. The views of people who live in the home are sought via annual questionnaires, regular residents meetings and day to day contact with management, an internal audit takes place monthly. The results of service user surveys are published and the views of families and other stake holders are also sought. Residents’ property is protected through appropriate insurances and records are kept of all transactions. Their security is safeguarded through good business and financial planning for the establishment, which is reviewed annually. The home does not act on behalf of service users in relation to their financial affairs; valuables are protected through secure facilities, which are provided for storing money and valuables. People in the home are cared for and supported by nursing staff, care staff and ancillary staff, however it was of some concern that care staff are not receiving receive formal supervision at least 6 times a year, which covers all aspects of practice and the philosophy of care. Nurses receive clinical supervision by the manager. People who live in the home may have access to their records and help to maintain them. Records seen were secure, up to date and in good order, constructed and generally maintained in accordance with statutory requirements. People who live in the home are kept safe through the support of staff who are trained in moving and handling, fire safety, first aid, food hygiene, health and safety; infection control training is being arranged. Health and safety is maintained through safe storage and disposal of hazardous substances and regular servicing and maintenance of equipment and installations. Security systems are in place however, residents who wander may be at risk as exits are not alarmed to alert staff if they leave the home unsupervised. Westbank Nursing Home H56-H06 S26213 Westbank Nursing Home V242726 121005 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 2 x 2 x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 x 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 3 3 3 3 2 3 3 3 3 2 Westbank Nursing Home H56-H06 S26213 Westbank Nursing Home V242726 121005 Stage 4.doc Version 1.40 Page 18 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. 1. Standard 16 Regulation 22 & Schedule 4 Requirement Timescale for action 30/11/05 2. 4 & 30 3. 33 4. 38 Complaints records should include details of any investigation and be maintained on an individuaol basis 18 (1)( c ) Assessments should take 30/11/05 & 5 (b) account of and Staff should be trained for the tasks which they perform specifically in caring for the specialist needs of people with a visual or other sensory impairment. 24 The quality assurance system 30/11/05 should be further developed to enable a report to be provided to the commission in line with the regulation 13(4)( c ) All hazards must be identified 30/11/05 and action taken to minimise risk specifically in relation to the security of the premises. 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 2 Good Practice Recommendations The statement of terms and conditions should include the H56-H06 S26213 Westbank Nursing Home V242726 121005 Stage 4.doc Version 1.40 Page 19 Westbank Nursing Home level of fees 2. Westbank Nursing Home H56-H06 S26213 Westbank Nursing Home V242726 121005 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection The Oast, Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT 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 Westbank Nursing Home H56-H06 S26213 Westbank Nursing Home V242726 121005 Stage 4.doc Version 1.40 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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