Inspection on 17/10/06 for Westbank Nursing Home

This inspection was carried out on 17th October 2006.

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

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

Other inspections for this house

Westbank Nursing Home 12/10/05

Westbank Nursing Home 24/05/05

Westbank Nursing Home 08/10/04

Westbank Nursing Home 05/07/04

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 Westbank Nursing Home 64 Sevenoaks Road Borough Green Kent TN15 8AP Lead Inspector Justine Williams Key Unannounced Inspection 17th October 2006 09:30 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 Westbank Nursing Home DS0000026213.V309834.R03.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. Westbank Nursing Home DS0000026213.V309834.R03.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Westbank Nursing Home Address 64 Sevenoaks Road Borough Green Kent TN15 8AP 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) 01732 780066 01732 780054 New Century Care (Borough Green) Limited Ruth Varley Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40), Physical disability over 65 years of age of places (5), Terminally ill over 65 years of age (5) Westbank Nursing Home DS0000026213.V309834.R03.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th October 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. The current fees range from £700.00 to £850.00, in addition to this newspapers, hairdressing and chiropody may be purchased. Westbank Nursing Home DS0000026213.V309834.R03.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection was carried out on 17th October 2006 between 9.30 am and 3.30pm by regulatory inspector Justine Williams. During that time a number of residents, relatives, staff, and the registered manager agreed to speak with the inspector both in public and privately. Feedback was given to the manager during and at the end of the inspection. This report contains assessments made from observation, conversation and records. What the service does well: What has improved since the last inspection? What they could do better: The format of the admission forms be reviewed to enable more room for staff to write and to include all the performance criteria in standard 3.3 It was identified at the last inspection that a resident who wandered was at risk of leaving the building undetected as the homes exits and entrances were not locked or alarmed, although the resident has since moved on, this was still the case and security measures need to be reviewed. Staff should continue to be put forward for NVQ training, in order that the home reach the 50 target. The manager is continuing to work on the homes quality assurance systems in line with the new regulations. The exposed pipe work should be boxed in and skandia toilet frames should be fixed or alternative equipment be installed. Westbank Nursing Home DS0000026213.V309834.R03.S.doc Version 5.2 Page 6 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. Westbank Nursing Home DS0000026213.V309834.R03.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Westbank Nursing Home DS0000026213.V309834.R03.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6 Quality on this outcome area is good. This has been made using available evidence including a visit to the service. Residents are confident their needs can be met in the home. Intermediate care is not provided. EVIDENCE: All new residents are assessed prior to moving into the home and again on admission to the home by a trained member of staff. Assessments conducted by social services are requested by the home to provide a full picture of the individual residents. The home uses the Roper, Tierney, Logan nursing model for assessment which if amended would prompt the staff to conduct a more thorough assessment, by including dexterity, foot care etc. this was discussed with the manager who agrees that the current form is limiting the amount of information that can be recorded, and could be more comprehensive.3 of the 4 assessments contained a social assessment some of which included information about past hobbies and interests enjoyed by the residents. As the assessments are somewhat limited, staff are compensating for this by producing care plans which also record an assessment. Westbank Nursing Home DS0000026213.V309834.R03.S.doc Version 5.2 Page 9 Of the 4 sets of records viewed, only 1 recorded the residents wishes on death. Westbank does not provide intermediate care. Westbank Nursing Home DS0000026213.V309834.R03.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality on this outcome area is good. This has been made using available evidence including a visit to the service. Residents health and personal care needs are well managed and residents are treated with dignity and respect. EVIDENCE: 3 of the 4 care plans seen were comprehensive and described in detail how residents needs are to be met. The other care plan did not detail some elements of the residents needs. None of the plans had been signed by residents and those residents spoken with had limited understanding of their care plans. Risk assessments in respect of risk of falls were seen on all of the records. The care plans are regularly reviewed and any changes had been written into the care plan rather than being left in the review information. This enables staff to ascertain up to date information at a glance rather than having to read through all the reviews. The health care needs of those residents too frail to leave the home are managed by visits from local health care services, for more able residents staff and family support them to access healthcare in the community as needed. One resident said her wheelchair was becoming a bit small due to her putting on some weight otherwise residents aids and equipment are well maintained. Westbank Nursing Home DS0000026213.V309834.R03.S.doc Version 5.2 Page 11 Residents said that they are helped to arrange contact with their GP’s opticians and can access chiropody through the home if they wish. A record of visits by health care professionals is kept. The home has a medication policy. The medication room was clean and orderly, there are hand-washing facilities in the room, and adequate storage. The medication fridge must be kept locked, and eye drops once opened must be labelled with the date or opening so they can be discarded after 4 weeks as per the manufacturers guidance. Controlled drugs were appropriately stored and recorded. Clear records of medicine entering and leaving the home are kept. None of the residents are self-administering medicines at present though each resident has lockable storage in their rooms. Residents spoken with said the staff are caring and conscientious, and they are helped with their personal care by a staff team who respect their privacy and dignity. Some bedrooms overlook car parking areas and do not have net curtains or blinds to prevent passers by seeing in, which could compromise their privacy and dignity, the inspector and manager discussed how best to monitor this and the manager agreed to review this. Westbank Nursing Home DS0000026213.V309834.R03.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality on this outcome area is good. This has been made using available evidence including a visit to the service. Residents enjoy the lifestyle and routines of the home and are helped to exercise control over their lives. Residents enjoy a well cooked, appealing and varied diet. EVIDENCE: Routines of daily living such as times for getting up, meal times and activities are structured around resident’s preferences but can be flexible to match residents wishes on a day to day basis. The home employs an activity coordinator to run and organise activities on a full time basis from Monday to Friday, external entertainers provide some of the activities during the week and at weekends. Activitities include various quizzes, word games, exercises to music, manicures, a pat dog regularly visits the home and plans for Christmas activities are underway. Residents who do not wish or are unable to participate in organised activities can spend some time on a one to one basis with the activity coordinator. Visitors are welcome at any time and facilities are available for them to have a drink or a meal with the resident. The menu is varied, balanced and nutritious, it is displayed daily in the dining room next to the serving hatch. It is recommended that menus be made available elsewhere as well as residents could rarely remember what they had Westbank Nursing Home DS0000026213.V309834.R03.S.doc Version 5.2 Page 13 chosen, having been asked to decide the day before. Meal times are at 8am, 12.30 pm and 5.30pm. It is recommended that the snacks available at supper time (8pm) be more widely advertised, as it is not obvious that snacks are available at this time. Westbank Nursing Home DS0000026213.V309834.R03.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality on this outcome area is good. This has been made using available evidence including a visit to the service. Residents can express their views and be listened to. They are protected from the risks of abuse as far as is possible. EVIDENCE: The home has a complaints policy, which is available in each residents room. Residents new how to make a complaint should they wish to. The home has received 6 complaints all of which have been dealt with within the timeframes of the policy. The manager had signed each complaint form. It is recommended that all telephone calls, letters, discussions with staff etc be documented and kept with the corresponding complaint, and that minor expressions of dissatisfaction be recorded in a central file so that patterns can be tracked and recorded rather than just in individual care plans. Policies, procedures and the home’s documentation reflect the rights of the individual. The home safeguards its vulnerable residents as far as possible through its policies, procedures and working practices and also its supervision of staff and robust recruitment procedures. Staff have received training in adult protection and receive planned updates to refresh their skills and knowledge. Westbank Nursing Home DS0000026213.V309834.R03.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality on this outcome area is good. This has been made using available evidence including a visit to the service. Residents live in what they describe as a homely and clean environment. EVIDENCE: The home is purpose built and was clean and odour free on the day of inspection. The home does not have a specific programme of routine renewal, though refurbishment is organised through the company. The home would benefit from replacement of some of the carpets which are stained. The grounds were attractive and tidy, with a pleasant area for residents to sit out in good weather. Fire doors were unlocked and the main entrance unlocked, allowing free access, in order to protect residents security and safety, if entrances and exits are not secure, residents should be advised to lock their doors. The laundry was very clean and well organised, and both washing machines have the required sluicing cycle for infected linen. The sink is used for soaking and as such a separate hand washbasin should be provided. Several staff have Westbank Nursing Home DS0000026213.V309834.R03.S.doc Version 5.2 Page 16 received training in infection control. One of the skandia frames is rusty and should not be used as this could present an infection control hazard. Westbank Nursing Home DS0000026213.V309834.R03.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality on this outcome area is adequate. This has been made using available evidence including a visit to the service. Residents are cared for by competent, trained and experienced staff. EVIDENCE: The staffing numbers appeared to be adequate for the number and needs of residents, however some resident spoken with said they had to wait for long periods on occasion for assistance, the manager agreed to look into this. The home has a recorded staff rota for all staff including ancillary staff. Domestic staff are employed in sufficient numbers to provide good standards in relation to food and cleanliness. 7 of the 19 care staff have attained NVQ qualifications and 10 staff are currently studying NVQ. 3 personnel files were looked at all had the required 2 written references, although one newly employed staff member did not have a reference from the previous employer. Each file had evidence of CRB and POVA check, and proof of identification. The regulations have recently been amended and as such the homes recruitment practices must be reviewed to ensure the home complies with the new legislation. Application forms cannot ask for information about the applicants children and this must be removed from the form. A variety of in house and external training is available for staff and regular updates are provided in mandatory training. Westbank Nursing Home DS0000026213.V309834.R03.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality on this outcome area is good. This has been made using available evidence including a visit to the service. Residents live in a well managed, safe home. EVIDENCE: The manager has recently successfully completed the fit persons process and is now registered and manager with the Commission. The manager has been in post as manager since march 2006 and prior to this was deputy manager at Westbank and an other home. The manager is undertaking the Registered Managers Award. The home has some quality assurance systems in place and undertakes monthly audits of medication, catering, nutrition, infection control etc. A regular report or annual development plan, should be formulated and a copy supplied to the Commission which shows where the service is now, and what the manager and staff hope and wish to accomplish at the home in the future. Westbank Nursing Home DS0000026213.V309834.R03.S.doc Version 5.2 Page 19 Residents control their own finances for as long as they wish and are able. The home does not manage the finances of any residents. A system for payment for services such as chiropody hairdressing and newspapers has been developed where the company pays for the services, then invoices the resident or their relatives. The pre inspection questionnaire indicates that required servicing and maintenance of equipment is up to date and undertaken by appropriate persons on a regular basis. Some health and safety issues were identified and rectified immediately by the manager, these were cupboards containing COSHH items were unlocked. The Skandia toilet frames should be fixed or grab rails and raised toilet seats fitted to further protect residents safety. Pipe work in one of the bathrooms was exposed and needs to be boxed in, to protect residents from falls and scalds. Westbank Nursing Home DS0000026213.V309834.R03.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Westbank Nursing Home DS0000026213.V309834.R03.S.doc Version 5.2 Page 21 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 OP27 Regulation 19 Requirement The registered manager shall obtain two written references, including, where applicable, a reference relating to the person’s last period of employment, which involved work with children or vulnerable adults, of not less than three months duration. The quality assurance system should be further developed to enable a report to be provided to the commission in line with the regulation Not met Timescale for action 30/11/06 2 OP33 24 30/01/07 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 OP3 Good Practice Recommendations It is recommended that the format of the admission forms be reviewed to enable more room for staff to write and to include all the performance criteria in standard 3.3 DS0000026213.V309834.R03.S.doc Version 5.2 Page 22 Westbank Nursing Home 2 3 4 5 OP19 OP26 OP28 OP38 It is recommended that security arrangements be reviewed where the entrance and fire doors are left unlocked. A hand washing sink should be provided in the laundry room. It is recommended that staff continue to be put forward for NVQ training, in order that the home reach the 50 target. It is strongly recommended that exposed pipe work be boxed in and that skandia toilet frames be fixed or alternative equipment be installed. Westbank Nursing Home DS0000026213.V309834.R03.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone 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 DS0000026213.V309834.R03.S.doc Version 5.2 Page 24 - 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!