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Inspection on 24/05/05 for Westbank Nursing Home

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

This inspection was carried out on 24th May 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 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 home provides a warm, comfortable, homely and safe environment for service users. Support is provided by a caring staff team in a way which offers service users choice, protects their privacy and dignity, promotes independence and keeps them safe from harm. 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?

Service users` privacy has been improved by the provision of locks on bedroom doors and providing additional equipment has reduced the risk of infection.

What the care home could do better:

Service users must be cared for by staff who have been provided with foundation training after the first six months following recruitment. All in house training should be provided by qualified trainers to ensure that service users are always supported by staff who are competent to carry out all the tasks which they undertake.

CARE HOMES FOR OLDER PEOPLE Westbank Nursing Home 64 Sevenoaks Road Borough Green Kent TN15 8AP Lead Inspector Ruth Burnham Unannounced 24 May 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 V226198 240505 Stage 4.doc Version 1.30 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 V226198 240505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Care of one service user is restriced to one person whose date of birth is 16/08/1959 Date of last inspection 08 October 2004 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. The home employs full time and part time care staff and registered nurses who work a rota which includes a waking night duty. In addition to the care staff there are domestic, catering, maintenance and administrative staff. There is also an enthusiastic activities co-ordinator. Westbank Nursing Home H56-H06 S26213 Westbank V226198 240505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, carried out by one inspector who was in the home from 10.30 to 15.30, during which time several service users and 3 relatives were spoken to, care and nursing staff were interviewed, a tour of the premises was made and records were examined. Feedback was given to the manager following the inspection. 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. 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 V226198 240505 Stage 4.doc Version 1.30 Page 6 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 V226198 240505 Stage 4.doc Version 1.30 Page 7 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) 1,3 & 6 Prospective service users are provided with sufficient information to make a decision about moving into the home and can be sure that their needs will be met EVIDENCE: Prospective service users are provided with a statement of purpose and a service user guide, which includes all information required to help them to make an informed decision about the suitability of this home. The manager or other suitably qualified persons carry out a full assessment, which is recorded, to ensure that the needs of service users moving into the home can be met. The home does not provide intermediate care. Westbank Nursing Home H56-H06 S26213 Westbank V226198 240505 Stage 4.doc Version 1.30 Page 8 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) 7,8,10 & 11 The health and personal care needs of service users are well met with evidence of good muti-disciplinary working taking place on a regular basis. EVIDENCE: Service users health and personal care needs are met through the provision of detailed care plans which are well set out and well maintained to provide staff with written information about how to meet the care and nursing needs of service users, it was useful to observe the handover between shifts where staff coming on duty receive an up to date briefing about how each service user is on that day. The home ensures that the health of service users is monitored regularly and that access to GPs is provided as and when required, records are maintained of all these visits. Service users and relatives who were spoken to said that staff are very considerate and helpful and that their privacy and dignity is always respected. Issues relating to death and dying were not discussed with service users however, discussion with staff and examination of records indicate the commitment of the home to upholding the dignity of service users at this time and to providing care and nursing to a high standard. The wishes of service users are recorded within the care pan and staff are provided with training to enable them to provide support to service users and relatives in th manner of their choice when death occurs. Westbank Nursing Home H56-H06 S26213 Westbank V226198 240505 Stage 4.doc Version 1.30 Page 9 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) 12,13,14&15 Service users are able to choose how they spend their time with support available to promote independence, choice and fulfilment. Dietary needs of service users are well catered for. EVIDENCE: A number of service users and relatives were spoken to who were generally satisfied with the opportunities to take part in activities and join in with religious services where appropriate. Service users benefit from the enthusiasm and dedication of the activities coordinator who arranges a variety of activities and entertainment for service users to choose from through the week. The majority of service users were enjoying a visit from a singing group on the afternoon of the inspection. Visitors who were spoken to said that they were always welcome in the home and could visit service users at any time and spend as much time as they wished with them. Service users said that they are free to choose how to spend their day, either spending time with other service users, taking part in activities, enjoying the beautiful grounds or remaining in their rooms. All service users said how much they enjoyed the meals, special diets are catered for and every effort is made to tempt service users to eat well and healthily. Westbank Nursing Home H56-H06 S26213 Westbank V226198 240505 Stage 4.doc Version 1.30 Page 10 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) These standards were not inspected on this occasion therefore no judgement has been made. EVIDENCE: Westbank Nursing Home H56-H06 S26213 Westbank V226198 240505 Stage 4.doc Version 1.30 Page 11 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) 19-26 Service users can feel comfortable, safe and secure in the attractive environment provided although they would benefit from additional communal space. EVIDENCE: Service users benefit from the picturesque location, accessible layout and good maintenance of the home they are provided with a comfortable, safe and homely environment. Service users can access the beautiful grounds, which are kept tidy, attractive and safe however service users only have one communal space where dining and all other activities take place. There is insufficient space should all service users wish to dine in the dining room or use the lounge at the same time although there is a small room where service users can meet visitors in private and which can be used at other times as a quiet room. Service users benefit from lighting that is suitable for their needs and activities and furnishings, which are domestic in character and are of good quality. Service users are able to access suitable toilet, washing and bathing facilities including those who rely on walking aids or wheelchairs and all service users have a toilet close to their private accommodation. Westbank Nursing Home H56-H06 S26213 Westbank V226198 240505 Stage 4.doc Version 1.30 Page 12 Suitably qualified persons, with specialist knowledge of the client group, have made an assessment of the premise to ensure it’s suitability for service users and recommended equipment and environmental adaptations have been provided such as ramps, grab rails and hoists where needed to help service users to move around in safety. The dignity and privacy of all service users is protected by the provision of accommodation in single rooms and bedrooms are furnished and equipped to ensure their comfort and privacy. Adjustable beds are provided for the benefit of service users receiving nursing care and bedroom doors are fitted with locks to protect their privacy which are suited to the service users capabilities and accessible to staff in emergencies. Service users are kept comfortable by suitable heating, lighting, water supply and ventilation and pipe work and radiators are guarded to keep them safe from harm. The Laundry is suitable, clean and well equipped and there are sluicing facilities and a sluicing disinfector to protect service users from risk of infection. Service users have been further protected by the purchase of additional hoist slings to avoid the need to share. Westbank Nursing Home H56-H06 S26213 Westbank V226198 240505 Stage 4.doc Version 1.30 Page 13 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) 27-30 Service users are supported by a well motivated nursing and care staff although there may be some risk to service users where some care staff may not have been trained to an adequate level in some areas by qualified trainers. EVIDENCE: There is a rota which shows that there are sufficient numbers of care and nursing staff on duty day and night to support service users, domestic staff are employed in sufficient numbers to ensure that service users enjoy a clean environment. Service users benefit from being cared for by staff who have achieved or are undertaking the appropriate National Vocational Qualification and the home is on track to meet the requirement to have at least 50 qualified. Service users are protected by the recruitment procedures, which ensure that references and appropriate checks are carried out on all new staff. Service users may be disadvantaged by the fact that staff do not all receive foundation training within the first 6 months which relates to meeting service users needs as defined in their care plan. Although some evidence of ongoing training was found, certificates seen were of attendance rather than competence and no evidence was found at the time of the inspection of the competence of some trainers to train which could place service users at risk. Westbank Nursing Home H56-H06 S26213 Westbank V226198 240505 Stage 4.doc Version 1.30 Page 14 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) These standards were not inspected on this occasion and therefore no judgement has been made. EVIDENCE: Westbank Nursing Home H56-H06 S26213 Westbank V226198 240505 Stage 4.doc Version 1.30 Page 15 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 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 4 2 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x x x x Westbank Nursing Home H56-H06 S26213 Westbank V226198 240505 Stage 4.doc Version 1.30 Page 16 yes 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 30 Regulation 18 Requirement All staff should receive foundation training to TOPSS specifications by 6 months and all training should be provided by quaified trainers Timescale for action 2. 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 20 Good Practice Recommendations sufficient communal space should be provided to accommodate and provide choice to all service users Westbank Nursing Home H56-H06 S26213 Westbank V226198 240505 Stage 4.doc Version 1.30 Page 17 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 V226198 240505 Stage 4.doc Version 1.30 Page 18 - 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. 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