Inspection on 11/04/07 for Westbrook House

This inspection was carried out on 11th April 2007.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Westbrook House 12/04/06

Westbrook House 09/11/05

Westbrook House 25/04/05

Westbrook House 18/11/04

Westbrook House 03/06/04

Similar services:

Claremont House

Coopers Mill Ltd

Sun Court Nursing Home

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

15 Bramble Close

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Westbrook House Cupid Green Lane Hemel Hempstead Hertfordshire HP2 7GH Lead Inspector Robert Kittle Unannounced Inspection 11th April 2007 10:00 Westbrook House DS0000019613.V335671.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Westbrook House DS0000019613.V335671.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Westbrook House DS0000019613.V335671.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Westbrook House Address Cupid Green Lane Hemel Hempstead Hertfordshire HP2 7GH 01442 264965 01442 267419 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) www.caretech-uk.com Caretech Community Service Limited Manager post vacant Care Home 8 Category(ies) of Learning disability (8), Physical disability (8) registration, with number of places Westbrook House DS0000019613.V335671.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for 8 people with a learning disability (aged 1865 years and over 65 years) or a physical disability 12th April 2006 Date of last inspection Brief Description of the Service: Westbrook House is situated between the Grovehill and the Woodland Farm areas of Hemel Hempstead and is within five minutes from the local shops, Health Centre and General Practitioners. The property is a conversion of a listed, two-storey farm building. It has been refurbished to a very high standard to provide for the needs of a highly dependent group of service users. The ground floor contains eight single bedrooms; each designed with the potential care needs of the service users in mind, 2 assisted bathrooms, 2 toilets and a laundry room. The lift provides access to the first floor, which consists of a lounge, dining area, kitchen, shower and toilet facilities. The fee range is from £1,242.67 to £1,428.78 with variance depending on assessed needs. (This fee range was correct at the time that the site visit to the service took place) Westbrook House DS0000019613.V335671.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection of this service for a year. The manager and four care workers were on duty supporting five of the service users who were at home at the time. Whilst the service has been judged as ‘adequate’ as a result of this inspection, the care practices seen were to a very good standard and the overall standards of the premises were also good. The judgement has been effected solely by the repeated requirements that have been made. What the service does well: What has improved since the last inspection? What they could do better: Whilst the premises are maintained to a good overall standard, the carpet in the lounge is stained. This must be cleaned or replaced. In view of the heavy traffic in this area, the providers are invited to consider if wood or wood laminate flooring would be better suited for the room. The manager has been in post for a considerable period without applying for registration with the Commission. The provider must ensure that this situation does not continue. Westbrook House DS0000019613.V335671.R01.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. The summary of this inspection report can be made available in other formats on request. Westbrook House DS0000019613.V335671.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Westbrook House DS0000019613.V335671.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4 & 5. Quality in this outcome area is good. The service meets service user’s assessed needs and identified aspirations. Each service user has a form of contract on their file. This judgement has been made using available evidence including a visit to the service. EVIDENCE: There have been no new admissions since the last inspection took place. Although most of the service users have no verbal communication skills, staff and other supporters make every effort to ascertain individual service user’s needs and aspirations. Many service users have social support from family members and all have the dedicated support of staff and other professionals. The service user guide has been reviewed and a copy placed on each service user’s file. Westbrook House DS0000019613.V335671.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9. Quality in this outcome area is good. Service users and/or their advocates are aware of how the service will look after them. Individuals are encouraged to live as independent a life as possible and receive suitable assistance to achieve this. They are appropriately involved in aspects of daily life and their wishes are sought and respected. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Care plans examined contained evidence that service users are involved in identifying their aspirations. The files contained assessments and reviews as well as risk assessments and accumulated information about individual likes and dislikes. This is particularly important, as the majority of service users have no verbal communication skills. (A good example of how staff observations are translated into choices was a ‘mood’ book that is kept for one of the service users, enabling staff to respond appropriately at any given time). Leisure choices have continued to expand since the last site visit took place and there are plans to enable all service users to enjoy a holiday for the second year running. Westbrook House DS0000019613.V335671.R01.S.doc Version 5.2 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 & 17. Quality in this outcome area is good. The range of opportunities for service users has continued to expand since the last inspection took place. Service users enjoy an appropriate presence in the community. Staff ensure that a varied and healthy diet is provided. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Conversations with staff and records in the home confirm the range of opportunities for leisure activities that are available. The service has its own minibus (to be upgraded this month). There is a range of day activities such as regular use of a hydrotherapy pool, as well as annual activities such as the annual canal trip. Following last year’s success, staff are again trying to arrange for annual holidays for all service users. During this visit, numerous examples of the variety of activities on offer were seen and these ranged from relatively mundane trips to the local shops to theatre and cinema trips. It was also noted that the staff team have begun using picture communication symbols book with great effect with one service user. Westbrook House DS0000019613.V335671.R01.S.doc Version 5.2 Page 11 Some of the service users enjoy considerable support from family members and this is both welcomed and encouraged by staff. Choice of meals and a list kept of alternatives served to ensure that the larder is kept stocked. The provision of meals is a good example of how staff employ positive observation techniques as well as communicating their observations to other team members. Policies and procedures are available that reinforce respect for service users rights and responsibilities. The terms and conditions of placement also set out the service user’s rights and responsibilities in a user-friendly format. Westbrook House DS0000019613.V335671.R01.S.doc Version 5.2 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20. Quality in this outcome area is good. Staff constantly review their practice to ensure that service users receive personal and healthcare support in a manner that is both appropriate to individuals and in a style that the individual prefers. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Care plans demonstrated that personal support is delivered in a way that individual service users prefer. This written evidence was supported by the practice of staff who were both caring and appropriately attentive during this site visit. Service user wishes were ascertained and respected. Therefore, if a service user indicated that, for the time being at least did not want attention, they were neither neglected nor patronised. This is a difficult balance to strike and staff should be congratulated for their practice. One service user is fitted with a PEG feed and the District Nurse checks the apparatus weekly. A dietician who calls every six weeks also supports the service user. All service users need full support with their medication. Records are accurately kept and medication appropriately stored. The supplying pharmacist Westbrook House DS0000019613.V335671.R01.S.doc Version 5.2 Page 13 conducted an audit of medication the week before this inspection took place. (This was conducted on behalf of the PCT and the outcome was positive). Westbrook House DS0000019613.V335671.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. Quality in this outcome area is good. Service users are protected from all forms of abuse. The staff go to considerable lengths to ascertain the feelings and views of service users and act on them. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Staff employ a range of approaches to obtain service user’s views. However, with the exception of the two service users who have verbal communication skills, ‘Talk Time’ has been abandoned in favour of resident’s meetings, (where all service users can be better represented). There is a pictorial and easily understood complaint policy readily available to service users. One complaint that was made to the provider has been dealt with appropriately. Since the last inspection took place, staff have received adult protection training from the County Council. Westbrook House DS0000019613.V335671.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27, 29 & 30. Quality in this outcome area is adequate. Requirements that were made at the last inspection have been met and the building generally offers a comfortable, safe and homely environment. However, a past issue over floor covering is now repeated in a new location and this reflects on the overall standard of the environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the premises revealed that the home is attractively decorated, kept to a good standard of cleanliness and appears to be appropriate to the needs of the service users. The providers should be applauded for the additional hi-lo bath that has been provided and staff confirmed that this is a very beneficial asset. Much of the house has been decorated since the last inspection and an impermeable floor covering has been laid in the dining room. However, the carpet in the lounge was stained and appeared to be easily marked. A requirement has been made. It is understood that contactors have recently been engaged to maintain the outside areas. Westbrook House DS0000019613.V335671.R01.S.doc Version 5.2 Page 16 Service user’s bedrooms were comfortably decorated and suitably equipped. Particularly noteworthy was a light projector and raised television that had been installed for one service user. Bedrooms revealed much about the needs and the interests of their occupant. Westbrook House DS0000019613.V335671.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 & 36. Quality in this outcome area is good. Service users are supported by a confident and well-trained staff team. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The service provider has acknowledged the staff group at this home as delivering a client focussed service and they have been presented with the provider’s ‘Top Team’ award. The home was fully staffed until three weeks ago, but they are working round a current problem by a temporary promotion and the working of additional hours. There has been hardly any use of agency or bank staff as a consequence and a ratio of one staff member to two service users (or better) has been maintained. Staff stated that they have recently completed epilepsy training and that all ‘mandatory training’ has either been completed or has been booked. One care worker is about to start her NVQ 2. There has been no need to recruit staff since the last inspection took place, but it is noted that the inspecting officer at the time acknowledged that the current manager kept meticulous recruitment records. Westbrook House DS0000019613.V335671.R01.S.doc Version 5.2 Page 18 Staff confirmed that they are well supported and receive regular individual supervision sessions. Westbrook House DS0000019613.V335671.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 40, 41 & 42. Quality in this outcome area is adequate. The service generally and the service users in particular benefit from a strong and progressive management. The service is well run and this outcome would have been judged higher had the manager been registered with the Commission. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The influence of the new manager was very much in evidence, especially in terms of the range of activities on offer and the skills and dedication of the staff team. Written evidence that was available in the home in terms of records, policies and procedures demonstrated supported this view as well as providing obvious evidence of good record keeping. Staff confirmed that they felt supported by the providers and the management team and service users gave every indication of being content and secure. Westbrook House DS0000019613.V335671.R01.S.doc Version 5.2 Page 20 The manager was able to demonstrate that she had an application for registration that was ready for submission save one piece of supporting documentation. However, in view of the length of time this service has been without a registered manager, a requirement has been made. Westbrook House DS0000019613.V335671.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 3 28 X 29 3 30 2 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 3 3 3 X Westbrook House DS0000019613.V335671.R01.S.doc Version 5.2 Page 22 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. 2. Standard YA30 YA37 Regulation 23(2)(d) 8(1)(a) Requirement The stained carpet in the lounge must be cleaned or replaced. The provider must apply for the registration of the manager. This requirement has been brought forward from the last inspection report. Timescale for action 30/06/07 18/05/07 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 YA30 Good Practice Recommendations It is recommended that the lounge carpet be replaced by wood or wood laminate flooring as this is easier to maintain and would facilitate easier manoeuvring for wheelchair users. Westbrook House DS0000019613.V335671.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Westbrook House DS0000019613.V335671.R01.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. 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