Inspection on 11/01/06 for Westbrook House

This inspection was carried out on 11th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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.

Other inspections for this house

Westbrook House 16/05/07

Westbrook House 06/09/05

Westbrook House 22/10/04

Westbrook House 12/05/04

Westbrook House 22/10/03

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Westbrook House 21 Cabbell Road Cromer Norfolk NR27 9HY Lead Inspector Mrs Lella Andrews Unannounced Inspection 11th January 2006 10.50a Westbrook House DS0000027329.V270057.R01.S.doc Version 5.0 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 DS0000027329.V270057.R01.S.doc Version 5.0 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 DS0000027329.V270057.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Westbrook House Address 21 Cabbell Road Cromer Norfolk NR27 9HY 01263 512482 NO FAX # 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) Jeesal Residential Care Services Limited Mrs Heather Rachel Hurn Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Westbrook House DS0000027329.V270057.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th September 2005 Brief Description of the Service: Westbrook House is a four storey house situated in a residential street in Cromer. It provides accommodation for up to seven adults with a learning disability. The Home has a communal lounge, dining room and kitchen on the ground floor. There are seven single bedrooms on the first and second floor. The basement provides an activities room and office space as well as an additional WC and shower. The Home has a patio with seating to the rear of the Home and a very small seating area to the front of the Home at basement level. The Home is situated next to communal gardens and is very close to the seafront and to the town. Westbrook House DS0000027329.V270057.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Inspection was unannounced and took place between 10.50am and 2pm on Wednesday 11th January 2006. The Manager and the acting deputy manager were present for the majority of the Inspection and provided information both verbally and in the form of records. The Inspector spoke to one member of staff on an individual basis. The tenants have some communication difficulties which can make it difficult for the Inspector to gather information from them about their life in the Home. However, the Inspector spent some time with two of the tenants and three of the tenants had previously completed comment cards. The comment cards all indicated that the tenants like living at the Home and that they feel well cared for. The Inspector also received a completed comment from a relative and this contained positive responses with additional comments stating that the care is “…first class…” There has been a change to the management within the Home. The previous Manager is now working very few hours in the Home and is job sharing with Heather Hurn who has recently been registered as Manager (job share with Shirley Luke) and undertakes the majority of the management hours within the Home. Heather Hurn has worked in the Home for many years and was the deputy manager before spending six months last year working in another Home owned by the organisation. What the service does well: The Home provides a good standard of care to the tenants who live there. The needs of the tenants are the priority for the staff team. The tenants are supported to take part in a range of educational and leisure activities. Relationships with relatives and friends are encouraged and supported. The staff team are currently providing a high standard of care to a tenant with a serious health need. The Manager is liasing with a range of health professionals and additional training has been provided to the staff team to enable the tenant to remain living at the Home. The staff team receive effective training and support to enable them to carry out their roles. Westbrook House DS0000027329.V270057.R01.S.doc Version 5.0 Page 6 The Home involves the tenants in a range of ways to measure the quality of the service provided. 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. Westbrook House DS0000027329.V270057.R01.S.doc Version 5.0 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 DS0000027329.V270057.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The Home has suitable procedures in place to ensure that effective assessments are undertaken prior to a tenant moving in EVIDENCE: The tenants have all lived at the Home for several years and so there has not been a recent need to carry out assessments for prospective tenants. However, the Home has detailed procedures in place to ensure that if this situation arose then effective assessments will be carried out to ensure that the Home can meet the individuals needs. Westbrook House DS0000027329.V270057.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 and 9 The care plans reflect the tenants changing needs and personal goals The tenants are supported to take risks as part of an independent lifestyle EVIDENCE: The staff team receive training so that they are able to use alternative forms of communication, in addition to speech, as the majority of the tenants have communication difficulties. Symbols, sign language and objects of reference are used with different tenants. The staff are aware of the importance of communication and the need to enable the tenants to communicate effectively so that their wishes and preferences can be understood. The Inspector looked at two care plans and these contain detailed information about the individuals needs, choices and preferences. The care plans contain evidence that they are regularly reviewed and updated and these are signed by the tenant wherever possible. The tenants meet with their keyworker on a monthly basis to review the important issues in their lives and to plan what they would like to happen in the forthcoming month. Westbrook House DS0000027329.V270057.R01.S.doc Version 5.0 Page 10 The care plans contain detailed information to staff about how to meet individual needs and the staff sign to confirm that they have read the care plans. The care plan was seen for one of the tenants who is currently quite unwell and this contains detailed records of health appointments and guidance to staff about how to meet the individuals changing needs. The provision of the updated care plans means that the needs of the tenant can be met in a consistent way which reflects their own preferences about the care that they receive. Risk assessments are an important part of the tenants care plan packages. These contain a general risk assessment with detailed guidance provided about how to manage issues/situations that are considered to pose a high risk to the tenant or others. Staff are aware of the content of the risk assessments and of the importance of these. The risk assessments are regularly reviewed and updated. The staff have received training about how to work with the tenants on a Person Centred Plan. The Inspector did not see any of these during this Inspection but spoke to staff about how these are being put together. The process will take some time as staff work on a one to one basis with the tenant at their own pace. The Person Centred Plan will provide a “care plan” which has been put together by the tenant, with support, and which aims to include their aspirations for the future with plans about how these will be met. Westbrook House DS0000027329.V270057.R01.S.doc Version 5.0 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15 and 17 The tenants are supported to take part in age appropriate activities within the local community The tenants are supported to maintain and develop relationships with family and friends The tenants are offered a healthy diet and enjoy their meals EVIDENCE: The Home is situated close to the seafront and to the town centre. The majority of the tenants are able to walk to the local facilities and the Home has a car for longer journeys. The care plans contain information about the tenants interests and a plan of the education and leisure opportunities that individual tenants take part in. The tenants are supported to take part in a range of adult education classes within the local and wider community. Tenants are supported to take part in leisure activities such as sailing, bowling, cinema and theatre. Tenants are assisted to do their own shopping and with food shopping and preparation. Westbrook House DS0000027329.V270057.R01.S.doc Version 5.0 Page 12 These activities are regularly reviewed with the tenants to ensure that they are enjoying what they are doing and the staff gave examples which showed that the wishes of the tenants are taken into consideration and action taken to change things if the tenant wishes to stop an activity or wishes to try something new. The tenants all have their own TV/DVD/video and music centre if they wish to have one in their bedroom. The Home has a room in the basement which has been nicely refurbished to provide somewhere to do craft type activities and which also provides somewhere for one of the tenants to play their drums. Tenants are able to choose where they spend their time and move freely around the Home. Staff spend time with the tenants in the Home and when they are supporting them in the community. The staff rotas are written around the needs of the tenants with staff working in a flexible way to ensure that the tenants are able to take part in activities of their choice. The three comment cards completed by the tenants state that the Home provides suitable activities. The tenants care plans contain information about the arrangements in place to support them to maintain contact with relatives and friends who are important to them. The staff provide transport and support when needed and two of the tenants told the Inspector about recent visits to family who do not live locally. The comment card completed by a relative states that they are made to feel welcome when they visit. The Inspector also saw some of the Homes Quality Assurance questionnaires completed by relatives and professionals and these also state that the person is made to feel welcome when they visit the Home. The tenants dietary needs and preferences are recorded in their care plan. The tenants comment cards state that they enjoy the food. The menus for the forthcoming week are discussed and agreed at the weekly tenants meeting and each tenant is encouraged to make a choice for one day per week. The tenants are able to choose an alternative if they do not want what is on the menu. Mealtimes are a sociable occasion and tenants and staff eat together. The tenants are encouraged to assist with food shopping and preparation. The kitchen is kept locked due to the needs of one of the tenants, however, the staff provide regular opportunities for the tenants to be involved in the preparation of drinks and meals. One of the tenants had drink making facilities in their room but due to health reasons, and following a risk assessment, this has had to be changed. However, the staff have worked hard to find an alternative that does not completely remove the tenants independence in this area but does also provide necessary protection. Westbrook House DS0000027329.V270057.R01.S.doc Version 5.0 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 The physical and emotional health needs of the tenants are met and the staff are currently providing good additional support to a tenant with a particular health need EVIDENCE: This standard was inspected in full during the last Inspection and was found to be met. During this Inspection the Inspector looked at the standard in relation to one particular tenant who has a serious health condition. The staff team, senior managers and the directors of the organisation are all working together to provide a high standard of care for the tenant and to enable him to remain living at the Home where he knows everyone. Staff gave examples which show that, despite communication difficulties, staff are able to find out what the tenant would prefer with regards to personal and physical care and that they are working hard to meet these needs. The Manager is currently liasing with a range of health professionals who are involved in the tenants care and clear, detailed records are kept of these meetings/conversations. The care plans contain clear guidance to the staff about how to meet the tenants needs and these have been regularly updated as necessary. Staff are aware of the care plans and risk assessments in place. A team meeting took place on the day of the Inspection so that all staff could Westbrook House DS0000027329.V270057.R01.S.doc Version 5.0 Page 14 be updated with regard to recent changes in the care provided to the tenant. One of the Directors of the organisation attended the meeting and has been providing support to the Manager and staff team. Staff have also received training from health professionals relating to specific tasks. The staff are genuinely concerned about the tenant and wish to provide him with the support and care that he needs. Westbrook House DS0000027329.V270057.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 The tenants have opportunities to raise any concerns that they may have and staff are aware that this may be difficult for those tenants with communication difficulties. EVIDENCE: The Home has a complaints procedure which is displayed in the Home in symbol format. The tenants are asked about any concerns that they might have during their monthly care plan reviews and at the weekly tenants meetings. One of the tenants also attends the organisations Quality Assurance Forum which is another opportunity to raise concerns. The staff are aware that the majority of tenants would find it difficult to raise concerns due to their communication difficulties. Relatives are sent a copy of the complaints procedure and the completed comment card stated that they are aware of the complaints procedure. The tenants comment cards state that they are aware of who to speak to if they are unhappy with their care. The Manager said that there have been no complaints about the service. Westbrook House DS0000027329.V270057.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 The tenants live in a homely, safe, clean and comfortable environment EVIDENCE: The Inspector looked around the communal areas only during this Inspection. The organisation has an ongoing refurbishment and redecoration programme for the Home and since the last Inspection the lounge has new furniture which is attractive and comfortable. The Home does not have a garden but does have a small patio area which is next to a large public green. The steps down from the kitchen to the patio have been replaced with wider steps to make them safer for the tenants to use. The Home has a laundry room on the first floor, near to the bedrooms. The staff have all recently undertaken training about infection control as it was recognised that there is currently an additional need for this. Westbrook House DS0000027329.V270057.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 35 and 36 The tenants are supported by an effective staff team who receive good training and support EVIDENCE: The staffing situation has improved since the last Inspection and the rotas show that there are adequate staff on duty. The rotas are written to reflect the needs of the tenants and there are additional staff on duty when tenants are all going out. The usual staffing arrangements are for there to be two staff on duty each morning and afternoon/evening with an additional member of staff on duty on a “middle” shift almost every day. There is a sleep in member of staff on duty at night and additional support can be obtained from the on call manager if necessary. Whilst the staffing situation appears to be adequate the Inspector understands that the staffing is being reviewed in relation to the additional health needs of one of the tenants. It is important that the Managers work pattern is included in the review of staffing as currently she is working the majority of her hours as part of the staff team and the organisation needs to make sure that she has enough time to undertake management tasks at a time when she is not counted as part of the staffing rota. Westbrook House DS0000027329.V270057.R01.S.doc Version 5.0 Page 18 The staff who spoke to the Inspector were enthusiastic about working with the tenants and have a good understanding of their role and that of others within the team. The staff team is fairly stable with low levels of staff turnover and so the staff know the tenants well. The organisation has its own training department and provides a good standard of training for the staff team. Records show that all staff have undertaken induction and mandatory training. Staff have dates booked for any updates of training that they may need. Additional training has been organised to ensure that staff have the skills to meet the health needs of one of the tenants. The organisation is working to ensure that all staff undertake NVQ training to either level 2 or 3. Currently three members of staff have completed this. The new Manager of the Home has started to carry out formal supervision for all members of staff. These have only started to take place in the last three months. Staff said that they feel well supported, both informally and formally, by the new Manager and that they are aware of how to use the on call system if they needed to. Westbrook House DS0000027329.V270057.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38, 39 and 42 The tenants benefit from living in a well run Home The Home has a quality assurance process which involves the views of the tenants and of others involved in the Home The health, safety and welfare of the tenants and staff are promoted and protected EVIDENCE: The tenants and staff know the new Manager well as she has worked in the Home for many years and was previously the deputy Manager before spending six months working at another Home within the organisation. The new Manager is currently job sharing the post with the previous Manager who still works at the Home for a few hours each week whilst also managing another Home within the organisation. Heather Hurn is clearly seen by the staff team as the Manager and is respected as such by them. The deputy manager has Westbrook House DS0000027329.V270057.R01.S.doc Version 5.0 Page 20 recently left the Home and one of the senior care staff is currently acting deputy manager. Both of the Managers of the Home have high standards and are both focused on the needs of the tenants being the priority for the staff. The Home has a quality assurance process in place which involves a variety of ways of gathering information about the quality of the service provided. For example, monthly care plan reviews, weekly tenants meetings, Quality Forum meetings within the Home, quarterly Quality Forum meetings for tenants run by the Directors, Annual Development Plan and annual questionnaires for relatives and health/social care professionals. The Manager said that she will shortly be starting to review last years development plan with a view to putting together the plan for the forthcoming year. The Inspector saw the returned questionnaires from last year and these contained all positive comments with one suggestion for improvement. One of the questionnaires stated that the “…standard of care is excellent.” Health and Safety issues are given a high priority within the Home. Monthly health and safety checks are undertaken and the Inspector saw examples of action being taken to address areas of concern. Risk assessments are carried out for individual tenants relating to health and safety issues and guidance provided to staff about how to reduce the risks. The Home has a very detailed fire risk assessment which contains one for each room in the building and for each individual tenant. Certificates of regular maintenance of the fire safety equipment were seen. Staff receive Fire Safety training and regular fire drills take place. It is recommended that the names of the staff who take part in the drills are recorded so that the Manager can ensure that all staff take part at least twice per year. Westbrook House DS0000027329.V270057.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 3 X 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Westbrook House Score X 4 X X Standard No 37 38 39 40 41 42 43 Score X 3 3 X X 3 X DS0000027329.V270057.R01.S.doc Version 5.0 Page 22 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA42 Good Practice Recommendations It is recommended that the names of staff taking part in fire drills are recorded Westbrook House DS0000027329.V270057.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Westbrook House DS0000027329.V270057.R01.S.doc Version 5.0 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!