Inspection on 09/08/05 for Westbury House

This inspection was carried out on 9th August 2005.

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

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

Other inspections for this house

Westbury House 10/11/06

Westbury House 27/01/06

Westbury House 17/01/05

Westbury House 29/09/04

Westbury House 13/01/04

Westbury House 30/09/03

Westbury House 11/03/03

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

CARE HOME ADULTS 18-65 Westbury House 2 Blenheim Road Deal Kent CT14 7DB Lead Inspector Joe Harris Unannounced 09/08/05 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Westbury House H56-H05 S23124 Westbury House V242158 090805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Westbury House Address 2 Blenheim Road, Deal, Kent CT14 7DB 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) 01304 360696 Robinia Care South East Limited Mr Michael Gregory Registered Care Home 13 Category(ies) of Learning Disability registration, with number of places Westbury House H56-H05 S23124 Westbury House V242158 090805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17/01/05 Brief Description of the Service: Westbury House is a large 13 bedded home for people with learning disabilities in the seaside town of Deal. The service is owned by Robinia Care, which is a relatively large organisation with a number of care homes in the South -East and nationally specialising in the care of people with learning disabilities. The house is set in a residential area close to the town centre and near to the beach. The premises benefit from a garden to the front and large courtyard to the rear. There ia adequate communal space and comfortable bedrooms. The resident group has been stable for some time and there is a good blend of youth and experience in the staff team. There is access to a suitable vehicle for trips out. A robust managerial structure is in place. Westbury House H56-H05 S23124 Westbury House V242158 090805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection on the 9th August 2005. The inspection lasted for around 4 hours. Discussions were held with staff and residents and a tour of the premises was undertaken. A range of documentation was viewed including service user plans and health and safety records amongst others. There were no requirements or recommendations as a result of the visit. What the service does well: What has improved since the last inspection? The service continues to improve and develop consistently. The registered manager and staff team continue to examine the support and care that is provided looking to innovate and further develop the service. Work has continued on service user plans and other documents relating to the residents with the aim to empower and assist individuals to communicate their needs Westbury House H56-H05 S23124 Westbury House V242158 090805 Stage 4.doc Version 1.40 Page 6 and wishes. The level and nature of activities available for service users continues to be expanded. 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. Westbury House H56-H05 S23124 Westbury House V242158 090805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Westbury House H56-H05 S23124 Westbury House V242158 090805 Stage 4.doc Version 1.40 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 standard(s) 2 and 3. The home ensures that the needs of service users are met. EVIDENCE: The current resident group have lived in the home for over 5 years. And the needs of service users are monitored on an ongoing basis. There has been evidence over recent years that the changing needs of individuals are catered for including the relatively recent installation of a passenger lift enabling residents to have access to all areas of the home. Further modifications are planned to the washing and bathing facilities to improve access. There is a good staff development programme within the organisation ensuring that the team has the skills to deliver support. The needs of people from minority groups are met, where this applies. The registered manager and staff team have developed awareness and well thought out aids to promote communication for those who have difficulty expressing their needs and wishes. The service has developed good links with local community healthcare professionals. Westbury House H56-H05 S23124 Westbury House V242158 090805 Stage 4.doc Version 1.40 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 standard(s) 6, 7 and 9. Service user plans identify the needs of service users and the home ensures that healthcare needs are met. Residents are enabled to make decisions affecting their daily lives. Risks are assessed positively and comprehensively. EVIDENCE: The home has developed well-structured, informative and person-centred service user files. The needs of each individual are clearly identified as well as the actions required by staff to support residents. There is an effective key worker system in place and they have been working with residents to develop life stories, communication books using photographs to demonstrate choices. All care plans are reviewed on a regular basis and handovers and team meetings are used to pool ideas and develop support plans further. The registered manager provides good support empowering key workers and residents to work positively together. The home has a good system of risk management and assessment in place clearly addressing issues and promoting the independence of the service users. Clear guidance is developed to ensure staff minimise any potential risks and the assessments are regularly reviewed. There is clear evidence through documentation and observation that service users are facilitated to make daily decisions affecting their lives with regard to Westbury House H56-H05 S23124 Westbury House V242158 090805 Stage 4.doc Version 1.40 Page 10 routines, trips out, activities and food choices amongst other things. A positive ethos of empowerment has been nurtured in the home. Westbury House H56-H05 S23124 Westbury House V242158 090805 Stage 4.doc Version 1.40 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 standard(s) 11, 12, 13 and 14. The home provides an excellent range of therapeutic and leisure activities based on personal needs, wishes and interests. Family and friends are welcomed into the home and contact with the local community is maintained. EVIDENCE: Staff in the home have worked very positively with residents to establish interests, likes and dislikes. They are supported by the organisation to provide a wide range of formal and informal activities and events for both recreational and therapeutic purposes. At the time of the visit a number of service users were at college or shopping and a trip was planned to Margate in the afternoon. Entertainers such as musicians and drama groups visit the home on a regular basis. Staff often take photographs of residents engaging in activities such as getting on a bus or going out to the theatre and use them to assist future communication. The registered manager with the support by the staff team has fostered a positive and active culture within the home. Family and friends are welcomed into the home to visit service users and assistance is also appropriately provided to enable residents to travel to visit Westbury House H56-H05 S23124 Westbury House V242158 090805 Stage 4.doc Version 1.40 Page 12 their relatives. The staff keep in good contact with significant others to update them on progress and changes. Residents have regular opportunities to use local community facilities such as the sports centre, library, cinema and local shops. Westbury House H56-H05 S23124 Westbury House V242158 090805 Stage 4.doc Version 1.40 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 standard(s) 18, 19 and 20. Service users are treated with respect and their privacy is respected. Healthcare needs are appropriately addressed. Medication systems and procedures are adequate and safe. EVIDENCE: Residents are treated with dignity and respect and levels of privacy are maintained. All of the service users require assistance with aspects of personal hygiene and care. The organisation ensures that staff are instructed and supervised to provide this thoughtfully and sensitively. Service users choose and wear their own choice of clothes and are assisted to live their lives as autonomously as possible. Adequate privacy is provided where residents share a bedroom. The healthcare needs of service users are monitored and addressed. It was reported that the home has developed positive relationships with local GPs and District Nurses who provide good levels of support. There is clear documentation demonstrating that health issues are identified and acted upon with advice from professionals. Additional equipment and facilities are assessed and provided where residents have had changing levels of need. The medication records and storage facilities were viewed, all of which is adequate for the needs of the home. Medication Administration records were clear, accurate and up to date. The home has good policies and procedures in Westbury House H56-H05 S23124 Westbury House V242158 090805 Stage 4.doc Version 1.40 Page 14 place and staff administering medication are provided with appropriate training. Westbury House H56-H05 S23124 Westbury House V242158 090805 Stage 4.doc Version 1.40 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 standard(s) These srandards were not assessed during this inspection. EVIDENCE: Westbury House H56-H05 S23124 Westbury House V242158 090805 Stage 4.doc Version 1.40 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 standard(s) 24 and 30. The premises are safe and well maintained and the home is clean and hygienic. EVIDENCE: The premises are suitable for the stated purpose of the home. Service users are enabled access to both floors of the building with the use of a passenger lift. There is an adequate amount of communal space with a large lounge and an activity/dining area. There are attractive gardens, which have been steadily improved and a large courtyard, which is due for some work to level the ground. The organisation has demonstrated a willingness to continually improve the environment and an annual development plan is submitted by the registered manager for consideration by senior managers. Maintenance and improvements are prioritised and costed. There is a works department that is available to address day-to-day maintenance issues as required. The building complies with environmental and fire department regulations. There is a CCTV camera monitoring the entrance to the home and is used for security purposes only. The premises were clean, odour-free and hygienic at the time of the visit. There are adequate policies and procedures in place for the control of infection and an understanding within the staff team of these issues, which are underpinned by induction and additional training. Laundry facilities are suitable Westbury House H56-H05 S23124 Westbury House V242158 090805 Stage 4.doc Version 1.40 Page 17 for the needs of the service and comply with relevant legislation with hand washing facilities readily available throughout the home. Washing machines are appropriate for the needs of the home. Westbury House H56-H05 S23124 Westbury House V242158 090805 Stage 4.doc Version 1.40 Page 18 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 35. There are sufficient numbers of staff on duty at all times and a good staff development programme. EVIDENCE: There are at least 4 members of staff on duty throughout the day and at night there is one waking and one sleep-in staff member. The registered manager is also on duty throughout the office hours of 9-5. In addition to this the home has a full-time cook, cleaners and available maintenance staff. There is also an Occupational Therapy assistant who provides support to the service users and staff team through organising individual and group activities both in and out of the home. She assists in the development of support plans and other information such as communication tools, etc. The home benefits from a good blend of youth and experience, with a senior staff member on duty at all times. The home also has a bank of relief workers who are employed to provide additional cover and deputise for annual leave and sickness. Robinia Care offer staff a good development programme. There is a comprehensive induction process that all staff are supported to work through. All mandatory training is provided within the first 6 months of employment and staff receive updates and refresher courses as required. Additional courses are also provided covering a wide range of issues from adult protection to challenging behaviour. Westbury House H56-H05 S23124 Westbury House V242158 090805 Stage 4.doc Version 1.40 Page 19 Westbury House H56-H05 S23124 Westbury House V242158 090805 Stage 4.doc Version 1.40 Page 20 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 and 42. There are robust quality assurance processes ensuring that the home is run in the best interests of the service users. The health, safety and welfare of all is promoted and protected. EVIDENCE: Monthly monitoring visits are carried out by senior managers to the home ensuring that the standard of care and relevant documentation is maintained and that the premises are in good order. Discussions are held with staff and service users. A staff forum has also been developed to provide a voice for care staff who have less opportunities to influence the development of the service and conditions of employment. The registered manager has fostered an open and positive ethos in the home enabling staff, relatives and service users, where possible, to feedback about the service. There is an annual development plan for the upkeep of the premises and the registered manager has elements of control over day-to-day budgets. There is a clear system of accountability within the organisation. Westbury House H56-H05 S23124 Westbury House V242158 090805 Stage 4.doc Version 1.40 Page 21 The health, safety and welfare of service users, staff and visitors is wellmaintained in all areas. Staff receive all necessary training and induction into the service. There are policies and procedures clearly set out to ensure the safety of all individuals, which are regularly reviewed and updated as required. A range of documentation was viewed regarding health and safety including fire and accident records and evidence of routine maintenance and service checks. All information was up to date and complete. Environmental risk assessments have been completed and are reviewed. Westbury House H56-H05 S23124 Westbury House V242158 090805 Stage 4.doc Version 1.40 Page 22 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 3 x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 3 4 3 4 x x x Standard No 31 32 33 34 35 36 Score x x 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Westbury House Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x H56-H05 S23124 Westbury House V242158 090805 Stage 4.doc Version 1.40 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 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 Good Practice Recommendations Westbury House H56-H05 S23124 Westbury House V242158 090805 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford Kent, TN23 1HU 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. 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