Inspection on 12/07/05 for Westbury House Nursing Home

This inspection was carried out on 12th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Westbury House Nursing Home 23/05/07

Westbury House Nursing Home 10/01/07

Westbury House Nursing Home 08/11/05

Westbury House Nursing Home 04/01/05

Westbury House Nursing Home 13/07/04

Similar services:

Flint House

The Cotswold Home

Fairways

Treloar College

Rush Court

The Maypole Nursing Centre

Fir Tree Lodge

Chilmington House

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

CARE HOME ADULTS 18-65 Westbury House Nursing Home West Meon Nr Petersfield Hampshire GU32 1HY Lead Inspector Gina Pickering Unnannounced 12/7/05 10:00am 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 Nursing Home H54 S11525 Westbury House V233305 120705.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Westbury House Nursing Home Address West Meon, Nr Petersfield, Hampshire, GU32 1HY 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) 01730 829511 01730 829108 Mr Ivine Navid Naqvi Mrs Linda Murray CRH 70 Category(ies) of PD- Physical Disability: 70 registration, with number PD(E)- Physical Disability over the age of 65 of places years: 70 TI- Terminally ill: 70 TI(E)- Terminally ill over the age of 65 years: 70 Westbury House Nursing Home H54 S11525 Westbury House V233305 120705.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1- No service user is to be admitted over the age of 70. Date of last inspection 4/1/2005 Brief Description of the Service: Westbury House is a care home situated on the edge of the rural village of West Meon. The home is registered to provide accomodation and nursing care for up to 70 service users, though at the present only upto 50 service users are accomodated at any one time. The home caters for persons that have an acquired brain injury or an illness affecting the nervous sytem. The home has an occupational therapy facility and a facility for service users to purchase private physiotherapy. The registered manager Mrs Linda Murray has been in post for six months. Westbury House Nursing Home H54 S11525 Westbury House V233305 120705.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced taking place over five hours on 12th July 2005. The inspector had the opportunity to speak with the manager, administrator, eight staff members, thirteen residents and one relative as well as sampling documents. Discussion with the manager revealed that the service users prefer to be called residents; this will be reflected throughout the report. Residents that the inspector spoke with were generally happy and satisfied with the level of care received at the home and the ethos of the home to enable them to ability to make choices regarding their daily routines and activities at the home. The relative that the inspector spoke with suggested that she was satisfied with the care and support delivered by the home. It is acknowledged that the registered manager is beginning to make improvements in the management of the home following a period of instability due to the home being without a registered manager. What the service does well: What has improved since the last inspection? An induction programme is in place that meets the current guidelines for new staff members. Work is to commence shortly to address the poor state of some of the carpets as well as work to enable residents control the temperature of the radiators in their own rooms. The dining room is now fully open to the residents with the college service having relocated to an alternative area of the building. Westbury House Nursing Home H54 S11525 Westbury House V233305 120705.doc Version 1.30 Page 6 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 Nursing Home H54 S11525 Westbury House V233305 120705.doc Version 1.30 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 Nursing Home H54 S11525 Westbury House V233305 120705.doc Version 1.30 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) 1 Information provided to prospective residents and their representatives allows for an informed decision to be made regarding the suitability of the home for the resident. EVIDENCE: The home has developed a statement of purpose that reflects the service provided at the home that is provided to all persons enquiring about the home. Discussion with the manager evidenced that she is aware that any changes to the service provided at the home will have to be reflected in the statement of purpose. A service users guide is provided to all residents on admission to the home that includes an outline of the information included in the statement of purpose and a sample of terms and conditions of residency at the home. Not included within the service users guide are the views of the residents regarding the service provided at the home. Discussion with residents evidenced that some of them remembered receiving information regarding the home prior to admission. It is acknowledged that due to the nature of the condition of some of the residents many of them are unable to remember events and would therefore have little memory for the admission process. Westbury House Nursing Home H54 S11525 Westbury House V233305 120705.doc Version 1.30 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 & 9 The residents are encouraged to be involved in decisions pertaining to their needs. The home encourages and supports the resident’s abilities to make decisions regarding their daily life and activities, supporting them to take responsible risks. EVIDENCE: The inspector reviewed a sample of care plans evidencing that information is detailed to enable care staff to meet the holistic needs of the individual resident. Discussion with several residents evidenced that some of them were aware of the care planning process and are involved with the process. However the greater majority of the residents displayed no interest with regard to the care planning process. Documentary evidence is available to confirm that care plans are reviewed monthly. Care plans reflect the residents right to make choices and decisions regarding daily life and activities. Discussion with several residents evidenced that they are supported to make their own decisions regarding daily routines and activities. Many of the residents have limited communication abilities; care Westbury House Nursing Home H54 S11525 Westbury House V233305 120705.doc Version 1.30 Page 10 plans reflect the individual residents method of communicating their needs and wishes. The ethos of the home is to enable the residents to live a full and active life. Within this scope it is acknowledged that residents will be exposed to certain risks at times. Risk assessments are in place for individual residents if required and action to be taken documented to reduce these risks. Residents access the local community for leisure interests by the use of the home’s minibus. At the time of the inspection there were no risk assessments in place regarding this practice. The manager is in the process of reviewing all risk assessments for the home and informed the inspector that a risk assessment regarding residents accessing the community will be completed as part of this exercise. Westbury House Nursing Home H54 S11525 Westbury House V233305 120705.doc Version 1.30 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) 12, 13, & 17 Social and recreational needs of the residents are well managed, enabling the residents to experience new activities and exercise their choices. The residents varied dietary needs are well catered for. EVIDENCE: The choice of activities arranged by the home is influenced by the wishes of the residents. The care planning system allows for an assessment of the residents past and present interests to be documented. An activity coordinator is responsible for the organisation of activities within the home. Discussion with residents evidenced that the occupational therapy department is responsible for many of the day-to-day activities within the home such as various craft activities and bingo, and the activity coordinator organises excursions. A minibus and driver is available daily during the week for residents to access the community. On the day of the inspection a group of residents were visiting a local shopping area and having lunch by the harbour. Residents discussed recent visits to Longleat, garden centres and the theatre. A six weekly rotating menu enables residents to have a varied, nutritional choice regarding meals. Several residents offered the information that they are Westbury House Nursing Home H54 S11525 Westbury House V233305 120705.doc Version 1.30 Page 12 happy with the variety and quality of the food provided at the home. Appetising pureed meals are made available for those residents that require it. Staff at the home were assisting residents with their lunch with sensitivity. There are a number of residents that receive their nutritional intake via tube feeds. Dieticians are involved in the assessment and care of these residents. Westbury House Nursing Home H54 S11525 Westbury House V233305 120705.doc Version 1.30 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) 20 The administration of medications to the residents is handled in a safe manner, however safety is not fully assured for those that administer their own medications. EVIDENCE: Medication policies and procedures are in place, however these have not been reviewed since 2002. The manager informed the inspector that this is planned to take place in the next few months. Despite two residents administering their own inhalers there is no policy for residents administering their own medications. A policy must be put in place. Records are maintained of all medications ordered, received and returned to the dispensing surgery. A list of domestic remedies is in place, however these have not been signed by the GP to confirm that he is happy for staff at the home to administer these medication. Medication administration records are completed accurately. Westbury House Nursing Home H54 S11525 Westbury House V233305 120705.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 Staff are aware of issues regarding the protection of vulnerable adults, despite the lack of formal raining, thus ensuring that residents are partially protected from the effects of abuse. EVIDENCE: The home has a copy of the Hampshire procedure for the Protection Of Vulnerable Adults as well as a local policy pertaining to the protection of vulnerable adults. The deputy matron was on a study day at the time of the inspection to equip her with the skills and knowledge to train staff members with regard to adult protection. No members of staff had received any training with regard to the protection of vulnerable adults. Discussion with staff members evidenced that they are aware of issues with regard to the protection of vulnerable adults and actions to be taken if they suspect an act of abuse has happened. Westbury House Nursing Home H54 S11525 Westbury House V233305 120705.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 The home is striving to achieve a homely, comfortable environment for the residents to live in. EVIDENCE: Following the previous inspection action is being taken to replace worn carpets and flooring and to enable residents to control the temperature of radiators within their bedrooms. A full assessment of the environment will be performed at the next inspection. Westbury House Nursing Home H54 S11525 Westbury House V233305 120705.doc Version 1.30 Page 16 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) 35 & 36 Training and formal supervision programmes are being developed to ensure a competent workforce is in place to ensure residents wellbeing and safety are protected at all times. EVIDENCE: The manager has obtained details of an induction programme that meets current guidelines that will be implemented when new members of staff are employed. A format to record all staff training and training that is required has been designed and is due to be implemented. Once this is in place the manager will be able to review staff learning needs and ensure their learning needs are met. Discussion with staff at the home suggested that they feel that although they receive training regarding mandatory topics such as health and safety, moving and handling and fire safety further training would be helpful to ensure they meet all the needs of the residents. One topic that they wish to have further training on is managing challenging behaviour. This was discussed with the manager who agreed to action this request. At the time of the inspection formal supervision had not been effectively implemented. The manager discussed with the inspector her plan to share this responsibility with other members of the staff team. Westbury House Nursing Home H54 S11525 Westbury House V233305 120705.doc Version 1.30 Page 17 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 & 42 Staff at the home recognise that Westbury House is the home of the residents and consequently residents views and wishes are an integral part of the running of the home. The health and safety of the residents, staff and all who enter the home are promoted and safeguarded by the practices at the home. EVIDENCE: The manager discussed with the inspector that she plans to utilise the Registered Nursing Homes Association information and training to aid in the audit of the service provided at the home. At the present time the reviewing of care plans, resident meetings, staff meetings, the review of risk assessments and the planned review of policies and procedures all aid in the audit of the service provided at the home. Residents are able to express their opinions directly to a staff member or through one of the resident meetings. Residents that the inspector had conversions with suggested that they are able to express their views regarding the home that these views are usually acted upon. A residents and relatives survey is to be utilised as part of the quality Westbury House Nursing Home H54 S11525 Westbury House V233305 120705.doc Version 1.30 Page 18 assurance programme for the home. Monthly visits by a representative of the provider result in a documented report regarding the service provided by the home that also enhances the auditing of the service provided. The manager informed the inspector that the policies and procedures relating to health and safety topics are due to be reviewed in the near future. All staff receive the recommended fire safety training and moving and handling training with relevant staff members receiving training with regard to food hygiene, first aid, COSHH and infection control. A sample of service certificates were viewed evidencing that all equipment and services are maintained as recommended by guidelines of the manufacturers. As stated previously the manager is in the process of reviewing all risk assessments for the environment that incorporate fire safety, COSHH, first aid, moving and handling, infection control issues for the environment. Westbury House Nursing Home H54 S11525 Westbury House V233305 120705.doc Version 1.30 Page 19 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 1 x x x x Standard No 22 23 ENVIRONMENT Score x 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x x Standard No 11 12 13 14 15 16 17 x 3 3 x x x 3 Standard No 31 32 33 34 35 36 Score x x x x 2 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Westbury House Nursing Home Score x x 2 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x H54 S11525 Westbury House V233305 120705.doc Version 1.30 Page 20 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. 2. Standard Regulation Requirement Timescale for action Septmeber 30th 2005 YA20 13(2) 3. YA23 13(6) 4. YA35 18 5. YA36 18 6. YA42 13(4) The registered person must ensure a poolicy and procedure is availble regarding service users administering their own medications. The registered person must ensure that all staff receive training with regard to the protection of vulnerable adults. The registered person must ensure that there is a structured training and development programme at the home, ensuring that all staff receive at least five training and development days per year. THIS IS A REPEATED REQUIREMENT FROM 04/01/05 The registered person must ensure that all care staff receive formal supervision at least six times a year. THIS IS A REPEATED REQUIREMENT WAS FROM 14/01/05 The registered person must ensure risk assessments are in place relating to the service users accessing the community. September 30th 2005 October 1st 2005 October 1st 2005 September 1st 2005 Westbury House Nursing Home H54 S11525 Westbury House V233305 120705.doc Version 1.30 Page 21 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. 2. Refer to Standard YA35 YA1 Good Practice Recommendations All staff should recieve training with regard to the management of service users with challenging behaviour. Residents views regarding the service supplied at the home should be included within the service users guide. Westbury House Nursing Home H54 S11525 Westbury House V233305 120705.doc Version 1.30 Page 22 Commission for Social Care Inspection 4th Floor- Overline House Blechynden Terrace Southampton Hampshire 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 Westbury House Nursing Home H54 S11525 Westbury House V233305 120705.doc Version 1.30 Page 23 - 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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