Inspection on 24/01/07 for Westcliffe House

This inspection was carried out on 24th January 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 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

Westcliffe House 26/04/10

Westcliffe House 22/01/09

Westcliffe House 11/12/05

Westcliffe House 14/10/04

Westcliffe House 13/05/04

Westcliffe House 24/02/04

Similar services:

Clouds House

Closereach

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

CARE HOME ADULTS 18-65 Westcliffe House 12 Madeira Road Weston Super Mare North Somerset BS23 2EX Lead Inspector Juanita Glass Unannounced Inspection 24th January 2007 09:30 Westcliffe House DS0000008108.V326259.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 Westcliffe House DS0000008108.V326259.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. Westcliffe House DS0000008108.V326259.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Westcliffe House Address 12 Madeira Road Weston Super Mare North Somerset BS23 2EX 01934 629897 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) Westcliffe House House Limited Mrs Patricia Margaret Bugler Care Home 20 Category(ies) of Past or present alcohol dependence (20), Past or registration, with number present drug dependence (20) of places Westcliffe House DS0000008108.V326259.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Westcliffe House House is a rehabilitation unit for up to 20 service users who have been through detoxification and are now embarking on an individualised therapeutic program working towards rehabilitation from addiction. The home is situated near the beach and within easy access of local amenities, bus and train services. The home also makes use of the amenities provided by Weston College for education purposes. Westcliffe House DS0000008108.V326259.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Current fees: unavailable This key inspection took place over 51/2 hours in the presence of the home manager Mrs Pat Bugler. During this inspection 11 clients undergoing the treatment programme and 2 clients who had completed the programme were spoken to. Records were also reviewed to support the evidence gathered through talking with the manager, staff and clients. Clients spoken to were unanimous in their praise of the treatment programme and the support they had received at Westcliffe House. The main emphasis of client comments was the respect and trust they experienced from staff and the programs emphasis on self worth and self-esteem. One client said they had tried to buck the system at a previous placement but felt no need to at Westcliffe House as they were trusted. No requirements were made following this inspection. What the service does well: What has improved since the last inspection? What they could do better: No requirements were made. It was recommended that the manager reviews staff personnel files to include all the information listed in schedule 2 of The Care Homes Regulations. Please contact the provider for advice of actions taken in response to this Westcliffe House DS0000008108.V326259.R01.S.doc Version 5.2 Page 6 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. Westcliffe House DS0000008108.V326259.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 Westcliffe House DS0000008108.V326259.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, and 4 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Information provided by the home is comprehensive and includes input from past clients. All new clients receive a full comprehensive needs assessment before admission, which is carried out by staff with skill and sensitivity. Prospective clients are given the opportunity to spend time in the home. EVIDENCE: Clients spoken to during the inspection all said that they had received adequate information to prepare them for the program at Westcliffe House. One client said there had been no surprises. Clients also stated that they had been given the choice of coming to Westcliffe House and they had all visited the home prior to making a final decision. Records reviewed showed that the manager receives an initial referral when basic details are given. A visit is then arranged to the home when an in-depth assessment of needs is carried out. A minimum of two hours is recommended for this process. Clients said that when they visited they got a chance to meet existing clients which they felt was helpful. Westcliffe House DS0000008108.V326259.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, 8 and 9 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. A key principle of Westcliffe House is based on the belief that residents should be able to take control of their lives. Staff have the necessary training and skills to support and encourage clients to be fully involved in their treatment programme and the running of the home. EVIDENCE: Client records reviewed contained all the information needed to provide individual plans. Each clients programme includes support and training in areas such as literacy, parenting skills and pursuing an education or job. Clients spoken to all stated that they had discussed and agreed their programme with counsellors and support workers. Clients also agreed that any decisions they made personally were respected by staff who would then help them and advise them when needed. Both care plans and clients spoken to emphasise the need for clients being encouraged to take personal responsibility for their own actions within the supportive network of the home. Westcliffe House DS0000008108.V326259.R01.S.doc Version 5.2 Page 10 Clear risk assessments are in place were a need is identified. These all showed clear evidence of having been agreed with the client and reviewed regularly. The manager conducts a weekly meeting with all the clients on Sunday, and then feeds back to a staff meeting on Monday. All clients spoken to felt that they were consulted adequately in the running of the home. Westcliffe House DS0000008108.V326259.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 14, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Westcliffe House gives a strong commitment to enabling residents to develop their skills including social, emotional, communication and independent living skills. The menu is varied with choices which include healthy options. EVIDENCE: During the inspection clients continued to attend the group sessions which form part of their programme. Apart from the one-to-one sessions and group work other support groups include parenting, communication skills, literacy skills, art therapy, drama and life skills. Outside assistance is also sought to support any client identified as having literacy problems. Clients are then also encouraged to follow courses of their choice at Weston College. Clients spoken to who had completed the programme said that the home had encouraged them to take part in events in Weston-super-Mare and they had been given Westcliffe House DS0000008108.V326259.R01.S.doc Version 5.2 Page 12 assistance to attend a AA (Alcoholics Anonymous), NA (Narcotics Anonymous), college and the YMCA. The program followed keeps clients very busy however they do have access to leisure activities at the weekend although a formal activities program is not arranged. Photographs displayed in the hall showed that clients had taken part in a two-day self-development session at Goblin Combe. Where they learnt how to work as a team, and then assisted with conservation work. On admission clients agree to no contact with family or friends for the first two weeks. Clients spoken to said they understood the need for this. They also said that any individual restrictions were agreed between the client and staff. All clients spoken to said they felt the restrictions were acceptable and not out of context. Clients spoken to said that the food in the home actually exceeded their expectations. A menu, which includes choice and healthy options, is maintained. Staff are aware of any health or cultural needs a client may have regarding their diet. Westcliffe House DS0000008108.V326259.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The statement of purpose clearly details specialist treatment the home can deliver. Staff understand the need to give personal support and respond to the varied and individual needs of the clients. Clients have access to health care services. Clients who have the capacity are encouraged to keep and take their own medication. Staff administering medication have undertaken accredited training. EVIDENCE: Westcliffe House does not provide nursing care. Staff provide personal support for clients needing one-to-one counselling. All clients are registered with a GP on admission and a full health check is carried out routinely. Where any special needs are identified such as mental health, or specialist medical needs the home maintains contact with the local health professionals who ensure ongoing support. All clients spoken to praised staff highly for the level of care they received in the home. The home has a very clear policy on unacceptable Westcliffe House DS0000008108.V326259.R01.S.doc Version 5.2 Page 14 behaviour, which involves the whole community. During the inspection one client was observed being assisted to make an appointment to see the dentist. Client’s records showed evidence of visits to the dentist, optician and outpatient appointments at the hospital. Clients are encouraged to manage their own medication whenever possible with support and guidance from staff. The storage and documentation of medication administered by staff was adequate and no errors were found. All staff administering medication have received appropriate training. A weekly audit is carried out of medication kept in the home and a clear audit trail is maintained. Westcliffe House DS0000008108.V326259.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Westcliffe House has an open culture, which enables residents to express their views and concerns in a safe and no blame environment. The policies and procedures regarding protection of individuals are well maintained and regularly reviewed and updated. EVIDENCE: The complaints policy and procedure is very clear and concise. It is included in the service user guide and clients spoken to said they had read it and had been made aware that they could approach anybody in the home with a concern. Clients said they felt the Sunday meetings held with the manager meant that any concerns they had could be raised immediately. Staff in the home have received training in adult protection issues and are aware of the homes policy on adult protection and whistleblowing. A copy of the North Somerset inter-agency policy and procedure is also available in the office Westcliffe House DS0000008108.V326259.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home provides a physical environment that is appropriate to specific needs of the clients who live there. The home has a good infection control policy and they can seek advice from external specialists if needed. EVIDENCE: A tour of the premises was not carried out during this inspection. Clients confirmed that their rooms are adequate for their needs. Communal areas are also used during the day for one-to-one and group sessions. One room and the garden has been allocated as a smoking area. The standard of décor and hygiene continues to be well maintained with clients encouraged to be responsible for some household duties. A programme of ongoing maintenance and decoration is maintained. Westcliffe House DS0000008108.V326259.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, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Westcliffe House ensures all staff within its organisation receives relevant training which is targeted and focused on improving outcomes for clients. Westcliffe House has a good recruitment procedure that clearly defines the process to be followed. This was difficult to evidence due to lack of some information. EVIDENCE: All staff employed at Westcliffe House have skills in areas other than dependency/addiction. This enables the home to provide alternative therapies and a high level of support for the clients. Staff personnel records showed that a programme of training is maintained. All staff have attended or have planned dates for mandatory training and training in issues relevant to their role in the home. Clients spoken to said that staff demonstrated the level of knowledge that they expected. Policies and procedures for recruitment in the home are robust. The manager confirmed that these procedures are followed when recruiting new staff. It was difficult to evidence that all the information required had been obtained as copies were not maintained in all personnel files. It was recommended that Westcliffe House DS0000008108.V326259.R01.S.doc Version 5.2 Page 18 the manager reviews personnel files ensuring they contain all the information required under Schedule 2 the Care Homes Regulations. Westcliffe House DS0000008108.V326259.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 and 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The manager has required qualifications and experience is competent in running the home. She works to continuously improve services and provide an increased quality of life for the clients. The home has a good record of meeting relevant health and safety requirements legislation. Clients are also made aware of safety arrangements within the home EVIDENCE: The manager is also the co-owner of the home and an experienced counsellor. Clients spoken to said they felt they knew where they were with the manager. Two clients said Pat is firm but fair and it is one rule for everyone, you know where you stand.. Clients also felt the Sunday meeting with the Westcliffe House DS0000008108.V326259.R01.S.doc Version 5.2 Page 20 manager were very helpful. They felt this direct contact with the person in charge reinforced their involvement in the running of the home. One client said you feel youve got a say and nobody puts you down. The home carries out a quality assurance process when a client has finished the program and leaves the home. Clients’ comments are readily available for others to read when they visit the home prior to admission. Health and safety within the home is satisfactory. A review was carried out of the firelog, service records and regular maintenance. Clients are always involved in regular fire drills. When first admitted to the home clients are also taken through a checklist of health and safety requirements that they must follow. All staff have received relevant training in fire prevention and health and safety. Westcliffe House DS0000008108.V326259.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 4 2 3 3 X 4 4 5 X 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 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 4 X LIFESTYLES Standard No Score 11 4 12 3 13 X 14 3 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 x 3 X 3 X X 3 X Westcliffe House DS0000008108.V326259.R01.S.doc Version 5.2 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 YA34 Good Practice Recommendations The manager should review personnel files ensuring they contain all the information required under Schedule 2 the Care Homes Regulations. Westcliffe House DS0000008108.V326259.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Westcliffe House DS0000008108.V326259.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. 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