Inspection on 26/07/05 for Westcliffe House

This inspection was carried out on 26th July 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

Westcliffe House 04/06/07

Westcliffe House 16/03/06

Westcliffe House 24/02/05

Westcliffe House 07/10/04

Westcliffe House 24/02/04

Similar services:

Littledale Hall Therapeutic Community

Bennett House

Padgate House

Mary & Joseph

Richards House

Hamer Cottage

Turning Point (Hoole Road)

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

CARE HOME ADULTS 18-65 Westcliffe House 3-4 Braddocks Close Hurstead Rochdale OL12 9UZ Lead Inspector Bernard Tracey Announced 26 July 2005 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. Westcliffe House F56 F06 S25533 Westcliffe House V221169 26.07.05 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Westcliffe House Address 3-4 Braddocks Close Hurstead Rochdale OL12 9UZ 01706 377197 01706 372910 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) Turning Point Deborah Bithell Care Home Only 8 Category(ies) of A - Alcohol dependence past/present registration, with number D - Drug dependence past/present of places Westcliffe House F56 F06 S25533 Westcliffe House V221169 26.07.05 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The home is registered for a maximum of 8 service users to include up to: 8 service users in the category of A (Adults with past or present alcohol dependence); 8 service users in the category of AD (Adults with past or present drug dependence). The service should employ a suitably qualified and experienced manager who is registered with the CSCI. Date of last inspection 24 February 2005 Brief Description of the Service: Westclife House is a residential service for 8 individuals who need support in achieving a drug and alcohol free lifestyle and have been unable to achieve this whilst living in their own home or community. The project operated by Turning Point, a national charity, enables individuals aged 18 - 65 years to develop skills so that they may eventually live independently. Single personal accommodation is provided along with shared communal facilities of lounges, kitchen, and bathrooms. The property is situated on the outskirts of Rochdale town centre and is conveniently close to local shops and post office.. Westcliffe House F56 F06 S25533 Westcliffe House V221169 26.07.05 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place on the 26th July 2005 by one inspector. A total of 5 hours were spent at the home. The home was made aware that this inspection was to take place. Several weeks before the inspection questionnaires were sent out to doctors, social workers and district nurses, as well as to the residents of the home and their relatives. The questionnaires asked what people thought of the care and services provided by the home. The Inspector spent time speaking to 5 residents both individually and as a group. He also spoke to 2 support staff and the manager. The Inspector also took the opportunity to read through records relating to how the care of residents was planned and carried out including how the residents spent their time during the day and how they were supported in taking personal responsibilities for themselves within their own capabilities. When talking with the residents they were asked what they thought of the home and had they been given enough information about the home before being admitted. They were also asked how they felt the staff looked after them. He also examined files that contained information about how the staff were recruited for their jobs, as well as records about staff training and how this helped staff to their job correctly. What the service does well: Prior to moving into the home each individual receives a detailed assessment to determine if the home can meet his or her needs. If admission to the home is appropriate individual written plans are provided with the full involvement of the individual and the resident receives a copy of this plan. One resident who had recently been admitted said that he “ was glad he had come to the home and felt they would definitely be able to help me”. Another resident said he felt “the staff are brilliant – really approachable” and added that “they had helped me open up and talk about what really bothers me”. The home offers a relaxed environment and residents spoken with described the project as “homely”, “comfortable”, and that “staff know their job and can’t do enough for you”. Westcliffe House F56 F06 S25533 Westcliffe House V221169 26.07.05 Stage 4.doc Version 1.40 Page 6 There is a structured treatment programme for each individual as well as the opportunity to develop new skills and enjoy new leisure pursuits. Staff felt that they provided a person centred approach with good involvement of residents in the running of the home. 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. Westcliffe House F56 F06 S25533 Westcliffe House V221169 26.07.05 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 Westcliffe House F56 F06 S25533 Westcliffe House V221169 26.07.05 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) 1 2 3 4 5 The system for ensuring that all residents had a detailed assessment before their admission gave an assurance both to residents, relatives and staff that a resident was only admitted if the home could meet their needs. Each resident is supplied with a licence agreement that ensures that they are aware of the terms and conditions of their stay. EVIDENCE: Before any resident was admitted to the home an assessment of their needs was undertaken, by a senior member of staff from the home. The assessment form of a recently admitted resident was looked at. The information obtained provided care staff with the necessary information to ensure that the individual’s care needs could be met and that the home was appropriate to his needs. Residents are provided with a Handbook and Service User Guide that gives up to date information about the services the home provides and enables the residents to make an informed decision in respect of admission to the home. During a group discussion with the Inspector, all of the residents said they felt they had been given sufficient information about the project prior to moving Westcliffe House F56 F06 S25533 Westcliffe House V221169 26.07.05 Stage 4.doc Version 1.40 Page 9 into the home and confirmed they had received the handbook and had a licence agreement. It would not be appropriate for residents to live in the home on a trial basis, as the nature of the project is short-term rehabilitation. Potential residents are, however, able to visit the project prior to admission and are provided with sufficient introductory information for an informed choice to be made prior to admission. Residents said that they had been able to spend time with prospective clients showing them around the project and answering any questions they may have. A resident recently admitted said had had found this “useful and it stopped the nerves jangling”. Westcliffe House F56 F06 S25533 Westcliffe House V221169 26.07.05 Stage 4.doc Version 1.40 Page 10 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 8 9 10 Residents are involved in drawing up their own care plans to ensure that their needs are identified and how these will be met. Residents are consulted to ensure that they have a say in their own care and in the running of the home. EVIDENCE: All residents have a care plan that has been signed by the individual and the project worker. Examination of the documents and subsequent discussions with the residents confirmed that each individual is involved from the outset in identifying their own needs and aspirations and in determining the support they required to enable them to achieve these. Individuals confirmed that there was the opportunity to regularly review the plan with staff, and if necessary include things that have changed. Residents are allocated a key worker and those residents interviewed confirmed that there are regular one to one support sessions. Some residents felt they would benefit from more frequent key worker sessions, although others said they thought the sessions they currently had were sufficient. Westcliffe House F56 F06 S25533 Westcliffe House V221169 26.07.05 Stage 4.doc Version 1.40 Page 11 Restrictions on choice and freedom are discussed and agreed prior to admission with the resident and recorded on the care plan. Restrictions are also recorded in the Resident Handbook, which each resident receives either prior to admission or on arrival at the home. Should additional restrictions need to be implemented they are agreed with the resident and documented on a monitoring contract, which is signed by both parties. Where it is identified there is a risk of self-harm, a risk assessment is drawn up and all staff are alerted to this. Risk assessments are also undertaken for other identified risk areas and the home operates a ‘current’ risk notification that is held in the daily communication book to ensure that all staff are aware of any changes in a residents mental health needs. Westcliffe House F56 F06 S25533 Westcliffe House V221169 26.07.05 Stage 4.doc Version 1.40 Page 12 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 14 15 16 Residents are encouraged and supported by the staff to acquire new skills and to live more independently, promoting a successful transition to returning to live in the community and to maintain their sobriety. A broad range of group and individual activities are designed in assisting residents to achieve their potential and fulfil their personal aims. EVIDENCE: As part of the rehabilitation programme, residents are expected to attend groups at the project, which are not optional. Group work forms an important part of the treatment programme and covers such areas as relapse prevention, living a sober life, assertiveness and building self - esteem. Outside of the treatment programme residents are encouraged to develop meaningful activities within the local community. Care plans inspected identified how this occurred in practice by attending other projects/organisations and undertaking voluntary work. Conversations with the residents identified how this was achieved in practical terms. Westcliffe House F56 F06 S25533 Westcliffe House V221169 26.07.05 Stage 4.doc Version 1.40 Page 13 A resident described how he had been able to access attendance at a local Resource Centre as well as regular access to the Alcohol and Drug Services in Rochdale. His leisure time was mainly spent at the local gymnasium for which the Project had obtained a ‘free pass’ for him. As part of his future personal development he said he was looking to enrol at the local college and undertake a course in counselling. A group discussion with four residents confirmed that the home provides support and advice to residents in accessing suitable training courses, educational facilities and leisure outlets. One resident said that within the agreed treatment programme individuals are able to make their own choices “you can go out and the staff trust you to keep your end of the bargain” Each resident’s personal privacy is maintained. One resident said that staff members “always knock on your door and wait until you respond before entering the room”. This was confirmed when the inspector toured the building with the manager. Staff enter bedrooms only with permission and in the presence of the resident. The Resident Handbook clearly sets out that visitors are welcome but that residents should inform the home that they are expecting guests. Residents’ families, including children, can visit the project with prior agreement of project workers and other residents. Examination of this policy indicates a need to provide a more detailed assessment and pre visit checklist that ensures all relevant authorities and contact details for the period of the visits are in place. This was discussed with the Project manager at the inspection. The home does arrange some organised activities, particularly trips out from the home. There is a trip arranged to Blackpool in the near future and one resident was going to York with the Alcohol ands Drugs Services During a group discussion residents explained that they are given a weekly amount of money for food shopping. Each person takes responsibility for their own meals though sometimes two residents might agree to cook for each other. Due to the previous lifestyles of some residents, neglect of personal diet is addressed at the initial medical assessment and if required a referral is made to the dietician. Westcliffe House F56 F06 S25533 Westcliffe House V221169 26.07.05 Stage 4.doc Version 1.40 Page 14 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 20 Residents are supported by the home to manage their own healthcare and to access NHS community facilities, thus ensuring the person’s health is reviewed and maintained. The ‘on – call’ arrangements in the home are not always adequate resulting in residents and staff being unable to summon assistance when it is required. EVIDENCE: Westcliffe House F56 F06 S25533 Westcliffe House V221169 26.07.05 Stage 4.doc Version 1.40 Page 15 Individual care plans are in place for each resident. Two care plans examined were well written, with evidence of resident involvement in formulation of the plan and the review of care. Access to all NHS services is upheld and documented within the care plan. Residents are registered with a local medical practice. For all other healthcare needs residents are supported in accessing relevant community facilities such as community nurses, dentists and opticians. Additionally where necessary, referrals would be made to specialist medical services. Project workers also provide residents with information regarding general healthcare and specific issues relating to their lifestyles and needs. Residents discussed how the group session held at the home provided strategies to deal with the emotional aspects of the illness as well as practical ways of dealing with maintaining sobriety. There is an expectation that all residents manage their own medication and the home provided written policies that supported this. Risk assessments are in place and each resident has a lockable personal space to store prescribed medication. At the time of the inspection the home was managing the medication of one resident in conjunction with the individual. Concern was expressed by residents at the arrangements made by the home for “out of hours” contact. One resident described an occasion when the arrangements had not worked well. An incident was also noted in the daily records of one resident where a member of staff had been unable to contact the on call person. There is clearly a need for the organisation to address the issues and provide an adequate on call system with written guidelines to both staff and residents. Westcliffe House F56 F06 S25533 Westcliffe House V221169 26.07.05 Stage 4.doc Version 1.40 Page 16 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) None of the key standards were examined on this occasion. EVIDENCE: The key standards were not inspected on this occasion. They will be inspected at the next inspection. Westcliffe House F56 F06 S25533 Westcliffe House V221169 26.07.05 Stage 4.doc Version 1.40 Page 17 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) None of the key standards were examined on this occasion.t EVIDENCE: The key standards were not inspected on this occasion. They will be inspected at the next inspection. Westcliffe House F56 F06 S25533 Westcliffe House V221169 26.07.05 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) 31 32 33 34 35 36 The residents were cared for by sufficient numbers of staff that were suitably trained and therefore had the knowledge and skills to meet the residents’ needs. The recruitment procedure suitably vets staff ensures that residents are not subject to a potential risk. EVIDENCE: Staff members interviewed, were able to demonstrate that they had a clear idea of their role and responsibilities within the home. They were able to describe the their role within the team, to support residents, as well as their specific responsibilities as key worker to the residents. Residents felt that the staff were supportive and very skilled in their role. Descriptions of staff members included “brilliant” “can’t do enough for you”. Although some residents felt that they would benefit from more one to one sessions, this was not an indication of insufficient staffing levels and it was felt this should be discussed at the community meeting where the opportunity to suggest changes is available. Westcliffe House F56 F06 S25533 Westcliffe House V221169 26.07.05 Stage 4.doc Version 1.40 Page 19 An annual training programme is circulated to all Turning Point establishments and staff consider which training courses will best meet their training needs. Two staff files were examined and were found to contain all of the information required. All staff receive an in-house induction as well as the mandatory induction training which Turning Point offers to all new employees which is in accordance with the Skills for Care induction programme. A system of formal staff supervision is in place with records of the monthly meetings maintained and kept in the individual staff file. Westcliffe House F56 F06 S25533 Westcliffe House V221169 26.07.05 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) 37 38 39 40 41 42 The home is well managed resulting in a consistent and reliable service for those using it. The home has a policy that relies on the views of residents and staff being able to be heard and thereby contributing to the development of the home in line with these views. Maintenance of equipment was up to date and staff had received relevant health and safety training, which promotes and safeguards the health, safety and welfare of the people using the service. Westcliffe House F56 F06 S25533 Westcliffe House V221169 26.07.05 Stage 4.doc Version 1.40 Page 21 EVIDENCE: The manager successfully completed BA (Hons) in Community Studies and the HNC in Business Studies. She has experience with the client group and has worked within the Turning Point organisation for the past 9 years. She is committed to training and has undertaken many of the mandatory training courses for managers i.e. recruitment and selection, equality and diversity, as well as other courses associated with her role. The manager is committed to ensuring that residents’ needs were well met and this is reflected in the standard of care provided. Feedback from residents and staff was positive with regard to her management style, stating she was “approachable and fair, as are all of the staff”. She had an “open door” policy whereby staff, or residents seek her out at any time if the matter could not wait until the community meeting. Regular staff meetings are held with resident representatives invited to the meeting. Through the use of questionnaires, daily meetings with residents the manager and staff constantly receive feedback on the project and whether it is meeting its intended purpose. Any areas of concern or suggested improvement are acted upon. This was confirmed in discussions with residents and staff members, Turning Point has a procedure for the safe working practices at the home and a full, comprehensive manual is available for staff to refer to. A named health and safety representative ensures that regular safety checks are undertaken throughout the building. Residents spoken with said they felt the environment was safe and free from any hazards. All maintenance and associated records were up to date. An accident book is in place and all incidents are recorded. Examination of these records indicated that appropriate recordings had been made and suitable actions taken in response to the incidents. Risk assessments for the home were in place. All residents spoken with confirmed they had knew what to do in the case of fire and were able to describe the course of action they would take in response to the fire alarm sounding. All staff have received training in first aid, food hygiene, alcohol/drug awareness. Westcliffe House F56 F06 S25533 Westcliffe House V221169 26.07.05 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 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 3 3 3 3 2 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Westcliffe House Score 2 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 3 F56 F06 S25533 Westcliffe House V221169 26.07.05 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. 2. Standard 15 18 Regulation 23 12 Timescale for action Detailed documentation must be 30th August in place when a child is visiting 2005 or staying at the home. Arrangement for out of hours 15th support to residents and staff september should be clarified. Staff and 2005 residents should at all times be able to contact an on call manager. Requirement 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 None Good Practice Recommendations Westcliffe House F56 F06 S25533 Westcliffe House V221169 26.07.05 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Turton Suite, Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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 Westcliffe House F56 F06 S25533 Westcliffe House V221169 26.07.05 Stage 4.doc Version 1.40 Page 25 - 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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