Inspection on 13/09/06 for Westcotes Rest Home

This inspection was carried out on 13th September 2006.

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 but made no statutory requirements on the home.

Other inspections for this house

Westcotes Rest Home 01/11/07

Westcotes Rest Home 10/01/06

Westcotes Rest Home 04/10/05

Westcotes Rest Home 08/12/04

Westcotes Rest Home 03/08/04

Westcotes Rest Home 26/11/03

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Westcotes Rest Home 113-115 Hinckley Road Leicester Leicestershire LE3 0TF Lead Inspector Ruth Wood Unannounced Inspection 13th September 2006 10:00 X10015.doc Version 1.40 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 Westcotes Rest Home DS0000006416.V311159.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 Older People. 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. Westcotes Rest Home DS0000006416.V311159.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Westcotes Rest Home Address 113-115 Hinckley Road Leicester Leicestershire LE3 0TF 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) 0116 233 2919 0116 299 4384 Mr Les Downing Mr Les Downing Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Westcotes Rest Home DS0000006416.V311159.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To be able to admit the person of Category MD named in variation application number 34009 dated 4th July 2002. 10th January 2006 Date of last inspection Brief Description of the Service: Westcotes Rest Home is located on Hinckley Road close to shops, public houses and bus routes, which lead to the centre of Leicester. The home provides a service for 20 older people in a spacious Victorian building. There are three lounges, one dining room and one double bedroom located on the ground floor. The remaining bedrooms (two doubles and fourteen singles) are located on the first and second floors and are accessible either by passenger lift or stairs. There is a paved courtyard to the rear of the building with patio furniture and tubs of plants and flowers where some residents like to sit. Current fees at the home are £320 per week. Westcotes Rest Home DS0000006416.V311159.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on a weekday between 10am and 5pm. Discussion was held with 9 residents and the care records of two of these were examined in detail. Discussion was held with the senior carer in charge about these residents’ needs as well as matters relating to all aspects of the management of the home. The Registered Manager met with the Inspector briefly to explain that he retained control of recruitment and finance within the home but had devolved responsibility for its day-to- day running to the senior carer. The inspector also spoke to one resident’s relative about the way their relative’s needs were met. Medication, fire, staff and residents’ finance records were examined and all areas of the home were viewed, with the exception of one double room. Five residents’ comment cards were received and the views expressed on these were also taken into account. What the service does well: What has improved since the last inspection? What they could do better: Certain aspects of practice relating to health and safety need improvement: • • • The hoist (although not currently in use) has not been serviced since April 2004 and must be serviced before use and by 13/10/06. Staff training in moving and handling needs updating It was recommended at the previous inspection that one resident’s longterm use of cot sides be re-assessed. This was not acted upon and should now take place as a matter of urgency. Westcotes Rest Home DS0000006416.V311159.R01.S.doc Version 5.2 Page 6 • • Documentation relating to the maintenance of the fire alarm system should be kept at the home and be available for inspection. Some staff’s training in food hygiene needs updating. Two further recommendations/requirements made at the previous inspection have still not been acted upon: • The registered manager should ensure that key staff be made aware of the Department of Health’s Guidance on the Protection of Vulnerable Adults. A system of internal monitoring involving regular consultation with residents and other interested parties must be developed. • Finally improvements are needed in assessment practice and care records: • • A member of the home’s staff should assess residents’ needs before they come to live in the home to make sure the home can meet those needs. Entries should be made to the daily record with sufficient frequency to ensure that all key information is recorded. 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. Westcotes Rest Home DS0000006416.V311159.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Westcotes Rest Home DS0000006416.V311159.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Improvement is needed in how residents’ needs are assessed before they move into the home, to ensure that they can be met. EVIDENCE: A resident who recently came to live at Westcotes said that no one from the home had visited them to talk about their needs before they were discharged from hospital. The senior carer in charge confirmed this. It is recommended that a member of the home’s staff assess all prospective residents’ needs before they come to live in the home, to make sure that they can be met. The resident’s care file did contain a social worker’s comprehensive assessment (which had been faxed to the home before the resident’s admission) together with an assessment completed by the senior staff member, after their admission. This covered all aspects of need and appeared to reflect actual care required as observed and as described by the resident. The home does not provide intermediate care therefore this key standard has not been assessed. Westcotes Rest Home DS0000006416.V311159.R01.S.doc Version 5.2 Page 9 Westcotes Rest Home DS0000006416.V311159.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are treated with respect, their health and medication needs are well met and care plans and other records mostly reflect their needs. EVIDENCE: Two residents’ care plans were examined in detail. Both contained details of their personal and social care needs, together with risk assessments relating to specific aspects of care such as mobility. They also contained evidence of action taken to ensure good pressure area care, and various aids (such as special mattresses and cushions) were in use. Daily records were written in appropriate language and contained detailed information. However information was not recorded on a daily basis and this had led to some gaps in information. It is recommended therefore that entries be made to the daily record with sufficient frequency to ensure key information is recorded. Residents have access to chiropodists, dentists and opticians and can retain their own GP (if appropriate) or register with one of the local practices. Specialist services such as consultant psychiatrists are also accessed if required. Westcotes Rest Home DS0000006416.V311159.R01.S.doc Version 5.2 Page 11 Medication records were accurate and there were good systems in place for recording medication received and returned. Running totals for controlled medication were accurately recorded. All medication was appropriately stored and there were no excessive stocks. The senior carer and staff displayed a good understanding of the physical and emotional needs of those who may be reaching the end of their lives. This was confirmed through discussion with one resident and their relative. Staff were observed to treat residents with respect, knocking before entering their rooms and speaking with them in an appropriate manner. Westcotes Rest Home DS0000006416.V311159.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ social, cultural and religious needs are met; they can exercise choice in their daily lives and are supported in maintaining contact with family and friends. Good food is served in pleasant surroundings. EVIDENCE: Residents can exercise choice in relation to their daily routine (for example in relation to when they get up and go to bed). Current residents’ religious needs are met by visiting clergy and a communion services is held once per month in the home. Residents’ hobbies and interests are recorded on care plans and most appeared satisfied with the range and frequency of activities on offer. The senior carer commented that it was becoming more difficult to arrange suitable outings given the increasing frailty of many of the residents. One resident commented, “There is room for improvement in this area”. All nine residents spoken with said that they enjoyed the singer who visited the home every month with one commenting, “He makes me laugh”. There are three lounges and a separate dining room, which means there is plenty of space for residents to meet with their relatives in private. One visiting Westcotes Rest Home DS0000006416.V311159.R01.S.doc Version 5.2 Page 13 relative said that they had always felt very welcome in the home and could drop in at any time. Menu records showed that there is a choice of main course at lunchtime and that fresh vegetables and home made puddings are regularly served. Comments received were favourable “the food’s good – it’s well cooked” “the food is very good”. All five residents who returned questionnaires said that they liked the food served. Some residents had recently asked if they could be served tea (the evening meal) in the lounges so they could continue to watch television. This choice is now offered. Westcotes Rest Home DS0000006416.V311159.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ concerns and complaints are listened to and adequate systems are in place to ensure protection. EVIDENCE: Eight of the nine residents spoken with said that they would tell one of the senior carers if they weren’t happy with anything and felt confident that any problems would be sorted out. The remaining resident commented that “You don’t have to tell them if anything is wrong, the staff can tell by looking at you and they will ask you what the matter is.” Introducing a book to record any concerns together with the response made to put things right would mean that this information could then be used as part of the home’s formal quality assurance (see also Standard 33). The two staff records sampled showed that they had received training in how to recognise abuse and that these staff also had an enhanced Criminal Records Bureau check. The senior staff member in charge appeared unsure as to the current Department of Health Guidance concerning the protection of vulnerable adults. As at the previous inspection it is recommended that the registered manager ensure that key staff be made aware of this guidance. Good procedures are in place to safeguard residents’ finances (see Standard 37). Westcotes Rest Home DS0000006416.V311159.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Westcotes is clean and comfortable and therefore provides a pleasant environment for residents to live in. EVIDENCE: All areas of the home appeared clean; bathrooms, toilets, communal areas and individual bedrooms. Four respondents to the residents’ questionnaires said that the home was always fresh and clean and one said the home was usually fresh and clean. Since the last inspection two bedrooms have been re-decorated and have had new carpets fitted. All areas of the home are comfortably furnished and residents expressed satisfaction with both the communal rooms and their bedrooms. There is a large patio area at the rear of the home with garden furniture and pot plants, which some residents said they had sat out in during the summer. Westcotes Rest Home DS0000006416.V311159.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported by sufficient numbers of trained staff and are protected by recruitment policies and practice. EVIDENCE: There are sufficient staff members on duty to meet current residents’ needs. The nine residents spoken with at the inspection generally gave positive comments about the staff members, describing them as “very good” and “nice girls”. Of the five responses to the residents’ questionnaires received, two stated that there were always staff available when needed, one felt that there were usually staff available and two that they were sometimes available. Staff were observed to respond promptly to requests for help from residents. Seven care staff hold a National Vocational Qualification in Care at level 2 and two care staff are due to start level 3 training, later this month. Updates are required for all staff in moving and handling and this should be arranged as soon as possible. Updates are also required for some staff in food hygiene. There has been no change in staffing since the last inspection. Two care staff’s records were examined; these contained a written application form, two written references and evidence that a criminal records bureau check had been undertaken. Westcotes Rest Home DS0000006416.V311159.R01.S.doc Version 5.2 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Improvements are needed in some aspects of management, quality assurance and health and safety to ensure that the home promotes the best interests of residents. EVIDENCE: The registered manager, Mr Downing has delegated the day- to- day running of the care home to a senior member of staff who has recently started a programme of learning to achieve the National Vocational Qualification in Care at level 4. Mr Downing retains responsibility for recruitment, administration and financial matters. There are some areas of management and administration that require improvement. There is still no formal system in place to make sure that the quality of service in the home is maintained and improved. Staff do respond to residents’ views but this takes place on an informal basis and does not ensure that everyone contributes and that everyone is heard. The senior carer in charge also keeps Westcotes Rest Home DS0000006416.V311159.R01.S.doc Version 5.2 Page 18 a log of thank you letters received from residents’ relatives but this is the only recorded contact with relatives. More systematic consultation must take place with residents, relatives and other interested parties such as general practitioners and commissioning social workers to find out their views on the quality of service provided and how it may be improved. The majority of residents are supported to manage their finances and full records are kept of all transactions. Two records and the balances held were checked at random and found to be correct. Some aspects of safe working practice need improvement: • The hoist (although not currently in use) has not been serviced since April 2004 (the required service interval is every six months). • Staff training in moving and handling needs updating • It was recommended at the previous inspection that one resident’s longterm use of cot sides be re-assessed. This was not acted upon. • There was no documentation available to say when the fire alarm system had been tested. • Several staff require an update in food hygiene training. Many • • • • • aspects of safe working practice have been addressed: Staff are currently receiving updates in their first aid training. The home’s passenger lift was serviced on the day of the inspection, Fire records record that the alarm system is tested on a weekly basis. Fire extinguishers were serviced on 19/09/06 Small electrical appliances were tested on 20/07/06. Westcotes Rest Home DS0000006416.V311159.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 1 Westcotes Rest Home DS0000006416.V311159.R01.S.doc Version 5.2 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 Standard OP18 Regulation 13 Requirement The registered manager must ensure that he and key staff are aware of the Department of Health’s Guidance on the Protection of Vulnerable Adults. (Previous timescale of 17/02/06 not met). The hoist must not be used again until it has been serviced. It must be serviced every six months. Advice must be sought from the District Nurse about one resident’s long-term use of cot sides. Timescale for action 31/10/06 2 OP38 13 13/10/06 3 OP38 13 30/09/06 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 OP3 Good Practice Recommendations A member of the home’s staff should assess residents’ needs before they come to live in the home to make sure the home can meet those needs. DS0000006416.V311159.R01.S.doc Version 5.2 Page 21 Westcotes Rest Home 2 3. OP7 OP33 4 5 6 OP38 OP38 OP38 It is recommended that entries be made to the daily record with sufficient frequency to ensure that all key information is recorded. A system of internal monitoring within the home that involves regular consultation with residents and other interested parties must be developed. (Required at the previous inspection and not followed) All staff members should receive an update of their training in safe moving and handling as it has been over 12 months since this training was last delivered. All staff members who prepare and serve food should receive update of their training in food hygiene as recommended by the training authority. Documentation relating to maintenance of the fire system should be kept at the home and available for inspection. Westcotes Rest Home DS0000006416.V311159.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX 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 Westcotes Rest Home DS0000006416.V311159.R01.S.doc Version 5.2 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. 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