Inspection on 11/01/06 for Westcroft Nursing Home

This inspection was carried out on 11th January 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Westcroft Nursing Home 09/06/09

Westcroft Nursing Home 13/06/07

Westcroft Nursing Home 03/11/06

Westcroft Nursing Home 22/06/05

Westcroft Nursing Home 09/02/05

Westcroft Nursing Home 14/10/04

Westcroft Nursing Home 09/02/04

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Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

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Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Westcroft Nursing Home 5 Harding Road Hanley Stoke-on-trent Staffordshire ST1 3BQ Lead Inspector Peter Dawson Announced Inspection 11th January 2006 09:00 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 Westcroft Nursing Home DS0000026970.V260652.R01.S.doc Version 5.1 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. Westcroft Nursing Home DS0000026970.V260652.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Westcroft Nursing Home Address 5 Harding Road Hanley Stoke-on-trent Staffordshire ST1 3BQ 01782 284611 01782 215265 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) None Pradeep Arvind Patel Mr Devdutt Meethoo Care Home 27 Category(ies) of Dementia - over 65 years of age (6), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (6), Old age, not falling within any other category (27), Physical disability (3) Westcroft Nursing Home DS0000026970.V260652.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22/06/05 Brief Description of the Service: Westcroft Nursing Home is a small nursing home providing personalised care for up to 27 people. IT is located close to Hanley town centre and is a large pre-war house with purpose built 2 storey extension. There are 17 singe and 5 shared bedrooms, 18 having en-suite facilities. There are 2 bathrooms (one assisted) and walk-in shower room. There are 3 lounges, a conservatory, separate dining room and the usual office, kitchen and laundry facilities on the ground floor. Bedrooms are located on both floors and there is a shaft lift access to the first floor. The home provides care with nursing for up to 27 people, 3 of who may have a physical disability, 6 a mental disorder and 6 may required dementia care. The home is staffed by nurses at all times and supported by care assistants and supportive auxiliary staff. Westcroft Nursing Home DS0000026970.V260652.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. At the time of this announced inspection there were the maximum number of 27 people in residence including one in hospital, 3 people were reported to awaiting a place at Westcroft. The home is consistently full. The inspection was conducted over a period of 8 hours. A pre-inspection questionnaire had been completed and some information contained this report. 10 Feeback cards were received directly by the Commission form residents and 6 from relatives. All indicated a high level of satisfaction with care provision at Westcroft. There were many complimentary individual comments. Two residents expressed an area of dissatisfaction: One related to living in the home, the person was seen and the wrong “box” had been ticked –the person was happy with his care and the service provided. Another younger resident felt his wish to engage in external community activities were not being met. He was quite prescriptive about his wishes. This was discussed with the Manager and Activities worker and although some options had been explored/tried and found not to be suitable, others will be pursued in the future. The home does have a good record of providing a broad range or activities. Most residents were seen and approximately 10 spoken to individually and alone. All were very positive about the care they received and about staff commitment. Manager, proprietor and staff engaged openly in the discussions and it was clear that there was a relaxed and open atmosphere where any matters of concern could be raised and objectively discussed. Visitors were not spoken to during the inspection, only through a lack of opportunity. A visiting social worker was seen and spoken to who was investigating a potential vulnerable adults matter referred by the home – previous visits/discussions had taken place. The social worker indicated that staff had acted quite appropriately in making the referral and had showed a high level of staff awareness of the correct procedures to be followed. The reception area has been transformed following decoration and presents a brighter, welcoming homely impression. The proposed re-carpeting of vitually all areas of the home will have a further significant effect upon the overall presentation of the home to visitors. The present owner inherited a lack of reinvestment from the former owners and is succeeding in an ongoing programme of refurbishment of most parts of the home. All requirements and recommendations of the last report have been satisfactorily addressed. Westcroft Nursing Home DS0000026970.V260652.R01.S.doc Version 5.1 Page 6 What the service does well: What has improved since the last inspection? All requirements and recommendation of the last report have been satisfactorily addressed – they include: Extension of the audible nurse call alert. Cleaning routines in the kitchen area have made required improvements and some redecoration contributed. Pressure area treatments have been recorded to required professional standards. All residents are weighed monthly or weekly if there are concerns about weight loss. Privacy locks on 2 toilet areas previously inoperative have been replaced. All surplus equipment/rubbish has been removed from the garden area improving the presentation of the area. Paving slabs in the garden area have been made safe. Redecoration continues with the reception area, corridor areas on both floors and some bedrooms redecorated. Westcroft Nursing Home DS0000026970.V260652.R01.S.doc Version 5.1 Page 7 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. Westcroft Nursing Home DS0000026970.V260652.R01.S.doc Version 5.1 Page 8 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 Westcroft Nursing Home DS0000026970.V260652.R01.S.doc Version 5.1 Page 9 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): 1-5 There was good evidence of pre-admission procedures being followed including pre-admission assessments and introductions to the home. The statement of purpose provides the necessary information. Standards relating to choice of home were met. EVIDENCE: There is a statement of purpose and service users guide available in the reception area of the home for use by residents and visitors. The document reflects the aims and objectives and level of service provided by the home. Sponsored residents have a contract provided by the Local Authority of which they have a copy. Self funding residents are given a satisfactory statement of terms and conditions provided by the home. Westcroft Nursing Home DS0000026970.V260652.R01.S.doc Version 5.1 Page 10 Documents relating to several recently admitted residents were seen and contained pre-admission assessments carried out by the home and Care Management Assessments provided also prior to admission. The home will not admit residents without a Care Management Assessment. Relatives always visit the home prior to admission. Prospective residents are invited to the home, this does not always take place due to residence in hospital, confusion etc. but the homes preferred option is for people to spend a day in the home prior to admissions to provide the opportunity for them to make informed decisions about admission and, of course, to allow a more objective assessment to be made about care needs. Westcroft Nursing Home DS0000026970.V260652.R01.S.doc Version 5.1 Page 11 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 - 10 Care plans contained all required information to provide care including personal, health, social, recreational and emotional needs. High dependency needs are matched by high levels of personal care and clinical interventions. Recording has also improved in this area. Residents must be given the option of the free NHS chiropody service. Recording of medication management is good although the use of prescribed creams in the home should be reviewed and improved. EVIDENCE: Care plans were sampled and included 2 recently admitted residents. Records showed good and comprehensive information concerning all aspects of care were in placed and based upon assessments carried out prior to and following admission. Westcroft Nursing Home DS0000026970.V260652.R01.S.doc Version 5.1 Page 12 There was particularly good concise and relevant information in relation to recent admissions. All plans are reviewed on a monthly basis as required and plans revised where there were swift or significant changes in care needs. At the time of the last inspection there were some deficiencies in the recording of clinical matters e.g. proper documentation of wound care treatments including grading of pressure areas, treatment regimes etc. These were further checked and the required information has been put into place updated and reviewed in the interim period. There were, in fact no pressure area management problems in the home at the time of this inspection. Wound care was required only in relation to two residents with ulceration of legs and this was adequately recorded. A requirement was also made at the time of the last inspection to ensure that all residents are weighed monthly or weekly where there are concerns about weight loss. This was checked and regular recording of weights as required had been carried out. Traditionally all residents have been provided with a private chiropody service which was paid for by the home. This has, understandably, now changed but all residents still access the same service for which they now pay individually. It is important that residents are offered the option of the free NHS chiropody service. This must be offered to all new residents automatically and retrospectively to those who have continued to pay for the private service. There is a fairly high dependency level of residents in this home e.g. 10 require use of hoist and 10 are doubly incontinent. Some required total or considerable care for personal needs due to deteriorating physical conditions and/or dementia care. Staff provide personal care in a sensitive and caring way which was witnessed during the inspection and confirmed by residents in discussions. The personal and nursing care provided at Westcroft has always been to a good standard. The recording of that care has not always been adequate but changes have been made and the recording is now to an equally satisfactory standard. All residents are now checked hourly throughout the night a recommendation of the last report was that night staff record in greater detail the status and activity in relation to residents throughout the night time period. This has been done – a new and fairly simple form put into place to record all activity. The MDS system of medication (blister packs) has been in place now for about a year. Staff have welcomed the new system and feel that it provides greater safety in all areas of medication management. Records were inspected, MAR sheets had been completed accurately and controlled drugs managed as required. There is no self medication in the home at this time. Creams are now dated when opened, although it was concerning to see that the name on a prescribed cream had been changed. Westcroft Nursing Home DS0000026970.V260652.R01.S.doc Version 5.1 Page 13 This was removed immediately and it is important that creams are used only for the person it is prescribed for. Service users spoken to said that they were treated with respect by staff and their privacy protected. New locks have been fitted to the main toileting areas of the home following 2 previous requirements when they were inoperative. This ensures greater privacy. Westcroft Nursing Home DS0000026970.V260652.R01.S.doc Version 5.1 Page 14 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 - 15 There was positive evidence and many examples of chosen lifestyle being supported. Contacts with family and friends are promoted. Choices made by residents are respected and examples were seen. There is an excellent activities programme, well organised and recorded and caters for all members of the resident group, taking account of their needs and expectations. Standards relating to Daily Life & Social Activities were found to be met. The home will further pursue community activities for resident identified EVIDENCE: Westcroft provides a flexibility of routines which allows and accommodates peoples choice of lifestyle. There have been many previous examples and two specifically seen in relation to people recently admitted. Both wish to spend time in their bedrooms during the day watching TV, receiving visitors etc. one has meals served in his bedroom as he wishes. Both are supported in their chosen lifestyles. Westcroft Nursing Home DS0000026970.V260652.R01.S.doc Version 5.1 Page 15 Dependency levels are high which sometime may limit choices which may be made because of high physical needs or mental health needs. The home nevertheless attempts to provide the required or chosen lifestyle which is limited only to ensure safety. This home provides and excellent activities programme. Two members of staff lead activities with specific staff time allocated for the purpose. Many activities are provided on 1:1 basis for residents with limited concentration spans etc. but many small group activities are provided inside and where possible, outside the home. There are regular residents meetings where the wishes and preferences of residents are sought in relation to activities. All activities are recorded allowing quantification of the diverse range of social and recreational needs which are met. A younger wheelchair-bound resident following feedback direct to the Commission, was spoken to privately by the inspector. He felt that activities did not meet his need to engage in activities in the community. This was discussed with an activity worker who had been made aware of the specific need/request and will continue to provide possible alternatives which can be tried in the hope of securing external contacts/activities which will be acceptable to the resident. The home are keen to listen to residents and to provide suitable and rewarding activities. Contacts with families and friends are part of the homes philosophy of care. The wishes of a recently admitted resident who chose not to received a visitor were respected and acationed. There is an open visiting policy with many daily visitors. Opportunity did not allow discussions with relatives/visitors during the inspection but written feedback direct to the Commission from relatives indicated a high level of satisfaction with the care provided at Westcroft. One stated “I cannot speak too highly of the excellent care my mother has received at Westcroft; nor of the attitude of the staff. She was always dubious about going into care, but now after 2 years at Westcroft and in her 100th year of life she often says “And to think – I didn’t want to come here! How silly I was”. Sample menus were sent to the Commission prior to the inspection and indicated a varied, wholesome and nutritious diet. This was confirmed by residents spoken to who were highly satisfied with food provision. There is a choice of food at all mealtimes, there are cooked options at breakfast time, choice of main meal and dessert at lunchtimes and choice of hot or cold dishes at teatime with choice of dessert again. Nutrition is monitored, all residents given fresh fruit at with 11am drinks, likes/dislikes and special diets known and recorded. Residents are given regular questionnaires about food provision. There are 2 sittings at lunch time allowing time for socialisation and appropriate time for those requiring to be fed to be assisted individually and sensitively. Westcroft Nursing Home DS0000026970.V260652.R01.S.doc Version 5.1 Page 16 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 An adequate complaints procedure is in place. The homes procedures were correctly followed recently in the referral of an incident of suspected abuse. Standards relating to Complaints and Protection were found to be met. EVIDENCE: There is a complaints procedure covering all required aspects of Regulation 22. There is a copy of the complaints procedure displayed prominently in the reception area of the home. No complaints have been received by the home or the Commission since the last inspection. There is a policy/procedure relating to reporting abuse which is known to staff and information which outlines the various definitions of abuse. There is a copy of the vulnerable adults procedures in the home. Westcroft Nursing Home DS0000026970.V260652.R01.S.doc Version 5.1 Page 17 The homes knowledge of the reporting procedures for abuse were tested recently – a referral was made by the home to Care Management personnel, concerning possible financial abuse the matter was being investigated and visiting social worker seen on the day of inspection who had come to further discuss the matter with the resident and staff. This referral was made quite appropriately by the home and is an indication of staff awareness of the reasons and procedures for reporting suspected abuse. Westcroft Nursing Home DS0000026970.V260652.R01.S.doc Version 5.1 Page 18 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 Since the purchase of the home by the present proprietor many areas have been upgraded on an ongoing programme, although this has been somewhat interrupted by other major works having to take priority. The arrangements to replace all wooden windows with double glazed units and replace carpets in virtually all areas of the home will have a significant effect upon the standard and presentation of the home. All bedrooms should be checked to ensure extensions to the call system are available particularly where residents spend time in their bedrooms alone during the day. EVIDENCE: Since the last inspection the reception area and all corridor areas on the ground and first floor have been redecorated, this has made a significant difference particularly to the reception area which is bright, pleasant and welcoming. Westcroft Nursing Home DS0000026970.V260652.R01.S.doc Version 5.1 Page 19 Arrangements have been made to replace all wooden windows in the home with double glazed units, the work is scheduled for 23rd January 2006. New carpets have been ordered for all parts of the home (communal areas and bedrooms) in February following completion of double glazing work. This will make a dramatic difference, particularly to the reception and communal areas, further enhancing the redecoration recently undertaken. Since the last inspection the paving slabs in the garden area have been made safe, as required and rubbish removed from the garden area which detracted from the pleasant but small garden. Following a requirement of the last report the kitchen area has been redecorated in part and revised cleaning routines evidenced from improved standards seen. A requirement of the last report to extend the audible alert of the call system to all parts of the home has been actioned. The call system alarm can now be heard in all parts of the home. A sample of bedrooms were inspected and found to be well personalised reflecting the individual interests of residents. It was noted in a shared bedroom that a resident using his room regularly throughout the day and having restricted mobility did not have an extension to the call system fitted allowing him to call staff as required. An extension should be fitted and checks made in all bedrooms for the same purpose. There are 18 en-suite bedrooms, 2 bathroom (one assisted) and walk-in shower area. The shower was in the process of attention following a leak to the floor below. Additionally there are adequate toilet facilities located near to the communal areas. There is a shaft lift providing access to both floors. There are grab rails and extensions to toilets throughout the home as required. The home use 2 hoists – one located on each floor (10 residents are hoisted). Hot water controls are on baths but not wash-hand basins in bedroom areas. Weekly checks of hot water are randomly carried out (records not seen). There are individual thermostatically controlled radiators in bedrooms and pipework and radiators appropriately guarded. Standards of hygiene throughout the home were noted to be high and indications that infection control practices were being followed correctly. Westcroft Nursing Home DS0000026970.V260652.R01.S.doc Version 5.1 Page 20 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 - 29 There are adequate numbers of well trained staff. The home has a good record of staff training. Recruitment procedures were robust and satisfactory. Standards relating to staffing were found to be met. EVIDENCE: The staffing level remains as agreed prior to April 2002. this provides 686 staffing hours per week. There are 2 nurses and 4 care staff on duty from 8 – 2 1 Nurse and 3 care staff on duty 2 – 10, although at certain times there are 2 nurses and 4 carers from 2 – 4pm. At night-time there is 1 nurse and 2 care staff. There are adequate numbers of catering, laundry, domestic staff in support of care hour duties. The home has handyperson employed also. Westcroft Nursing Home DS0000026970.V260652.R01.S.doc Version 5.1 Page 21 The level of staffing is adequate for the perceived dependency levels of the current resident group. There has been no use of agency staff in the past 2 months. There are 17 care staff – 6 have completed NVQ training and 3 further presently involved in training. There has been recent staff training in prevention of pressure sores and wound care, dementia care, mental health awareness, fire training, moving & handling, food hygiene, infection control and Health & Safety. The homes Moving & Handling trainer has been off sick for sometime. Another person has become an approved trainer and training updated for all existing staff and provided for new staff. The home have commissioned a Health & Safety audit and H & S Training from Safety First UK and have a policy/procedure and statement now in place. Staff meetings are held regularly approximately every 6 weeks. The minutes of the last meeting dated 17.11.05 were seen it was reassuring to see that care assistants were raising issues like privacy for residents and infection control issues. They clearly feel comfortable raising such issues in a formal meeting. This was in contrast to a list of care assistant duties seen by the inspector which identified basic duties almost along domestic lines. The Manager agreed that the role of care assistants should be defined in a more positive way, reflecting the status, training and skills of many care assistants and acknowledging the very positive role they play in the care scenario. Staff records were seen relating to recent appointments. All required checks and references had been obtained prior to employment and there were indications of a sound recruitment procedure. Westcroft Nursing Home DS0000026970.V260652.R01.S.doc Version 5.1 Page 22 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 -38 The Registered Manager has the required skills and experience to run the home. There is a good and open management approach from Manager and Proprietor in the home. The Manager provides good professional leadership, setting high standards of care. All residents should have bank accounts in their name, with only small amounts kept in cash. Risk assessments are in place and reviewed in relation to resident activity and the home. The home provides a safe environment for residents. Standards relating to Management and Administration were found to be met. Westcroft Nursing Home DS0000026970.V260652.R01.S.doc Version 5.1 Page 23 EVIDENCE: The Registered Manager is a qualified nurse and has considerable experience in providing a service for older people. He commenced training at Newcastle College in November 2005 to obtain the required Registered Managers Award. The proprietor has a presence in the home on most days during the week. The Registered Manager has the required authority and job description to allow him to manage the home effectively. The distinction of roles between Proprietor and Manager are well defined and the joint management approach works well with good ongoing dialogue. The Manager gives a clear lead to all staff in the home and has a positive hands-on role in this relatively small nursing home. Residents have direct daily access to both Manager and Proprietor. The atmosphere is relaxed and friendly there is an open and positive dialogue between residents and all staff. An administrative assistant works in the home on 2 days each week. The financial standing of the home was not discussed on this visit. The planned improvements over the next few weeks indicate a positive financial standing with re-investment in the home. The home consistently runs to full capacity, with small waiting list at this time. Monies held on behalf of residents were spot checked with two accounts and balances seen which were complete and accurate. One of the residents does not have a bank account and has no family to assist, she is accruing a larger amount of cash. The home were advised to open a bank account in her name where surplus cash can be secured. Not all entries in residents accounts seen had signatures. It is recommended that all expenditure is signed by 2 people if possible, the resident and the member of staff involved in the money transaction. Health & Safety issues checked in the home were satisfactory: A moving and handling trainer has been appointed and all staff received training. Fire records were not seen but all staff attended a Fire Training Course in August 2005. A fire risk assessment was recently completed on the building. The Fire Officer visited on 5.8.05. A Health & Safety Audit has recently been completed by private company and training for staff also accessed. Westcroft Nursing Home DS0000026970.V260652.R01.S.doc Version 5.1 Page 24 The cleaning routines in the kitchen area have been revised and some remedial work to paintwork and the flooring have improved standards. Hot water outlets in resident areas are reported to be checked weekly to ensure safety (records not seen). All required notifications under Regulation 37 had been notified to the Commission as required. Westcroft Nursing Home DS0000026970.V260652.R01.S.doc Version 5.1 Page 25 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 x 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 3 18 3 3 3 3 2 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 x 3 2 Westcroft Nursing Home DS0000026970.V260652.R01.S.doc Version 5.1 Page 26 Are there any outstanding requirements from the last inspection? YES 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 3 Standard OP9 OP8 OP38 Regulation 13(2) 12 13(4) Requirement Creams must be used only for the person prescribed for. All residents must be given choice of NHS chiropody. Portable heater in conservatory & bedroom identified to be wallmounted or removed Provide extension to call system in bedroom identified. Appropriate consents must be obtained fro provision of bedguards after risk assessment Timescale for action 12/01/06 31/03/06 12/01/06 4 5 OP22 OP38 23(2)(n) 13(4) 12/01/06 12/01/06 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 12 Good Practice Recommendations Ensure adequate supply of library books is available for resident identified. Westcroft Nursing Home DS0000026970.V260652.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Westcroft Nursing Home DS0000026970.V260652.R01.S.doc Version 5.1 Page 28 - 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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