CARE HOMES FOR OLDER PEOPLE
Westdale Care Home 129 Melton Road West Bridgford Nottingham NG2 6FG Lead Inspector
Linda Hirst Unannounced Inspection 16th September 2005 10:30 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 Westdale Care Home DS0000008805.V251137.R01.S.doc Version 5.0 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. Westdale Care Home DS0000008805.V251137.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Westdale Care Home Address 129 Melton Road West Bridgford Nottingham NG2 6FG 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) 0115 233128 0115 233128 westdale1@btconnect.com Westdale Quaker Housing Association Limited Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (19) of places Westdale Care Home DS0000008805.V251137.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. I bed is to be used for short term respite care only Date of last inspection 11/5/05 Brief Description of the Service: Westdale is registered to provide personal care and accomodation for up to 19 older people. It does not provide nursing. The home is owned by a voluntary organisation and it is located on a main road in West Bridgford. There are shops, churches, restaurants, public houses and public transport links in the centre of West Bridgford. The home is an adapted period property with an extension over two floors. There is a vertical lift and stair lift to provide access to the upper floor. All bedrooms are single and 10 have en suite facilities, one bedroom is below minimum space requirements and is only used for respite care. There are large,very attractive and well maintained gardens to the rear of the property with seating available. There is a small care park to the front. Westdale Care Home DS0000008805.V251137.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The main method of inspection used was called ‘case tracking’ which involved selecting two residents and tracking the care they receive through checking their records and discussion with them. The inspector also looked at the records of complaints, staff training, quality assurance, and Health and Safety records. A tour of the accommodation was undertaken and lunch was observed. What the service does well: What has improved since the last inspection?
Care plans are now of a more consistent quality, the managers have provided training to staff along with samples of how to complete care plans to make sure that the staff properly detail the residents’ needs and how these should be met. Staff have been reminded to knock on bedroom doors before entering and those interviewed said that this always happens.
Westdale Care Home DS0000008805.V251137.R01.S.doc Version 5.0 Page 6 Although breakfast has not been staggered, residents are offered breakfast in bed on a tray if they wake late or feel unwell. Around five of the residents have their breakfast in this way. New residents are informed of the nearest fire points and instructed on the proper use of the call alarm system by staff and these details are now also in the service user guide to the home. 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. Westdale Care Home DS0000008805.V251137.R01.S.doc Version 5.0 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 Westdale Care Home DS0000008805.V251137.R01.S.doc Version 5.0 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, 5 Residents are fully assessed before being admitted to the home and have the chance to visit to check if they feel the home is right for them before committing themselves to admission. EVIDENCE: The last person who was admitted to the home was selected for “case tracking” to make sure that they had been properly assessed before admission to the home. A pre admission assessment had been undertaken by staff at the home before the resident was admitted. This covered all of the main areas of need, a risk assessment in respect of self medicating was also undertaken along with details of family history to enable staff to be aware of key information about the resident. There was evidence that the resident had visited for a trial visit to the home before being admitted so she could be sure that she would settle and to enable staff to meet her. In discussion, this was confirmed by residents, who both confirmed that they have settled well and the home and feel happy and content there. Westdale Care Home DS0000008805.V251137.R01.S.doc Version 5.0 Page 9 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 The care plans accurately reflect the needs of the residents and offer good guidance to staff about how needs should be met. The staff treat the residents with dignity and respect and value their independence. EVIDENCE: The care plans for the residents who were “case tracked” were inspected to check that these covered their needs and offer guidance to staff about meeting them. The care plans seen were of a more consistent quality than on the previous visit and there was evidence of residents and their representatives being involved in the development and review of the plans along with regular updates and reviews of need. Those spoken with said the staff discuss their needs with them regularly. The care plans are holistic and include social needs, preferences and routines, not solely focusing on medical and personal needs. The care plans offer good guidance to staff about how needs should be met. Residents who were interviewed said that staff offer help in a discreet way and they said they knock on doors before entering. The residents feel their privacy
Westdale Care Home DS0000008805.V251137.R01.S.doc Version 5.0 Page 10 is respected and the residents said that the staff encourage independence but “do not let you struggle.” Westdale Care Home DS0000008805.V251137.R01.S.doc Version 5.0 Page 11 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 The lifestyle offered to residents is flexible and activities provided are enjoyable and meaningful. Residents are encouraged to maintain existing relationships and foster new ones. The food provided is varied, healthy and the residents enjoy their meals. EVIDENCE: One resident said she enjoys the outings provided at the home and confirmed there are regular trips out in the minibus belonging to the home. Regular activities are provided and these are evidenced in the care plans and one resident said she joins in with all activities, the other chooses not to because of personal circumstances. The residents said they had enjoyed the garden in the summer and had sat out a great deal. The residents said they go out into the community with family, friends and the staff, and they also visit each other in their rooms. The staff bring them up a tray of drinks and biscuits for these visits and are “very obliging.” Both of the people spoken with choose to get up early and they said the staff bring them a drink in bed. They both choose to go to bed late, and watch television in their own bedrooms before bedtime, this is their preference.
Westdale Care Home DS0000008805.V251137.R01.S.doc Version 5.0 Page 12 Routines and preferences are recorded in the residents’ care plans and the discussions with residents would indicate that these are respected. Lunch was observed. The dining room provides a comfortable and informal setting for residents to eat in, and the daily menu is displayed so that residents are aware of the choices available at lunch and tea time. The meal during this visit was vegetable soup followed by fried fish or fried egg, chips, mushy peas and sweetcorn and to finish a choice was available of marmalade pudding and custard or fruit, jelly and cream. Both alternatives had been prepared. The residents were relaxed during lunch and sat chatting, commenting that the soup was “lovely.” The residents who were interviewed confirmed that the food is good, plentiful and varied and that drinks are available regularly. Westdale Care Home DS0000008805.V251137.R01.S.doc Version 5.0 Page 13 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 Residents are encouraged to air their complaints and concerns and they feel confident in doing so. EVIDENCE: The record of complaints was inspected but none have been received since the last visit. The residents are encouraged to air their concerns informally at any time to prevent issues building up. Residents confirmed that the staff ask them if they have any complaints when they are reviewing their care plans and they were both well aware of how to complain and who to complain to. Neither would have any qualms about complaining and they feel confident that the manager would address any complaints fairly and take them seriously. Westdale Care Home DS0000008805.V251137.R01.S.doc Version 5.0 Page 14 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, 20, 21, 22, 23, 24, 25, 26 The accommodation is homely, well maintained, clean and comfortable. EVIDENCE: A full tour of the accommodation was undertaken. The home employs a person to undertake maintenance tasks and repairs are noted and referred for attention. The home is comfortable and throughout offering a variety of communal space including a lounge, quiet lounge, use of the dining room (with a residents’ payphone and very pleasant, well maintained gardens. The residents can fully furnish their bedrooms with items from their own home and consequently their rooms are highly personalised and homely. There are handrails on the corridors, an alarm call system throughout and a bath chair for those needing assistance to get into and out of the bath. All areas of the home are clean and fresh smelling. The residents commented that the home is clean and that repairs are done quickly. They feel the home is comfortable and homely. Westdale Care Home DS0000008805.V251137.R01.S.doc Version 5.0 Page 15 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): 30 Staff have good access to training and they are said to be “very good” by the residents. EVIDENCE: The staff training record was inspected to check that the staff are competent in undertaking their roles. Basic First Aid training and training on the Control of Substances Hazardous to Health Regulations are imminent, but other than this all staff have completed statutory training courses. National Vocational Qualification training has progressed well providing evidence that staff have good access to ongoing training and development to help them do their jobs. Residents commented that the staff are very good, helpful and kind. Westdale Care Home DS0000008805.V251137.R01.S.doc Version 5.0 Page 16 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): 33, 38 Residents have various forums open to them where they can air their views and raise concerns. The managers act on these comments. The health and safety arrangements need to be monitored more closely to avoid safety certificates passing their expiry date and placing the residents at risk of harm. EVIDENCE: Quality assurance systems were inspected to check that residents’ views are sought and acted upon. Several resident satisfaction questionnaires were seen, the last ones dated 2004. A summary of the findings of these is incorporated into the service user guide. The managers have been struggling to find an auditing system they were happy with for checking the quality of the rest of the service. A general discussion was held about undertaking this through the course of a year and them developing their own system of audits and action
Westdale Care Home DS0000008805.V251137.R01.S.doc Version 5.0 Page 17 planning in response to areas of weakness. The managers will work on this. The residents said that they are asked for their opinions on the home and the care provided via questionnaires, direct approaches from staff and the residents’ meetings. The health and safety checks were inspected to make sure that these are done at the correct intervals. Risk assessments are done on all safe working practices and reviewed monthly to minimise any issues of concern. The electrical testing is imminent and the gas safety test has been done to ensure residents and staff are protected. Fire safety testing is undertaken at the required intervals to check it will operate properly in the event of an emergency. The bath lift needs servicing as soon as possible to make sure it is maintained in proper working order. The legionella checks and task disinfecting is overdue and must be done as soon as possible to minimise the risk of infection. It is recommended that a system of monitoring be introduced to make sure that health and safety checks are done before the certificates expire. Westdale Care Home DS0000008805.V251137.R01.S.doc Version 5.0 Page 18 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 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 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 X 18 X 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 X 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X X X 1 Westdale Care Home DS0000008805.V251137.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? N/A 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 OP38 Regulation 13 Requirement The Legionella check and tank disinfecting must be undertaken without delay. The bath lift must be serviced as soon as possible. Timescale for action 28/10/05 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 OP38 Good Practice Recommendations It is recommended that a system for monitoring when health and safety checks need undertaking be introduced. Westdale Care Home DS0000008805.V251137.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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