Inspection on 23/01/07 for Westerham Place

This inspection was carried out on 23rd January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Westerham Place 10/02/09

Westerham Place 10/07/07

Westerham Place 04/10/05

Westerham Place 31/05/05

Westerham Place 26/08/04

Westerham Place 14/04/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Westerham Place Quebec Square Westerham Kent TN16 1TD Lead Inspector Debbie Sullivan Unannounced Inspection 23rd January 2007 09:25 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 Westerham Place DS0000024042.V320120.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. Westerham Place DS0000024042.V320120.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Westerham Place Address Quebec Square Westerham Kent TN16 1TD 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) 01959 565805 Yewcare Limited Mr Scott Bryn Ernest Davies Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Westerham Place DS0000024042.V320120.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th October 2005 Brief Description of the Service: Westerham Place is a care home providing personal care and accommodation for up to 24 older people. The home is located on the outskirts of the small town of Westerham, which has a variety of shops, pubs, a post office and churches. There is a local bus service and bus stops are nearby. The home consists of a large detached two-storey building with a newer purpose built two-storey extension. All the home’s bedrooms are single with en-suite facilities, including a WC, wash hand basin and bath. In addition there is one assisted bathroom located on the ground floor. There is a large lounge surrounded by a conservatory and a separate dining room. The garden is well kept and attractive. All areas of the home are accessible to people who have limited mobility; there is a lift to the first floor. The home employs care staff 24 hours a day. The weekly fee range for the service is £750 to £850. Westerham Place DS0000024042.V320120.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit to Westerham Place was unannounced and lasted a little over six hours. During the day time was spent with the manager, residents and staff. A tour of the home took place and some records and documents were read. Throughout the visit staff and residents were helpful in providing information and offered a positive views on living in and working at the home. The pre inspection questionnaire completed by the manager, and survey forms completed by some residents, provided additional information Some comments made by residents during the site visit included, “The care is good” “Can’t fault it, staff are wonderful” “Food is very good” “Everyone is kind and helpful” “The manager is very approachable” Comments from staff included, “It is like a little family” “It’s a lovely place to work” “There is time to spend with the residents” A comment from a relative was, “Staff are always very courteous and welcoming, they look after my mother very well” What the service does well: The home provides a well-maintained, well-decorated and furnished, clean and attractive environment for residents to live in. Westerham Place DS0000024042.V320120.R01.S.doc Version 5.2 Page 6 Prospective residents and their relatives are able to visit the home before moving in and needs are fully assessed before a place is offered. Care plans are up to date and reviewed regularly, risk assessments are in place. Staff are well supported and the turnover is low providing continuity for residents. Residents spoken with felt that they were treated as individuals and were complimentary about staff. Meals are varied and of a good quality. What has improved since the last inspection? What they could do better: Some progress has been made with staff training although it remains a high priority that training is provided for all staff in Adult Protection, First Aid and Manual Handling. Heads of care would benefit from having regular recorded supervision as well as appraisal meetings. Although residents say they are mainly not keen on having arranged group activities, the option still needs to be offered regularly and the views of residents on activities sought. It must be recorded if a resident chooses not to have a lock on their door and homely remedies must be agreed by the GP as safe to be administered. Westerham Place DS0000024042.V320120.R01.S.doc Version 5.2 Page 7 Records relating to staff and residents must be on the premises and available for inspection at all times. 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. The summary of this inspection report can be made available in other formats on request. Westerham Place DS0000024042.V320120.R01.S.doc Version 5.2 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 Westerham Place DS0000024042.V320120.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are able to access written information and visit the home before deciding to move in. Needs are assessed before a place is offered and each resident is supplied with a contract. EVIDENCE: The home’s Statement of Purpose and Service Users Guide are incorporated into one document. Service users spoken with had either moved to the home as they had known of it or their relatives had compared it to other services. One resident had moved Westerham Place DS0000024042.V320120.R01.S.doc Version 5.2 Page 10 from another home and much preferred Westerham Place, another had experience of a relative living there. Visits to view the service are welcomed and some people were looking round during the site visit. Residents or their relatives had been offered the opportunity to visit before deciding to live there. A resident, at the home for respite, said that when they need permanent care they hoped to be able to move in. The manager visits prospective residents and assesses their needs; there is a trial period on moving in and each resident has a contract with the home. Residents said that they felt their needs were well met. Westerham Place DS0000024042.V320120.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 and 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have care plans that accurately reflect their needs. Personal care is delivered respectfully and independence is promoted. EVIDENCE: Each resident has a care plan that includes up to date and regularly reviewed information about their needs, risk assessments, personal information and daily recording. Residents can access their care plans if they wish. The GP visits once a week and health concerns are referred to appropriate professionals, care plans had entries relating to contact with chiropodists and District Nurses. One resident needs to be reassessed as a priority due to a change in their condition that could indicate the home may no longer be able to meet their Westerham Place DS0000024042.V320120.R01.S.doc Version 5.2 Page 12 needs, during the inspection the manager received a telephone call relating to progress towards this. Residents said that staff respected their privacy and dignity when giving personal care and they are supported to be independent, with help only being given when necessary or requested. Staff echoed this and said that sometimes they need to gently offer more help to those who like to be most independent and where some activities could present a risk. If residents choose, their wishes in the event of death are recorded; the manager said that staff had received bereavement training. Since the last inspection all staff administering medication have received training. Medication is stored discreetly in each resident’s room in a secure cabinet; it is administered in the rooms except for at lunchtime; the home has developed a procedure for managing this. It is recommended that a record be kept that the GP has agreed homely remedies can be taken. Westerham Place DS0000024042.V320120.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to exercise choice over their daily lives and contact with friends and families is supported. Meals are varied, well cooked and nutritious. EVIDENCE: The last inspection identified a need for residents to be consulted about activities at the home and they have now been asked their views. The results were that some were happy with no formally arranged activity programme and others would like an activity such as a quiz. The manager said that quizzes had been arranged but were not that well attended and that residents are not generally keen on group activities but are supported in individual activities whenever possible, such as shopping, going for walks and attending clubs in the town. Again take up can be low but information is available on local activities. It is recommended that the offer of activities continues on a regular basis. Westerham Place DS0000024042.V320120.R01.S.doc Version 5.2 Page 14 Clothing sales at the home prove popular and there is a well-equipped hairdressing room in use once a week. Residents spoken with were mainly happy to spend time in their rooms or in the lounge and to watch TV, listen to music, read and do crosswords. One had been out for a walk into the town. Visitors are welcomed and there is private space available to see them, visitors arrived during the inspection, and care plans recorded trips out with relatives. Residents said they are able to make choices such as when to get up and what to do; about half manage their own finances. The last inspection identified that residents liked the food but sometimes it was too fussy, the menu has now been simplified and includes a wide variety of meals, it is changed regularly and the preferences of residents as a whole are taken into account. There is no set daily choice of main meal although an option can always be available. The chef is provided by an outside catering company. Meals are chosen on a weekly basis, residents said they did not mind this and could be reminded of their choices, menus with choices identified are kept in their rooms. Residents were very complimentary about the meals and enjoyed their lunch. Special diets are catered for. Westerham Place DS0000024042.V320120.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents can feel confident that they can raise any concerns or complaints. Adult Protection procedures are in place, although staff have not received adult protection training. EVIDENCE: The home has a complaints procedure that is included in the statement of purpose. No complaints had been recorded since the last inspection. Residents said that they would feel able to tell the manager or head of care about any concerns. Residents are supported to vote and although all the current residents have relatives who can advocate for them if necessary, the manager said there is access to an advocacy service. There is an adult protection policy in place that staff were aware of, although the home has not yet provided them with adult protection training. All staff are CRB checked, this includes those employed by the contract caterer and cleaning service. Westerham Place DS0000024042.V320120.R01.S.doc Version 5.2 Page 16 There have been no Adult Protection alerts in relation to the home. Westerham Place DS0000024042.V320120.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25 and 26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents live in a clean, well-maintained, homely and comfortable environment. Bedrooms are personalised and equipment is available to promote and maintain independence. EVIDENCE: The home is well furnished, decorated and maintained. All the bedrooms are singles and are ensuite with a bath; they are redecorated and recarpeted when each new resident moves in. All the bedrooms visited were personalised, residents are invited to bring their own furniture although the home can provide the required items if necessary. Westerham Place DS0000024042.V320120.R01.S.doc Version 5.2 Page 18 The standard of cleanliness is good and residents were satisfied with their rooms. There was an odour in one bedroom; this is being addressed with the planned involvement of health professionals. Residents can choose whether or not to have locks on their doors when they move in. Accommodation is on two floors with access via a shaft lift. Reassessment takes place if it is identified that a resident would be safer or would prefer to move downstairs. A bathroom with a Parker bath is available downstairs. a number of residents have personal equipment to help them maintain mobility and independence and the home provides equipment for communal use. Communal areas are the large lounge with two adjoining smaller sitting areas and the dining room. The tables in the dining room had been rearranged at the suggestion of residents, as they liked the way they were set up over Christmas. Westerham Place DS0000024042.V320120.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A well-established and confident staff group supports residents. Further staff training is required as a priority to ensure that staff are competent in all areas of their work and that residents are protected. EVIDENCE: The home is more than adequately staffed and as at the time of the site visit, it was not fully occupied they had plenty of time to spend with residents. Cleaning and catering staff are contracted in. It was stated that agency staff are never needed. The home has a very low care staff turnover, staff are knowledgeable about the individual needs of residents and residents speak highly of them. Staff like working at the home and are genuinely concerned about the well being of residents. Those on duty were observed to be confident and attended to the needs of residents promptly and discreetly. Westerham Place DS0000024042.V320120.R01.S.doc Version 5.2 Page 20 Over 50 of the care staff have gained an NVQ in care qualification, and since the last inspection training has taken place in fire safety and first aid. Care staff still require training in manual handling, health and safety, infection control and adult protection. The manager said that providers were being sought or arranged for the training. No new care staff have been employed for approximately a year, the manager said that new staff shadow experienced carers until they feel confident to work alone. The home undertakes CRB checks on new care staff. Westerham Place DS0000024042.V320120.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36,37 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run by an experienced manager. The health safety and welfare of residents is taken seriously and will be further protected with more staff training in safe working practices. EVIDENCE: Westerham Place DS0000024042.V320120.R01.S.doc Version 5.2 Page 22 The home is well run by an experienced manager who has gained a care and management qualification. Residents say that the home meets their needs and that the manager and staff are approachable. Quality assurance systems are now in place and residents must continue to be regularly surveyed about their views on the home. Improvements to the property are made as the need is identified and policies and procedures are regularly reviewed. The home has a valid insurance certificate and fire and other equipment is properly maintained. Care staff are supervised by the heads of care, written records are kept and appraisals take place, heads of care do not receive such regular supervision but are appraised. Staff meetings are held at times when the maximum number of staff can attend. Residents’ records are kept securely and procedures for the safekeeping of their finances and recording of expenditure have improved. Some staff records were not available for inspection as they were off the premises. A radiator in one bedroom was at an unsafe temperature, the manager agreed to immediately take action to reduce risk to the resident. Health and safety policies are in place, although practices will be improved when staff are trained in all necessary safe working topics. . Westerham Place DS0000024042.V320120.R01.S.doc Version 5.2 Page 23 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 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 2 4 3 4 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 2 2 2 Westerham Place DS0000024042.V320120.R01.S.doc Version 5.2 Page 24 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. OP18,37 13(6) Standard Regulation Requirement “The registered person shall make arrangements by training staff or by other measures, to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse” In that all staff must complete adult protection training as a priority and evidence of training be submitted to the Commission. This requirement is repeated from the last inspection. 2. OP30,37 13 (3)(4)(5) 18 (1)(c) “The registered person shall having regard to the size of the 30/03/07 care home, the statement of purpose and the numbers and needs of the service users ensure that persons employed by the registered person to work at the care home receive training appropriate to the work they are to perform” In that all staff must undertake training in Manual Handling, First aid and Adult Protection Westerham Place DS0000024042.V320120.R01.S.doc Version 5.2 Page 25 Timescale for action 30/03/07 This requirement is repeated from the last inspection. 3. OP38 “The registered person shall 13(4)(a)(c ensure that all parts of the home ) to which service users have access are so far as reasonably practicable free from hazards` to their safety” In that the radiator identified as being over heated on a residents’ bedroom be kept at a safe temperature at all times. “ The registered person shall maintain in the care home the records specified in Schedule 4 and the records are at all times available for inspection in the care home” “The registered person shall ensure that the care home is conducted so as to promote and make proper provision for the health and welfare of service users.” In that all care staff must be trained in safe working manual handling, adult protection and first aid as a priority. 31/01/07 4. OP37 17(2)(3)( b) Schedule 4 (6) 12(1) 31/01/07 5. OP38 30/03/07 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. OP1 2. Westerham Place Refer to Standard Good Practice Recommendations It is recommended that the name and address of the Commission be included in the statement of purpose. It is strongly recommended that a specialist reassessment DS0000024042.V320120.R01.S.doc Version 5.2 Page 26 OP8 take place as soon as possible of the resident whose needs have changed and who may no longer be suitably accommodated at the home. It is strongly recommended that a record be kept that a GP has agreed the use of a homely remedy. It is recommended that a copy of the complaints procedure be displayed prominently in the entrance area. It is strongly recommended that residents continue to be consulted as their views on the provision of activities. It is recommended that residents choices to have locks on their doors or to not have a lock be documented It is recommended that the staff rota includes the full names of staff It is recommended that the Heads of Care receive regular documented supervision. 3. 4. 5. 6. 7. 8. OP9 OP16 OP12 OP24 OP27 OP36 Westerham Place DS0000024042.V320120.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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