Inspection on 29/01/09 for Westerlands Care Centre

This inspection was carried out on 29th January 2009.

CSCI found this care home to be providing an Excellent service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Westerlands Care Centre 30/01/07

Westerlands Care Centre 02/03/06

Westerlands Care Centre 12/09/05

Westerlands Care Centre 08/03/05

Westerlands Care Centre 30/09/04

Westerlands Care Centre 16/03/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Westerlands Care Centre Elloughton Road Brough East Yorkshire HU15 1AP     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jo Bell     Date: 2 9 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Westerlands Care Centre Elloughton Road Brough East Yorkshire HU15 1AP 01482667223 F/P01482667223 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Prime Life Ltd care home 35 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability terminally ill Additional conditions: Date of last inspection Brief description of the care home Westerlands Care Centre is a large house situated in its own spacious grounds in a residential area of the village of Brough. Two decked areas are available for residents to sit outside. Car parking is available to the front of the building. The village itself has numerous shops, a train station and is adjacent to a motorway. Accommodation is provided over 3 floors serviced by a lift. The majority of the bedrooms are single, one with an en-suite and six bedrooms being shared. The home is owned by Prime Life Ltd. The home may provide residential and nursing care for up to 35 people of either sex, who may also have dementia, a physical disability or terminal illness. Services provided include personal care, meals, laundry and health care, with additional health services being accessed as necessary, for example, the district nursing services. The weekly fees range from £350-£600. Additional charges are made for hairdressing, Care Homes for Older People Page 4 of 25 Over 65 35 35 35 35 0 0 0 0 Brief description of the care home chiropody or toiletries. A copy of the latest inspection report and statement of purpose are reaily available in the home for people to access. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection peterchart Environment Staffing Management and administration Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. We went to the home without telling them that we were going to visit. This report follows the visit that took place on Thursday 29th January 2009. The visit lasted from 9:30 until 14:30. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. Care Homes for Older People Page 6 of 25 In future, if a requirement is repeated, it is likely that enforcement action will be taken. The purpose of the visit was to make sure that the home was operating and being managed in the best interests of people living there. Information has been used from different sources for this report. These sources include- Reviewing information that has been received about the home since the last inspection. The annual quality assurance assessment. This is information which details what has happened during the past 12 months. Nine surveys from people using the service, three staff, and one health care professional survey. Notifications (Regulation 37) relating to incidents in the home affecting people using the service. Details of complaints and allegations raised by people connected to the service. At the site visit one inspector spent 5.0 hours at the home. During this time observations of care practices took place. People using the service were spoken with along with some relatives. Discussions with the manager regarding meeting needs, mealtimes, protecting people and the environment took place. The lunchtime meal was observed and time was spent inspecting care plans, looking at individual rooms and reviewing a selection of health and safety information. Staffing and management issues were discussed and feedback was given to the manager at the end of the inspection. The weekly fees range from 350pounds-600pounds. Additional charges are made for chiropody, hairdressing and newspapers. The home has a copy of the latest inspection report, the Statement of Purpose and Service Users Guide. These are readily available and are discussed with people. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are effectively assessed prior to admission, which helps to ensure individual needs can be met Evidence: The three pre-admission assessments looked at confirmed that a senior person completes an assessment before an individual moves to the home. This is to check what type of care and support the person needs and whether the staff have the skills and knowledge to provide that care if the individual chooses to move there. The process also reassures the individual and their family that they will receive the right support. Assessments are completed if the person has a care manager or is privately funded. These detail health, personal, nursing, social and mental health needs. All the surveys completed by people living there report that people are given enough information Care Homes for Older People Page 10 of 25 Evidence: about the service and what it provides. This means they can make an informed choice about whether to move there or not. One person said I tried it here first before I came permanently, another person said the manager asked me lots of questions before I arrived. The manager is very aware of the categories of registration and knows the client group well. Intermediate care can be catered for and this involves liaising with the physiotherapist or occupational therapist, and specialist health care professionals. This is discussed in the Statement of Purpose. At the time of the visit the intermediate care facility was not being used. Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their health and personal care needs met in a dignified manner. Evidence: Everyone observed during the visit looked clean and well cared for. Three care plans were looked at during this visit. These describe the care and support people need to stay in charge of their own lives as much as possible. The plans looked at contained a lot of information, so that an unfamiliar carer could look at them and would be able to work out how much support they needed. There were written assessments as to whether people were at risk of developing pressure sores, of losing weight because of poor appetite or a health problem or needing help with moving and handling. Those identified as at risk had a care plan in place describing how that risk was to be managed. All nine surveys received from people using the service had positive comments regarding the care received. the staff are wonderful, I get all the care and attention I want were two comments. The home is very pro-active in promoting peoples well being. This was evident when discussing with the manager research into cranberry tablets and yogurt flavoured drinks to aid digestion and prevent infections. Care Homes for Older People Page 12 of 25 Evidence: The home have a designated Doctor who visits twice a week. Health care professional surveys confirmed that the medical support is good and people receive the attention they need. One person said the home sort out the chiropodist, dentist or optician for me. All accidents and injuries are dealt with appropriately and these are reported promptly to The Commission. The medication system was inspected. The administration of medication is effective. There are clear records in place which show that staff sign in the correct place on the medication charts once a person takes their tablets. Regular stock balances are in place and an audit of the system identifies any errors or areas for improvement. Fridge temperatures are taken daily and the controlled drugs are stored and recorded correctly. This is a robust system which is routinely monitored. Staff in the home are respectful and ensure people have the privacy they need. People are able to have personal possessions in their room and telephones can be fitted. One person recently had a telephone installed and this was viewed. Staff were observed speaking in a dignified manner to all people they came into contact with. (see also Staffing outcome) Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People participate in a range of activities and visitors are welcomed. Staff encourage autonomy and choice, and people enjoy dining in pleasant surrounding with appealing food Evidence: The home encourages social activities by offering; music to movement, cards, dominoes, church services; and a selection of seasonal events. All events/activities are advertised in via a notice board and newsletter displayed in the home. Activities are available every day. Manicures and pedicures take place, people visit the hairdresser, there are DVDs to enjoy, music, television and plenty of newspapers and magazines to read. A mini-bus is available twice a month and trips to local areas are arranged. On external outings staff supervise people on a one to one basis. Visitors are welcomed into the home and the visitors book confirm people arrive at different times of the day. One person said people come at anytime, staff always welcome them. People have their religious and cultural needs met and the manager is aware of equality and diversity issues. Care Homes for Older People Page 14 of 25 Evidence: The lunchtime meal was observed. There are two dining areas for people to use. A light and airy conservatory area is used for people who need a small amount of assistance and a smaller lounge area for people who may have dementia care needs and need more assistance at mealtimes. The food looked appetising, with a range of portion sizes available. One person had oxtail soup, followed by chicken and fresh vegetables. The food is delicious one person said. The tables were laid with white table cloths and different sizes tables were available. A range of drinks were offered and alternative food was available as required. Staff ask people what they would like to eat and drink and this is done in a dignified way. It was evident that some people were given assistance with their food whilst the member of staff was standing up instead of sitting down next to the person. Two people had different staff assisting them at different times. This could have been improved to ensure the dining experience was positive. The manager was made aware of this and was going to address this straight away. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their concerns listened to and acted upon, with staff been alert to signs of abuse.This helps keep people safe. Evidence: The home have a complaints procedure in place which people and their visitors are aware of. This is discussed at the admission stage and a copy of this is displayed in the home. No formal complaints have been made. Staff spoken to were aware of the safeguarding procedures in place. Some staff have completed abuse awareness training,and staff knew about the different types of abuse and the action to take if an abusive situation occurs.The home have a policy in place and staff are encouraged to use the Whistle Blowing policy. The manager was generally aware of the action to take if an allegation of abuse occurs though she needs to familiarise herself with the involvement of social services and the role they play as the lead agency. There have been no safeguarding referrals made in the past twelve months. People looked safe in the home and staff have protection of vulnerable adults check prior to starting work in the home. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a comfortable and very clean environment. Evidence: The home is welcoming, warm with a high standard of cleanliness. There are a range of communal areas for people to use, and the home has friendly and homely feel to it. Three bedrooms were inspected these were all spacious, clean and personalised. One person felt their room waas too hot and they did not know how to adjust this. The manager dealt with this immediately. A maintenance person carries out a range of health and safety checks to ensure the home is safe. There is an accessible garden which is suitable for people with or without mobility problems. People clearly enjoy living in this environment, during the site visit the lift was been repaired, this had been unusable for three days. This meant some people had to stay in their rooms all day. However, staff were aware of individual needs and made sure they spent more time with people upstairs. There were areas of the home which needed redecorating, the manager was aware of this. Staff were observed wearing protective clothing and using hand washing techniques. Some staff had previously completed infection control training but this was a few years ago and should be updated. People were observed wearing clean and well-ironed clothes, the system for removing soiled laundry was discussed and this system was Care Homes for Older People Page 17 of 25 Evidence: robust and effective. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are cared for by sufficient staff who are extremely competent, well trained and safely recruited. This ensures individual needs can be consistently met. Evidence: The home has thirty people who have nursing and may have dementia care needs. Registered nurses are well supported by care and ancillary staff. Staff were observed dealing with people promptly and efficiently. One survey said the service is tailored to individual needs. Positive comments were received through the surveys and through verbal discussions with people at the visit. The staff are absolutely wonderful, I would not hesitate in asking the staff for anything, they are lovely, and the staff really know how to look after me, its like a hotel. These were some of the comments made. Staff were observed moving and handling people and interacting with people with differing needs. The communication observed was extremely professional, and friendly. This had a positive impact on people, and many people had a smile on their face when staff were speaking with them. The different skill mix of staff worked well and the number of staff was appropriate. Many care staff have completed an NVQ Level 2 in care and this is continually offered with some staff undertaking an NVQ level 3. Staff are safely recruited and the manager usually obtains three written references, Care Homes for Older People Page 19 of 25 Evidence: along with a police check and a protection of vulnerable adults check prior to a new staff member starting work. Three files were checked and this information was confirmed. Details of the nurses registration are also kept up to date. An induction programme equivalent to Skills for Care is in place. This covers an orientation to the home and a range of care practises and health and safety issues. Extra training regarding Parkinsons disease, dementia care and palliative care have been offered to staff and this helps them develop further. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run in the best interests of the people using the service. Evidence: The manager is registered with The Commission and has completed an NVQ Level 4 in Care and Management. She is an experienced manager with many years experience working with older people. At the site visit the manager had to deal with a range of issues, these related to staffing and maintenance. These issues were all dealt with in a calm, robust and professional manner. This clearly demonstrated the managers ability to run the home to a high standard. The atmoshphere in the home is calm and relaxing and visitors feel they can approach the manager and staff if they have any concerns.The annual quality assurance assessment was completed comprehensively, and information regarding the improvements that have taken place in the past twelve months.The evidence relating to what the service does well again was detailed. The home have a quality assurance system in place which includes client and visitor Care Homes for Older People Page 21 of 25 Evidence: questionnaires and a range of audits which relate to health and safety, the environment and care practices. A senior manager also visits monthly and speaks to people using the service and identifies what improvements have been made. Records of these visits were available. Resident and staff meetings take place, and care plan and medication audits help confirm that people are happy with the personal and healthcare they receive. People can keep personal money in the home. This may be used for chiropody, hairdresing, clothes or toiletries.Well-maintained records are kept of all transactions and invoices are available which confirm the money coming in and going out. Health and safety was discussed and a selection of policies were inspected. A fire risk assessment is in place and staff had a good understanding of the action needed in the event of a fire. Staff receive fire, moving and handling, infection control and food hygiene training. However, this needs updating as some staff have not had formal training since 2004 or 2005. The training matrix is not up to date and staff training files examined need to be accurate and reflect the training people have had. Some of this is inhouse whilst other aspects are more formal. Water temperatures are taken and both the electrical wiring certificate and gas safety checks are in place. This helps to keep people safe in their environment. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 37 17 Accurate records must be 28/02/2009 kept regarding staff training. This will ensure training can be properly planned for staff, and they will receive this in a timely manner. 2 38 18 Staff must be made aware of the current practice regarding fire safey, moving and handling, infection control and food hygiene practices. This will minimise any risk of harm to people using the service. 30/04/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 15 People should be given assistance at mealtimes by one member of staff at a time. Staff should be at the same level as the person requiring assistance.This will enhance the dining experience. Care Homes for Older People Page 24 of 25 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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