Inspection on 21/10/08 for Westerleigh

This inspection was carried out on 21st October 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Westerleigh 10/10/06

Westerleigh 17/01/06

Westerleigh 19/08/05

Westerleigh 27/01/05

Westerleigh 13/07/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

Thorndene

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Westerleigh 18 Corsica Road Seaford East Sussex BN25 1BD     The quality rating for this care home is:   two star good 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: Rebecca Shewan     Date: 2 1 1 0 2 0 0 8 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 © (2008) 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: Westerleigh 18 Corsica Road Seaford East Sussex BN25 1BD 01323-892335 01323892667 jackie.anderson@westerleigh.info Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Carolyn Whelan Type of registration: Number of places registered: Regency Medicine care home 31 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: Service users must be older people aged sixty five (65) years or over on admission Service users with a physical disability can be accommodated. The maximum number of service users to be accommodated is thirty-one (31) Date of last inspection Brief description of the care home Westerleigh Nursing Home is registered to provide nursing care for up to 31 residents, older people over the age of sixty-five and individuals with physical disabilities. The home is situated in a residential area close to the seafront on the western edge of Seaford and is approximately 30 minutes walking distance from the town centre. An extension has recently been completed at the north end of the building, which includes four rooms with en suite facilities and two lounges. There is a smaller seating area at the rear of the home that overlooks a patio area. In addition there are two patio areas, Care Homes for Older People Page 4 of 25 Over 65 31 0 0 31 Brief description of the care home one in the centre of the building with some residents rooms leading directly onto it and one at the side. These are accessible to wheelchair users and are used when the weather permits. A shaft lift enables residents to access all parts of the building and there are appropriate aids, including hoists, to ensure the safe transfer of residents within the home. The ranges of fees charged (at the time of this report) are 545 GBP to 800 GBP per week. Additional charges are made for newspapers, hairdressing, toiletries, private physiotherapy and chiropody. Potential new service users can obtain information relating to the home via the internet, CSCI Inspection Reports, Care Managers, Placing Authorities, by word of mouth and by contacting the home direct. 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: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced inspection took place during the morning and afternoon of the 21st October 2008. The Annual Quality assurance assessment (AQAA), incident reports and previous inspection reports, held by the Commission for Social Care Inspection, were read before the inspection. The inspection of the home took six and thee quarter hours. Records such as care plans, staff files and medication records were also viewed. Thirty one service users (known as residents) were accommodated at the home at the time of the inspection. A tour of the whole home was undertaken and the Registered Manager, two Senior Carers, a Cook, an Activity Coordinator and three residents were spoken with. The CSCI also conducted Service User and Staff surveys. Of which ten Service User and Care Homes for Older People Page 6 of 25 five Staff surveys were received. The responses from the surveys received were positive in all areas relating to the home and the care provided. 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 Care Homes for Older People Page 9 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 10 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. There a good processes in place for assessing potential new residents with services being offered to only those residents whose needs can be met. Evidence: Documentation relating to the most recent admissions to home were viewed and found to have been completed fully and conducted with the involvement of the resident and/or their representatives (where applicable). The homes Registered Manager carries out pre- admission assessments. All Registered Nurses (RNs) employed by the home are also trained to conduct pre assessments. Copies of care management assessments from the placing authority are obtained, where these exist. The Registered Manager addresses any issues, which are highlighted within this assessment. Documented records are maintained of all correspondence with the placing authority. Care Homes for Older People Page 11 of 25 Evidence: Intermediate care is not provided by this home. Care Homes for Older People Page 12 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. Residents are offered a good provision of health care and personal support. All care is administered in way that protects residents privacy and dignity. Medication procedures require updating to ensure that all necessary precautions are taken to ensure that errors do not occur. Evidence: Care plans set out in detail the action which needs to be taken by care staff, to ensure that all individual health, personal and social care needs are met in a structured and consistent manner. Care plans were sampled and it was evidenced that they were comprehensive, detailed in content and covered all aspects of residents needs. Care plans are written to allow the assessor to gain a good overview of individuals medical, mental health, social and personal care needs and provide the assessor with a clear overview of the Residents current needs, limitations and required assistance. Residents involvement in the care plan review process was also evident. Risk assessments for falls/tissue viability/nutrition were viewed and found to be comprehensive in detail. Care Homes for Older People Page 13 of 25 Evidence: Residents are registered with a GP from one of two local GP surgeries. A Speech and Language Therapist, Occupational Therapist, Tissue Viability Nurse and a Continence Advisor are available to the home and attend to residents as needed and are accessed either directly by the staff of the home or via the GP. Residents can attend one of three local Optician clinics, home visits can also be arranged. Dentist treatment is arranged via private and/or NHS surgeries. There are both types of surgeries available locally. Access to audiology, physiotherapy and the Dietitian are sourced via GP. The home has a Chiropodist who attends the home every three weeks and as required. Appointments with a Podiatrist are also arranged for residents, as required. The home has access to pressure relieving equipment , as required. The home has good procedures in place for the monitoring and recording of all drugs administered, disposed of and those entering and leaving the home. The stores for medication were viewed and these were found to be maintained in a clean and orderly manner. Medication administration records were viewed and these were found to be maintained appropriately. It was evidenced that some entries had been made in red pen, therefore a recommendation has been made. Controlled Drugs are maintained on the premises and were found to be recorded on a sheet of loose leaf paper, which is easy to alter and increases the risk of abuse of Controlled Drugs. Therefore an immediate Requirement was made. This was addressed prior to the conclusion of the inspection and all Controlled Drugs are now recorded in bound, tamper proof book. It was also observed that unexplained, undated and unsigned handwritten entries had been made onto Medication Administration Recording (MAR) charts, providing an unclear audit trail of where the information has been sourced. Therefore an Immediate Requirement has been made. Staff were observed providing personal support to residents in such a way that promoted and protected their privacy and dignity. Care Homes for Older People Page 14 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are able to enjoy a full and stimulating programme of activities to choose from everyday of the week. The home provides a wide range of social, cultural and recreational facilities. Menus and meals including specialist diets are designed to meet residents, nutritionally assessed needs. Residents choice and wishes are respected in all activities and mealtimes. Evidence: Residents are consulted regarding their social and leisure interests and an activities programme is implemented to reflect those interests and preferences. There are three Activity Coordinators who conduct activities. Activities are provided by one Coordinator everyday, from Monday through to Sunday. Though there is a list, the daily activity can be changed according to residents choice. Records are maintained of all activities conducted. Activities include Individual sessions for those who chose not to attend group activities or those who are unable to attend due to health or medical reasons, residents birthdays and seasonal events are celebrated, exercises (chair based movement and stretching exercises), knitting club, quizzes, crosswords, Film afternoons, Cookery, gardening, arts and crafts, music and nostalgia, Strawberry Teas, Pat Dog, pantomimes and music therapy. Residents spoken with said that they liked Care Homes for Older People Page 15 of 25 Evidence: most of the activities and could pick and choose those that they attended. A hairdresser attends the home once a week. Residents religious wishes are observed and arrangements are in place for residents to receive non denominational Holy Communion, if they wish. Roman Catholic communion is also provided for those residents who request it. The management of the home believes in promoting an equal and diverse culture among staff and residents. External activities are arranged three to four times a year. Such outings are coach trips to places of local interest such as Bexhill, Pevensey, Hampden park. There are currently no day centre attendees at present. Contact with family and friends is positively encouraged with visitors being able to attend the home at any time and in accordance with the residents wishes. The homes menus are devised on a four week rolling programme. All meals are home cooked with an alternative option available for each mealtime. Mealtimes can be varied upon request and residents guests are also welcome to have meals at the home. Meals can be taken in the residents bedroom or in the communal dining room. Medical, therapeutic or religious diets are provided as needed. All residents are nutritionally assessed and diets are tailored accordingly. Residents who are at risk of malnutrition are encouraged to eat little and often, sandwiches are provided at morning and afternoon tea and small meals are provided at the regular meal times. Residents requiring weight loss diets are weighed regularly and food counts for Carbohydrates, Fat and Protein content of food are measured and meals are given that fall within the required food count for weight loss. Drinks and snacks are available at all times. The meal served during the inspection was ample in quantity and attractively presented. The lunchtime meal was observed to be unhurried. Care Homes for Older People Page 16 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. Residents benefit from a robust and efficient complaints procedure, whilst the homes procedures, processes and staff training should protect residents in the event of an allegation of abuse. Evidence: There is an established complaints procedure in place. The management of the home has received three complaints within the past twelve months, all of which have been recorded as addressed. Each of the complaints have been resolved and appropriate action was taken by the Registered Manager, to address the concerns raised. Criminal Record Bureau (CRB) checks have been carried out on all existing staff. Nursing and Midwifery Council (NMC) PIN checks are conducted for all Registered Nurses. Both CRB and Protection of Vulnerable Adult (POVA) checks are carried out on all new staff. Staff have attended training in the Protection of Vulnerable adults within the last twelve months. This was evident from the staff files were viewed. A copy of the East Sussex County Councils Safeguarding Adults procedures is readily accessible to staff. There have been no Safeguarding Alerts raised by the home in last twelve months. Care Homes for Older People Page 17 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. The accommodation provided for residents is well maintained, safe, hygienic and odour free. Infection control procedures are adhered to at all times. Evidence: The location and layout of the home are suitable for its stated purpose. The home is well maintained and all areas of the home, including the garden, are accessible to residents. The home has an ongoing plan of refurbishment in place. The garden is well maintained by the homes Maintenance person, Activitties Coordinators and residents. The home has recently won the Seaford in Bloom competition for its garden flowers and bedding plants. Further awards have also been presented by Lewes District Council to the home, having been awarded the Clean Catering Award 2008. Furniture in the home has been assessed, repaired or replaced, in oder to ensure that the home follows its infection control policies. Therefore the previous inspection requirment has been met. The home has an infection control policy in place and staff are trained in infection control procedures, staff training records viewed confirmed this. Staff were observed adhering to infection control procedures. The home was clean and odour free throughout. There is a daily cleaning schedule in place. 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. The health needs of residents are well met by a staff team that have the necessary skills and experience to the meet the needs of current residents. There is good maintenance of all staff recruitment files. Staff training exceeds the National Minimum Standards and ensures that staff receive training that is both current and appropriate to the needs of residents. Evidence: A competent staff team, sufficient in number, meets the residents needs. There is a staff rota in place, which details staff designations and hours of working. The home is staffed on the basis of six Health Care Assistants (HCAs) in the morning, five HCAs in the afternoon and two in the evening and overnight. There is an RN on duty twenty four hours a day, seven days a week. There are three Housekeepers on duty during weekdays and two at the weekend. The kitchen has a cook on a daily basis and there is a Kitchen Assistant on duty every morning and evening. Housemothers are on duty daily, in order to assist with tray collection following meals and to undertake laundry duties. The home has a permanent staff team of the Registered Manager, six RNs (and two Bank), eight Senior Carers, fifteen HCAs (and two on the Bank), three Cooks (and one on the Bank), three Activity Coordinators, three Kitchen Assistants, four Care Homes for Older People Page 19 of 25 Evidence: Housekeepers, two Housemothers, one Administrator and one Maintenance person (and one on the Bank). Three HCAs are National Vocational Qualification (NVQ) level 3 trained and nine HCAs are NVQ level 2 trained. Four HCAs are currently completing the NVQ level 2 in care traing. One Cook is completing the NVQ level 2, in Catetring (Food Processing). One Senior Carer has achieved NVQ level 4, the Registered Managers Award (RMA) and has achived the Level 4 NVQ in Teaching, as a result she is responsible for staff training and coordinates supervision sessions. Staff recruitment files were viewed and it was evidenced that these files contain all items required under the Care Homes Regulations 2001. It was observed that where staff references are basic in content, further references are obtained in order to enhance the recrutiment process. The home has an Equal Opportunities policy in place and is an equal opportunities employer. Staff induction training is conducted in line with Common Induction Standards guidance. Mandatory training consists of Infection Control, Moving and Handling, Health & Safety, Protection of Vulnerable Adults, Induction, basic First Aid and Fire Safety. Additional training is conducted in pressure area care, NVQ, Nutrition, continence, medication, tissue viability, wound care, Dementia, care planning, falls, respect and autonomy and basic food hygeine. Fortnightly staff workshops are also held, whereby staff discuss and are trained in matters relevant to residents needs. Subjects covered include Dementia, Diabetes, Catehter Care, Air beds, Communication skills and Key Worker systems. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents experience the benefits of a home that is well managed and administrated. Consideration is given to residents choice and opinion in all aspects of provisions provided. The health, safety and welfare of residents and staff is protected at all times. Evidence: The Registered Manager of the home is also the Registered Provider and has owned and managed the home for a number of years. She is an RN level 1, Registered Midwife Level 1, is NVQ level 4 qualified and has achieved the RMA. There is a formal quality monitoring and quality assurance system in place. Thisis conducted in line with the Blue Cross Mark of Excellence Quality Assurance Procedures. A Senior Carer coordinates all Quality Assurance processes. Yearly audits are conducted, which consists of resident questionnaires (conducted at three monthly resident care reviews), menu audits, resident care and documentation, spiritual needs, and rights and choice are also included in the audit process. The results of all audits Care Homes for Older People Page 21 of 25 Evidence: are correlated and residents are told of the findings during residents meetings or during individual sessions or care reviews. The Statement of Purpose and Service User guide is also audited and updated as required. Residents meetings are held every quarter, these meetings have an agreed agenda and are minuted. Residents relatives are invited to attend these meetings. Monthly staff meetings are also held, the minutes of which were viewed. The Senior Carer who coordinates quality Assurance stated that there are plans in place to produce a newsletter for Residents and visitors. The home does not take any responsibility for many of the residents finances and most residents have family, friends or representatives who protect their financial affairs. The homes maintenance files were viewed and it was evident that fire drills, fire alarm testing and fire equipment checks, health & safety checks and water checks had been carried out. There were no health & safety issues noted at the time of this inspection. 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 1 9 13 That all handwritten entries are made onto Medication Administration Recording (MAR) charts are signed, dated and explained. In that it was evidenced that there were unsigned, undated handwritten entries made onto MAR charts, which did not clearly specify where the information had been sourced. 22/10/2008 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 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 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 © (2008) 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. Re-publishing this information is in breach of the terms of use of that website. 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