Inspection on 15/03/07 for Westerley

This inspection was carried out on 15th March 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 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

Westerley 30/07/08

Westerley 02/03/06

Westerley 18/08/05

Westerley 23/03/05

Westerley 25/05/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Westerley King Edward Road Minehead Somerset TA24 5JB Lead Inspector Shelagh Laver Unannounced Inspection 10:00 12 March 2007 th 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 Westerley DS0000016017.V323268.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. Westerley DS0000016017.V323268.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Westerley Address King Edward Road Minehead Somerset TA24 5JB 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 01643 702066 01643 708978 The Leaders of Worship and Preachers Homes Mr Vaughan Clive Ogden Care Home Westerley DS0000016017.V323268.R01.S.doc Version 5.2 Page 4 No. of places registered (if applicable) 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places Westerley DS0000016017.V323268.R01.S.doc Version 5.2 Page 5 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd March 2006 Brief Description of the Service: Westerley is a large detached property, set in spacious and beautifully maintained gardens. The home is situated close to the centre of Minehead, where there are all local amenities. The home is registered with the Commission for Social Care Inspection to provide care and accommodation for up to twenty-one people over the age of 65 years, who require assistance with personal care. The Registered Manager is Mr Vaughan Ogden. The Registered Provider is Mutual Aid Homes trading as LPMA Homes. The Responsible Individual is Mrs Ros Peedle. The home cares for service users within a Christian community and accepts requests for assessment from all Christian denominations. A short Christian service takes place in the home each morning. Service user accommodation is provided over two floors. There is a passenger lift, two assisted bathrooms and a call system available to service users. All areas of the home have been well maintained and furnished to a high standard. Westerley DS0000016017.V323268.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced Key Inspection took place on one day over six hours and was conducted by one inspector. A Pre-Inspection questionnaire had been submitted and comment cards had been sent to service users, relatives and a doctor. Five service users cards were received. They confirmed that care and support was always available and that staff listened and acted on what service users said. Four relatives returned comment cards. All were pleased with the care provided. The inspector made a tour of the premises and spoke to seven service users individually. The registered manager Mr Ogden and Mrs Ogden were on duty in the afternoon and were able to assist the inspector with all documentation. Records relating to care, staff and health and safety were examined. Three new bedrooms with en-suites are now completed but are not yet commissioned. What the service does well: It is clear that home is run to provide the best possible individual care to service users. There is an established positive group of carers. There have been no staff changes since the last inspection except a retirement. Service users are able to determine themselves how they will spend the day according to their wishes and capabilities. A few service users are able to access the nearby town independently. Others enjoy spending time in their own rooms. The inspector talked with service users who described their hobbies and interests. Service users confirmed they were well cared for at Westerley. One service user commented, “I am very happy here. Staff are very good.” Another said “Staff are polite and kind. …I am perfectly happy to call this my home.” And another said “We are fine here….we live quietly and nicely….we are perfectly alright.” A relative said “I admire the tact and kindness of the staff.” Westerley DS0000016017.V323268.R01.S.doc Version 5.2 Page 7 The friend of a service user who had recently died asked to see the inspector. She said “This is a wonderful home …all staff are so kind. I can’t praise them enough.” Service users benefit from the contributions made by all members of the support staff. Service users enjoy a wholesome and varied menu which takes into account the needs and preferences of people in the home in a very individual way. The home environment is very well maintained. It is safe, clean and comfortable. One service user said “There is an excellent standard throughout.” There is a choice of communal areas. The gardens surrounding the homes are particularly attractive and contribute significantly to the enjoyment and sense of well being of some service users. Service users are actively supported in the development of a variety of lifestyles and daily routines that suit them individually. There is an activities and social programme. The home has support from the local GP practice although service users can choose to maintain their own GP. There is regular contact with Nurses and doctors when needed. At the time of the inspection there were several service users who were unwell. It was clear that they had been made as comfortable as possible and that regular medical assistance had been sought. There is continuous upgrading and decoration of the environment. What has improved since the last inspection? The home now has professional visits listed on a separate form and not in the daily records. En-suites and bathrooms have been up-graded and decorated. Westerley DS0000016017.V323268.R01.S.doc Version 5.2 Page 8 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Westerley DS0000016017.V323268.R01.S.doc Version 5.2 Page 9 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 Westerley DS0000016017.V323268.R01.S.doc Version 5.2 Page 10 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): 12345 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users are provided with appropriate information which will assist them in making a decision about admission. A full assessment of prospective service users needs is undertaken prior to admission. The pre-admission process is detailed and well managed. EVIDENCE: The home has produced a Statement of Purpose and Service User Guide which is made available to service users, prospective service users and their representatives. The home’s current fee range is dependant upon the room to be occupied and the assessed needs of the service user. Westerley DS0000016017.V323268.R01.S.doc Version 5.2 Page 11 The manager ensures that prospective service users are fully assessed prior to admission. A service user is visited if possible and information from other health professionals and for example hospital care notes are taken into account. Service users are invited to visit the home whenever this is possible. One service user had written “I came for a holiday prior to making the decision to come here permanently.” Others had “help from family.” The manager liaises with other home managers in the group if the service user lives too far away to be visited. The manager nearest the service user will undertake the assessment and provide information. All service users who returned a comment card confirmed that they had a contract. Westerley DS0000016017.V323268.R01.S.doc Version 5.2 Page 12 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 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home involves residents in all aspects of their life. The home arranges for health professional to visit frail residents. The home takes appropriate action to ensure the health care needs of service users are met. Residents have choice over their personal care and are encouraged to be independent. The home’s procedure for the management and administration of medication was found to be satisfactory. Service users are treated with respect. Care practices support privacy and dignity. EVIDENCE: All service users have care plans maintained. Two were examined and were found to be up to date and well maintained. There were monthly reviews. Westerley DS0000016017.V323268.R01.S.doc Version 5.2 Page 13 Care plans are compiled from appropriate assessments, which include preadmission assessment, prevention of pressure sores, moving and handling needs and nutrition. It was observed from care plans that service users have access to appropriate health care professionals. District nurses and GPs are currently visiting regularly. Service users who had been unwell had received regular medical attention. One service spoken with described the care taken by the home to ensure she accessed the service of specialist nurses and consultant clinics. The care plans are designed to reflect the care needs and the actions to be taken whilst the service users’ health is relatively stable. During the inspection we discussed the need for the care plan to give clear instructions to carers concerning the action required and not a statement of the service users condition. The home should review the plans to enable short term and fluctuating needs to be accommodated and easily followed. For example those service users who were ill with chest infections were clearly well cared for. This could only be determined by reading all the daily notes. Some work has been undertaken but it is now time to review the overall format in order to also include ,for example diabetic care plans. There should be a risk assessment for the service user who gives her own insulin and guidance regarding action to be taken in the event of a significant variation in blood sugar. All staff attended to and addressed service users with respect and in a dignified manner. Service users spoke of the kindness of staff. Observations confirmed that residents are well cared and treated with respect at Westerley. Service users received visits from chiropodists and opticians. The home uses the Monitored Dosage System (MDS) with some additional boxed prescriptions and pre-printed MAR charts. All records examined were appropriately completed. The home provides care for some service users for a several years and supports them through many changes. There was evidence at this inspection of how well support and care is provided at the end of a service users life. The home staff work with doctors and nurses to ensure the service user receives the best care. A friend praised the care given to a service user who had recently died. “She was surrounded with love and kindness here.” Westerley DS0000016017.V323268.R01.S.doc Version 5.2 Page 14 Westerley DS0000016017.V323268.R01.S.doc Version 5.2 Page 15 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 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users choose a variety of lifestyle patterns in the home. The home provides a wholesome and varied menu which takes into account the needs and preferences of service users. Service users are supported to maintain contact with family and friends is good. Family and friends are made welcome in the home. The home provides activities and entertainments to enrich the service users lives. Efforts are made to ensure service users enjoy suitable meals . EVIDENCE: Westerley DS0000016017.V323268.R01.S.doc Version 5.2 Page 16 The home menu is wholesome, appetising and varied and takes in to account the needs and preferences of service users. One service user talked about the care taken to ensure her special dietary needs were met in the home. Service users are informed in the morning of the choices available for lunch. Service users confirmed that there was always something “different” available. A service user said, “I think food is nicely cooked and there is plenty of it.” There is a cooked breakfast choice each day. The dining room is pleasant and tables are set to a good standard. Visitors are made welcome at any reasonable time in accordance with the wishes of the service user. There is a choice of communal areas ensuring there is always “a quiet spot”. Some service users prefer to meet visitors in their rooms that were seen to contain sufficient seating. Service users are encouraged to maintain their interests and hobbies wherever possible. The inspector met with a service user who enjoyed painting and another who enjoyed quilting knitting and reading. Service users said they had attended a musical evening that had been enjoyed. Comment cards indicated that of the five returned three felt there were activities they could take part in “always.” One said “usually” and one “sometimes.” It is suggested that a review of all service users social needs is undertaken with a view to providing further appropriate “low key “ social events. These may be enjoyed by a few people but may include those less able to organise their own day. Morning prayers take place in the lounge each morning. Service users at the home are able to participate in a range of activities including exercises and after tea events. There is a small library. Visitors are welcomed at the home. Local clergy also make visits to the home on a regular basis. Service users are able to bring possessions with them into the home. All service user rooms had been individualised with photographs and personal belongings. Service users were smartly dressed and have the regular services of a hairdresser. There is an efficient laundry service that included hand ironing. Westerley DS0000016017.V323268.R01.S.doc Version 5.2 Page 17 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 18 Quality in this outcome area is good. The complaints procedure in this home is good with evidence that the views of service users/visitors are listened to and acted upon. Residents and others associated with the home state they are extremely satisfied with the home. Procedures and policies aim to protect service users from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There had been no formal complaints. Service users spoken to knew who would be able to address any concerns they had. One record of a service users finances was observed. Records had been kept that were clear and accurate. Comment cards returned indicated all those service users would know how to make a complaint and who to talk to if unhappy. Westerley DS0000016017.V323268.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 20 21 22 23 24 25 26 Quality in this outcome area is excellent. Service users live in a comfortable, safe and clean environment. Bedrooms are relaxed and personalised. The home’s environment is able to meet the assessed needs of service users. The home provides specialist equipment to ensure the needs of service users are met. There is a choice of communal spaces. Outdoor facilities are attractive and designed to be used by the service users. The home is very clean and well cared for. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All communal areas and most bedrooms were seen at this inspection. Bedrooms vary in size but all were pleasant and comfortable. It was evident Westerley DS0000016017.V323268.R01.S.doc Version 5.2 Page 19 that service users brought personal possessions into their rooms. Some rooms were very “lived in” and contained plenty of books, newspapers and family momentoes. Specialist beds and pressure relieving equipment are available where there was an assessed need. The staff and nurses were making arrangements for one service user to have during the inspection. Service users informed the inspectors that they were happy with their rooms. Some appreciated the views from the bedroom windows across the gardens or to the hills. One service user enjoyed watching “the comings and goings” in the front drive. There is a choice of sitting areas and the standard of decoration and furnishing is comfortable and smart. The home has a lounge, a dining room and a conservatory. Bedrooms are decorated systematically and service users choose colours and patterns of rooms. The home showed evidence of steady investment. Service users have a choice of where to spend the day. Some prefer to spend a great deal of their time in their bedroom although all are encouraged to come to the dining room for lunch if they are well. Overall the home is very pleasantly decorated and well maintained. The home is cleaned and cared for to a high standard. Carpets are deep cleaned regularly and replaced on a rota. Domestic staff on duty were satisfied with the time provided to care for the home and the equipment provided. There were some empty rooms in the home. These were prepared and welcoming. Westerley DS0000016017.V323268.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 30 Quality in this outcome area is good. The home benefits from a stable and well trained work force. The ensures that there are sufficient staff on duty to meet the service users needs. The home’s recruitment practices are robust and designed to protect the service users. Staff have access to a range of mandatory and developmental training opportunities. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of inspection there were three care staff on duty. Also on duty were the cook, two domestic staff and the gardener. The duty rota showed permanent staff working in numbers to meet the needs of service users. Four comment cards said staff are always available when needed. One card said “usually.” The home’s training and development plan was seen by the inspector and discussed with the manager. Staff spoken to confirmed they had received Westerley DS0000016017.V323268.R01.S.doc Version 5.2 Page 21 manual handling up-dates and fire training. Written records of training were seen. 73 of staff have NVQ2 and above. This year the manager has introduced a range of in-house training modules that have been enjoyed by staff. These cover health and safety, food safety , basic first aid and manual handling. It is recommended that there is a designated manual handling assessor and trainer in- house who has access to regular up-dates. There have been no new staff recruited since the last inspection when sound recruitment practice was observed in two files. Westerley DS0000016017.V323268.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31 32 33 34 35 36 37 38 Quality in this outcome area is good. The home is effectively managed by the registered manager who promotes a clear and inclusive style of management. The formal quality assurance system should be fully implemented. Measures are taken which ensure the needs and well being of service users takes priority. Staff are appropriately supported however some appraisal supervision should be formalised. The home’s systems for ensuring the health, safety and welfare of service users and staff are structured and well managed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Westerley DS0000016017.V323268.R01.S.doc Version 5.2 Page 23 Mr and Mrs Ogden demonstrated through discussion with the inspector that they had a very clear understanding of the needs of service users living at the home. They are clearly committed to meeting the needs of the service users and to the effective running of the home. Staff benefit from regular meetings. There is evidence that staff do have group supervision meetings on issues of practice. However there were few planned appraisals and supervisions. These should be implemented in line with NMS 36. Service users and their families are asked for their views and consulted on an on-going basis. There are plans to implement a more formal quality assurance scheme and this should be pursued. The manager is an experienced administrator responsible for managing the finances of the home, maintaining appropriate records and liaising with Head Office. Contracts are in place for key maintenance. At the time of this inspection, the home was taking appropriate steps to ensure the health & safety of service users, staff and visitors to the home. The following records were examined: FIRE – Records indicated that appropriate checks were being carried out on the home’s fire detection and fire fighting equipment. Regular training is conducted for all staff. SERVICING – Servicing schedules indicated that hoists are serviced according to LOLER. There are planned dates for all servicing. ACCIDENT – The home maintains appropriate records relating to accidents at the home. The accident records include action to be taken and evidence of analysis. HOT WATER/SURFACES – Bath hot water outlets are thermostatically controlled to reduce the risk of scalding. Those checked at this inspection were found to be within the acceptable limits. First aid training is provided for staff. COSHH sheets were seen. Westerley DS0000016017.V323268.R01.S.doc Version 5.2 Page 24 Westerley DS0000016017.V323268.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 4 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 x 3 3 2 3 3 Westerley DS0000016017.V323268.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 (2) Requirement The manager must review the format of the care plans to enable short term and fluctuating care needs to be easily followed. Timescale for action 01/06/07 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. 2. Refer to Standard OP12 OP36 Good Practice Recommendations The range of social activities available to service users should be reviewed. It is recommended that staff supervision should conform to National Minimum Standards. Westerley DS0000016017.V323268.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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. Extracts may not be used or reproduced without the express permission of CSCI Westerley DS0000016017.V323268.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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