Inspection on 11/07/06 for Westfield

This inspection was carried out on 11th July 2006.

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

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

Other inspections for this house

Westfield 07/11/05

Westfield 05/07/05

Westfield 12/02/05

Westfield 05/08/04

Westfield 28/02/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Byars Care Home

St Marys Nursing Home

Jubilee Villa Care Home

Bramble Lodge

Parkmanor Residential Home

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

CARE HOMES FOR OLDER PEOPLE Westfield 34 Sleaford Road Boston Lincs PE21 8EU Lead Inspector Kima Sutherland-Dee Unannounced Inspection 11th July 2006 10:00 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 Westfield DS0000002474.V301227.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. Westfield DS0000002474.V301227.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Westfield Address 34 Sleaford Road Boston Lincs PE21 8EU Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01205 365835 www.countrycourtcarehomes.com Mr Abdul Kachra Care Home 32 Category(ies) of Learning disability (1), Learning disability over registration, with number 65 years of age (1), Old age, not falling within of places any other category (29), Physical disability (1) Westfield DS0000002474.V301227.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Condition of Registration A condition of registration is that the service user under the category of Learning Disability (LD) should be aged 57 or over and that the service user under the category of Physical Disability (PD) should be aged 44 or over. Date of last inspection Brief Description of the Service: Westfield Residential Home is a two storey detached building with a purpose built extension to the rear. It is situated in the market town of Boston and is a short walk from the shops and local facilities. The accommodation in the older part of the building is in 10 single and three double rooms and in the extension there are 15 single rooms with en-suite facilities. There is car parking to the front of the home and a courtyard garden to the rear. The home is registered to provide care for up to 32 Service Users, one of those having a learning disability and one being under the age of 65 years with a learning disability. Westfield DS0000002474.V301227.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Key inspection was undertaken using a review of all the information available to the Inspector regarding Westfield, and by undertaking a visit to the home. During this visit the inspector used a method of inspection called “case tracking”. This involved identifying three residents who currently live at the home and tracking the experience of the care and support they have received during the time they have lived at Westfield. The inspector also gathered evidence by talking to the manager, touring the home, looking at information on care plans and files, talking with the residents and care staff, and observing day-to-day care practice within the home. The Fees for living at Westfield vary from £335.00 to £460.00 per week. What the service does well: What has improved since the last inspection? What they could do better: The acting manager has agreed to move some medication to a separate fridge from the homes food. Currently the provider’s policy is not being followed. Westfield DS0000002474.V301227.R01.S.doc Version 5.2 Page 6 The fridge needs repair to maintain a safe temperature. The bath in the older part of the home needs replacing. 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. Westfield DS0000002474.V301227.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Westfield DS0000002474.V301227.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service. The residents do not have an up to date and accurate statement of purpose on which to base decisions about the home. The responsible individual does provide each resident with a contract that includes the terms and conditions. EVIDENCE: The Statement of Purpose was available to the residents but the information was inaccurate. The need to update this was discussed with the acting manager. A sample of the contracts were seen and they included the terms and conditions. The care plans included assessments that were carried out before the residents moved to the home, this allowed the manager to assess whether the service could meet the needs of each resident. Westfield DS0000002474.V301227.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The personal care and health needs of the residents are being met. EVIDENCE: Three care plans were seen. They identified each persons needs and how the staff should care for them. Detailed daily records were kept and these have improved recently. Residents said they are happy with the care, although two said that the staff don’t have time to meet all of their social needs. The records that show these residents have been out on several occasions, and offered opportunities to participate in activities contradict this. The manager said this is because more activities have been provided and the residents have been consulted therefore their expectations are raised. Westfield DS0000002474.V301227.R01.S.doc Version 5.2 Page 10 The staff were observed caring for the residents and maintaining their privacy and dignity. The staff interactions were positive. The care plans have records of health appointments and follow up. The staff knew about the needs of each resident, and any medical care. One resident’s relatives said they were happy with the care since the resident returned from hospital, and resident was looking better. Part of a medication round was observed; the medication was administered safely and the senior carer was able to describe safe practise. Medication was being stored in the kitchen fridge, even though the homes policy states this should not happen. The acting manager agreed that the medication would be moved to a separate fridge. Westfield DS0000002474.V301227.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The resident’s social needs are being met and the staff do make visitors welcome. The residents are consulted about their food choices and provided with a balanced diet. EVIDENCE: Residents said that there are activities but two people said they would like more to do. Records show that these residents have been out and participated in activities. They have also recently had a meeting to discuss choices of activities. A member of staff was observed talking with two residents and playing games. The inspector and the acting manager had a discussion about the need to tailor activities to resident’s individual needs. Westfield DS0000002474.V301227.R01.S.doc Version 5.2 Page 12 Visiting relatives were positive about the activities that were on offer, they also said that the staff at the home made them welcome. The cook was observed discussing food choices with the residents. The lunches were different depending on the resident’s preferences. Specialist diets were also being provided. The residents said they liked the food, but two said the sausages were tough. The pantry was well stocked, however dry goods were open and uncovered. This was discussed with manager and cook. The fridge door seal was broken and leaking water, because of this the temperature was raised. The cook reported this to the manager and recorded the defect. Westfield DS0000002474.V301227.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The acting manager has responded appropriately to a recent complaint, and the staff were confident to report any suspicions of abuse, following recent training. EVIDENCE: Two members of staff were asked how they would respond to suspicions of abuse, and they were able to respond in accordance with the homes policy. The acting manager acted appropriately to a recent complaint when they were contacted by a social worker, a written reply to the complaint was seen. Westfield DS0000002474.V301227.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 24, 26 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The home is suitable for the current clients and generally provides a comfortable environment. EVIDENCE: The providers are currently refurbishing the older part of the home, in order to apply to vary the conditions of the home’s registration, and create a separate unit. The refurbishment includes new furniture and carpets, along with new lighting. The downstairs bath in the older part of the home is extremely worn and marked and does not provide a comfortable facility. A large new deck area, which is fully enclosed and accessible, adds to the homes outdoor facilities. Westfield DS0000002474.V301227.R01.S.doc Version 5.2 Page 15 The new side of the home is clean and odour free. A sample of the bedrooms were seen and they were comfortable and well furnished. Three residents said they liked their rooms and although they took a little while to settle in to the new part of the home they were glad they moved. Westfield DS0000002474.V301227.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The providers have safely recruited staff, but not all of the staff are receiving regular supervision. EVIDENCE: Three staff records were seen and they all had the correct information including CRB or police checks. A member of staff showed the inspector a job description, and said the acting manager was offering all of the senior carers development opportunities such as conducting interviews, and assessments. The staff said they work well together and they support each other. The staff said they would approach their senior carers first with any concerns or questions, but if they weren’t available they would approach the manager. Training has been offered both in house and with external providers. The staff files included supervision notes for the senior carers. The manager explained that when the seniors have had two supervisions they would then supervise the carers. However the carers said they haven’t had any supervision since April. Westfield DS0000002474.V301227.R01.S.doc Version 5.2 Page 17 The manager said the staff are still adjusting to a recent change in staffing levels, and the staff said they were adjusting to a change in management but things were beginning to settle down after the changes. The staff ROTA showed that there are at least 3 staff on duty during the morning and afternoon shift. The manager also said that they spend about half of their time in the home and not in the office. Westfield DS0000002474.V301227.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service. The acting manager is working with the providers support to ensure that the service is safe and well managed. EVIDENCE: The home has had an acting manager in place since May 2006 and the inspector discussed the need to ensure that a manager is registered with the commission within a reasonable timescale. This was also discussed with the providers spokesman two days after the site visit. The providers are currently refurbishing the old part of the home in order to set up a separate specialist home. All of the residents, except three, who were living in the older part of the home have moved to the new part. This process Westfield DS0000002474.V301227.R01.S.doc Version 5.2 Page 19 took place after full consultation with the residents, their families and their social workers. The acting manager has not carried out any other quality reviews, but this process along with a meeting for the residents to discuss activities, demonstrates an understanding of the importance of fully consulting the residents about all aspects of the home. The pre inspection questionnaire states that all the required safety checks have been completed. The pre inspection questionnaire also states the financial arrangements for the residents, and where the manager is responsible for money the providers have developed policies to ensure it’s safe handling. The acting manager had been sending notifications to the commission for events that affect the residents as required, however advice was given about sending notifications for all events including a recent incident involving a staff member. Westfield DS0000002474.V301227.R01.S.doc Version 5.2 Page 20 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 2 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 2 X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X X Westfield DS0000002474.V301227.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 OP1 Regulation 4(1) Requirement The updated statement of purpose must be made available in the home. It must include a sample of the terms and conditions and the correct categories for which the home is registered. The provider must ensure that all medication is stored appropriately and in line with policy and guidelines. The provider must ensure that the food is stored safely to prevent a risk to the resident’s health. The registered provider must ensure that a manager applies to the commission to be registered. Timescale for action 30/09/06 2. OP9 13(2) 30/07/06 3. OP15 13(4)(c) 30/07/06 4. OP31 8 30/09/06 Westfield DS0000002474.V301227.R01.S.doc Version 5.2 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP21 Good Practice Recommendations It is recommended that the provider renew the downstairs bath in the older part of the building. Westfield DS0000002474.V301227.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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