Inspection on 05/07/05 for Westfield

This inspection was carried out on 5th July 2005.

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 11/07/06

Westfield 07/11/05

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 Lincolnshire PE21 8EU Lead Inspector Kima Sutherland-Dee Unannounced 5 July 2005 10:15 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 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 C53 C04 S2474 Westfield V224767 050705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Westfield Address 34 Sleaford Road Boston Lincolnshire PE21 8EU 01205 365835 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Abdul Kachra Mrs Diane Bensusan Care Home 32 Category(ies) of Learning Disability (LD) - 1 registration, with number Learning Disability Over 65 (LD(E)) - 1 of places Older Person (OP) - 29 Physical Disability - PD - 1 Westfield C53 C04 S2474 Westfield V224767 050705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions 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 12.02.05 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. On the day of the inspection 25 service users were resident. The home’s aims and objectives include providing a happy, content and safe environment for the residents. Westfield C53 C04 S2474 Westfield V224767 050705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place by speaking with 7 residents, 2 staff and the manager. A sample of the care plans and records were seen and there was a partial tour of the building. What the service does well: What has improved since the last inspection? What they could do better: The care plans do detail the care that each resident needs, but they need to be fully completed, so that staff can use these to give them information about how the residents like to be cared for. One of the lounges contained a large wooden structure that had been stored at the home for about 3 months. This needs to be removed within the next 7 days, so the residents can enjoy the lounge. The outside of the home at the front needs some attention to the paint work, there were also some items of rubbish left to the side at the front. The home would look more welcoming if the car park and garden areas at the front were tidied up. The manager did say that the painter would be repainting the front of the home this year. The manager said that activities do take place but not all of them had been written down. At the moment it appears as if there are few activities. Westfield C53 C04 S2474 Westfield V224767 050705 Stage 4.doc Version 1.30 Page 6 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 C53 C04 S2474 Westfield V224767 050705 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Westfield C53 C04 S2474 Westfield V224767 050705 Stage 4.doc Version 1.30 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 standard(s) 1,3 The home provides incomplete information for prospective resident’s, in the form of the old statement of purpose. The assessment process needs to record further information before a place can be offered. EVIDENCE: The current statement of purpose is out of date, and the manager is waiting for the new one to arrive the home, so that it can be displayed, it needs to contain a sample terms and conditions and the correct categories that the home can admit. The pre admission assessments were seen for 2 residents, and they do contain useful information. There was a discussion with the manager about recording more about each prospective residents need for admission and whether there is any medical diagnosis. This would ensure that the home only admits residents whose needs can be met. It would also ensure that residents are only admitted where the home is registered for those categories. Westfield C53 C04 S2474 Westfield V224767 050705 Stage 4.doc Version 1.30 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 standard(s) 7,8,10 The home does meet the resident’s healthcare needs. The care plans need further work before they are used as an individual plan of care. The staff do have a good understanding of each residents needs. It is positive that the resident‘s are aware of the care plans, and that they are consulted and they sign them whenever possible. EVIDENCE: 4 care plans were seen. These do identify each persons care needs, but they do not identify the objectives or how the need is to be fully met. Some of the care plans were very brief, but they are regularly reviewed. The contact sheets that detail the care that is given were well recorded. Each resident has an assessment and this goes some way to recording each persons preferred routine in some areas but it needs to have more detail. There are records to show any medical intervention or appointment including when the district nurse visited. There was evidence in the records to show that medical advice had been sought and to demonstrate that the staff do maintain the residents health. One resident who is diabetic had a diabetic diet advice sheet and the staff were aware of their medication and diet. The staff are also involved in monitoring this residents blood glucose levels and in liaising with the diabetic nurse. Westfield C53 C04 S2474 Westfield V224767 050705 Stage 4.doc Version 1.30 Page 10 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 standard(s) 12,13,14,15 The staff do respect each resident and their wishes. There was not enough evidence to show that the resident’s are being offered adequate activities or opportunities to go out of the home. The home provides a suitable and adequate diet to meet each persons needs. EVIDENCE: The residents were generally positive about the care at the home and the staff. 3 Residents said that there were not enough activities and the staff always seemed too busy to help them get out. The manager gave examples of when residents had gone out recently but this was not recorded. There is an activities list in the hall that states an activity takes place every day, this is not happening. The manager agreed that when an activity could not take place the reason should be recorded. There are normally 4 staff on each shift and staff were seen sitting and chatting with the residents after lunch. The residents said the staff were kind and all the interaction observed was caring and thoughtful. The staff on duty gave examples of respecting the resident’s wishes. The residents spoke about contact with their families and families and them visiting the home, one resident had a personal telephone. Each resident’s religion is recorded in the care plans, and although there are religious services available there is little information about the residents wishes. Westfield C53 C04 S2474 Westfield V224767 050705 Stage 4.doc Version 1.30 Page 11 The residents were really positive about the food at the home and said they have as much as they want. One resident likes small portions and the meal that arrived was small, but nicely presented. Each residents preferred diet is recorded and the cook is aware of this. Westfield C53 C04 S2474 Westfield V224767 050705 Stage 4.doc Version 1.30 Page 12 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 standard(s) 16. The home competently manages complaints and any complaints have been acted upon. EVIDENCE: The homes complaints book has guidance for the staff and the actions taken are recorded. There are separate forms to use if a written complaint is received. There have been complaints recorded after 2004. The staff were aware of the procedure for dealing with complaints and the residents said they would be confident in complaining. There is a copy of the complaints procedure on the inside of each bedroom. Westfield C53 C04 S2474 Westfield V224767 050705 Stage 4.doc Version 1.30 Page 13 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 standard(s) 19,20,21,22,23,24,26 The home is generally well maintained and furnished but there are a number of areas that require attention. The home is suited to the needs of the residents. EVIDENCE: The home is generally clean and pleasant although the front of the home has peeling paint and the garden areas are not well maintained, there were a number of items of rubbish including an old carpet and a unit at the side, in view of visitors and residents. There is good ramp access outside and lift access inside. An immediate requirement was left with the manager at the inspection, as during a tour of the home it was observed that a large wooden structure was stored in the lounge. The manager stated that this had been left at the home for about 3 months and it had been delivered from another home. This structure was intrusive and the lounge needs restoring to full use. The home employs cleaning staff and the residents said the home was kept ‘nicely’. One room smelled strongly of urine and the manager explained possible solutions that had been tried but had failed. The manager will contact Westfield C53 C04 S2474 Westfield V224767 050705 Stage 4.doc Version 1.30 Page 14 the continence nurse to seek their advice. The resident was unaware of the odour when asked. Further environmental solutions need to be sought. A sample of 10 rooms were seen, in the older part of the building some of the bedroom furniture looked worn, the newer extension had good sized rooms that were well furnished. The manager has requested new bed linen for all the rooms. The home has three shared rooms but only one is currently fully occupied. Although there are no problems with the resident who do share it would be useful to have an agreement to show that this is the residents choice to share. There are adequate numbers of toilets and bathrooms, one bath upstairs was noted to be in poor condition. The manager explained that this is not used. There are hoists and each resident has the equipment they need to mobilise. The bedrooms were personalised and the residents said they could bring their belongings. Westfield C53 C04 S2474 Westfield V224767 050705 Stage 4.doc Version 1.30 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,30 The staff team are caring, trained and competent to do their jobs. There appear to be adequate staff on duty to meet the resident’s needs, however not all the residents agree with this. EVIDENCE: 4 staff on duty in the morning and in the afternoon usually staff the home. The manager said that the staffing levels never fall below 3 on duty. At night there are 2 waking staff and 1 sleep in staff. The staff and the manager said that although at times they are very busy they do generally have time to sit and talk with the residents and they can meet their needs. The residents said that the staff always seem busy and they would like to have more time to spend with the staff, not including personal care tasks. The staff did find time to sit and talk with the residents during the inspection and the manager gave examples of how the staff team are able to offer social opportunities. The staff are trained, although N.V.Q courses have stopped, due to the end of funding. The staff said they work well as a team and support each other. Westfield C53 C04 S2474 Westfield V224767 050705 Stage 4.doc Version 1.30 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,36,38 The staff team are lead by the home manager who has been at the home for 20 years. The staff are supported to carry out their roles. Not all the residents have risk assessments and this needs to be addressed. The home is not safe for all the residents until the door alarm is put back into use. EVIDENCE: The manager is competent to lead the staff team and the staff said they felt supported. Regular supervisions are carried out and the list of dates is available in the staff room. The manager works closely with the staff and monitors their practice. The manager agreed that they need to spend time reviewing the records that the staff are responsible for keeping, so that standards can be maintained and that the staff are trained to complete them correctly, this particularly relates to the key workers filling in the care plans. The care plans do include a number of risk assessments but one care plan did not have a risk assessment for pressure areas and this is required. Westfield C53 C04 S2474 Westfield V224767 050705 Stage 4.doc Version 1.30 Page 17 The home is generally well maintained, but one alarm on the main door is awaiting a battery, this has been ordered but in the mean time residents could leave the building without the staff’s knowledge, which could be a risk. Westfield C53 C04 S2474 Westfield V224767 050705 Stage 4.doc Version 1.30 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 3 3 3 2 x 2 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 x x x x 3 x 2 Westfield C53 C04 S2474 Westfield V224767 050705 Stage 4.doc Version 1.30 Page 19 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP1 Regulation 4(1) Timescale for action The updated statement of Timescale purpose must be made available 28.3.05 in the home. It must include a not met, sample of the terms and new conditions and the correct timescale categories for which the home is 30th August registered. 05. The care plans must be improved 30th August to include each residents need 05. and how the staff are to meet the need. The provider must record each 30th August residents preferences regarding 05. their social activity and any activity must be recorded. The home must be maintained Removal of externally and internally. The wood wooden structure must be whithin 7 removed from the home. days, by the 12th July 05.Other items by 30th August 05 and improveme nt to the front of the home by 30th October Version 1.30 Page 20 Requirement 2. OP7 12(1)(a)( b) 12(3) 3. OP12 4. OP19 23(2)(b)( h)(o) Westfield C53 C04 S2474 Westfield V224767 050705 Stage 4.doc 05. 5. OP24 23(2)(c) The providers must audit the furnishings in the house and an improvement plan, for the bedrooms and communal areas. Solutions to the odour in and around room 5 must be found and the odour eliminated. The entrances must be maintained safely for the protection of the residents. Risk assessments need to be completed for each resident.. 30th August 05. 30th September 05. 30th August 05. 6. 7. OP26 OP38 23(2)(d) 13(4)(a)( b) 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 OP3 OP24 Good Practice Recommendations The pre admission assessment should be clear regarding the reasion for admission and whether there are any diagnosed conditions. Before shared rooms are occupied by two unrelated residents an agreement should be sought and recorded. Westfield C53 C04 S2474 Westfield V224767 050705 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Unity House, The Point Weaver 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. Extracts may not be used or reproduced without the express permission of CSCI Westfield C53 C04 S2474 Westfield V224767 050705 Stage 4.doc Version 1.30 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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