Inspection on 29/11/05 for Westfield Care Home

This inspection was carried out on 29th November 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 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

Westfield Care Home 30/05/08

Westfield Care Home 27/06/07

Westfield Care Home 13/06/06

Westfield Care Home 22/08/05

Westfield Care Home 14/02/05

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Westfield Care Home Devon Drive Mansfield Nottinghamshire NG19 6SQ Lead Inspector Jayne Hilton Unannounced Inspection 29th November 2005 09:30 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 Care Home DS0000008773.V266728.R01.S.doc Version 5.0 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 Care Home DS0000008773.V266728.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Westfield Care Home Address Devon Drive Mansfield Nottinghamshire NG19 6SQ 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) 01623 427846 01623 429874 Lantraz Co. Limited Mrs Angela Jane Betts Care Home 45 Category(ies) of Dementia (8), Old age, not falling within any registration, with number other category (37) of places Westfield Care Home DS0000008773.V266728.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 37 Residents shall fall within registration category OP. 8 Residents shall fall within registration category DE Date of last inspection 22nd August 2005 Brief Description of the Service: Westfield Care home provided 45 bedrooms of which 11 are en-suite, providing long term, short term and respite care for older persons. Eight beds are reserved for service users with dementia needs. Situated on Devon Drive in Mansfield, the home was purpose built in 1985. The home has 3 lounges on the ground floor and three on the first floor, which includes a lounge for those service users who wish to smoke. There is a call alarm system throughout, with grab rails and assisted bathing facilities. There is a spacious dining room. Access to the first floor is by means of a lift. Westfield Care Home DS0000008773.V266728.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Regulation Inspector Jayne Hilton undertook the unannounced inspection, on 29th November 2005. The main focus of the inspection was to assess the requirements set at the previous inspection and the remaining key standards. The methodology used included, the examination of three service users care plans for selective information and other related documentation. Two service users were spoken with at this visit. A sample of records was examined, including accident records, the duty rosta, menus, complaints records and some policies and procedures. A part tour of the environment was included. What the service does well: Service users have the information they need and an assessment is carried out prior to them moving to the home. The service users’ personal and health needs are generally set out in a care plan and service users feel their needs are met. Service users praised the staff and management and stated that overall their needs were met. The service users confirmed that their privacy and dignity was respected, and that the lifestyle experienced in the home matches their expectations and preferences in relation to exercising control of their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings. Service users reported that the food was very nice. Service users reported that an ample supply of drinks is provided 24 hours a day. Service users and their relatives are encouraged to make complaints if they are not happy with the service provided. Service users appear to be protected from abuse, neglect and self–harm. The purpose built environment was homely, appeared comfortable, safe and cleaned to a high standard. Furniture, carpeting and decoration was all to a high standard. The home is spacious and well laid out, with ample lounge facilities for those that wish to have quiet time. Maintenance of communal areas and bedrooms was good. Service users needs are met by, the numbers of staff provided. There appears to be an adequate level of induction and training for staff and the health, welfare and safety of service users is protected. Westfield Care Home DS0000008773.V266728.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Good practice recommendations have made to use separate record sheets for chiropody, dental, GP, hospital, Optician etc to provide running records of treatments.To use monitoring tools, record incidents and evaluate challenging behaviour alongside care plans. Safety bumpers should always be used with bedrails. The fridge thermometer should be replaced with a minimum /maximum temperature indicator type and a policy should be devised for supporting service users to maintain contact with friends and family. The inspector suggests a daily menu on the dining tables each day, to inform service users of the meal options for the day and to personalise the toilet and bathrooms. A training programme for 2005/2006 should be developed and further development to the policy for service users financial accounts is recommended. Formal supervision should be to 6 sessions per year and the provider should consider the provison of exterior gates. Westfield Care Home DS0000008773.V266728.R01.S.doc Version 5.0 Page 7 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 Care Home DS0000008773.V266728.R01.S.doc Version 5.0 Page 8 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 Care Home DS0000008773.V266728.R01.S.doc Version 5.0 Page 9 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): 3, 4 Service users have the information they need and an assessment is carried out prior to them moving to the home. Service users and their representatives know the home they enter will meet their needs. EVIDENCE: Three care plans were examined; all were found to contain an assessment and included information on medication on admission, mental health and foot care. There was evidence seen that relatives are involved in the assessment process, signatures of both the service user or their representative had been obtained in agreement, on most occasions. Extended community Care assessments were also examined and care plans that were devised appeared generally to derive from the assessed needs of the service user. Service users spoken with praised the staff and management and stated that overall their needs were met. Westfield Care Home DS0000008773.V266728.R01.S.doc Version 5.0 Page 10 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): 7,8,10 The service users’ personal and health needs are generally set out in a care plan and service users feel their needs are met. Some good practice recommendations have carried forward. Service users confirmed that their privacy and dignity was respected. EVIDENCE: Care plans were in place and most of those examined were signed by the service user and/or their representative. Care plans and risk assessments were noted to be generally up to date, up until October and were due for review in November. The care plans indicate whether service users had been offered a bedroom door key or key to their lockable facility, which is signed by the service user or their representative. Service users reported that the health care needs of service users were well met. Care is needed regarding follow-ups of blood test results, although there was evidence that the requirement from the previous inspection had been met, the inspector and providers felt that the system for follow ups for blood test results should be further improved, as very often reliance was on the medical practice to inform the home and therefore results/outcomes even if tests were Westfield Care Home DS0000008773.V266728.R01.S.doc Version 5.0 Page 11 negative, were not always then documented and at risk of being overlooked. The district nurse is involved as required and provides support for those with pressure areas and continence and diabetes. Clear records of blood sugar readings are noted in the care records. Chiropody and other health checks are documented in care plans. It is suggested that separate sheets are used for chiropody, GP, dental, optical, district nurse and hospital visits. Where service users present challenging behaviour, care plans should be used in conjunction with monitoring tools and incident records kept separately. There was evidence that the manager had tried to pattern the behaviour incidents of one service user, however there was no documentation in place for this. Appropriate risk assessments were in place regarding mobility, manual handling, and risk of falls, infection control, tissue viability and nutrition and the reviews of these were up to date. Weight records were found to be generally satisfactory. Accident records were satisfactory. There is still some bedrails used without bumpers. The registered provider is advised to make further purchases of these. Service users confirmed that their privacy and dignity were always respected. Westfield Care Home DS0000008773.V266728.R01.S.doc Version 5.0 Page 12 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): 13, 14, 15 Service users find the lifestyle experienced in the home matches their expectations and preferences and maintain contact with family/friends and representatives. Service users receive a wholesome appealing balanced diet in pleasing surroundings and enjoy their food. EVIDENCE: Service users told the inspector that they could get up and go to bed when they required and were observed to move freely throughout the home. Overall service users confirmed they could please themselves and make choices. The home does not have a policy to support service for maintaining contact with service users friends and family and therefore this is recommended. Community links are in place with age concern and the local school and church. The lunchtime meal was partly observed and the ‘four weekly cycle’ of menus examined. The menu offers alternative choices and a record is kept of the choices made. Service users provided contradictory information about whether they have a choice of meals but this was probably because of memory problems rather than lack of choice given. Service users reported that the food was very nice and adequate in portion. Mealtimes observed were Westfield Care Home DS0000008773.V266728.R01.S.doc Version 5.0 Page 13 unhurried and dining facilities pleasant. Staff, were observed to be seated to assist those who needed help with eating. Care plans contain nutritional risk assessments. Westfield Care Home DS0000008773.V266728.R01.S.doc Version 5.0 Page 14 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 Service users and their relatives are encouraged to make complaints if they are not happy with the service provided. Service users appear to be protected from abuse, neglect and self–harm. EVIDENCE: A complaint procedure was displayed. A copy of the complaint procedure is also available in the service user guide posted in service users rooms. The format for recording complaints is still to be indicated whether the complaint was upheld or not upheld. Service users reported that they felt confident to make a complaint, and would speak with the management if necessary. They felt confident any concerns would be dealt with appropriately. Two complaints’ was recorded in the home’s complaint records since the last inspection and had come through CSCI and was related to care issues. One was unresolved and the other not upheld. One of the complainant’s wishes for the complaint to be re-opened and the inspector assessed some issues as part of this inspection. A recent incident had been notified to CSCI under Regulation 37 notification, whereby a service user had wandered out of the home. The abuse procedures now state that all allegations must be reported to CSCI under Regulation 37. Westfield Care Home DS0000008773.V266728.R01.S.doc Version 5.0 Page 15 Westfield Care Home DS0000008773.V266728.R01.S.doc Version 5.0 Page 16 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): 19,20,21,22,25,26 The purpose built environment was homely, appeared comfortable, safe and cleaned to a high standard. Furniture, carpeting and decoration was all to a high standard. The home is spacious and well laid out, with ample lounge facilities for those that wish to have quiet time. Maintenance of communal areas was good. EVIDENCE: The purpose built environment was homely, appeared comfortable and cleaned to a high standard. Furniture, carpeting and decoration was all to a high standard. The home is spacious and well laid out, with ample lounge facilities for those that wish to have quiet time. Maintenance of communal areas is good. There is a conservatory area in addition to the lounge and dining facilities. Window restrictors are fitted to the ground floor windows. Doors are alarmed. Westfield Care Home DS0000008773.V266728.R01.S.doc Version 5.0 Page 17 The home appears to have appropriate facilities to meet the needs of disabled people. A rotunder and sit on scales are provided. Call alarms are sited throughout the home, the manager reported that staff are reminded to ensure that these are in reach of the bath at all times and not tied up. A passenger lift provides access between the ground and first floors. The lift had broken three days prior to the inspection and the service engineer had removed a part for repair. A regulation 37 was prepared for this and contingency plans had been made regarding service users who could not use the stairs Radiators are the low temperature surface type apart from one in the service access area to the kitchen. The bathroom and toilets are adequate but they would benefit from some personalisation. Westfield Care Home DS0000008773.V266728.R01.S.doc Version 5.0 Page 18 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): 27,30 Service users’ needs are met by the numbers of staff provided. There appears to be an adequate level of induction and training for staff. EVIDENCE: The staffing numbers for 30 service users appeared satisfactory. New staff, are registered with Peoples College for principles and practice of care training which consists of a twelve week induction package and provides a baseline for mandatory training and there was a record of this on the premises, The inspector has requested that a training programme be devised for this inspection which indicates what has been provided over a twelve month period and also identifies areas of any gaps in individual staff members’ training needs. This is still yet to be completed. Westfield Care Home DS0000008773.V266728.R01.S.doc Version 5.0 Page 19 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): 35,36,38 Service users financial interests of service users but the policy and procedures in relation to finances should be improved. Staff are appropriately supervised and the health safety and welfare of service users is promoted and protected, however the registered provider is advised to gate the exterior of the grounds. EVIDENCE: A sample of service users financial records were examined and found to be satisfactory. Valuables kept on behalf of service users are receipted for as written in the policy. The policy needs amending to address that staff must not benefit from making purchases on service users behalf; this is in relation to the use of advantage/bonus cards etc. The inspector did not find any practice to indicate this but felt that staff need to have this issue made clear in the financial procedures. Westfield Care Home DS0000008773.V266728.R01.S.doc Version 5.0 Page 20 Formal supervision is arranged and the manager is endeavouring to undertake up to 6 sessions a year. Assessment of health and safety practices overall at this and the last inspection evidenced good practice. As the home has a registration category for 8 beds for people with dementia, and there have been several instances of service users wandering, the exterior security should be looked at. It is recommended that the gardens and pathways be gated. Westfield Care Home DS0000008773.V266728.R01.S.doc Version 5.0 Page 21 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 X X 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 2 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 X X 3 3 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 X X X X 3 3 X 3 Westfield Care Home DS0000008773.V266728.R01.S.doc Version 5.0 Page 22 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. Standard Regulation Requirement Timescale for action 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 3 4 5 6 7 8 9 Refer to Standard OP8 OP8 OP8 OP9 OP13 OP15 OP21 OP30 OP35 Good Practice Recommendations Use separate record sheets for chiropody, dental, GP, hospital, Optician etc to provide running records of treatments. Use monitoring tools, record incidents and evaluate challenging behaviour alongside care plans. Safety bumpers should always be used with bedrails. The fridge thermometer should be replaced with a minimum /maximum temperature indicator type. Provide a policy for supporting service users to maintain contact with friends and family. Provide a daily menu on the dining tables each day, to inform service users of the meal options for the day. Personalise the toilet and bathrooms. Ensure that a training programme for 2005/2006 is developed. Further develop the policy for service users financial accounts. DS0000008773.V266728.R01.S.doc Version 5.0 Page 23 Westfield Care Home 10 11 OP36 OP38 Extend the formal supervision to 6 sessions per year. Consider the provison of exterior gates. Westfield Care Home DS0000008773.V266728.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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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