Inspection on 30/05/08 for Westfield Care Home

This inspection was carried out on 30th May 2008.

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

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

Other inspections for this house

Westfield Care Home 27/06/07

Westfield Care Home 13/06/06

Westfield Care Home 29/11/05

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 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Westfield Care Home Devon Drive Mansfield Nottinghamshire NG19 6SQ Lead Inspector Rose Moffatt Unannounced Inspection 30th May 2008 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.V365489.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 Care Home DS0000008773.V365489.R01.S.doc Version 5.2 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@btconnect.com Lantraz Co. Limited Mr Ahmad Ally Toorabally Care Home 45 Category(ies) of Dementia (45), Old age, not falling within any registration, with number other category (45) of places Westfield Care Home DS0000008773.V365489.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered provider may provide the following categories of service only: Care Home Only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home fall within the following categories: Old Age, not falling within any other category - Code OP Dementia - Code DE. The maximum number of service users who can be accommodated is : 45 27th June 2007 2. Date of last inspection Brief Description of the Service: Westfield Care Home is a modern, purpose built home providing care for up to 45 older people. The home is registered to provide care for people with dementia. The home provides long term, short term and respite care. The home has 3 lounges on the ground floor and three on the first floor, including a lounge for those people who wish to smoke. The bedrooms are on both floors, with a lift to the first floor. 11 of the bedrooms have en-suite facilities. There are accessible gardens and space for car parking. The fees range from £294 to £348 per week. This information was provided by the registered manager on 30th May 2008. Information about the home, including CSCI inspection reports, is available from the home. Westfield Care Home DS0000008773.V365489.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The focus of our inspections is on outcomes for people who live in the home and their views on the service provided. The inspection process looks at the provider’s ability to meet regulatory requirements and national minimum standards. Our inspections also focus on aspects of the service that need further development. We looked at all the information that we have received, or asked for, since the last key inspection or annual service review. This included: • The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. • Surveys returned to us by people using the service and from other people with an interest in the service. • Information we have about how the service has managed any complaints. • What the service has told us about things that have happened in the service, these are called ‘notifications’ and are a legal requirement. • The previous key inspection and the results of any other visits that we have made to the service in the last 12 months. • Relevant information from other organisations. • What other people have told us about the service. We carried out an unannounced inspection visit that took place over 6 hours on one day. The inspection visit focused on assessing compliance to requirements made at the previous inspection and on assessing all the key standards. There were 23 people accommodated in the home on the day of the inspection visit. People who live in the home, visitors and staff were spoken with during the visit. The owner-manager was available and helpful throughout the inspection visit. Some people were unable to contribute directly to the inspection process because of communication difficulties, but they were observed during the visit to see how well their needs were met by staff. ‘Case tracking’ was used during the inspection visit to look at the quality of care received by people living in the home. 4 people were selected and the Westfield Care Home DS0000008773.V365489.R01.S.doc Version 5.2 Page 6 quality of the care they received was assessed by speaking to them, and /or their relatives, observation, reading their records, and talking to staff. What the service does well: What has improved since the last inspection? 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 Westfield Care Home DS0000008773.V365489.R01.S.doc Version 5.2 Page 7 be made available in other formats on request. Westfield Care Home DS0000008773.V365489.R01.S.doc Version 5.2 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.V365489.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was a comprehensive needs assessment process and sufficient information provided so that people were confident the home was able to meet their needs. EVIDENCE: The care records of 4 people were seen. All the care records included a range of assessment information and 3 had a care plan that covered all the assessed needs. Information about the person’s personal preferences and choices was included. People, or their relatives, had signed the assessment information to indicate their involvement and agreement. The home had confirmed in writing to the person that the home was able to meet their needs. Westfield Care Home DS0000008773.V365489.R01.S.doc Version 5.2 Page 10 People spoken with, and those who responded to the surveys said their needs were met at the home. All people living in the home had a contract/statement of terms and conditions of living in the home. There was a copy of the Service User Guide in each bedroom. Standard 6 did not apply as there were no people receiving intermediate care at the home. Westfield Care Home DS0000008773.V365489.R01.S.doc Version 5.2 Page 11 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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was a consistent, purposeful approach to care planning so that people received care and support to meet their individual needs and preferences. EVIDENCE: The care plans seen covered all the assessed needs of the person and had sufficient detail of how their needs should be met. There were details of the person’s preferences, such as preferred routines, what name they wanted to be called by, and food likes and dislikes. The care plans referred to how privacy and dignity should be maintained. All the care plans had been reviewed monthly and updated as necessary. Relatives said, “the home ring if something happens or tell me when visiting”. One relative said they were pleased that they had been informed straightaway when their mother had a fall and needed hospital treatment. Westfield Care Home DS0000008773.V365489.R01.S.doc Version 5.2 Page 12 One person did not have a care plan, although there was information about their needs in the assessment. It was explained that this person was quite independent and would be returning to their own home soon. Staff spoken with were aware of the person’s needs and preferences. There were appropriate risk assessments for each person. The risk assessments were reviewed monthly and updated as necessary. Records were kept of the visits and treatment by GPs, District Nurse, chiropodist and other healthcare professionals. It was clear from daily records that any health concerns were addressed promptly and followed up. People spoken with said they, or their relatives, were able to see their GP when they wanted to. The 5 surveys completed by people living in the home said they always received the medical support they needed. People spoken with said that staff respected their privacy and dignity. The 5 completed surveys said that staff always listened to what people said and acted on it. It was observed that staff spoke to people in an appropriate and respectful way. Staff spoken with were able to give examples of ensuring privacy and dignity for people. The medication records seen were correctly completed. All staff who administer medication had received appropriate training. It was observed that the door to the treatment room where medication and some records were stored was not kept locked. Medication was stored in a locked trolley secured to the wall and locked cupboards within the room. There were no records available to show that the temperature of the fridge in the treatment room was checked daily to ensure the correct storage of medication. The fridge also required defrosting. Three requirements made at the last inspection about the administration, storage and safe handling of medication had been complied with. Westfield Care Home DS0000008773.V365489.R01.S.doc Version 5.2 Page 13 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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The lifestyle offered in the home generally met the needs and expectations of people living there. EVIDENCE: Since the last inspection, an activities coordinator had been employed, working approximately 4 hours per day, Monday to Friday. Records were seen of the range of activities offered and these included games, quizzes, music, arts and crafts, local shopping and trips out. People spoken with said they enjoyed a regular trip out for local pub lunch, and also shopping in the town centre. People said, “the home provides good activities for all that can take part” and “I love the activities and am always involved”. Spiritual needs were noted in care records. There were contacts with local churches so that people were visited by clergy on request. Westfield Care Home DS0000008773.V365489.R01.S.doc Version 5.2 Page 14 Meetings were held with people living in the home and the activities coordinator to ask about their satisfaction with life in the home, and any changes they would like. Notes were kept of the discussion at the meetings. The home produced a newsletter approximately every 3 months to keep people and their relatives informed and updated. People said they were able to get up and go to bed when they wanted and could follow their preferred routines. They were able to personalise their bedrooms with photographs and other items. Visitors said they were always made welcome and could see their relative in private if they wished. Those spoken with and the 4 relatives who completed surveys said the home always kept them informed about any changes in their relative’s condition. There was a large dining room where most people ate their meals. Some people chose to eat in their rooms. People had been consulted on what food they would like. There was no choice of main meal indicated on the menu. People living in the home and staff said people could choose something else if they did not like what was on the menu. Staff also said that they became familiar with what people preferred for meals. People described the meals as: “nice”, “ beautiful”, and “its my kind of food.” People spoken with said they did not know what was for lunch that day. A menu for 2 weeks was displayed in the dining room, but it was not clear which week was the current one. The menu appeared varied. There were positive comments from people about the home, including: “we are pleased mum gets looked after well” “they have a very caring attitude to everyone in the home” “ my father has always been happy staying at the home” “it’s just like one family helping and caring for each other” “I have everything I need here and am very happy.” “I think my mum gets excellent support” Westfield Care Home DS0000008773.V365489.R01.S.doc Version 5.2 Page 15 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were policies in place and good staff awareness so that people were protected and their concerns effectively dealt with. EVIDENCE: The complaints procedure was displayed in the home and was included in the Service User Guide provided to each person living there. 4 of the 5 people living in the home, and all 4 of the relatives who completed surveys said they knew how to make a complaint. People said, “never had to complain” “any concerns we have had have been resolved within a short time” “the door is always open to have a chat and discuss any worries.” Since the last inspection one complaint was made directly to CSCI. This was referred to the providers for investigation and no further action was taken by CSCI. Complaints records at the home showed that complaints were dealt with promptly and the outcome was recorded. Westfield Care Home DS0000008773.V365489.R01.S.doc Version 5.2 Page 16 Since the last inspection 2 allegations of abuse had been dealt with by the home. In both cases they appeared to have taken appropriate action. Most of the staff at the home had received training about safeguarding vulnerable adults and about dealing with challenging behaviour. Staff spoken with were aware of safeguarding adults issues and the correct procedures to follow if abuse was suspected or alleged. Westfield Care Home DS0000008773.V365489.R01.S.doc Version 5.2 Page 17 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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was clean and well maintained so that people lived in a pleasant and comfortable environment appropriate to their needs. EVIDENCE: The home was modern, purpose built and suitably equipped for the people living there. The home appeared clean in all the areas seen during the inspection visit. The home was well maintained. Staff said that there were 2 maintenance staff employed who ensured that any necessary work was promptly carried out. Staff were satisfied with the equipment provided. People spoken with were pleased with the environment of the home. Some people particularly liked to sit in the conservatory. People spoken with and Westfield Care Home DS0000008773.V365489.R01.S.doc Version 5.2 Page 18 those who completed surveys said the home was always fresh and clean. One person said the home was a “lovely clean place”. Another person commented that the home was “spotless”. The AQAA gave details of improvements made to the home to meet people’s needs, such as blinds in the bedrooms to ensure privacy, and appropriate signs on toilet and bedroom doors for people with dementia. The laundry was suitably equipped. There was a sluice room on each floor. Some staff had received training about the control of infection. Staff spoken with were aware of good practice in maintaining hygiene and controlling infection. Westfield Care Home DS0000008773.V365489.R01.S.doc Version 5.2 Page 19 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were satisfactory recruitment practices, staff training and staffing levels so that people were protected and well supported. EVIDENCE: There were 4 care assistants on duty for the morning and afternoon shifts on the day of the inspection visit. The staff rota was seen and showed that this was the usual staffing, with 2 care assistants working the night shift. In addition to the care staff there was a cook, cleaner, laundry assistant and maintenance staff. People spoken with and those who completed the surveys were mostly satisfied that staff were available when needed. One person said, “there is always someone here to help”. Another person said that they sometimes had to wait for staff to help them to the toilet. Staff said that current staffing levels were appropriate to meet the needs of people living in the home. Westfield Care Home DS0000008773.V365489.R01.S.doc Version 5.2 Page 20 The records of 3 members of staff were seen, including 2 recruited since January 2008. The records had all the required documents and information. Staff spoken with said they had a period of shadowing a more experienced member of staff when they first started at the home. Induction was provided for new staff. New staff started working towards National Vocational Qualification in Care Level 2 as soon as possible, usually within 2 or 3 months. Staff training records showed that most staff had received all the required training, plus training about caring for people with dementia and challenging behaviour. A relative commented, “the staff seem to be very experienced in all matters”. The AQAA said that 8 of 18 care staff (45 ) had already achieved National Vocational Qualification in Care at Level 2 or above. Westfield Care Home DS0000008773.V365489.R01.S.doc Version 5.2 Page 21 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, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was well managed and there were satisfactory systems in place so that the health, safety and welfare of people was promoted and protected. EVIDENCE: The registered manager for the home is Mr Toorabally. Management responsibility appeared to be shared with Mrs Toorabally. Mr and Mrs Toorabally were at the home every day, Monday to Friday. People spoken with were confident that action would be taken to address any issues raised and were able to give examples of when this had happened. A member of staff said, “I know I can approach my manager for advice if I need it”. Westfield Care Home DS0000008773.V365489.R01.S.doc Version 5.2 Page 22 The AQAA was returned by the home after the inspection visit and gave all the information required. The quality assurance system at the home included surveys sent out to people in the home and their relatives approximately every six months and meetings with people in the home. There was no report produced to inform people of the findings of the surveys and any action taken to address issues raised. The AQAA included references to how people were asked for their opinions and of action taken as a result of listening to people. For example, menus were changed after people were asked about their satisfaction with the meals provided. Satisfactory records were seen of personal money help for people living in the home. The money was securely stored with access limited to Mr and Mrs Toorabally. There were satisfactory records of accidents and a monthly audit was carried out of all accidents. Deaths and other incidents had been reported to CSCI as required. The records of testing and maintenance of fire equipment and systems were up to date. The AQAA said that the home’s 5 year electrical safety certificate was dated May 2003 and so a new certificate was due. A requirement made at the last inspection about the safe storage of cleaning products had been complied with. Westfield Care Home DS0000008773.V365489.R01.S.doc Version 5.2 Page 23 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 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Westfield Care Home DS0000008773.V365489.R01.S.doc Version 5.2 Page 24 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 Requirement There must be a care plan in place for each person in the home, including people staying short-term. This will ensure that the person’s needs and preferences are agreed and met. The daily maximum and minimum temperatures of the medication fridge must be recorded to ensure that medication is stored correctly. Records that include personal information about people living in the home must be kept securely and in accordance with the Data Protection Act 1998, specifically, the records stored in the treatment room. This will ensure that people are protected and that confidentiality is maintained. Timescale for action 31/07/08 2 OP9 13(2) 31/07/08 3 OP37 17(1)(b) 31/07/08 Westfield Care Home DS0000008773.V365489.R01.S.doc Version 5.2 Page 25 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 Refer to Standard OP9 OP9 OP15 Good Practice Recommendations The medication fridge should be regularly defrosted, and records kept to show this has been done. This will help to ensure that medication is stored correctly. The door to the room where medication is stored should be kept locked to ensure the security of drugs. There should be a daily menu displayed where people can easily see it. The menu should be in an appropriate format to make it easy for people to read and understand. This will help to ensure people are informed and aware of choices available to them. The quality assurance system should be further developed to include an annual report of the analysis of surveys and other information collected, and details of the action taken to address any issues raised. This will help to ensure that the home is run in the best interests of the people living there. 4 OP33 Westfield Care Home DS0000008773.V365489.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection East Midland Regional Office Unit 7 Interchange 25 Business Park Bostocks Lane Nottingham NG10 5QG 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. 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