Inspection on 13/09/05 for Westfield House

This inspection was carried out on 13th September 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 House 31/01/07

Westfield House 14/02/06

Westfield House 24/01/05

Westfield House 24/08/04

Westfield House 03/05/02

Similar services:

Whiteley House

Tyndale Avenue

2-10 Norfolk Road

Bennfield House Nursing Home

Eastfield Residential Home

Sign Health

Springwood

Fairburn Mews

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

CARE HOME ADULTS 18-65 WESTFIELD HOUSE Westfield Road Rawmarsh Rotherham S62 6EY Lead Inspector Mike Hamstead Unannounced 13 September 2005 07:40. 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 HOUSE 20050913 Westfield House X00023 UI Stage 4 S3121 V187934 J55.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Westfield House Address Westfield Road Rawmarsh Rotherham S62 6EY 01709 529412 01709 529412 westfield.house@craegmoor.co.uk Parkcare Homes Limited 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) David Blakesley PC Care Home only 12 Category(ies) of MD Mental Disorder: 12 registration, with number of places WESTFIELD HOUSE 20050913 Westfield House X00023 UI Stage 4 S3121 V187934 J55.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The manager show evidence of a commitment to undertake formal training/ qualification in the needs of people with mental health problems living in a residential setting. 2. One specific service user over the age of 65, named on variation dated 1st April 2005, may reside at the home. Date of last inspection 24 January 2005 Brief Description of the Service: Westfield House is part of Craegmoor Healthcare, owned by Parkcare homes Ltd and is a registered care home providing care and support for 12 adults all experiencing mental health problems between the ages of 18-65 , the youngest being 33 and the oldest 65 years of age.Westfield House cares for both male and female service users and on the day of the inspection there were 12 residents including 8 male and 4 female residents. Westfield House is located within the private complex containing two other establishments owned by Craegmoor Healthcare, Westfield Mews and Fitzwilliam Lodge. Westfield House provides accommodation that contains 11 single en suite bedrooms, and 1 training flat all completed to a high standard of specification, and the home is situated in a residential area of Rotherham and has good access to local shops and transport facilities. WESTFIELD HOUSE 20050913 Westfield House X00023 UI Stage 4 S3121 V187934 J55.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection methodology consisted of interviews with the care manager and all staff on duty, and an examination of the progress made since the last inspection and homes records. It also included a tour of the building to observe the accommodation. Additional information of the overall situation had been gained from previous inspection visits. The inspection was commenced at 07:40 and finished at 16:20 and included talking to all members of staff and residents. What the service does well: What has improved since the last inspection? The Statement of purpose now contains the correct information. All staff administering medication have received accredited training. The care manager has addressed the dangerous practice of some residents smoking in their bedrooms. New equipment and an improved ventilation has been provided in the laundry room. WESTFIELD HOUSE 20050913 Westfield House X00023 UI Stage 4 S3121 V187934 J55.doc Version 1.40 Page 6 Supervision and appraisals for staff are now taking place. Safe working practices particularly a check of the homes electrical hard wiring and maintenance to control the water temperatures has taken place. 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. WESTFIELD HOUSE 20050913 Westfield House X00023 UI Stage 4 S3121 V187934 J55.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection WESTFIELD HOUSE 20050913 Westfield House X00023 UI Stage 4 S3121 V187934 J55.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 2 3 4 & 5 Potential residents/representatives have all the information about the home available to them to enable them to understand and decide whether the services the home provides meets their needs. Opportunities are provided for residents/representatives to visit the home prior to admission so that they can familiarise themselves with their potential surroundings and meet other residents and staff before deciding whether they want to live at the home. All staff require training in mental health issues for the benefit of residents. EVIDENCE: There is a Statement of Purpose and Service User Guide that now contains the relevant qualifications and experience of the registered provider as required by this standard. One of the residents was 65 in March 2005, and continues to enjoy her stay at the home and the staff are confident they can continue to meet the residents needs. WESTFIELD HOUSE 20050913 Westfield House X00023 UI Stage 4 S3121 V187934 J55.doc Version 1.40 Page 9 There has been one new resident admitted since the last inspection who was admitted with a care management assessment, and staff have acted cautiously and caringly to provide a caring environment to meet this residents complex needs. This resident said that staff were attending to her needs and that she had settled in well. The care manager is aware of the need to ensure that all the requirements of this standard are met via the homes own assessment documentation, even if they are omitted from the care management assessment information supplied to the home. The current resident group at Westfield House all have varying mental health needs, and there is one resident with an associated moderate learning difficulty. The homes assessment process enables staff to devise a plan of care to meet such needs, via staff training and supervision. Since the last inspection, and in an effort for the home to demonstrate it’s capacity to meet the assessed needs of service users, the home has commenced a programme of mental health awareness training via a visiting CPN and external trainer. This has been arranged to bolster the limited mental health content of the NVQ Level2 qualification being studied by staff, and there are still 5 members of staff awaiting this training. This training should enable all staff attending to obtain a greater insight into some of the problems being experienced by their client group. All residents are on the Care Programme Approach (CPA), and receive appropriate support in this respect. A 3 monthly review is held with a hospital consultant, and a (CPA) review every 6 months with a multi –disciplinary team that includes the consultant, CPN’s and social workers. In addition the home has a training flat to encourage independent living skills, and for teaching rehabilitation and independent living skills to residents deemed to have made sufficient progress to benefit from this experience. The resident in the flat, said that he was enjoying the experience, and information from the care manager and staff indicated that he was making good progress, and that there were currently 4 residents that could benefit from a more independent living situation were this available. The religious needs of residents are respected and information is provided on their availability and location of churches/chapels for any residents that are interested. One resident continues to attend church with his parents on a weekly basis. The majority of residents have some contact with family and friends, and one resident without this facility has been offered advocacy services but has refused the service. All staff in the home continue to act on her behalf whenever necessary. WESTFIELD HOUSE 20050913 Westfield House X00023 UI Stage 4 S3121 V187934 J55.doc Version 1.40 Page 10 There is ready and available access to policies and procedures within the home, and the care manager offers regular support. Contact with line management is also available if necessary. All potential residents are invited on pre-admission visits, which can amount to 2 or 3 visits to the home with a gradual introduction starting with one day a week progressing to an overnight stay, then a weekend stay and the further days in the week dependant upon how the resident is coping with the transition. As some residents are admitted from hospital it can take some time for them to adapt to the less structured approach of the home and staff make every effort to make residents feel at home offering support at all times. All admissions are based upon a comprehensive assessment of the residents needs, and the care manager and staff also assess whether they think any prospective referrals would be compatible with the existing resident group before making a final decision. All residents receive a contract/statement of terms and conditions, that meets the requirements of this standard and enables them to have a security of tenure within these arrangements. WESTFIELD HOUSE 20050913 Westfield House X00023 UI Stage 4 S3121 V187934 J55.doc Version 1.40 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 7 8 9 & 10 The individual needs and choices of residents are being met demonstrating the availability of an accurate and ongoing assessment of the residents needs. EVIDENCE: There is a plan of care for each resident, and these were examined at random and found to be generally satisfactory. The files contain supporting evidence from staff working notes, social worker visits, and consultants reports that their needs are being met by Westfield House. All plans of care are still being reviewed via the CPA programme, on a 6 monthly basis and residents are consequently seen and reviewed by consultants on a regular basis. One visiting social worker with 3 residents in the home spoke highly of the standard of care provided and said that staff always keep her informed about any issues involved. Staff are aware that in caring for people with a mental illness there is a need for diligence in observation, and the passing on of subtle/ significant changes WESTFIELD HOUSE 20050913 Westfield House X00023 UI Stage 4 S3121 V187934 J55.doc Version 1.40 Page 12 in resident’s attitudes and or behaviour, which may be symptomatic of a more serious problem requiring specialised attention. Staff encourage residents to make their own decisions, and ensure that they have sufficient information to enable them to make choices. Where residents need extra support, staff will assist them with a whole range of life skills in accordance with the philosophy of the home. The needs of residents vary considerably, but staff offer assistance with, food preparation and cooking, budgeting and money management, self medication, personal hygiene, social skills and many more aspects of daily living skills to prepare the residents for the possible return to some form of supported living experience. None of the residents are restricted in visiting and contact agreed through the assessment process, and only 6 residents need assistance with managing their own finances. Residents have held their own meetings in the past, and the care manager is aware that this an area for further development, in which they are encouraged to speak freely and openly about their life at Westfield House, and to suggest any improvements that might be made. Resident inclusion has not yet extended to their participation in staff meetings, but two residents have been involved in staff selection in the past, and the care manager is aware that this is a potential area for further development to the benefit of residents. All the homes policies and procedures are available for residents if required, and a Craegmoor brochure on activities is also available. Craegmoor organise and despatch resident satisfaction questionnaires for completion, and extend this to include relatives and friends. Staff encourage residents to get on with their lives, subject only to any risk assessment agreed at that time. All residents are informed about the homes safety rules and procedures, and fire tests, and drills are held in accordance with the Fire Officers requirements. It was noted that at a recent fire drill 3 residents refused to evacuate that could have potential serious consequences for them in a real fire situation and the care manager has addressed the situation with them. The home has a missing persons procedure, and residents are asked to let staff know if they anticipate being in late, and that the police may be called if staff are not informed of their whereabouts. WESTFIELD HOUSE 20050913 Westfield House X00023 UI Stage 4 S3121 V187934 J55.doc Version 1.40 Page 13 All resident documentation is securely stored and locked, and any matters of a confidential nature between residents and staff are addressed in private. Staff handovers take place at the end of every shift in private, and discretion is assured in the passing on of information. All staff are aware of the homes confidentiality policy, and all residents are informed that under certain circumstances information given to staff may have to be shared with the home’s management in the protection of their interests. WESTFIELD HOUSE 20050913 Westfield House X00023 UI Stage 4 S3121 V187934 J55.doc Version 1.40 Page 14 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11 12 13 14 15 16 & 17 Most residents are able to maintain appropriate and fulfilling lifestyles both in and outside the home. There are opportunities for personal development and education, and community links are promoted. Regular communal and leisure activities are available, and contact with family and friends is encouraged and maintained to enable residents to engage in appropriate relationships. The failure to provide an annual 7 day holiday has disappointed a number of residents. EVIDENCE: Lifestyle aspirations for all residents at Westfield House, varies according to a number of factors including their age, background experiences, interests and hobbies, as well as the severity of their mental illness, and their own perception of the progress being made towards recovery. All residents are encouraged to pursue their own personal development, and to become involved in activities, to maintain links with their families where WESTFIELD HOUSE 20050913 Westfield House X00023 UI Stage 4 S3121 V187934 J55.doc Version 1.40 Page 15 possible and to lead as normal a life as is possible. Sometimes this is done in conjunction with social workers, particularly where it involves arranging day care attendance, but more normally staff provide information and encouragement for residents to pursue any area of activity that will interest and occupy them. The home also offers practical life skills training on a 1:1 basis to increase their self-confidence, and foster rehabilitation skills, and one resident receives 10 hours per week on a 1:1 basis, funded by the placing authority. At the present time, there is a variety and range of activities that residents are involved with including, three residents attending day centres within the week, one resident attends Eastwood Day centre 5 days per week, another resident goes to Clifton Court 2-3 times per week where he attends a walking group, and another resident attends “Innovations” in Rotherham to do computer training. In addition, two other residents have been referred to Clifton Court and one has been accepted for a maths and computer course, and it is hoped that the remaining resident will obtain a place in the near future. Two residents attend Tai Kwando training in Rotherham, and also play badminton with the care manager and his partner twice a week. The majority of other residents do other, and just as important things that interest them, including going to the local shops and Meadowhall, helping with homes gardening, and visiting pubs and restaurants. One resident likes cycling and is going to Cleethorpes on the train this week with a member of staff who are both taking their bikes and hoping for a good day out. The activities co-ordinator receives a moderate activities budget and also an allowance for each resident towards a 7 day annual holiday. However, there has not been a 7 day annual holiday this year because of the alleged failure to fund staffing costs necessary to undertake the holiday. The activities coordinator has diverted the holiday allowance into providing more daily recreational trips away from the home on either a 1:1 basis with staff or in larger groups. One resident paid for himself to have a 3 day break in Amsterdam. There have been trips to Alton Towers, the Freeport shopping complex in Castleford and the dry ski-slope, and Chester Zoo and York with residents. There have been 3 trips to Blackpool and a recent trip to Whitby. One resident went on a 2 day mystery trip including a visit to Cadburys World. There have been separate trips to London with different residents, and a resident and member of staff are going to York tomorrow for a day out. Some residents mentioned that they had missed an organised holiday and the home must address the situation for the future in resident’s interests. WESTFIELD HOUSE 20050913 Westfield House X00023 UI Stage 4 S3121 V187934 J55.doc Version 1.40 Page 16 The care manager and staff work alongside care co-ordinators and social workers to identify the possibility of employment prospects for residents, but there is nobody at present considered suitable for a job. Residents are frequently approached by the Benefits Agency on “ Back to work schemes” but any decisions made would be in conjunction with the residents social worker/CPN All residents are encouraged by staff to become involved in independent living skills, as part of their rehabilitation process, and staff support residents in a number of ways, some mentioned above, but also provide information and encourage them to use other facilities like the library, and visit the leisure centre and other community outlets. The home also organises a weekly film night where DVD’s are available. Some residents also visit the snooker hall in Rotherham, and one resident has his own vehicle that he shares with others when involved in a joint activity. Some residents voted at the recent general election demonstrating their involvement in the community and all residents are able to develop and maintain intimate personal relationships, with people of their choice. Residents are free to use the communal areas of the home both inside and outside as they wish. Mealtimes are flexible, but a general pattern is adhered to. Rising and retiring times are also flexible, although some routine is necessary for the residents attending a day centre. Staff are respectful of residents privacy and dignity, and would not open their mail, or enter their rooms without their permission There is a “training day” for residents in the week, staff prefer to generally encourage all residents to participate in the basic skills of cooking, cleaning and maintaining hygiene skills on an ongoing basis. Some residents are quite adept at cooking, and others are at varying levels of learning independent living skills, requiring different levels of supervision from staff. All resident’s nutritional likes and dislikes are recorded upon admission, and currently there are three residents who are overweight, and staff try to encourage them to eat more healthily. Staff have discussed the situation with the residents and their relatives, particularly where food taken outside the home or brought into the home by residents or relatives includes lots of chocolates, biscuits, or other weight gaining foods, and have suggested that this be replaced by fruit. Whilst the home provides the meals, an objective of rehabilitation is to encourage residents to assist in both meal planning and preparation but this has a variable success rate dependent upon differing abilities. WESTFIELD HOUSE 20050913 Westfield House X00023 UI Stage 4 S3121 V187934 J55.doc Version 1.40 Page 17 All residents have at least one cooked meal per day, within a minimum of 3 meals per day. A risk assessment is in place for one service user prone to choking, known to all staff and the resident’s social worker. There are two budgerigars, and a cat and one resident has his own fish tank in the lounge that provides an interest for him and is maintained by him. WESTFIELD HOUSE 20050913 Westfield House X00023 UI Stage 4 S3121 V187934 J55.doc Version 1.40 Page 18 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 19 20 & 21 The promotion of personal healthcare and specialist support to residents is taken seriously and acted upon to safeguard their interests at all times. EVIDENCE: All residents receive personal and emotional support on a daily basis to a greater or lesser degree, and any assistance required with personal hygiene is identified on a “living skills” profile. One resident is encouraged to continue washing her own hair and now has it blow - dried and styled by staff. Residents have some choice of staff they wish to work with them, and the home operates a key-worker system Most residents will inform staff if they are not well in the physical sense. Staff try to remain vigilant in order to recognise subtle changes in residents behaviour which may be the early warning signs of something more serious approaching resulting from their mental ill - health. Any such concerns are recorded and monitored, and include the prompt referral to an appropriate specialist if considered necessary. The majority of residents are registered with the local GP Practice, and arrangements are in place for Chiropody Ophthalmic and Dental services. WESTFIELD HOUSE 20050913 Westfield House X00023 UI Stage 4 S3121 V187934 J55.doc Version 1.40 Page 19 . There are two residents that self –harm, and the care manager has risk assessment in place for these eventualities. Residents are now offered minimum annual health care checks that include blood pressure and cholesterol checks, and the GP practice notifies the home with a date of appointment. One resident was due for an appointment on the day of the inspection. There is a medication policy and procedure, and all staff that administer medication have now received accredited training. All but 5 residents have their medication administered by staff in the home. The Nomad system is used and the 5 residents are still not fully independent in terms of self-medication, but actually visit the medication room and administer their own medication under staff supervision, as the first stage in an eventual process towards selfmedication. This system was seen in operation and appeared to work satisfactorily. There are no controlled drugs at the present time. There is a policy and procedure to ensure that the ageing and death of a resident is handled with dignity, sensitivity, and tact, at this distressing time. WESTFIELD HOUSE 20050913 Westfield House X00023 UI Stage 4 S3121 V187934 J55.doc Version 1.40 Page 20 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 Staff have a knowledge and an understanding of Adult Protection issues that promotes the protection of residents but need updated training in abuse awareness. It is suspected that complaints made by residents are not being recorded in the complaints book and the care manager is to address this issue. EVIDENCE: There is a complaints policy and procedure and a complaints record, and every resident has a copy, together with a copy of the Whistle Blowing policy. There have been no complaints recorded since the last inspection . The care manager has addressed the issue of complaints at a staff meeting to ensure that all staff are vigilant in recognising and recording when actual complaints are being made by residents in order that their concerns can be dealt with, but it is suspected that staff are still forgetting to record issues as complaints and are dealing with them as they go about their duties. The care manager is to address this matter once again at the next staff meeting. The home has an Adult Protection procedure, which includes a Whistle Blowing section that is posted on the office wall for all staff/service users to see, but there have been no recorded incidents since the home was registered in 2000. The care manager was informed that free Adult Protection Training for staff can be obtained from Rotherham Metropolitan Borough Council and he is to pursue this option. WESTFIELD HOUSE 20050913 Westfield House X00023 UI Stage 4 S3121 V187934 J55.doc Version 1.40 Page 21 There is also a procedure on physical and verbal aggression by residents, and restraint guidelines are available for all staff. Training on the proper use of physical intervention and restraint techniques took place in Jan/Feb 2004, and is to be updated before the end of this year. WESTFIELD HOUSE 20050913 Westfield House X00023 UI Stage 4 S3121 V187934 J55.doc Version 1.40 Page 22 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 25 26 27 28 29 & 30 Continuing investment is necessary to ensure residents live in a safe well maintained environment. There is a need for ongoing maintenance and general housekeeping to maintain the home in good order. EVIDENCE: The home is suitable for its intended purpose, and comprises of 11 single ensuite bedrooms and a rehabilitation training flat, and the rooms sampled were all in a reasonable state of décor. There is also sufficient communal space via a fully furnished large lounge and conservatory, and a large kitchen and dining area to encourage independent living skills. There are a number of areas that need urgent attention, the communal bathroom with an overhead shower on the first floor needs attention and bringing up to date. The care manager is hoping to eventually have a walk in shower installed in the bathroom to improve the overall facilities. WESTFIELD HOUSE 20050913 Westfield House X00023 UI Stage 4 S3121 V187934 J55.doc Version 1.40 Page 23 The main lounge is in need of redecoration, and the majority of the homes corridor carpets are stained/dirty to some extent, and one staircase that is badly stained is apparently as a result of a resident’s dripping cup as he takes his drink from the kitchen to his bedroom. Other stains appear to be chewing gum and food that are unacceptable. In addition the kitchen furniture of tables and chairs also need attention, as the tables are stained and the chairs unstable, and this also applies to the conservatory furniture that is dirty and in need of replacement. The blinds in the kitchen and conservatory are also badly stained giving the home a neglected appearance. There are plans to convert the existing ground floor office, medication room, and computer room into an additional bedroom and to make alternative arrangements to relocate these areas in the near future. The smoking room is currently not being used and it was noticed that some residents are smoking in the conservatory that must cease. There is maintenance book, and a renewal programme, but the care manager still has to request additional work/items on a capital expenditure form which is then assessed by Craegmoor before being approved. The care manager has addressed the serious issue of 2 residents who smoke in their bedrooms, and has taken the appropriate action by writing to all residents warning them of the dangers, and also written to the resident’s social worker/CPN’s to acquaint them of the dangerous situation. The care manager has also prepared a risk assessment for smoking to protect the safety of all residents and staff ion the home. There is one resident who is visually impaired, and his needs have been assessed by an Occupational Therapist and include cassettes with information from Social Services and books on compact disc. The home does not have any disability equipment installed, but has a shaft lift that is not used and has not had a “Thorough Examination” because it needs repairing. Craegmoor are considering removing the lift, which was left in operation from the homes previous registration as a care home for older people. None of the current residents have a physical disability that requires them to use the lift, but residents are getting older and there may be a requirement in the near future. One resident has an electrically operated bed purchased by herself for her own convenience. There is a policy and procedure on infection control, and the home was found to be free from odours on this inspection. The poor ventilation in the laundry room has been rectified and an industrial washer/dryer, with improved ventilation has been installed for the benefit of residents and staff alike. WESTFIELD HOUSE 20050913 Westfield House X00023 UI Stage 4 S3121 V187934 J55.doc Version 1.40 Page 24 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 32 33 34 35 & 36 There is a stable and competent staff team in sufficient numbers who receive regular updated training to meet residents needs. EVIDENCE: All staff have job descriptions, verified with those staff on duty, and staff are aware of their respective roles in relation to other staff including seniors, and the Care Manager. There was evidence of a good interaction between staff and service users and the home operates a key worker system. The home is now aware of the GSCC standards of conduct and practice, and although there are no volunteers at present it has a volunteers policy. WESTFIELD HOUSE 20050913 Westfield House X00023 UI Stage 4 S3121 V187934 J55.doc Version 1.40 Page 25 All staff receive statutory training and are undertaking NVQ Level 2 training, and at the present time 50 of staff members have completed this. Other training undertaken since the last inspection and continuing includes fire training, infection control training, COSSH training, food hygiene training, health and safety training and managing challenging behaviour. The home provides 2 staff on duty at all times 24 hours a day 7 days a week, with 1 waking and 1 sleeping in staff at nights, and one resident is contracted for 10 hours per week of 1:1 staffing cover. In addition the home employs a part-time activities co-ordinator on 21 hours per week, a part-time domestic person on 20 hours per week over 5 days, and an administrator on 20 hours per week. All staff were seen to be interested, motivated, and committed towards providing the best possible care for residents, and the care manager is continuing with the registered managers award, and is hoping to complete this in 2005. There is a recruitment and selection procedure, and one person has been employed since the last inspection. The details were checked and found to be in order. The care manager intends to verbally check, at least one written reference for verification of authenticity, in future appointments. All staff receive a statement of their terms and conditions, and the care manager is following the requirement for all new staff to be cleared in accordance with Schedule 2 of the National Minimum Standards, including CRB checks. All staff undertake a 3 monthly probationary period as mentioned in the staff handbook. There is a staff training and development programme and plan, containing a record of individual staff’s training which is kept in the office, and all staff have an individual training and assessment profile. The home send a quarterly report of all training undertaken to Craegmoor’s training co-ordinator. All staff receive induction training, and the Inspector was informed that foundation training will be commencing within the next 2 weeks. Staff are asked to read the equal opportunities policy on induction. Supervision and appraisals are taking place and there are opportunities for feedback at handovers, and at proposed staff meetings, and specialised supervision is available from within the community psychiatric nursing service. All staff are aware of the homes grievance and disciplinary procedures which are kept in a copy of the staff handbook in the office. WESTFIELD HOUSE 20050913 Westfield House X00023 UI Stage 4 S3121 V187934 J55.doc Version 1.40 Page 26 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 38 39 40 41 & 42 The care manager has considerable experience of working in a senior position caring for young adults in this client group, and is using this experience to good effect in his present role. He is currently undertaking the Registered Managers Award to further his expertise for the benefit of all residents. EVIDENCE: The registered care manager, has considerable experience in working with people with mental ill-health, including having worked as a deputy manager at Church View for 5 years and more recently as the manager of the adjacent Westfield Mews for approximately 2 years, an unregistered home, next door to Westfield House providing supported living arrangements for people with a mental illness. The registered care manager came to Westfield House in April 2002. The care manager has started the registered managers award and is fully WESTFIELD HOUSE 20050913 Westfield House X00023 UI Stage 4 S3121 V187934 J55.doc Version 1.40 Page 27 aware that there is an expectation that this qualification should be achieved in 2005, after which there is a condition of registration that he will undertake some formal mental health training course once this has been completed. All staff said that they were comfortable with the management approach of the care manager and his knowledgeable and friendly approach towards them. Staff felt that their views were listened to, which gave them extra confidence and commitment within their role. The quality assurance system is carried out on a continuous basis throughout the year by the care manager , and is audited and verified by the company’s area manager. There is an annual development plan, and the home is seeking Investors in People accreditation that can only be to the benefit of residents. The home’s written policies and procedures, comply with current legislation, and the Inspector has seen these at one time or another on previous inspections. All these policies and procedures are available to residents if requested, and are updated by Craegmoor. Policies and procedures are not signed or amended within the home, as Craegmoor as registered owner organises this centrally for all its homes. All records checked were found to be accurate and up to date. All residents are able to have access to their records, but in the care manager’s time at the home, there has been only one request to do so. There is a policy and procedure for the maintenance of safe working practices within the home, to provide a safe working environment for residents and staff. Staff receive statutory training and the most recent fire evacuation was on the 6th September 2005 and the fire bell is tested weekly, most recently on the 13th September 2005. First aid training has taken place for staff, and there must be a qualified first aider on duty at all times. There is a first aid box in the kitchen and the staff sleeping–in room to enable a ready access to be gained in the the interests of residents and staff. The last inspection of the gas appliances was on the 13th July 2004, by a Corgi registered person, but has not been done this year to date because the contyractor has been changed. The care manager is to inform CSCI when the servicing has been carried out. The care manager said that the 5 year electrical wiring check had been carried out but that the certificate had been sent to Head Office, and this will also be faxed to CSCI when received. Renewal work on the thermostatic valves to control the water temperature has been carried out, and a test for Legionella was carried out on the 21st April 2005 WESTFIELD HOUSE 20050913 Westfield House X00023 UI Stage 4 S3121 V187934 J55.doc Version 1.40 Page 28 All windows have restrictors on them, and the door is alarmed on the training flat fire door. The care manager has only had one appraisal whilst managing the home and this should be scheduled to take place on an annual basis to promote the interests of residents and staff. WESTFIELD HOUSE 20050913 Westfield House X00023 UI Stage 4 S3121 V187934 J55.doc Version 1.40 Page 29 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 2 4 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 2 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 WESTFIELD HOUSE Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 3 20050913 Westfield House X00023 UI Stage 4 S3121 V187934 J55.doc Version 1.40 Page 30 No 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 YA 3 Regulation 19 Requirement The registered person must ensure that all staff have the skills and experience necessary for the work, with regard to mental health training. The registered person must ensure that residents have the option of a 7 day annual holiday as part of the basic contract price. The registered person must ensure that residents live in a homely and comfortable environment and that the necessary redecoration is carried out. The registered person must ensure that residents live in a homely and comfortable environment with regard to the need to maintain the furniture and fittings of the building. The registered person must ensure that residents live in a homely and comfortable environment with regard to the need to maintain the cleanliness of carpeting around the home. Timescale for action 31/12/05 2. YA 14 16 Immediate 3. YA 24 23 30/11/05 4. YA 24 23 30/11/05 5. YA 24 23 30/11/05 WESTFIELD HOUSE 20050913 Westfield House X00023 UI Stage 4 S3121 V187934 J55.doc Version 1.40 Page 31 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 YA 22 YA 37 Good Practice Recommendations The care manager should reiterate to staff the importance of them recording residents complaints. The registered person should ensure that the Care Manager achieves a qualification at NVQ Level 4 in both management and care by 2005. WESTFIELD HOUSE 20050913 Westfield House X00023 UI Stage 4 S3121 V187934 J55.doc Version 1.40 Page 32 Commission for Social Care Inspection First Floor, Barclay Court Heavens Walk Doncaster DN4 5HZ 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 HOUSE 20050913 Westfield House X00023 UI Stage 4 S3121 V187934 J55.doc Version 1.40 Page 33 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!