Inspection on 01/09/05 for Westfield Lodge Nursing Home

This inspection was carried out on 1st September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 Lodge Nursing Home 20/02/09

Westfield Lodge Nursing Home 29/02/08

Westfield Lodge Nursing Home 08/08/06

Westfield Lodge Nursing Home 28/12/05

Westfield Lodge Nursing Home 26/01/05

Westfield Lodge Nursing Home 04/08/04

Westfield Lodge Nursing Home 17/03/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Westfield Lodge Nursing Home Weston Coyney Road Weston Coyney Stoke-on-Trent Staffordshire ST3 6ES Lead Inspector Mrs Yvonne Allen Unannounced Inspection 01/09/05 13:30p 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 Lodge Nursing Home DS0000026971.V249580.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 Lodge Nursing Home DS0000026971.V249580.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Westfield Lodge Nursing Home Address Weston Coyney Road Weston Coyney Stoke-on-Trent Staffordshire ST3 6ES 01782 336777 01782 598368 westfield.lodge@ashbourne.co.uk 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) Exceler Healthcare Services Limited Ashbourne Homes Limited, Ashbourne Consolidated Group Mr David Forrester Care Home 54 Category(ies) of Old age, not falling within any other category registration, with number (54), Physical disability (3), Physical disability of places over 65 years of age (54) Westfield Lodge Nursing Home DS0000026971.V249580.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th January 2005 Brief Description of the Service: Westfield Lodge is a purpose built nursing home admitting service users over 65 of age that require personal and nursing care. The home was built about 17 years ago. Accommodation is to two floors, bedrooms are single occupancy and some have an en-suite facility consisting of toilet and wash hand basin. There are three lounges - one to the first floor and two on the ground floor. There is a separate dining room. The two floors are accessed via a passenger lift. There is a central kitchen and laundry. There are bathrooms and toilets sited on both floors. There is limited garden area but a small conservatory opens out on to a smallgrassed area with a high-level flowerbeds and seating area. There is parking space for several cars. The home is situated two miles from Longton town centre and a short walk allows access to bus routes. Westfield Lodge Nursing Home DS0000026971.V249580.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over one afternoon by two inspectors. The inspection commenced at 1.30pm and finished at 5pm. The inspectors met the prospective registered manager with whom lengthy discussions were held and verbal feedback was given at the end of the inspection. One of the inspectors toured the home, meeting with and chatting to several residents and staff members. The other inspector examined relevant records and documentation. Not all standards were assessed during this inspection. The scoring of 1 for standards 31 and 32 is because the manager was not officially registered with the CSCI at the time of the inspection. What the service does well: What has improved since the last inspection? Staff morale had improved somewhat since the last inspection. The staffing situation had improved and the permanent staff were not covering so many extra shifts as previously. Staff were now having regular supervision and this was documented. The home appeared tidier and better presented than previously. There had been some redecoration and new furniture purchased. A number of windowpanes had been replaced. The outside courtyard was now much tidier and could be enjoyed by the residents and their visitors. Westfield Lodge Nursing Home DS0000026971.V249580.R01.S.doc Version 5.0 Page 6 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 Lodge Nursing Home DS0000026971.V249580.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Westfield Lodge Nursing Home DS0000026971.V249580.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 4 and 5. Residents and their families are given information about the home prior to admission and can be assured that the home they are entering will be able to meet their assessed needs. EVIDENCE: There was evidence contained within care plans that pre-admission assessments of individual needs were being undertaken. The manager confirmed that he goes out to assess residents prior to admission. The manager stated that prospective residents and their families are given the opportunity to visit the home before making a decision to move in. This could also include having a meal with the existing residents if they wished. By examination of individual care plans and direct observation of care practices it was evident that the assessed personal and nursing care needs of individual residents were being met by the staff at the care home. Westfield Lodge Nursing Home DS0000026971.V249580.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 The health care needs of residents are well met with evidence of good multi disciplinary working taking place on a regular basis. Personal support is offered in such a way as to promote and protect the privacy and dignity of residents. The systems for the administration of medication are in need of some attention to detail. EVIDENCE: Four individual care plans were examined in detail. These plans were found to be comprehensive and informative. Healthcare needs were particularly well recorded and followed through. Access to other healthcare professionals was evident throughout each of the care plans sampled. This included visits and advice from the continence nurse specialist, GP, tissue viability department, optician and dietician. Records of treatment and healing of pressure sores were detailed and identified high standards of nursing care. Westfield Lodge Nursing Home DS0000026971.V249580.R01.S.doc Version 5.0 Page 10 Care plans had been reviewed monthly and daily reports were completed. Risk assessments had been developed and were detailed. All were identified as being signed previously by a representative where the resident was incapable of signing. The receipt, storage, administration and disposal of medication were examined. It was noted that the lock on one of the mediation trolleys was broken and this will need urgent attention. On one of the creams – Betamethasone – there was no date of opening documented on the box. There was a box of Movicol in the trolley with no prescription label in place. These issues were highlighted to the nurse on duty and to the manager and must be addressed. Examination of the care plans and observation of staff interaction throughout the home identified that individual privacy and dignity were promoted and upheld. Staff were observed speaking to residents in a respectful manner. Residents were addressed by their preferred name and this was recorded in individual plans. Personal care was carried out in a discreet manner either in individual bedrooms or bathrooms/toilets. Westfield Lodge Nursing Home DS0000026971.V249580.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, and 15 The home needs to review the activities delivered to residents in order to ensure that social needs are met. Residents benefit from the links maintained with local amenities. The meals in the home are good but the arrangements in place for dining are in need of improvement. EVIDENCE: There was a planned programme of activities and entertainment and a coordinator employed by the home. On examination it was identified that activities are not always geared to suit individual abilities. This was discussed with the manager and it was agreed that the activities programme would be reviewed and re-developed to suit individual needs and capabilities. It is recommended that the co-ordinator receive training in this area. Visitors were observed coming and going on the day of the inspection and visitors are welcome at any reasonable time. Westfield Lodge Nursing Home DS0000026971.V249580.R01.S.doc Version 5.0 Page 12 One of the residents stated that he enjoyed visiting the local public house next-door. Some of the residents use the pub on a regular basis, for meals and for socialising. Residents commented that the meals were good and that there were choices available. The residents were observed enjoying their teatime meal with a choice of soup, sandwiches, cakes and soft diet for residents requiring this. The dining arrangements were much the same as on the previous inspection. Some residents were sitting in the dining room whilst others were eating in the foyer outside with over bed tables. This was discussed with the manager who would be reviewing dining arrangements along with other environmental changes he was considering. Westfield Lodge Nursing Home DS0000026971.V249580.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Residents and their families could be assured that their complaints would be taken seriously and acted upon. The systems in place at the home help to protect residents from harm or abuse. EVIDENCE: The complaints procedure was examined and found to be satisfactory. A copy of this was on display within the entrance hall of the home. Contact details for making complaints directly to the CSCI were set out. It is required that the telephone number of the CSCI be included in this procedure. Since the last inspection the manager had dealt with one complaint in accordance with the procedure and this had been documented. The CSCI had not received any complaints directly since the last inspection. This was a vast improvement on the previous record of complaints. The home had an Adult Protection Procedure in place, which is reviewed annually, and all staff receive abuse awareness training as part of their induction period. Westfield Lodge Nursing Home DS0000026971.V249580.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26 The standard of the environment within this home had improved somewhat since the last inspection. There are areas still to be improved and the manager has a good understanding of the areas in which the environment needs to improve and planning was in place indicating how this improvement was going to be resourced and managed. Over-crowding of some areas and under use in others was part of the planned change. EVIDENCE: A tour of the home was conducted where all communal areas and a random selection of bedrooms were inspected. Some improvements had been made to the environment since the last inspection and the home was cleaner and tidier. More storage spaces had been provided and the home appeared less cluttered. Westfield Lodge Nursing Home DS0000026971.V249580.R01.S.doc Version 5.0 Page 15 Sixteen bedrooms had been redecorated since the last inspection and residents had been able to choose from a sample of colours and designs. There was evidence of new furniture being introduced into bedrooms and these included lockable drawers for residents to be able to lock away personal items. A resident spoken to at the last inspection had expressed her desire for a lockable drawer and this had now been provided for her. There was a slight mal-odour noted on arrival at the entrance to the home. The manager stated that he was aware of this and that new flooring had been ordered for this room. During the tour of the home it was noted that in the main lounge on the ground floor the carpet was badly stained and in need of replacement. The manager stated that this was in hand and the carpet was on order. In bedroom 39 it was noted that a commode had been left in an unacceptable condition and was in need of a thorough clean. Throughout the home it was noted that the seals had gone a number of the double glazed windows. This was especially annoying in some of the bedrooms where this prevented residents from being able to see out. This was discussed with the manager who stated that a number of widows had been replaced since the last inspection. This had included the windows in the dining room, where it was observed that all but one had been replaced. This one remaining window needs replacing in order to complete the work. It was observed that some of the residents who are requiring nursing care are nursed in divan beds, which are quite low and difficult for staff to manage when delivering care. It is recommended that nursing beds are purchased and provided for all residents who are in receipt of nursing care. The manager confirmed that some nursing beds had already been purchased and that others would be purchased as and when the company were able to do so over a period of time. It was identified that the home was not being used to its full potential. The communal rooms on the second floor were empty whilst all the residents who were not in their bedrooms were accommodated in the lounge and dining room downstairs. This had the effect of these rooms being somewhat overcrowded, and, as previously outlined; the arrangements for dining were unacceptable. There was not enough room in the ground floor dining room to accommodate all the residents and yet there was this facility upstairs which was empty. This was discussed with the manager who stated that he was considering the option of some residents dining upstairs. This would be preferable to residents eating from over bed tables in the foyer. Which was not conducive to enjoyable dining. Westfield Lodge Nursing Home DS0000026971.V249580.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 29. After a period of instability in staffing there is now a good match of well qualified staff offering consistency of care within the home. Residents were safeguarded by the recruitment procedure in place. EVIDENCE: On the day of the inspection there were 43 residents accommodated in the home with a total of nine residents in receipt of personal care and 34 receiving nursing care. From 8am until 2pm there were two qualified nurses supported by eight care assistants. From 2pm until 8pm there were two nurses with six care staff and from 8pm until 8am there was one nurse supported by four care staff. There was a full time administrator employed. There was a full time housekeeper. The domestic hours provided totalled 75 and 36 for the laundry. There was a maintenance person employed who worked 30 hours per week. The catering staff were provided by an outside agency. Westfield Lodge Nursing Home DS0000026971.V249580.R01.S.doc Version 5.0 Page 17 An activities co-ordinator was provided and worked 24 hours per week and the company provided a gardener as and when required. The skill mix, qualifications and numbers of staff were agreed to be satisfactory to meet the needs of the residents living in the home at the time of the inspection. A random selection of employee files were examined and found to be in order. The required documentation was in place with references and CRB checks having been obtained. Westfield Lodge Nursing Home DS0000026971.V249580.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 36, 37 and 38 The manager has a clear development plan and vision for the home, which he has effectively communicated to the residents, staff and relatives. The systems in place help to provide a safe working and living environment. EVIDENCE: The manager’s application for registration with the CSCI was currently being processed. He had recently attended an interview and was awaiting confirmation of registration. He had all the necessary clinical qualifications and experience to run the home and had made many positive changes to the home since the last inspection. Westfield Lodge Nursing Home DS0000026971.V249580.R01.S.doc Version 5.0 Page 19 Staff morale had improved since the last inspection and staff stated that they felt supported by the manager. Staff meetings were held and staff were encouraged to participate in the day-to-day running of the home. Minutes of meetings were seen and action taken as a result of these had been recorded. Residents meetings were also held at the home, the last one was seven weeks prior to the inspection and had been recorded. Staff confirmed that they received formal supervision every three months and records of this were seen. The systems in place helped to maintain a safe working and living environment. Safe working practices were observed and evidenced throughout recently completed training sessions such as moving and handling, fire safety and infection control. The deputy manager carries out this mandatory training. General risk assessments had been completed in relation to the environment. These were well documented and detailed. Records were maintained securely and in accordance with the Data Protection Act. Westfield Lodge Nursing Home DS0000026971.V249580.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 3 2 3 3 3 3 3 2 2 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 1 x x x 3 3 3 Westfield Lodge Nursing Home DS0000026971.V249580.R01.S.doc Version 5.0 Page 21 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 9 Regulation 13(2) Requirement Medication must be correctly labelled with the name of the individual for whom it has been prescribed. The medication trolley lock must be repaired or replaced. The mal odour noted on the entrance to the home must be eliminated. The carpet in the main ground floor lounge must be replaced. Commode chairs must be left in a hygienic condition at all times. The windowpanes where the seals have gone must be replaced. It is required that the telephone number of the CSCI be included in the complaints procedure Timescale for action 01/09/05 2 3 4 5 6 7 9 26 19 26 19, 25 16 13(2) 16(2)(k) 23(2)(d) 16(2)(j) 23(2)(b) 22(7) 20/09/05 20/09/05 27/10/05 01/09/05 02/12/05 01/09/05 Westfield Lodge Nursing Home DS0000026971.V249580.R01.S.doc Version 5.0 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard 12 15 19 Good Practice Recommendations It is recommended that the activities programme be reviewed in order to suit individual needs and that the coordinator receives training in this area. The arrangements for dining should be reviewed with a view to providing dining facilities on the second floor. Nursing beds should be increased for residents requiring nursing care. Westfield Lodge Nursing Home DS0000026971.V249580.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Lodge Nursing Home DS0000026971.V249580.R01.S.doc Version 5.0 Page 24 - 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. 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