Inspection on 05/11/08 for Westfield Rest Home

This inspection was carried out on 5th November 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

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Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Westfield Rest Home 2 Westfield Road Blackpool Lancashire FY1 6NY     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jacqueline Riley     Date: 0 5 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Westfield Rest Home 2 Westfield Road Blackpool Lancashire FY1 6NY 01253344899 01253344899 arrowsmithlodge@tiscali.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Kesavamalar Rajaratnam Type of registration: Number of places registered: Mrs Kesavamalar Rajaratnam care home 9 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC To people of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Mental disorder, excluding learning disability or dementia - Code MD Dementia (DE) The maximum number of service users who can be accommodated is: 9 Date of last inspection Brief description of the care home Westfield Care Home is registered for up to nine people who have a mental health disorder or conditions relating to dementia. It is situated in a residential area of Blackpool close to a main road, shops and leisure facilities. There is also a good transport network close to the home. The home is a corner property, comprising of two floors. There is a passenger lift to access the first floor. There is a garden area to the side and front of the home, and a rear yard area. On the ground floor there are three Care Homes for Older People Page 4 of 28 Over 65 0 0 9 9 Brief description of the care home rooms for residents with the other rooms situated on the first floor. There is a front lounge and seperate dining room to the rear of the home. There is a range of mobility aids for residents with limited mobility. The home has a Statement of Purpose and Service User Guide providing information about the care, and services available , so that people can make an informed choice about moving into the home. A copy of the Service User Guide and the most recent inspection reports are in the hallway and available for inspection at any time. The range of fees at the time of the inspection were 300 pounds to 361 pounds per week. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection which took place over a five hour period on 5th November 2008. We spoke to the owner the manager and another member of staff on duty. During the time spent at the home we looked at a number of records including care plans, policies and procedures and staff files, this information helped us to make a judgment as to how the home is meeting the needs of residents and how the home meets National Minimum Standards, the Commission for Social Care Inspection make judgments against. Time was spent talking to staff and residents, and moving around the home to give us Care Homes for Older People Page 6 of 28 a flavour of what it is like to live and work there. Comments we received during the inspection were good and comments from surveys we sent to people prior to the inspection were also good. There will be a number of the comments received throughout the report, so that people reading it can see how satisfied people are using the service. In addition to looking at records and talking to people we looked at the homes environment and how this impacts on people living at there. What the care home does well: What has improved since the last inspection? What they could do better: Where residents have been admitted to the home for a short term placement, they should have in place an individual risk assessment so that it is clear for staff to follow. A care plan we tracked for a resident on a short stay, had information about their care, however there was limited information about how areas of risk were going to be managed by the staff team. We found the medication trolley is locked but not secured to the wall for additional security. This needs to be addressed so that the trolley is secure at all times. The homes call bell system is operational however it should be sited in the central area of the home so that staff can hear it wherever they are in the home, and a response can be made immediately. The general decoration and maintenance of the home, needs to be improved so that all areas of the home are well furnished, decorated and maintained to a good standard. The current bathing facility should be improved so that there is a choice of bathing facility for residents. At the time of the inspection we saw there is one assisted bath available for residents, this can be difficult to use for residents with poor mobility. There should be more than one bathing facility for the number of residents occupying the home when full. There should be further development in the training of staff. We found some staff require updates for various areas of training including Moving and handling, First Aid, and care practices for residents with Dementia or mental health conditions. The manager and staff told us this is an area currently being developed so that the staff team have the knowledge and skills to provide a good level of care. Care Homes for Older People Page 8 of 28 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents, families and friends have information about what services they can expect to live at the home. Admission and assessment procedures are in place so that the home knows they can meet the individual needs of residents. Evidence: We looked at the records of three residents living at the home. Two of the records were for residents living there on a permanent basis, the other one was for a resident on a short stay placement. We saw they had assessment details in place from social workers, or healthcare professionals. In two more recent admissions there had also been a pre admission assessment carried out by the homes manager. The information showed the home is informed through these assessments of the needs of the residents. Staff spoken to said they use this assessment information to determine the level of care the resident needs. Comments received said, The information is important to us so that we know what the needs of residents are. Care Homes for Older People Page 11 of 28 Evidence: Since the change of ownership the home has produced up to date information about the home and what services it provides. This information is given to residents and to prospective residents or their families or advocates, so that they know what the home can provide and make an informed decision. There were people looking around the home for their relative during the inspection process and this information was provided to them. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Promotion of health is taken seriously. Residents welfare is monitored and their health needs are identified and met. Evidence: The three care planning records we looked at were accurate and up to date. There was good information about individual healthcare needs as well as how residents those needs are going to be met. Staff we spoke to said the information is clear and they can follow the plans to maintain and support residents who live in the home. A resident spoken to said the staff are a good bunch, and help the resident out with things. The records we looked at show there are risk assessments in place for residents, which highlight what the risk is, how it can be managed and what the outcome is for the resident. In one instance a resident on short term placement had information detailed about their needs, however there was no individual risk assessment in place, which does not clearly inform staff how risk can be managed. We spoke to the staff and manager about this and the issue was being addressed. Comments included, we will Care Homes for Older People Page 13 of 28 Evidence: make sure this information is included on all short stay files. The care plans we looked at are being reviewed regularly so that the changing needs of residents are identified and their needs met. Senior care staff are involved in the process and those spoken to said, it is important we review the residents because some of them have different dependency and so they need more support. By looking closely at the records we found there is a good link between the home and other healthcare professionals including, doctors district nurses and psychologists. We were informed of a good outcome for a resident by way of a full review of medication, which improved the residents awareness of the surroundings and communication with others. Medication records and observation of practices in administration showed us it is safe. Only senior staff or the manager administers medication. We looked at three records and found them to be complete and up to date. We looked at how the home stores medication and found it to be in a locked purposeful facility, however this is not bolted to the wall to ensure the security to the medication. We spoke to the manager about the issue and this is going to be addressed, to make sure it complies with medication storage protocols. We saw residents privacy and dignity is respected during the visit by looking at how staff talk to and respond to residents. We found staff to be respectful and sensitive to individual residents needs throughout the inspection. Staff spoken to said, I treat residents the way I would expect to be treated or my family. Because of the dementia some residents need to be watched over even more and sometimes just to protect their dignity. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social activities and meals are being well managed, creative and provide daily variation and interest for residents. Evidence: We spoke to some of the residents and staff about routines in the home. They said they are flexible and residents can get up and go to bed when they choose. We saw two residents using their rooms during the day. Other resident were in the lounge and dining areas. We saw they are free to move around the home when they choose to. The lunchtime meal was being prepared and seen to be wholesome and nutritious. A resident said, they liked the meals and they can eat them when they choose if they are out during mealtimes. We saw staff supporting some residents with their lunchtime meal. This was carried out sensitively by way of the member of staff sitting with the resident and talking to them. Menus we looked at were balanced and the use of fresh produce is made available whenever possible. Staff members spoken to said they like preparing the meals for residents, and that they know that due to the home being of a moderate size they Care Homes for Older People Page 15 of 28 Evidence: know the likes and dislikes of individual residents and they respect this. We were told that there have been instances where special diets are necessary, but the staff always work with the doctor or other health professional for advice and guidance. This information was seen to be included on some of the files seen. There has been a review of social activities designed for residents with dementia conditions. We spoke to staff members who said there are suitable numbers of staff on duty in the afternoon for activities to take place, including board games, music, singing, jigsaws and other entertainment from time to time. In addition to these activities the manager told us they are introducing activities designed specifically for residents with short term attention span, so that they are being stimulated in some way. One resident spoken to likes to go out daily and this is not seen as a problem to the staff. The resident said they tell the staff when they are going out and what time they will be back. Staff said they know the routine and would be alert if the resident was late for any reason. There are no restrictions for visitors to the home, however there were no visits during the time spent doing the inspection. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The arrangements for recording and responding to complaints are good making sure people feel listened to. Staff have access to safeguarding training for the protection of users of the service. Evidence: We looked at the homes complaints procedure, which is made available to residents and their relatives or advocates during the admission process. We were told by staff and a resident they are aware of the complaints procedures and how to use them. Comments included, I know I can talk to the manager if I am not happy about something. The manager takes complaints seriously if somebody is not happy about something. There has been one complaint made to the Commission since the registration this year. We asked the home to investigate the issues, which they did and we were satisfied with the response. We spoke to the staff about how residents are protected they told us they are receiving updated training in safeguarding people. Three files looked at confirmed training is taking place so that staff are equipped with the knowledge and skills for the protection of people using the service. Care Homes for Older People Page 17 of 28 Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is designed to be homely and comfortable, however the need for decoration and replacement furniture, as well as improved bathing facilities has the potential to have a negative impact on residents living at the home.The call system is situated in an area which is not always convenient to staff, having the potential to be detrimental to the health and well being of residents. Evidence: We looked at the homes layout and design, and found to to be of a domestic nature homely and comfortable. There is a ground floor lounge area used by most residents. There is a dining room to the rear of the home. All residents have there own bedrooms. Residents were seen to be moving around the home freely with some residents using the lounge and dining areas in between meals. There is a passenger lift to access the first floor of the home. There are three bedrooms on the ground floor mainly used by residents with limited mobility. We looked at all residents bedrooms. We found them to be a good size and they had various items of furniture. This helps them to feel comfortable with personal things around them. In all rooms the furniture and decoration is looking tired and would benefit from decoration and replacement of some of the furniture. Some residents had personal items with them including individual pieces of furniture and personal items Care Homes for Older People Page 19 of 28 Evidence: such as photos, pictures and ornaments. A resident spoken to said they could use their bedroom whenever they choose to, and this was seen in two rooms. The garden area to the front and rear is well maintained and a resident told us they use it in the summer months. The number of bathing facilities are limited, in that there is one bathing facility for the residents using the service. We spoke to the manager about the development of this and were told there are plans in place for the redevelopment of the home, which will improve the environment throughout the home and will include additional bathing facilities. We found the homes emergency call system is working however the site of the call panel would benefit from being moved to a central location in the home so that at any time, staff can clearly hear the call system if activated and respond in a timely manner, for the welfare of residents. We saw there are a range of aids and adaptations including hoists and walking aids to help residents move around the home. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The procedures for recruiting staff are good, ensuring the safety and protection of residents. Training and deployment of staff is being developed so that they are meeting the needs of residents. Evidence: We looked at the duty rotas and discussed staffing levels with the manager. The home has increased staffing number during the day so that there are sufficient numbers of staff with various skills and experience to meet the needs of the residents living there. Staff we spoke to said they were happy with the way they are supported and how they work in the home. Comments included, we work well together as a team, we all know what we are doing and help each other out. The way staff are trained is being reviewed and we saw there is evidence the staff team are going on courses to meet the needs of residents living in the home. Staff have recently attended safeguarding training, most staff have a care qualification. Some staff are waiting to update their first aid and moving and handling qualifications so that they are up to date. Training in the area of dementia is another area the staff are to complete training. This will help them to meet the specific needs of the residents with dementia type conditions, based upon current good practice. Care Homes for Older People Page 21 of 28 Evidence: We looked at two staff files. They showed us staff are recruited safely using procedures which take into account full information about them including application records, references which have been checked, Criminal Record Bureau (CRB). Protection of Vulnerable Adults (POVA)checks to make sure they are safe to work with people who may be vulnerable. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed well with systems and policies in place for the safety and protection of residents. Evidence: We saw the manager is running the home on a day to day basis in the best interests of residents and staff. Comments included, we feel really supported by the manager, the manager is always there for you, if you are not sure about anything you can just ask. There was evidence of the home conducting a formal staff meeting following registration this year. The meeting records the agenda, and what staff feel they need for the service to develop. There is a clear action plan to meet some of those requests and they are being addressed by the owner. We found that all records and systems in the home have been reviewed or are at the review stage, so that the information is comprehensive and up to date. Staff were able Care Homes for Older People Page 23 of 28 Evidence: to follow clear instructions in the records for the health and welfare of residents. We saw there is a clear line of management responsibility and that staff communicated well with the owner throughout the inspection process. By looking at records we saw regular tests and servicing of essential equipment including, gas, electric and fire they were safe. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 19 23 There must be improvement 31/03/2009 in the standard of decoration and furnishings in residents rooms. In order to ensure the comfort of residents, their rooms must be maintained to a satisfactory standard. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 3 Risk assessment should be completed for residents who are on short term placements, so that staff have clear instruction as to what the individual risk is and how it will be managed. In order to ensure the security of the medication trolley, it should be bolted to the wall. The siting of the call bell system should be reviewed so that it is centrally located and can be heard by staff anywhere in the home. so that residents receive a response within an suitable timescale. There should be development in the bathing facilities in the home so that residents have a choice of facilities to meet their needs. Page 26 of 28 2 3 9 19 4 22 Care Homes for Older People 5 30 Staff training and development should be ongoing so that the staff team are equipped with the knowledge and skills to carry out their roles. Care Homes for Older People Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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