Inspection on 19/12/06 for Westfield Road (1)

This inspection was carried out on 19th December 2006.

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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Westfield Road (1) 15/12/08

Westfield Road (1) 16/01/06

Westfield Road (1) 01/08/05

Westfield Road (1) 02/02/05

Westfield Road (1) 09/11/04

Westfield Road (1) 01/03/04

Similar services:

Flint House

The Cotswold Home

Fairways

Treloar College

Rush Court

The Maypole Nursing Centre

Fir Tree Lodge

Chilmington House

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

CARE HOME ADULTS 18-65 Westfield Road (1) 1 Westfield Road Bletchley Milton Keynes Bucks MK2 2RR Lead Inspector Philippa MacMahon Unannounced Inspection 19th December 2006 09:50 Westfield Road (1) DS0000015079.V316912.R01.S.doc Version 5.2 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 Road (1) DS0000015079.V316912.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. 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 Road (1) DS0000015079.V316912.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Westfield Road (1) Address 1 Westfield Road Bletchley Milton Keynes Bucks MK2 2RR 01908 366168 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) The Disabilities Trust Sandra Stevens Care Home 3 Category(ies) of Physical disability (3) registration, with number of places Westfield Road (1) DS0000015079.V316912.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for 3 people with a physical disability. Date of last inspection 16th January 2006 Brief Description of the Service: Westfield Road is a care home for three people with a physical disability. The aim of the home is to provide rehabilitation for people with brain injury into more independent living. The Brain Injury Rehabilitation Trust owns the home. The day-to-day support and external management of the home is provided by Thomas Edward Mitton House, which is based in Milton Keynes. The home consists of a two-storey building. All of the bedrooms are single, and one of the bedrooms has an en -suite shower. The home is situated in Bletchley, close to local shops, leisure facilities and other amenities. It is easily accessible for public transport. The fees for this service range from £1,849 to £2,635 per week. Westfield Road (1) DS0000015079.V316912.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 09:50 hours and was in the service for 5½ hours. It was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s owner or manager, and any information that CSCI has received about the service since the last inspection. The inspector asked the views of the people who use the services and other people seen during the inspection or who responded to questionnaires that the Commission had sent out. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. The inspector was offered a warm welcome by the residents and staff and all cooperation was given throughout this inspection. The House leader was not rostered to be on duty but had taken the time to escort one of the residents to the City so he could do his Christmas shopping. The registered manager took time to meet with the inspector . Residents documentation was examined and these where discussed with the staff. The inspector observed the interaction between the residents and staff. A tour of the premises was made, and records required by regulation were examined. The medication system was examined. The inspector observed the residents preparing their lunch. One “have your say about 1 Westfield Road “ had been received by the commission. No comment cards were received from any professionals involved in the residents care. The inspector would like to take this opportunity to wish the residents and staff a very Happy Christmas. Westfield Road (1) DS0000015079.V316912.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: The residents must have an individual care plan in place that identifies their assessed care needs and how these will be met. The complaints procedure needs to be updated to include the commission’s local office contact details, and to explain that concerns or complaints may be taken to the commission at any stage. A review of the petty cash budget for housekeeping should be undertaken. Westfield Road (1) DS0000015079.V316912.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Westfield Road (1) DS0000015079.V316912.R01.S.doc Version 5.2 Page 8 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 Outcomes Statutory Requirements Identified During the Inspection Westfield Road (1) DS0000015079.V316912.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each resident has his or her individual needs and aspirations assessed. EVIDENCE: The inspector examined the care records of both of the present residents. Each record contained a thorough assessment of the residents needs and included assessments from the Rehabilitation unit where they had been previously cared for. This was further developed by the Trusts own health professionals. New documentation is being implemented at the present time and although this is very comprehensive there was no care plan, or rehabilitation plan in place for either of the residents. It is a requirement that every resident must have a written care plan as to how the residents needs in respect of this health and welfare are to be met. Westfield Road (1) DS0000015079.V316912.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Overall the residents individual care records contain a lot of information about their needs and how the staff will support them but the lack of an individual plan does not clearly indicate any progress or the goals to be worked towards. There is clear evidence of ongoing review of the rehabilitation and progress being made. Risk assessments are made when necessary. EVIDENCE: The inspector examined both of the residents care documentation and found good evidence of current specialist requirements and planned interventions, rehabilitation and therapeutic programmes and very clear regular reviews. However the lack of a specific care plan does not show the progress of the individuals rehabilitation and the ongoing changes in their needs and how these will be met. A requirement has already been made that a care plan must be implemented. There was clear evidence written in the documentation Westfield Road (1) DS0000015079.V316912.R01.S.doc Version 5.2 Page 11 that the residents made decisions about their lives and that the staff provide the necessary assistance and information to support them. Both of the residents manage their own finances unaided by the staff. Risk assessments are carried out by the staff in accordance with the Trusts risk management strategy and are included in the individual residents documentation. Westfield Road (1) DS0000015079.V316912.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are able to take part in appropriate activities in keeping with their lifestyle preferences. The residents are able to access and be part of the local community. The residents rights and responsibilities are respected and recognised. Contacts with family and friends are supported. The residents are offered a healthy diet. From the evidence seen and comments received, the inspector considers that the service would be able to provide a service to meet the needs of individuals of various religions,race, or culture. EVIDENCE: Both of the residents are still in employment but are on sick leave and as such not able to carry out the duties they previously had. Both of the residents have always had a high level of physical fitness and this is being continued by regular visits to the local gymnasium. Part of the rational for a placement in this home is to improve the individuals opportunity to integrate into the local community life. The home is very well placed for this as it is very close to the Westfield Road (1) DS0000015079.V316912.R01.S.doc Version 5.2 Page 13 centre of the town and the variety of facilities available offer the residents the opportunity to broaden their experiences. The staff spoken to explain to the inspector the various opportunities given and how the support is offered and how each resident has gained in confidence over a relatively short period of time. One of the residents had been out shopping in the City that had required a bus journey to get there and as it is Christmas time coping with crowds of people. A member of staff had accompanied him. All of these activities are recorded in the resident’s individual file and give a clear picture of the event and how the resident had responded. There is ready access to information and advice about local activities, support and transport. Both of the residents use public transport on a regular basis and members of staff who are identified car users are able to support the residents in pursuit of their chosen lifestyle. Assistance is given by the staff to ensure that family links and friendships outside the home are maintained. Records are kept of any contacts made. Family and friends are always made welcome in the home. The daily routines in the house and the house rules fully respect and support the resident’s individual choice and freedom of movement. The resident’s rooms are very much their private domains and the staff only enters them with permission from the resident. The residents have responsibility for housekeeping tasks such as cleaning rooms, cooking and seeing to their own laundry. The residents choose individually what they wish to eat and when, and they are assisted by the staff to shop, prepare and cook the meals. The present residents have very different preferences and choose to eat alone and have different food. The staff support them in this and have offered to provide communal meals and the residents have turned this down. The budget allocated to the house for the residents is very tight as it covers all food provided, cleaning materials, entertainment, travel (including the staff member escorting them). This budget allowance per resident has not changed in the last 3 years. It is recommended that a review of the petty cash allowance should take place particularly in the light of two physically fit residents who have healthy appetites, and wide interest to follow. Westfield Road (1) DS0000015079.V316912.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are given personal support in the way they prefer and require. Every effort is made to ensure the physical and emotional health needs are met. The residents are able to safely take responsibility for their own medication, supported by the homes policies and procedures. EVIDENCE: The present residents are able to carry out their personal care unaided and both of them have assistance from the Trust Occupational therapists and speech therapist on a very regular basis. This therapy is continued by the staff between visits. The local medical centre is close by and the residents are well supported by the local GPs. and the services they provide. Access to other healthcare facillities in the locality is also readily available and supported by the staff. The present residents have regular health checks by their employers and the reababilitation unit they came from. The medication system in the home is provided by a local pharmacist and is a monitored dosage system that is designed for people who administer their own Westfield Road (1) DS0000015079.V316912.R01.S.doc Version 5.2 Page 15 medication. One of the staff members has responsibility for the ordering and receipt of medication into the home and a delivery was made during this inspection and the correct procedures were in place. Both of the residents are responsible for giving their own medication and they were assessed on admission as being able to safely carry this out. The staff are trained in the administration of medicines and clearly demonstrated to the inspector their knowledge of the present users medication and the ongoing monitoring and safeguards required. The pharmacist from the provider visits the home on a regular basis and is readily available to the staff for advice. Westfield Road (1) DS0000015079.V316912.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure needs to be reviewed and changed to reflect the current local office of the commissions contact details. Every effort is made to ensure that the residents are protected from any form of abuse. EVIDENCE: The homes complaints procedure was found in the service users guide, and on the notice board in the hallway. The inspector noted that the present address of the local office of the commission was incorrect and the telephone number was missing. Within the procedure it was not explicit that any concerns or issues may be raised with the commission at any stage and not just after going throught the homes procedure. It is a requirement that the current name, address and telephone number of the local office of the commission must be provided in the homes complaints procedure, and that it is explicit within the procedure that residents may approach the commission at any stage. The inspector looked at staff training files and discussed with staff about the protection of residents from any form of abuse. Each of the staff has training and are very aware of issues concerning the protection of adults from abuse. Issues of physical and verbal aggression are understood by the staff and strategies for dealing with it are in place should it be required. The homes policy and practices regarding the residents money and financial affairs is that staff do not have any involvement under any circumstances. Westfield Road (1) DS0000015079.V316912.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home offords a very pleasant comfortable homely environment. Ongoing maintenance and improvement plans are in place. EVIDENCE: The inspector toured the building and found all areas to be clean hygienic and offering a comfortable homely environment. The staff informed the inspector that refurbishment of the bathroom downstairs toilet , and the residents private rooms is programmed to take place in the next few weeks. The living room is very well appointed and furnished to a high standard and provides a comfortable place for the residents to relax in. The garden is well maintained and a patio area provides a pleasant area to sit out in in fine weather. New garden furniture has been purchased ready for the spring. The kitchen is well appointed and provides all the necessary equipment for the day to day running of the home. Westfield Road (1) DS0000015079.V316912.R01.S.doc Version 5.2 Page 18 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The recruitment procedures in place afford the protection of the residents. The staff are appropriately trained to meet the needs of the residents. EVIDENCE: The inspector examined the staff roster and found that the home is appropriately staffed at all times by suitably skilled and qualified staff. There is a staff vacancy at the moment although a new member of staff has been recruited and is going through the necessary checks before commencing duties. The present staff are covering the extra shifts at the moment so as not to use agency staff. The Trust operates a thorough recruitment procedure and this is administered centrally and copies of documentation are held in the home in individual staff files. The inspector examined staff files and found them to be up to date and complete. Training and development of staff is very thorough and competancies are required in all areas as the staff are designated lone workers. Evidence of the staff training undertaken was found in their individual files. The registered manager is responsible for the training and development of staff within the local Trust services, and is an NVQ assessor. At the present time 2 of the 3 staff have the NVQ level 3 in care and a third is registered on the programme. Westfield Road (1) DS0000015079.V316912.R01.S.doc Version 5.2 Page 19 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed on a day to day basis by the present House leader and the staff, supported by the registered manager. EVIDENCE: The inspector met with all of the staff during this inspection and had the opportunity to briefly meet the registered manager. The registered manager is experienced and qualified to manage the home although she has other responsibilities within the trust and is not in the home on a daily basis. The home has a House leader who is responsible for the day to day running of the service and is able to contact the registered manager by telephone. The House leader and her team work very well together and there are clear lines of accountability and responsibility. Westfield Road (1) DS0000015079.V316912.R01.S.doc Version 5.2 Page 20 The registered manager told the inspector that the Trust has a quality assurance programme and on an annual basis sends out a satisfaction survey to people who have been discharged from the service, and present users. (Residents generally only stay in the service for up to 6 months as part of their rehabilitation programme.) The results of this are published in the Trust newsletter. Regular audits are carried out on various aspects of the service and managers meet on a weekly basis to discuss quality issues. The residents are informed that the commission carries out inspections and are given the opportunity to meet with the inspector if they wish. Neither of the residents wished to meet with the inspector on this occasion. One of them completed the commissions Have your say about 1 Westfield Road document. Each of the staff receives mandatory training in moving and handling and fire safety, and the fire log was examined and found to be up to date and all necessary checks carried out. Staff also have training in first aid. All records required by regulation are in place. Westfield Road (1) DS0000015079.V316912.R01.S.doc Version 5.2 Page 21 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 Standard No Score 1 X 2 2 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 x 3 X X 3 X Westfield Road (1) DS0000015079.V316912.R01.S.doc Version 5.2 Page 22 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 YA2 Regulation 15(1) Requirement Timescale for action 08/01/07 2 YA22 22(7)(a) It is a requirement that every resident must have a written care plan as to how the residents needs in respect of this health and welfare are to be met. It is a requirement that the 08/01/07 current name, address and telephone number of the local office of the commission must be provided in the homes complaints procedure, and that it is explicit within the procedure that residents may approach the commission at any stage. 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. Refer to Standard YA17 Good Practice Recommendations It is recommended that a review of the petty cash allowance should take place particularly in the light of two physically fit residents who have healthy appetites, and wide interest to follow. DS0000015079.V316912.R01.S.doc Version 5.2 Page 23 Westfield Road (1) Westfield Road (1) DS0000015079.V316912.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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