Inspection on 04/07/06 for Westfields

This inspection was carried out on 4th July 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 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

Westfields 22/09/05

Westfields 08/04/05

Westfields 08/12/04

Westfields 19/07/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Westfields Westfield Road Swaffham Norfolk PE37 7HE Lead Inspector Mrs Jacky Vugler Key Unannounced 4th July 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Westfields DS0000034875.V303736.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Westfields DS0000034875.V303736.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Westfields Address Westfield Road Swaffham Norfolk PE37 7HE 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) 01760 721539 glenistudor@norfolk.gov.uk Norfolk County Council-Community Care Mrs Glenis Tudor Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Westfields DS0000034875.V303736.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home to accommodate 40 Service Users who are older people not falling within any other category. 22nd September 2005 Date of last inspection Brief Description of the Service: Westfields is a purpose built Local Authority Home providing accommodation for 40 elderly residents. The accommodation is on the ground and first floor. There are 40 single rooms. The home is set in its own grounds, with a car park at the front and side of the home. The home has a small rehabilitation unit on the first floor. The home receives nursing care from the District Nurse and medical services from GP practices. The home is situated adjacent to the town centre of Swaffham. The fees for the home are £368.72 a week. Westfields DS0000034875.V303736.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection, which involved and unannounced visit to the home and an examination of information submitted, comment cards and information held by the Commission. On the day of inspection thirty-six residents were accommodated in the main unit and one in the STEPS unit. The Manager, Mrs Glenis Tudor, was present throughout the inspection. Preparation for this inspection had taken place at the CSCI office. A tour of the premises was undertaken and several records were viewed. Four residents and four members of staff were spoken with. Comment cards were received from ten residents and these commented positively of the care provided at the home. Two residents had decided to move to Westfields following respite care there. What the service does well: What has improved since the last inspection? What they could do better: Westfields DS0000034875.V303736.R01.S.doc Version 5.2 Page 6 Although evidence was seen that training takes place, some of the records need updating. The internal fabric of the building could be better maintained. Some parts of the home are looking tired and there are wheelchair scuffs around doorways. The toilets and bathrooms need redecorating and making more homely. The passenger lift is very small and cannot accommodate a wheelchair and staff member unless the footplates are removed and this is not a safe practice. Also there is quite a jolt felt when the lift stops and staff reported that the lift does not always stop level with the floor. The Manager said that the control for the central heating system is situated in the boiler house and only has a summer or winter setting. Some residents can adjust the heating in their room, but this is often difficult because the regulator is stiff to turn. Norfolk County Council are mindful of the need for the original metal windows to be replaced. Residents and staff spoken to say that some of these windows are very difficult to open and close, thus taking away some independence for the residents. Some windows are also draughty causing further discomfort. 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. Westfields DS0000034875.V303736.R01.S.doc Version 5.2 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 Westfields DS0000034875.V303736.R01.S.doc Version 5.2 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 and 6 Quality in this outcome area is good. The home has the care needs information prior to admission for all prospective residents, to ensure care needs can be met. The residents assessed and referred for intermediate care are helped to maximise their independence and return home. EVIDENCE: Prospective residents are referred by a social worker. They are invited to visit the home with their family to have a look round, meet staff and have lunch with the other residents. The resident, their family, the social worker and the nurse if necessary are involved in this assessment process. The manager said that she likes to complete the pre-admission assessment at this stage when she is also able to observe the interaction with the other residents. The resident and their family are given the service user guide and a copy of the statement of purpose. A copy of the service user guide is in every bedroom and displayed with the inspection report and the leaflet How Well Are We Doing in the entrance hall. Westfields DS0000034875.V303736.R01.S.doc Version 5.2 Page 9 STEPS is the homes rehabilitation unit, which consists of three beds. Residents can stay for up to six weeks. There is input from the occupational therapist and a physiotherapist. On admission the resident signs to agree their identified goals. The occupational therapist visits and observed the service user undertaking simple personal and household tasks to see how they manage. If this visit is satisfactory the service user then has a day visit at their home to see how they get on. They then return to Westfields and their discharge is arranged if appropriate. Currently there is one service user accommodated in this unit. The STEPS unit has a kitchenette for the residents use. The unit has one dedicated member of staff from 7 am -9.30 pm, who has completed rehabilitation training. Westfields DS0000034875.V303736.R01.S.doc Version 5.2 Page 10 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 Quality in this outcome area is good. The residents care plans are clear and give good guidance to staff with regard to their health, personal and social care needs. Residents healthcare needs are fully met. Residents are protected by the homes policies and procedures for dealing with medications. Residents feel they are treated with respect and their right to privacy is upheld. EVIDENCE: Since the last inspection, extra detail has been added to the care plans, for example, a dependency level assessment, which will help to assess staffing levels needed. The manager is in the process of implementing a dementia supplement to the main care plan, and this will be used for all residents who show any sign of short term memory loss. The manager said that an updated care plan is now ready to be implemented for new admissions. Westfields DS0000034875.V303736.R01.S.doc Version 5.2 Page 11 The care plans are detailed giving good guidance to staff and a monthly review sheet is kept inside wardrobe doors, for easy access, for staff to record any changes in care. The care plans are then updated three monthly. The care plans are signed where the resident is able, and where this is not the case unable to sign has been written and this is good practice. Moving and handling assessments, and personal risk assessments are in place. A falls assessment tool and a record of falls is in use. A record is kept of visits by other healthcare professionals and any outcomes recorded. The chiropodist visits six weekly and the dietician when necessary. An optician visits the home regularly and two residents visit the local optician. The care plans were found to be accurate for those residents spoken with. The lunchtime medication round was observed and the medications were appropriately administered and the records signed after the medication was given. The home uses a monitored dosage system and the record sheets contained a photograph of the resident and were appropriately completed. Staff sign a sheet to say they have completed the medication round. Medications are appropriately stored in the medical room. Two short term residents self-administer their medications and the medicines are dispensed into a compliance aid by the pharmacist and stored in a locked drawer of their bedside cabinet. Insulin was appropriately prepared and administered to those residents needing it. All staff administering medicines have received training. It was reported and observed that all staff knock on doors before entering, close the doors and protect the residents dignity. This was verified by the residents spoken with. Westfields DS0000034875.V303736.R01.S.doc Version 5.2 Page 12 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, 14 and 15 Quality in this outcome area is good. Activities are offered to the residents, with some on a one to one basis, which they particularly enjoy. Entertainment and outings are also offered. Good contact with family, friends and the local community is maintained. The residents are encouraged to exercise choice and control over their lives. Residents receive a choice of nutritious meals in a pleasant dining room. EVIDENCE: The home employs a relief carer who has time each week dedicated to activities. She said that there is no pre-arranged programme of activities as she speaks individually to the residents, who like to choose what they would like to do on the day. She has completed a training course on reminiscence. An activities book is completed including photographs, and it indicates which activity has taken place and who participated. This is a good record. A wide range of activities offered include manicures, games, planting bulbs in pots for the window sills, cooking and hand massages, a favourite. A separate room is used when outside entertainers visit. The home hires a minibus once a month to go on an outing and sometimes on Sundays go for a ride around the villages in the summer. All activities and outings with familys are written in the residents daily records. One of the Care coordinators writes a magazine Westfields DS0000034875.V303736.R01.S.doc Version 5.2 Page 13 and the booked entertainment and Bingo is included as well as residents and staff birthdays. The home has an open visiting policy if possible avoiding meal times. People from the local community regularly visit the home, recently a childrens string quartet visited which the residents said they enjoyed. School children and church representatives visit at Christmas time. The home holds a family day twice a year. Staff take one resident home to have lunch with his wife and then pick him up later in the afternoon. There was evidence of many choices being offered to residents, for example, the way staff enable them to choose their clothes for the day, some residents have breakfast in their room, and one resident chooses to have all her meals in her room. Residents said that they are able to talk to staff all the time and meetings are held three monthly. The home has a pleasant dining room with the menu displayed and small tables seating four. Residents spoke of the choices available and the cook said that she goes round to the residents with the menu and if necessary she will cook another dish. Food dislikes are recorded on the care plan. In the near future, the home will become a pilot for restaurant style meals and this should provide a greater choice for the residents. Westfields DS0000034875.V303736.R01.S.doc Version 5.2 Page 14 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 Quality in this outcome area is good. The home has a complaints procedure that is actively used, taken seriously and acted upon in the best interests of the residents, relatives and friends. Service users are protected from abuse. EVIDENCE: The home has a complaints procedure which is displayed and all residents have a copy in their room. The form on which complaints are recorded is headed confidential information. Since the last inspection five in-house complaints have been recorded and all were dealt with appropriately. The home has a procedure in place for the protection of vulnerable adults and a whistle blowing procedure is also in place to protect staff. All staff have received training in the protection of vulnerable adults. The manager said that all staff employed had a criminal records bureau disclosure returned and thirty of these were seen. The manager is a recognised trainer for abuse awareness and all staff have completed this training. Westfields DS0000034875.V303736.R01.S.doc Version 5.2 Page 15 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 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is comfortable and safe, but some areas need redecorating and making more homely. There are some issues around the older parts of the building and equipment, and improvements need to be made. EVIDENCE: On the day of the inspection the removal of asbestos had commenced. Since the last inspection some refurbishment and redecoration has taken place. For example, new carpets in the main hallway and Honeysuckle Way, a bedroom on the first floor has been redecorated and new name plates are on bedroom doors. There are also plans to upgrade the dining room by 25 September 2006 ready for the new restaurant. There is an ongoing program of redecoration. The passenger lift is very small and cannot accommodate a wheelchair and staff member unless the footplates are removed and this is not a safe practice. Also there is quite a jolt felt when the lift stops and staff reported that the lift does not always stop level with the floor. Westfields DS0000034875.V303736.R01.S.doc Version 5.2 Page 16 A requirement has been made. The Manager said that the control for the central heating is situated in the boiler house and only has a summer or winter setting. Some residents can adjust the heating in their room, but this is often difficult because the regulator is stiff to turn. Radiator guards in place on the ground floor. A requirement has been made. The home has old metal window frames, many of which need repainting. Some are very difficult to close therefore the residents are unable to independently open or close their windows. A requirement has been made. Some parts of the home are looking tired and there are wheelchair scuffs around doorways. The toilets and bathrooms need redecorating and making more homely. A requirement has been made. The management of the home display information relating to the home including the inspection report in the front hall and actively encourage comments by having a suggestion box and comment cards in this area. This is good practice. In other parts of the building there is a visitors room, a hairdressing salon and a separate unit for people wishing to acquire the skills necessary for returning home (the STEPS unit). There is the visitors room and a hairdressing room. In the entrance hall there is a suggestion box and also available are the Statement of Purpose, inspection reports, comment cards and tell us what you think leaflets. Photos of outings are on the notice board. The STEPS unit is for those residents rehabilitating and there is a lounge/dining room and a kitchenette. The laundry and clinical waste are all dealt with appropriately with clear infection control guidelines. The home is very clean and tidy and there are no unpleasant odours. Westfields DS0000034875.V303736.R01.S.doc Version 5.2 Page 17 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, 28, 29 and 30 Quality in this outcome area is good. The home has the appropriate numbers and skill mix of staff to meet the residents needs, however, the night staffing hours need to be monitored. Residents are in safe hands at all times. Residents are protected by the homes robust recruitment and selection processes. Staff are trained and competent to do their jobs. EVIDENCE: The duty rota shows there to be a Care Coordinator working from 7am - 10pm and her responsibilities involve management tasks as well as caring when needed. A senior carer works from 7am - 9.30pm. In addition five carers work in the mornings and four in the afternoons and evenings. Two carers work on night duty and if a resident needs the help of two carers then nobody is available for the other residents during that time. It is required that the Manager monitors this situation and consideration be given to increasing the staffing levels at night. Some of the comments from residents about the staff included they have the patience of Job, you couldnt better the staff, excellent, its like staying at the Ritz, they do anything for you. They also said that they don’t have to wait long when they ring the bell. Westfields DS0000034875.V303736.R01.S.doc Version 5.2 Page 18 All the care coordinators (three) and one senior carer hold the NVQ level 3 certificate and nine care staff hold the NVQ level2 certificate. This equates to 43 of the care staff with a further two currently undertaking it. All the domestic staff have received first aid training. The home has a robust recruitment and selection procedure using the Norfolk County Council policies. Some staff recruitment files were seen and these contained evidence of ID and all of the necessary checks. Evidence of several Criminal Records Bureau disclosures were seen. All staff have signed an ethnic and disability monitoring form and a policy on confidentiality. Each member of staff has an Evidence of Learning file and this contains details of training undertaken. Staff said that the training opportunities at this home were good and courses available were put on the notice board and discussed at supervision. Training undertaken included, abuse awareness, dementia care, emergency aid, medicine management, fire awareness and moving and handling. Some of the records of training were not up to date and it is recommended that these be reviewed. Westfields DS0000034875.V303736.R01.S.doc Version 5.2 Page 19 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, 33, 35, 37 and 38 Quality in this outcome area is good. Residents live in a home which is run and managed by a competent manager who is able to fulfil her duties in an open and inclusive manner. The home is run in the best interests of residents. Resident finances are safeguarded. Staff are appropriately supervised. The health, safety and welfare of residents are promoted and protected. EVIDENCE: The Manager, Glynis Tudor, has many years experience and has managed Westfields for six years. She has completed the Registered Managers Award and plans to commence the NVQ level 4 in Care in October 2006. She has Westfields DS0000034875.V303736.R01.S.doc Version 5.2 Page 20 completed the Train the trainer course for abuse awareness and moving and handling and has the NVQ assessors award. Satisfaction questionnaires have not recently been sent to residents and their families as this is being coordinated by County Hall and survey forms from the Commission have just been completed. Evidence of audits was seen, for example, medications. A residents dependency level assessment in place, which assists with ensuring adequate staffing levels. Staff have recently completed a questionnaire, which was returned to County Hall. There is a development plan for 2006/07, which contains a brief summary of provision and an action plan for the forthcoming year. The Manager goes round to see the residents every day and her door is always open. Residents, visitors and staff were seen to call throughout the day. Regular residents and staff meetings are held and these are minuted. A well being programme is in place to support staff and two members of staff are facilitators for this. Thank you letters and cards seen and comments included, x felt secure, warm and well looked after, thank you for x 100th birthday party. Residents money is kept secure in a safe and good records are kept, including receipts. Eight monies were randomly checked and found to be correct. These records are audited quarterly by the Manager and administrator. Staff spoken to often referred to the private supervision sessions they had received and records of these were seen. Good Legionella procedures are in place. Random service certificates were seen for equipment used and these were in good order. Fire training, drill and evacuation records were seen. Regular tests were carried out on the alarms, emergency lighting and appliances. Fire procedures and risk assessments were seen. Westfields DS0000034875.V303736.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 Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 3 x 3 Westfields DS0000034875.V303736.R01.S.doc Version 5.2 Page 22 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 OP19 Regulation 23 (2)(d) Requirement The Registered Person must submit a plan of improvement to the Commission of those areas of the home which are tired, including the redecoration of bathrooms and toilets to make them more homely. The Registered Person must submit a plan of improvement to the Commission for the passenger lift as it is not large enough to carry a wheelchair plus a member of staff safely. The Registered Person must submit a plan of improvement to the Commission for redecorating and replacing the windows causing the most discomfort. The Registered Person must submit an improvement plan to the Commission for improving the heating system. The Registered Manager must monitor residents dependency levels and consider increasing staffing levels at night when indicated. Timescale for action 30/09/06 2 OP22 23 (2)(n) 30/09/06 3 OP24 23 (2)(b) 30/09/06 4 OP25 23 (2)(p) 30/09/06 5 OP27 18 (a) 31/08/06 Westfields DS0000034875.V303736.R01.S.doc Version 5.2 Page 23 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 OP30 Good Practice Recommendations It is recommended that staff training records are updated. Westfields DS0000034875.V303736.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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. 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