Inspection on 26/04/07 for Westgate

This inspection was carried out on 26th April 2007.

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

Westgate 09/03/06

Westgate 26/10/05

Westgate 19/01/05

Westgate 09/08/04

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

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

CARE HOME ADULTS 18-65 Westgate Westgate 5 Ellenborough Crescent Weston Super Mare North Somerset BS23 1XL Lead Inspector Nicola Hill Unannounced Key Inspection 26th April 2007 13:30 Westgate DS0000008101.V336200.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 Westgate DS0000008101.V336200.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. Westgate DS0000008101.V336200.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Westgate Address Westgate 5 Ellenborough Crescent Weston Super Mare North Somerset BS23 1XL 01934 621952 NONE i.hallscott@btinternet.com 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) Mr Iain Hall-Scott Mrs Jacqueline Hall-Scott Mr Iain Hall-Scott Care Home 10 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (10), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (10) Westgate DS0000008101.V336200.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th March 2006 Brief Description of the Service: Westgate is a pleasant Victorian terraced building located within easy reach of the town centre and local amenities. The home offers care to older service users with enduring mental health issues. The weekly fee for the home is £413.02. Westgate DS0000008101.V336200.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key inspection was undertaken with the resident general assistant and Mrs Hall Scott. The inspector spoke with the residents at Westgate to obtain some of the evidence for this report. The inspector also reviewed care files for residents, and administrative records relating to the implementation of running of the home. At the time of the inspection there were no vacancies at the home. The inspector recorded comments from several residents, all of which were very complimentary about the lifestyle offered to them at the home; several of the residents had been at the home for some considerable amount of time. The quality of the home has been judged as being adequate because the outcomes for the people who use the service were based only on verbal evidence given by the residents and staff. Some of the outcome groups have been judged as adequate and the proprietors will need to demonstrate continued improvement at the home in order to be able to improve their quality rating. What the service does well: What has improved since the last inspection? Westgate DS0000008101.V336200.R01.S.doc Version 5.2 Page 6 No recommendations or requirements were made at the last inspection. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Westgate DS0000008101.V336200.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Westgate DS0000008101.V336200.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Evidence suggests that prospective residents have a needs assessment carried out prior to admission; the service consults the assessment information to see if they can meet the prospective service users needs before an offer of a placement is made. EVIDENCE: There have been no recent admissions to the home and consequently the documentation for established residents has been read and approved on prior inspection visits. The home has an established admission process, whereby preadmission visits occur but there is flexibility in admission to the home. However, the resident who transferred to the home from another home could not confirm this process had been followed for them, but they were able to confirm that a choice was offered and that they had sufficient information about the home prior to admission. The resident did confirm that the decision to move to Westgate had been positive and that they were happier there than anywhere they had been ‘since being put away’. The manager will always be involved in the care programme approach (CPA) if applicable to residents prior to admission. Westgate DS0000008101.V336200.R01.S.doc Version 5.2 Page 9 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 adequate. This judgement has been made using available evidence including a visit to this service. The plan in all cases includes the basic information necessary to plan the resident’s care and includes a risk assessment element. No personal developmental planning is evident in the documentation. EVIDENCE: The residents at Westgate have individual care plans, which indicate their personal care needs and support with the activities of daily living. The residents generally sign the care plans and the support identified is known to care staff. Residents confirmed to the inspector that the staff team supported them. One resident stated that the staff were always available to them, and reminded them to do things. The manager, with resident’s involvement, regularly reviews the plans. The inspector discussed with the duty staff and Mrs Hall Scott the lack of personal development plans at the home. They were able to state what individual residents were doing and recognised that personal skills had been developed, but stated that this was not recorded anywhere and so there was Westgate DS0000008101.V336200.R01.S.doc Version 5.2 Page 10 no documented evidence to demonstrate good practice. This should be developed with residents so that where appropriate the home is able to demonstrate that the people who live there are supported with opportunities toward more independence in their daily lives. The daily records for most residents were completed weekly and were a summary of resident activity for that week, unless there had been an unexpected event in which case this is recorded in full. The daily records are supported by the diary/day book and handover book. The manager has undertaken to assess the potential risks for people who use the service, this may relate to a varied situations and circumstances the resident may find themselves, however there are also control measures identified to reduce the risk and support residents. All of the residents at this home are able to self-advocate and make their wishes known to staff and management. The inspector was able to observe that the residents at Westgate spent time with each other and shared activities, whilst talking with them it was also observed that they support and encourage each other to achieve personal objectives. Westgate DS0000008101.V336200.R01.S.doc Version 5.2 Page 11 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. Residents make individual choices about their personal lifestyles. EVIDENCE: As part of the inspection process the inspector spoke on an individual basis with two residents, and spoke with five other residents as a group. Residents stated that they were happy living at the home and that they were able to make choices about how they spent their time. One resident stated that they did not wish to attend any day centres of courses at the college, as they preferred to stay at home and help out with the household tasks. This person also expressed that they would like to go out on more trips but was unsure about how to make this happen. The resident was advised to discuss this with staff or the manager. Another resident preferred to remain in their room; they confirmed that opportunities had been offered for activities outside the home but that they did not wish to take them up. Westgate DS0000008101.V336200.R01.S.doc Version 5.2 Page 12 Whilst talking with the group of residents it was evident that a variety of community resources were accessed by residents; colleges, resource centres and day centres were used regularly, whilst other residents stated that they attended the cinema and enjoyed shopping. Currently the home do not arrange for group holidays, although individuals have breaks away from the home often with relatives. None of the residents has any employment through their personal choice, although support employment may be a possible development for some people who use the service in the future. The comments recorded by the inspector were that the home is a pleasant place to live, with staff that are friendly and supportive. The food was felt to be of good quality with plenty of variety; one resident stated that if they didn’t like what was on the menu then the staff would cook them something they liked. Healthy eating is promoted at the home with the inclusion of fresh fruit and vegetables in the menu. Westgate DS0000008101.V336200.R01.S.doc Version 5.2 Page 13 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 adequate. This judgement has been made using available evidence including a visit to this service. Staff understand the key principles of giving personal support and responsive to the varied and individual requirements of the residents. EVIDENCE: The personal care support needed by the residents is variable and has been identified in the care plan. All of the support staff at the home are female, however, if necessary the manager would be able to support a resident who preferred a male worker. One resident confirmed that staff helped them to decide about clothing and to take decisions about keeping up their appearance. Residents also confirmed to the inspector that they made choices about when to get up, and when to go to bed. The inspector also observed the staff whilst working around the home respected residents personal decisions. All of the residents at the home are registered with a GP and are supported to maintain optimum health and well being. The people using the service have direct access to the mental health services based at Weston General Hospital. The medication for the home is supplied in a unit dosage system, which was examined and found to be correct and up to date. When reconciling the Westgate DS0000008101.V336200.R01.S.doc Version 5.2 Page 14 medication not included in this system it was evident that the stock control procedure at the home was not working correctly and the home had stock surplus to that recorded. This was due to historic problems with the unit dosage system and staff being unsure about returning excess stock. The inspector advised that excess stock should be returned to the pharmacy and that only stock provided for the current month be held at the home. This would reduce the number of medications held, and take away the confusion relating to the stock records. Westgate DS0000008101.V336200.R01.S.doc Version 5.2 Page 15 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 adequate. This judgement has been made using available evidence including a visit to this service. Residents at the home understand how to make a complaint and are clear in their expectations of what should happen if a complaint is made. Safeguarding adults procedures are out of date and staff are unclear about the action t take should an incident occur and the manager unavailable. EVIDENCE: The complaints information is readily available to residents, who confirmed to the inspector that they are able to raise issues directly with staff or the manager. The manager confirmed to the inspector that no complaints had been received and there were no recorded complaints outstanding at the time of the visit. The inspector reviewed the home’s policy on adult protection, and found that the information held on file was out of date and did not relate to the local protocol and procedures now in place for safeguarding adults. The member of staff on duty did not know the current protocol and stated that if an incident occurred then she would phone the manager. This is not good practise and the manager and staff should attend the North Somerset Council training on Safeguarding Adults to ensure that they understand what is expected of them should an issue arise. The staff should be cognisant with procedures as they may find themselves in the position of whistleblowers and need to be confident that any concerns will be listened to and appropriate action taken. Westgate DS0000008101.V336200.R01.S.doc Version 5.2 Page 16 Westgate DS0000008101.V336200.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 adequate. This judgement has been made using available evidence including a visit to this service. The home provides a physical environment than meets the specific needs of the residents who live there. EVIDENCE: Westgate is an older property that requires regular maintenance and repair. All of the bedrooms are used as single rooms that are furnished to meet the residents individual taste. The bathrooms have been recently refurbished and are very pleasant, clean and light; there is evidence of mould on the ceiling on the first floor bathroom and this should be removed. The communal lounge area is comfortably furnished and has been equipped with domestic type furniture and audiovisual equipment. Staff have overall responsibility for the cleanliness and hygiene of the house; residents can choose to be responsible for their own room or have assistance to keep it clean. One resident stated that the staff supported them with keeping their bedroom clean and changing the bed; they also stated that at Westgate DS0000008101.V336200.R01.S.doc Version 5.2 Page 18 times they helped keep clean other areas of the home but it was on a voluntary basis. Smoking is allowed in individual bedrooms only, and not extended to communal areas within the home. The outside areas of the home are accessible and can be used for various leisure activities. One resident was using the front garden when the inspector arrived at the home; staff confirmed that on sunny afternoons residents regularly access the garden. The laundry facilities are available for residents to use if they wish to. Westgate DS0000008101.V336200.R01.S.doc Version 5.2 Page 19 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 adequate. This judgement has been made using available evidence including a visit to this service. The service ensures that all staff receive relevant training that is targeted and focused on improving outcomes for residents. EVIDENCE: There is 24-hour support available to the residents and a member of staff is always in the house. Staff records confirmed that professional development and training is offered to the team which provides underpinning knowledge about good care practice (NVQ) and staff can attend specialist training days which are specific to clients need i.e. dealing with difficult behaviours. All of the staff who work at Westgate have NVQ 2 in care. The recruitment practice at the home ensures that all staff have a POVA first check/CRB and a minimum of two references prior to starting work at the home. The home does not use an application form, and do not keep any records of interview. The induction process at the home is a mixture of formal information on policies and procedures, a tour of the premises in order to meet staff and to get to know the building and residents, and informal training through shadow shifts which allows the new member of staff to be observed to be competent in practice. Residents are able to feed back their views about new staff directly Westgate DS0000008101.V336200.R01.S.doc Version 5.2 Page 20 to the manager. The induction programme should be cross-referenced to the common induction standards identified through Skills for Care. Westgate DS0000008101.V336200.R01.S.doc Version 5.2 Page 21 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): 37,39,42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager is experienced in running the home and is aware of and works with the basic processes set out in the national minimum standards. EVIDENCE: Mr Hall Scott manages both Westgate and Shalcott Hall using the same policies and procedures and management style. The comments made in the report on Shalcott Hall are relevant to Westgate and have been repeated in this report. Mr Ian Hall Scott has been managing the home for several years and attends regular training in order to maintain an up to date knowledge base. The staff who spoke with the inspector have great respect for the manager who listens to them and is always available either in person or by telephone. Westgate DS0000008101.V336200.R01.S.doc Version 5.2 Page 22 The quality assurance systems at the home were limited, the manager identified that there was a yearly resident survey but no other formal audits or service monitoring was established. The home does not have house meetings for residents or staff meetings. There is low staff turnover and low levels of sickness at the home, which means that there is a continuity of staff support to residents. The implementation of health and safety legislation at the home is good; staff attend regular updates to practice, all of which is documented. The risk assessments of the environment were reviewed but the inspector would advise linking the level of risk to the known number of incidents that have occurred, as this will give a balanced potential risk factor. Fire safety precautions are observed; PAT testing is up to date. There were no recorded accidents at Westgate. Westgate DS0000008101.V336200.R01.S.doc Version 5.2 Page 23 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 3 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 3 23 2 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 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 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 2 X X 3 X Westgate DS0000008101.V336200.R01.S.doc Version 5.2 Page 24 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 YA39 Regulation 24,21 Requirement The proprietor should establish and maintain a system that measures the success in achieving the aims and objectives of the home. The manager and staff must attend the North Somerset Council training on Safeguarding Adults to ensure that they understand what is expected of them should an issue arise. Timescale for action 26/10/07 2 YA23 18,19 26/06/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA20 YA6 YA8 Good Practice Recommendations Medication supplied for the current month should be held at the home. Person centred planning should be developed with residents so that where appropriate, the home is able to demonstrate that the people who live there are supported with opportunities toward more independence in their daily lives. Westgate DS0000008101.V336200.R01.S.doc Version 5.2 Page 25 3 4 YA34 YA35 The recruitment process should be based on equal opportunities. The induction programme should be cross referenced to the common induction standards identified through Skills for Care. Westgate DS0000008101.V336200.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Taunton Local Office Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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. Extracts may not be used or reproduced without the express permission of CSCI Westgate DS0000008101.V336200.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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