Inspection on 04/01/07 for Westgate House

This inspection was carried out on 4th January 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 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

Westgate House 09/12/05

Westgate House 21/07/05

Westgate House 17/03/05

Westgate House 22/06/04

Westgate House 20/02/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Westgate House Millington Road Wallingford Oxon OX10 8FF Lead Inspector Chris Sidwell Unannounced Inspection 4 th January 2007 10:00 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 Westgate House DS0000047098.V322621.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. Westgate House DS0000047098.V322621.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Westgate House Address Millington Road Wallingford Oxon OX10 8FF 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) 01491 836332 01491 827851 manager.westgate@osjctoxon.co.uk www.oxfordshire.gov.uk The Orders Of St John Care Trust vacant Care Home 61 Category(ies) of Dementia - over 65 years of age (25), Learning registration, with number disability over 65 years of age (3), Old age, not of places falling within any other category (61), Physical disability over 65 years of age (30), Terminally ill over 65 years of age (5) Westgate House DS0000047098.V322621.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The total number of service users that may be accommodated at any one time must not exceed 61. Up to a maximum number of 21 places may be used for nursing needs. 9th December 2005 Date of last inspection Brief Description of the Service: Westgate House is a care home providing personal care and accommodation for 60 older people. It is able to offer nursing care for up to 20 service users. Westgate House is managed by The Orders of St John Care Trust, which is responsible for 19 other care homes in Oxfordshire. Westgate House has been purpose-built and became operational in June 2003. It is located on a new housing development close to the centre of Wallingford and all the amenities of the town. Each room has been designed with en-suite facilities and the new furnishings and fittings are of a high standard. The Two-storey building is arranged in three wings providing unit living and the communal lounge area creates a central heart of the home. The home has pleasant grounds with seating and a small water feature. Westgate House also provides day centre accommodation for 35 older people from the local community. The fees range from £570.00 to £860.00 Westgate House DS0000047098.V322621.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a period of three days and included an unannounced one-day visit to the home. Prior to the visit all previous information about the home was reviewed. Comment cards were sent to residents and their families and to other professionals who have contact with the home. Eight residents and one healthcare professional responded. The care of four residents was case tracked. Residents, family members, staff and the manager were spoken to on the day of the unannounced visit. The home’s approach to equality and diversity was observed. What the service does well: Residents needs are assessed prior to their moving to the home to give confidence to both residents and their families that their needs can be met. One resident said that she had chosen the home because it was homely and had a nice feel to it. Residents personal, healthcare and medication needs are met in a timely way. Their self-esteem is promoted by the staff who protect their privacy and dignity. One resident said that she preferred a female carer and the staff respected this. The routines of the home are flexible and residents are supported to take part in organised activities to provide stimulation and diversion to their day. The meals are of a high standard and residents nutritional needs are met. A group of residents said that there is always lots to do if you want There are complaints and safeguarding procedures in place to protect residents from harm arising from their care. The Commission for Social Care Inspection has not received any complaints nor has it been notified of any allegations of abuse. The home is well maintained, residents rooms are homely and the standards of hygiene and infection control are excellent, providing residents with a comfortable and safe place in which to live. One resident said that she was pleased to be able to bring some of her furniture and her ornaments when she gave up her own home saying they may not look much but they have happy memories for me. The staffing levels are good and staff have the necessary training to meet residents needs. The staff spoke highly of the organisation and commented Favourably on the training offered and the equipment available to care for residents. Westgate House DS0000047098.V322621.R01.S.doc Version 5.2 Page 6 The home is well managed and the quality of care for residents is monitored regularly by the organisation. There are health and safety systems in place to protect residents and staff from harm arising from their care. What has improved since 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 House DS0000047098.V322621.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 Westgate House DS0000047098.V322621.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents needs are assessed prior to their moving to the home, to give confidence to both residents and their families that their needs can be met. EVIDENCE: The care of four residents was case tracked from their initial contact with the home to the care that they were receiving at the time of the inspection. All had been visited prior to their move and a comprehensive assessment of their needs made. One confirmed that he had been able to visit prior to moving to the home and confirmed that he had stayed on a trial basis initially. There was evidence in the care files seen that care managers had undertaken an assessment and that the needs identified by the care managers had been included in the care plan. Residents nursing needs had been identified and they had been assessed as to the level of contribution to their fees, to be paid by the local Primary Care trust, to which they were entitled. The home does not offer intermediate care. Westgate House DS0000047098.V322621.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9and 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents personal, healthcare and medication needs are met in a timely way. Their self-esteem is promoted by the staff, who protect their privacy and dignity. EVIDENCE: The care plans seen contained detail of the care needs of the residents. Residents had been involved in planning their care and in those who were able had signed to say so. The care plans had been reviewed monthly and were up to date. They contained evidence that the relevant healthcare professionals visit residents regularly. Residents had risk assessments covering the their risk of developing pressure damage and falls. Continence and nutritional assessments had also been undertaken. The Community Psychiatric Nurse (CPN) visits the home and there was evidence that those with dementia are seen regularly. The CPN also confirmed that the home communicates clearly with her and incorporates any specialist advice into the care plan. She was satisfied with the overall care provided to residents. Westgate House DS0000047098.V322621.R01.S.doc Version 5.2 Page 10 Medication was managed well. There are policies and procedures in place. Three residents manage their own medication and they had risk assessments in place and safe storage in their rooms. The staff said that no medication is administered covertly and that if a resident refused medication that was considered essential the doctor and family would be informed and a way forward agreed as a multidisciplinary team. There was evidence in the training records that staff who administer medication have had training to do so. Records were kept of medication entering and leaving the home. The medication administration charts were correctly completed. It is recommended that residents allergies be written on the front sheet of the medication records. This information was available in the care plans. Staff were observed to treat residents with courtesy and to protect their dignity. All the residents who returned the questionnaire said that staff listened to and acted upon what they say. The mail was observed to be delivered unopened. Residents were wearing their own clothing, which was in good condition. Westgate House DS0000047098.V322621.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The routines of the home are flexible and residents are supported to take part in organised activities to provide stimulation and diversion to their day. The meals are of a high standard and residents nutritional needs are met. EVIDENCE: There is an activity coordinator in post. A small group of residents from the residential unit were spoken to and they said that they were happy here and that there is lots to do if you want to. Activities are arranged almost every day of the week and include crafts, musical events and one to one working with residents who cannot or do not wish to participate in group activities. There were photos displayed in the home celebrating summer outings that had been arranged. Residents had been invited to a Christmas dinner in the officers mess at RAF Benson. One, a retired pilot, particularly enjoyed this. Recognising that Christmas is a time of giving the staff had helped residents make and plant ceramic bowls with bulbs, to give as a gift for their relatives. The routines of the day appeared flexible. Of the seven residents who returned the questionnaires all said that activities were always or usually arranged for them. Westgate House DS0000047098.V322621.R01.S.doc Version 5.2 Page 12 Visitors are welcome at any time and residents can see visitors in private in their rooms or in the main lounges. Information about local advocacy groups was posted on the notice boards in the main entrance hall. The meals are of a high standard. There is a varied menu and the residents spoken to all said that they enjoyed the food. Several knew the chef by name and appreciated that she took the time to visit them and ask them if they had any favourites. The mealtimes were observed to be a pleasant and sociable occasion. Staff were sitting to assist those residents who could not eat unaided. Pureed foods were presented attractively. Residents were weighed regularly and for most their weight was stable. High calorie foods are prepared for those in the dementia unit whose activity levels may mean that they are at risk of losing weight. Westgate House DS0000047098.V322621.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are complaints and safeguarding procedures in place to protect residents from harm arising from their care. EVIDENCE: There are complaints, protection of vulnerable people, whistle blowing and restraint policies and procedures in place. A complaints record is kept. The staff spoken to said that they had had protection of vulnerable adults training and this was confirmed by the training records. The residents spoken to said that the staff were kind and that they had never been treated badly. Those who returned the comment cards said that the staff were always kind and that they knew who to complain to if they were unhappy. The Commission for Social Care Inspection has not received any complaints nor has it been notified of any allegations of abuse. Westgate House DS0000047098.V322621.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24 and 26 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 maintained, residents rooms are homely and the standards of hygiene and infection control are excellent, giving residents a comfortable and safe place in which to live. EVIDENCE: The building is well maintained and a programme of routine maintenance and decoration is evident. The grounds are tidy and accessible to residents. One resident said he was looking forward to going out into the garden and seeing the bulbs. Residents rooms are homely and had been personalised. Residents requiring nursing care had profiling height adjustable beds. One resident said that she had been pleased to be able to bring some of her own furniture and her ornaments with her when she gave up her home, saying they may not look much but they have happy memories for me. Westgate House DS0000047098.V322621.R01.S.doc Version 5.2 Page 15 The carpets in some rooms were slightly stained. The housekeeping staff said that they were washed regularly although the stain seemed to reappear. Residents rooms were clean and there were no offensive odours. The home should ensure that carpets are replaced if it is not possible to remove stains. There are infection control policies and procedures in place and the staff training records showed that staff had had training in infection control. Staff were observed to wash their hands. Not all rooms have soap and paper towels for use by the staff. The manager said that she was working towards this. It is recommended that this be achieved. Alcohol gel hand rub is provided at the entrance to all units for staff and visitors to assist in protecting residents from cross infection. There are good systems for separating and washing soiled laundry. There are contracts in place to dispose of clinical waste and staff were aware of these. Westgate House DS0000047098.V322621.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The staffing levels are good and staff have the necessary training to meet residents needs. EVIDENCE: A staff rota is kept. On the day of the unannounced inspection the staffing levels met the numbers recorded on the rota. The residents spoken to said that staff were able to meet their needs and to respond to their call bells. The residents who returned the questionnaires also confirmed this. There are no staff under the age of 18 and the manager said that no staff under the age of 21 would be left in charge. There are fifteen qualified nurses, forty-eight carers and twenty-two ancillary staff on the homes staffing list working a mixture of full, part time and bank contracts. The staff spoken to were complementary about the organisation and said that they felt that there were sufficient staff. One said that she travelled some distance because this was the best home she had worked in and she valued the support that was given to staff to maintain their skills and knowledge. The training records showed that staff had had the basic mandatory training and that specialist training was in place. The staff confirmed this. The staff spoken to on the dementia care unit had undertaken a two-day training course run by the Alzheimers society. Two carers were able to describe initiatives that they had learnt on the course that they felt they could implement and both said that they felt that they had a better understanding of the needs of people with dementia after the course. Westgate House DS0000047098.V322621.R01.S.doc Version 5.2 Page 17 Of the forty-eight carers on the staff team, thirteen hold the National Vocational Qualification in Care at Level 2 (27 ) and a further fourteen are working towards it. The home does not yet meet the standard that 50 of staff hold this qualification but is making good progress towards meeting it. The recruitment files of four members of staff were examined and all contained the required information and evidence that checks on identity, references and criminal records bureau checks are undertaken prior to the staff member commencing work. There is an in house induction programme and evidence was in the files to confirm that staff had undertaken this. New staff who undertake the National Vocational Qualification in Care at Level 2 commence the foundation programme, which meets the Skills for Care induction standards. Westgate House DS0000047098.V322621.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38 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 and the quality of care for residents is monitored regularly by the organisation. There are systems in place to protect residents and staff from harm arising from their care. EVIDENCE: The manager is an experienced home manager who has been appointed since the last inspection. She is currently registering with the Commission for Social Care Inspection. She is supported by a head of care and care leader on each of the residential wings. The staff spoken to said that the management team was approachable. The manager was clear of her targets for development during the next year. There are clear lines of accountability in the home. The Orders of St Johns Trust has a quality assurance system in place and evidence of regular audit was seen. Residents are asked their views and regular Westgate House DS0000047098.V322621.R01.S.doc Version 5.2 Page 19 residents and family meetings are held. Quality assurance visits were undertaken in line with Regulation 26 of the Care Homes Regulations 2001. Records of these visits were in the home and available for inspection. The pre inspection questionnaire showed that all policies and procedures had been updated at least once since 2004 and that there was an ongoing process of updating policies and procedures. The home does not act as agent or manage monies on behalf of residents. A small amount of personal allowance may be kept at the home for residents and records were seen to verify that receipts are given for receipt of money and for any expenditure made on behalf of the resident. There was some evidence that supervision and appraisal was in place for staff although the manager was clear that this had not yet been fully rolled out and identified this as a priority for the coming year. She had a clear plan as to how to achieve this. The pre-inspection questionnaire showed that regular servicing and maintenance of equipment takes place. There are health and safety policies and procedures in place and generic risk assessments have been undertaken to promote safe working practices. The staff spoken to had had manual handling training and the training matrix showed that a programme was in place to ensure that all staff had mandatory health and safety training with annual updates where required. Westgate House DS0000047098.V322621.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 2 X 4 STAFFING Standard No Score 27 4 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 2 X 3 Westgate House DS0000047098.V322621.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP9 OP24 OP26 Good Practice Recommendations It is recommended that residents allergies be written on the front sheet of the medication records. It is recommended that that bedroom carpets be replaced if it is not possible to remove stains. It is strongly recommended that all residents rooms have liquid soap and paper towels for the use of staff to prevent cross infection. Westgate House DS0000047098.V322621.R01.S.doc Version 5.2 Page 22 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. Extracts may not be used or reproduced without the express permission of CSCI Westgate House DS0000047098.V322621.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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