Inspection on 09/12/05 for Westgate House

This inspection was carried out on 9th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 04/01/07

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 Jane Handscombe Unannounced Inspection 9th December 2005 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 Westgate House DS0000047098.V271943.R01.S.doc Version 5.0 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.V271943.R01.S.doc Version 5.0 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 The Orders Of St John Care Trust Care Home 60 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 (60), Physical disability over 65 years of age (30), Terminally ill over 65 years of age (5) Westgate House DS0000047098.V271943.R01.S.doc Version 5.0 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 60. Up to a maximum number of 20 places may be used for nursing needs. 21st July 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 who are 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 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. Westgate House DS0000047098.V271943.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection that took place on the 9th December 2005. The purpose of the visit was to see how the home is meeting the National Minimum Standards. The visit involved speaking to residents in order to ascertain their views on the care and the services they receive at the home, speaking to the staff members and the manager of the home and viewing care plans and assessments whilst observing the general day to day operations of the home. The home presented as one which was clean and tidy throughout. Residents were going about their daily activities in a calm relaxed manner. Staff were seen to provide care and support in an unhurried manner whilst addressing their needs appropriately. Comments received from residents during the inspection included: • • • • ‘The staff are very good, they spoil us’ ‘the staff always knock before entering’ ‘the manager is very astute and keen to get on with her work. She is very approachable and helpful’ ‘my room is smashing, very new and comfortable’ The following comment was received from a district nurse in contact with the home: • ‘the staff I come into contact with are very helpful and carry out any changes which I suggest for residents’ The inspector would like to thank the residents, their families and staff members for their assistance during this inspection. What the service does well: The home is maintained to a good standard and provides a warm, homely atmosphere. Staff were observed to work well as a team and were seen to be respectful and to interact with the residents in a manner that was thoughtful and considerate of their needs. Westgate House DS0000047098.V271943.R01.S.doc Version 5.0 Page 6 Meals provided at the home are varied, well balanced, offer choice and are well presented. All residents spoken to were complimentary of the meals provided at the home. Residents are provided with an excellent varied programme of activities and events which are provided during the daytime, evenings and weekends 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. Westgate House DS0000047098.V271943.R01.S.doc Version 5.0 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.V271943.R01.S.doc Version 5.0 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): 1 Prospective service users are provided with comprehensive information about the home and the services it offers to all prospective residents, to allow them to make an informed choice when choosing a home suitable for their needs. EVIDENCE: Westgate House has a comprehensive and detailed statement of purpose and service users’ guide that all prospective residents are provided with. A trial visit is offered whereby prospective service users can meet fellow service users and members of staff in order that they can make an informed choice about where to live. Westgate House DS0000047098.V271943.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 and 10 The care planning system within the home is very complex and there are inconsistencies in the documentation used. Because of this it is unclear whether assessed care needs are being met. The nutritional needs of the residents are not being fully assessed. Staff understand the issues of privacy and dignity, and always treat the residents with respect. EVIDENCE: The inspector examined a sample of care plans and found that the documentation used for care planning is very comprehensive and in some instances there is duplication of information. This makes it time consuming and difficult to find out what the care needs are and how they are to be met. The care plans are reviewed although it was observed in a few cases that both the residents’/representatives’ and assessors’ signatures had not been gained to evidence that an appropriate consultation took place, and therefore a requirement has been made within this report. Westgate House DS0000047098.V271943.R01.S.doc Version 5.0 Page 10 Any changes to the care plans are recorded in the daily record but do not get uplifted onto the care plans. In the inspector’s view it is not good practice that changes in the residents’ care needs are not uplifted onto the care plan and could lead to the residents’ care needs not being fully met. It is recommended that the whole care planning process is discussed with all the staff who are involved in care planning to ensure that all of the care plans clearly reflect the resident’s individual care needs and how these will be met. One of the care plans examined identified that the resident had a wound but there was no description of the wound, including measurements or photographs, to enable the mapping of progress or deterioration of the wound. It is recommended that any wounds should be described in detail in the care plan to include measurements, diagrams or photographs so that progress can be measured. The nutritional risk assessment tool is not being completed in accordance with the guidelines, and there are inconsistencies in completing the documentation. The inspector observed two very informative documents - firstly ‘Know your Resident’ which gave detailed information about the resident’s care needs and is kept on the back of the resident’s wardrobe door and, secondly, a handover summary sheet that identifies all the residents and sets out what their care needs are and any other problems. A new bank nurse who was working her first shift on the nursing wing found these to be very helpful. The inspector observed staff assisting the residents in an appropriate and respectful manner. Westgate House DS0000047098.V271943.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Contact with family, friends and the local community is encouraged and support is given where required.. A varied programme of activities satisfies the recreational interests of the residents. EVIDENCE: The inspector met with the activities co-ordinator who has developed an excellent programme of activities and social events for the residents. Her working hours are flexible so that she can provide events in the evenings and at weekends to suit the residents. This is commendable and reflects the focus of all the activities being planned around and for the residents. Every two months an event is arranged for relatives, and family days are much appreciated and supported. A restricted number of residents are able to attend the day centre adjacent to the home from 10.00am to 11.45am, Monday to Friday. A new activities log has just been implemented and this will provide a detailed account of the residents’ social and recreational needs and how these are being met. Westgate House DS0000047098.V271943.R01.S.doc Version 5.0 Page 12 Relatives and visitors are made very welcome and those spoken to enjoyed visiting the home. Westgate House DS0000047098.V271943.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 There are policies and procedures in place to guide the manager and staff on how to respond to any suspicion of abuse. Training is provided to all members of staff to assist them in becoming aware of their own care practices, to recognise signs and symptoms of abuse and to emphasise each staff member’s responsibility to ‘whistle blow’ on any poor practice or concerns that come to their attention. EVIDENCE: The home has procedures in circumstances where there are any suspicions concerning possible abuse. Staff are all aware of the procedures and have attended training on the protection of vulnerable adults and are clear on the procedures to follow. Westgate House DS0000047098.V271943.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20, 21, 22, 23 and 25 The home was purpose built and offers all the essential facilities required of a care home with nursing. The décor and furnishings are of a high standard and afford a comfortable and pleasant home for the residents. The home is well appointed and provides a very pleasant, homely and comfortable environment for the residents. EVIDENCE: At the time of this inspection the residents were busy going about their daily activities and were observed using the attractive communal lounges that afford a choice of environment for them to enjoy. All areas of the home are cleaned to a high standard and there were no unhygienic odours. Westgate House DS0000047098.V271943.R01.S.doc Version 5.0 Page 15 One room examined was found to have a badly stained carpet that had been seen on the previous inspection. A new resident now occupies the room and the same unsightly stains were visible. It is recommended that any bad carpet stains should be removed or the carpet replaced before a new resident occupies the room. Residents have access to all their communal and private space through the provision of specialist equipment such as ramps and a passenger lift. The home also provides grab rails in corridors, bathrooms and toilets. All rooms viewed had en-suite facilities. Toilet washing and bathing facilities are provided in sufficient numbers and at locations that are suitable and convenient for the residents. One bathroom was found to have a notice displayed on the inside of a cupboard door with details pertaining to one particular resident which was a breach of the individual’s privacy and dignity. A requirement has been made within this report to address this issue. A call system with an accessible alarm facility is provided in all rooms, in order that residents can call staff in the case of an emergency. Westgate House DS0000047098.V271943.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28,29 and 30 A thorough recruitment procedure is in place to ensure the health, safety and well-being of the residents in their care. However, it was found that this was not being adhered to in all cases. Staff undergo the appropriate training to meet the residents’ needs. EVIDENCE: The recruitment procedures at the home were generally robust with clear monitoring systems in place to promote the protection of service users, including application form, interview notes, references and Criminal Records Bureau (CRB) check being sought. However, one personnel file evidenced that only one reference had been sought and not two as is required. All members of staff undergo induction training upon appointment to their posts, and are offered ongoing training which equips them to meet the assessed needs of the residents within the home. The bank nurse in charge was working her first shift in the home and said that she had a very good induction prior to this, working alongside other nurses. Westgate House DS0000047098.V271943.R01.S.doc Version 5.0 Page 17 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, 33 and 35 Westgate House is a well managed home, run in the best interests of the residents using the service, with safeguards in place to protect their health, safety and welfare. There are clear, robust systems in place to protect the residents’ financial interests. EVIDENCE: The inspector met with the administrator and discussed the management of the residents’ finances. The systems and records were examined and found to be in good order and provided a clear audit trail to safeguard the residents’ financial interests. Westgate House DS0000047098.V271943.R01.S.doc Version 5.0 Page 18 The manager is in the process of undergoing registration with the Commission for Social Care Inspection. She presents as a caring, competent and dedicated manager of the home, with a sound knowledge of the issues relating to the elderly. A score of 2 has been assigned to this standard since registration is still in process and therefore does not fully meet the standard. Comments from both staff and residents around the management were positive. One member of staff informed the inspector that ‘the manager is approachable’ whilst another stated ‘she is lovely’. The home undertakes quality assurance surveys in order to gain feedback on the services provided and the care given, along with monthly monitoring of meals to ensure that the residents’ needs and preferences are sought. Westgate House DS0000047098.V271943.R01.S.doc Version 5.0 Page 19 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 3 x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 x 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 3 x 3 3 3 3 x 3 x STAFFING Standard No Score 27 x 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x 3 x x x Westgate House DS0000047098.V271943.R01.S.doc Version 5.0 Page 20 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 OP7 Regulation 14(1)c Requirement The manager must gain both the residents/representatives signatures and that of the assessors to evidence that an appropriate consultation regarding the assessment took place. The manager must raise the issue of notices on display with regard to the residents dignity and respect with all staff. The manager must ensure to gain two written references in respect of any member of staff proposing to work at the home before employment, and these must be held on file. The manager must forward in writing to CSCI confirmation that a second reference has been undertaken with regard to the identified member of staff. Timescale for action 13/01/05 2. OP10 12(4)a 13/01/05 3. OP29 19 Schedule 2 09/12/05 4 OP29 19 Schedule 2 13/01/05 Westgate House DS0000047098.V271943.R01.S.doc Version 5.0 Page 21 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 OP7 Good Practice Recommendations It is recommended that the whole care planning process is discussed with all the staff who are involved in care planning to ensure that all of the care plans clearly reflect the resident’s individual care needs and how these will be met. It is recommended that any wounds should be described in detail in the care plan to include measurements, diagrams or photographs so that progress can be measured. It is recommended that any bad carpet stains should be removed or the carpet replaced before a new resident occupies the room. 2 OP7 3 OP26 Westgate House DS0000047098.V271943.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU 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. Extracts may not be used or reproduced without the express permission of CSCI Westgate House DS0000047098.V271943.R01.S.doc Version 5.0 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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