Inspection on 12/09/06 for Westgate House Nursing Home

This inspection was carried out on 12th September 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

Westgate House Nursing Home 09/05/08

Westgate House Nursing Home 28/11/05

Westgate House Nursing Home 30/06/05

Westgate House Nursing Home 01/11/04

Westgate House Nursing Home 05/04/04

Similar services:

Trevayler Residential Care Home

Thornham Grove

Thistle Hill Hall

Conifer Lodge

Westwood Lodge

Egerton Lodge Care Home

Alfred Minto House Care Home

St Matthews Unit

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

CARE HOMES FOR OLDER PEOPLE Westgate House Nursing Home Eastcote Road Gayton Northants NN7 3HQ Lead Inspector Mrs Linda Preen Unannounced Inspection 12th September 2006 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 Nursing Home DS0000012656.V311765.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 Nursing Home DS0000012656.V311765.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Westgate House Nursing Home Address Eastcote Road Gayton Northants NN7 3HQ 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) (01604) 859355 (01604) 858074 Mr James Byrom Mrs Patricia Byrom Mr James Byrom Care Home 41 Category(ies) of Dementia (41), Dementia - over 65 years of age registration, with number (41), Mental disorder, excluding learning of places disability or dementia (41), Terminally ill over 65 years of age (41) Westgate House Nursing Home DS0000012656.V311765.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. No one falling within the category MD (E) may be admitted into the home where there are 40 Service Users of this category already accommodated within the home. No one falling within the category DE (E) may be admitted into the home where there are 40 Service Users of this category already accommodated within the home. No one falling within the category DE may be admitted into the home where there are 41 Service Users of this category already accommodated within the home. No one falling within the category MD may be admitted into the home where there are 41 Service Users of this category already accommodated within the home No one falling within the category TI may be admitted into the home where there are 40 Service Users of this category already accommodated within the home. The age range for the Service Users in the category MD is 40 years and above Bedrooms numbered A50 and C6 may only be used to accommodate Service Users who are fully ambulant. 28th November 2005 2. 3. 4. 5. 6. 7. Date of last inspection Brief Description of the Service: Westgate House is a large nursing home situated in the outskirts of the village of Gayton near to Northampton. The home provides nursing and personal care for up to forty-one Service Users within the categories of Dementia, Mental Disorder and Terminal Illness. Fees range from £475 to £600 according to resident’s assessed needs. Westgate House Nursing Home DS0000012656.V311765.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two hours were spent prior to the inspection reviewing previous requirements and recommendations, and collating information provided by the service. The inspection took place over a period of five hours as part of the statutory inspection programme. Four residents were chosen in order that their experience in the home could be monitored by “Case Tracking”. This included looking at their records, talking to them and their relatives and also to the staff concerning the care received. In addition to this staff rotas and medication records were seen. A limited tour of the environment was undertaken. One relative spoken to during the inspection stated that he was satisfied with the care and that it could not be better. The Commission had sent out comment cards to a selection of residents prior to the inspection, and comment cards from relatives had also been received. Five Comment cards had been returned by relatives. All of these were complimentary concerning the care and service provided, with comments such as “ This is an excellent home which always strives to preserve the dignity of each patient” being made. A limited response had been received from residents owing to their limited understanding, but those who were able to comment, were happy with the service provided. What the service does well: There was a happy, friendly atmosphere in the home, and residents were well groomed and appeared relaxed and comfortable in staff presence. A group of residents visit a local public house once a week, to enable them to be integrated into the community, and residents were looking forward to this on the day following the inspection. In addition to this, several residents visit the local ”MIND” club weekly. The home has a commitment to staff training and employs a training manager to ensure staff are fully informed concerning the needs of residents. Twelve of the twenty- three carers currently hold a National Vocational Qualification in care, which gives them a basic understanding of residents needs, and a further six are working towards this award. Staff spoken to were aware of the special needs of the residents in their care and confirmed that they had received training in specific conditions relating to residents as well as receiving statutory training in Moving and Handling, Fire, Food Hygiene, Health and Safety and First Aid. Westgate House Nursing Home DS0000012656.V311765.R01.S.doc Version 5.2 Page 6 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 Nursing Home DS0000012656.V311765.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 Nursing Home DS0000012656.V311765.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): 1, 2, 3. Standard 6 does not apply in this home. Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. Thorough assessments and Terms and Conditions ensure that residents are confident that their needs may be met in the home. EVIDENCE: A Statement Of Purpose and Resident Guide, which set out the service to be provided are available in the home. These documents are currently under review to ensure recent legislation is included. Comprehensive assessments to include physical, mental and social aspects were available for the residents chosen to monitor. Evidence of consultation with relatives, carers and Health Professionals was available to ensure a full picture of resident needs was obtained. Copies of Terms and Conditions of residence were seen on these files. Westgate House Nursing Home DS0000012656.V311765.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 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 group is good. This judgement has been made using available evidence, including a visit to the service. Staff have the information required to ensure that all resident needs are met. Residents are treated with dignity and respect. Systems in place for the control of medication are satisfactory. EVIDENCE: Four residents were chosen to “Case Track” in order that their care in the home could be assessed. A new system of care planning is currently being introduced in order that staff have the necessary information in order to meet resident’s needs. Care plans are now in place for all assessed needs, but advice was given that information recorded in two separate documents should be cross-referenced in order that unfamiliar staff may be fully aware of this information. Residents seen appeared well groomed and well cared for, and approached staff freely during the inspection. Meaningful conversation was limited owing to the mental condition of many of the residents but their body language suggested that they were contented. One lady spoken to said she was happy Westgate House Nursing Home DS0000012656.V311765.R01.S.doc Version 5.2 Page 10 with the care provided by the home. Comment cards sent out to residents by The Commission prior to the inspection, confirmed that medical attention was provided when needed. One relative spoken to visits the home every day and stated that the care could not be better and that staff were very caring. Staff were observed to be treating residents with due respect to their privacy and dignity. Residents who are assessed as being at risk of developing pressure ulcers had the necessary pressure relieving devices in place, and those who had been admitted with pressure ulcers or developed these owing to their frail condition, had been referred to the Tissue Viability Nurse for her advice on treatment. This nurse visited the home during the inspection in order to monitor progress of this group of residents. Clear records of these wounds and their progress were available. A speech therapist was also present in the home, to provide training for staff concerning those residents who had difficulty swallowing, in order that their nutritional intake remained satisfactory. Residents identified as having a poor dietary intake had food records kept and were regularly weighed to monitor their situation. Systems for the ordering, storage, recording, administration and disposal of medication in the home were monitored and were found to be satisfactory except that some records of the administration of controlled medication still only had one signature and not the two as required. This was a requirement at the last inspection and is therefore only partly met. Westgate House Nursing Home DS0000012656.V311765.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 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 group is good. This judgement has been made using available evidence, including a visit to the service. Residents are encouraged to maintain contact with the Community and family and friends are encouraged to visit. EVIDENCE: Some residents attend the local “MIND” day centre and one attends a sheltered workshop. An Occupational Therapist is employed in the home to organise activities, and residents enjoy playing dominoes, card games and Bingo. A group of residents visit the local public house for lunch once a week, and one lady stated that she was looking forward to this on the day after the inspection. Records of resident choice concerning times of rising and retiring, and nighttimes routine were available. Staff spoken to confirmed that the daily routine was flexible and that residents could chose when to get up and go to bed. Westgate House Nursing Home DS0000012656.V311765.R01.S.doc Version 5.2 Page 12 Several visitors were in the home and one spoken to confirmed that he visited most days and was made welcome by staff. He is able to share a meal with his wife during his visits. Menus provided as part of the pre inspection questionnaire, demonstrate that a varied, nutritious diet is provided. Lunch was observed and appeared and smelled appetising. This meal was served at family sized tables, and residents requiring assistance to eat were offered this in an unobtrusive way, with due regard to their dignity. Comment cards confirmed that the standard of food was good. Westgate House Nursing Home DS0000012656.V311765.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 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 group is good. This judgement has been made using available evidence, including a visit to the service. Residents may be assured that they will be protected from abuse and that their concerns will be addressed in a professional manner. EVIDENCE: A complaints procedure is available on display in the entrance to the home. There have been no complaints received by the Commission for Social Care Inspection or to the home directly since the last inspection. Staff training records demonstrated that they have received training on the Protection of Vulnerable Adults and abuse, and those spoken to were aware of the different types of abuse, which may occur, and of their responsibility to report this. Westgate House Nursing Home DS0000012656.V311765.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 24, 25 and 26 Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. A safe, clean, well-maintained environment is provided for the residents. EVIDENCE: A limited tour of the environment was undertaken. This demonstrated that all areas seen were clean and tidy. The home has a bright, airy atmosphere. Many of the resident’s rooms have been redecorated in the last few months and new floor covering, furniture and curtains provided. Individual rooms showed evidence of personalisation, with small items of furniture, pictures and ornaments on display. Some residents have their own television to enable them to watch their own choice of programme. One resident showed her system for locking her room when she left it as some of the residents wander into other rooms by mistake. This system worked well Westgate House Nursing Home DS0000012656.V311765.R01.S.doc Version 5.2 Page 15 for her and she stated that she never locked the door when inside so she couldn’t get locked in accidentally. A range of communal lounges and a pleasant garden are available that residents are able to access at all times. Alarm systems are in place to alert staff if vulnerable residents leave the building unaccompanied. Ceramic tiles have been installed in the entrance hall where residents are allowed to smoke, and this provides an attractive, safe surface, free from the risk of burning. Westgate House Nursing Home DS0000012656.V311765.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 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 group is good. This judgement has been made using available evidence, including a visit to the service. Staff are provided with training and are in sufficient numbers to meet the needs of the residents. The homes recruitment policies protect residents from possible abuse. EVIDENCE: Staffing levels in the home appear sufficient to meet the needs of the current resident group. Nine staff provide care in the morning, seven in the afternoon and three staff at night. This includes at least one First Level registered Nurse at all times. A selection of staff files was seen. These demonstrated that recruitment practices are in place to protect residents from possible harm and include Criminal Records Bureau checks and references for all care staff. The registered Provider was advised that Criminal Records Bureau checks were also required for kitchen staff although they have little direct contact with residents. She undertook to address this shortfall as soon as possible. An equal opportunities policy is in place, with staff from a wide age range, ethnic backgrounds and sex being employed. Some staff with minor physical Westgate House Nursing Home DS0000012656.V311765.R01.S.doc Version 5.2 Page 17 disabilities are employed but this is limited by the physical nature of the work involved. The home has a commitment to staff training and a training officer is employed to oversee this area of the home. Currently twelve of the twenty three care staff hold a National Vocational Qualification in care which gives them an introduction to the care needs of residents, with a further six staff working towards this award. Four staff have completed the Registered Managers Award since the last inspection. This gives training in the management aspects of running a care home and ensures that an experienced person is available to manage the home at all times. Staff training records demonstrated that in addition to statutory training in Fire, Food Hygiene, Moving and Handling, Health and Safety and First Aid, staff receive training specific to the needs of residents in the home. For example diabetes mellitus, wound care and abuse. Staff spoken to confirmed they had received this training. Overseas qualified nurses are employed in the home whilst they undergo adaptation training to enable them to be registered in this country. Two staff spoken to were pleased to report that they had just been accepted by the Nursing and Midwifery Council as having completed this programme and were now registered to practice in this country. A speech therapist was in the home to provide training for staff in the feeding of residents with swallowing difficulties. Staff receive regular supervision concerning their progress in the home and to identify training needs. This supervision is carried out by the training manager and was confirmed by staff interviewed. Westgate House Nursing Home DS0000012656.V311765.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. The Registered Manager ensures that the home is run efficiently, in a way that serves the best interests of the residents. EVIDENCE: The provider who is an experienced Registered Nurse and qualified social worker, assisted by his wife as business manager, runs the home. She is also experienced in caring for this resident group and holds the Registered Manager’s Award. In addition to this, a Training Manager as well as a Quality Assurance Auditor are employed. Westgate House Nursing Home DS0000012656.V311765.R01.S.doc Version 5.2 Page 19 The home holds ISO2000 quality award and undertakes regular audits as part of this scheme to ensure good standards of service are maintained. In addition to this a Registered Nurse is responsible for the regular auditing of care plans. A new fire alarm system was being installed during the inspection to ensure that new legislation, which comes into force in October, is complied with. Radiators in the home have been provided with covers in order to reduce the risk of residents burning themselves on the hot surface. No other health and safety issues were identified during the limited tour of the environment undertaken. All residents in the home are subject to Power of Attorney to control their financial interests and the home has no responsibility in this respect. They do however manage small pocket money accounts for residents and good records of these individual accounts were available for inspection. Advice was given that a second member of staff should witness transactions from these accounts where the resident did not have the mental or physical capacity to sign as witness themselves. This would afford protection to both staff and resident in case of a dispute over these accounts. Westgate House Nursing Home DS0000012656.V311765.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 3 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 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 3 3 X X X 3 3 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 X 3 X 2 X X 3 Westgate House Nursing Home DS0000012656.V311765.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 OP7 OP9 Good Practice Recommendations Care plans should be modified to ensure the necessary documents are cross -referenced to allow staff to have complete guidance on the care required. Staff should be reminded of the requirement that all administration of controlled medication should be witnessed by a second person. Criminal Records Bureau clearance should be obtained for catering staff as discussed. OP29 Westgate House Nursing Home DS0000012656.V311765.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 Nursing Home DS0000012656.V311765.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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