Inspection on 29/11/07 for Westholme

This inspection was carried out on 29th November 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

Westholme 04/08/06

Westholme 14/09/05

Westholme 20/04/05

Westholme 14/12/04

Westholme 01/07/04

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 Westholme 55 Harestock Road Winchester Hampshire SO22 6NT Lead Inspector Kathryn Kirk Unannounced Inspection 29th November 2007 09:00 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 Westholme DS0000039597.V349437.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. Westholme DS0000039597.V349437.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Westholme Address 55 Harestock Road Winchester Hampshire SO22 6NT 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) 01962 881481 Hampshire County Council Mr Gerald Frizell Care Home 67 Category(ies) of Dementia (67), Dementia - over 65 years of age registration, with number (67), Old age, not falling within any other of places category (67) Westholme DS0000039597.V349437.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users must be over 60 years on admission. A maximum of 37 service users requiring nursing care may be accommodated. 4th August 2006 Date of last inspection Brief Description of the Service: Westholme is owned by Hampshire County Council and provides nursing care, personal care and accommodation for up to 67 older persons. Any within this number can have been diagnosed with dementia. The home, which is purpose-built, is organised into five small self-contained units, each with their own kitchenette, dining room and sitting room. Accommodation is arranged on two floors with a passenger lift providing access to the first floor. Six communal bathrooms are available to service users, two of which benefit from assisted baths. Other aids and adaptations have been fitted throughout the home, to assist residents to maintain their independence. Accommodation is arranged around a central paved courtyard, providing additional seating areas and raised flowerbeds. The home is located on a main residential road on the outskirts of Winchester, and is accessible to local amenities and transport. Current fees, as given in November 2007, are £464 per week. Westholme DS0000039597.V349437.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. All key National minimum standards have been reviewed during this inspection. Evidence for this report was gathered in the following ways: The manager completed an annual quality assurance document, which provides information about how the service is currently operating. Surveys were completed by three relatives, four staff and one health care professional Information gathered during the previous inspection of August 2006 and information received by CSCI since this time was also reviewed. A visit to the service took place on 29 November 2007. This lasted for 7 hours and during this time the manager; four staff, six residents, one relative and one visiting health care professional gave their views about the home. Time was spent in the company of service users who were unable to provide verbal feedback. The quality of interactions between service users and staff were also observed. The home was toured and some paperwork was examined. No requirements or recommendations have been made as a result of this inspection. What the service does well: In surveys conducted by the home and by CSCI relatives said that they were happy with the overall care provided. Comments included: “I am delighted with all aspects of … care” “The care/nursing home is excellent ” from “Most of the staff you get a very warm, friendly greeting” “Always looks very clean and tidy” “They seem to look after my mum well” Staff comments included: “Westholme is a very good home with all the facilities to provide a safe environment in which service users are well looked after and cared for” Westholme DS0000039597.V349437.R01.S.doc Version 5.2 Page 6 “ We promote residents independence and choice and encourage them to do as much as possible for themselves” Westholme “provides a happy caring environment” “Ongoing training programme is good.” “I’m well supported and listened to by my manager and I feel valued” Other evidence gathered as part of this inspection supports these views. The service is well managed and there are effective quality assurance systems in place. This means that the service is regularly evaluated as to how well it is meeting its aims and objectives. One particular area of good practice is that the manager or senior in charge walks around the home every morning and visits all service users. Any concerns are noted and are discussed with staff on the unit. 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. Westholme DS0000039597.V349437.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 Westholme DS0000039597.V349437.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 Standard 6 does not apply Quality in this outcome area is good. Enough detailed information is gathered about prospective service users to ensure that they are admitted appropriately to this service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All prospective service users have a care management assessment of need. This covers all aspects of personal; health and social care needs and considers any risk factors. The care management assessment helps to establish whether the service will be suitable to meet people’s needs and wishes. Westholme DS0000039597.V349437.R01.S.doc Version 5.2 Page 9 The manager said that all who are able, come to Westholme for a day visit and a further assessment of their needs is made by staff at the home. Those who are not able, are visited and assessed by a senior member of staff. The annual quality assurance audit states that all new service users have a six week trial period in the home. A review of the placement takes place after this time before it becomes permanent. All service users and their relatives are provided with an information pack about the service. Intermediate care is not provided. Westholme DS0000039597.V349437.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good Peoples health, medical and care needs are understood and are well managed. Privacy and dignity is respected This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two care plans were seen. These included information about service users needs, wishes and interests. Any cultural or religious requirements were considered. Plans of care were written in such a way as to ensure that peoples abilities as well as what they need assistance with was documented. Care plans seen had been reviewed every month and so were up to date, and had been signed where possible by the person concerned to indicate their Westholme DS0000039597.V349437.R01.S.doc Version 5.2 Page 11 agreement. Staff said that relatives and where relevant health care professionals are consulted in the care planning process. This ensures that the information is as accurate as possible. Staff surveyed generally felt that the written and verbal information they received was sufficient to ensure that they could provide appropriate care to service users. The annual quality assurance audit confirms that staff that undertake risk assessments, for example in moving and handling are trained to do so. Up to date assessments for moving and handling and for other areas of identified risk, were seen on service users files. Since the last inspection the manager said that staff have had training in falls prevention. The three Relatives that returned surveys from The Commission for Social Care Inspection all felt that the care home always meets the needs of their relative. They said that staff always give the support or care to their relative that they expect. This was echoed by relatives who had responded to the services own survey. One health care professional said that health care at the home was generally fine. Nursing staff said that two senior nurses have recently undertaken training in Liverpool Care pathways and these staff have plans to cascade this training to other members of the team. The annual quality assurance audit states that all relevant staff are trained in management of medicines. Staff on the day of the visit confirmed this and said that they felt that medication systems within the home were good. There are regular audits of medicines by senior staff and medication is also checked at random by a senior member of the organisation during a monthly quality assurance visit. Staff were observed to speak with service users in a friendly and respectful way. Staff always knocked on bedroom doors before entering and attended to service users personal care needs discretely Westholme DS0000039597.V349437.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14, 15 Quality in this outcome area is good The service provides appropriate social activities. People are consulted about their daily routines and preferences and their views are taken into account. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Relatives surveyed by the home generally felt that activities provided were satisfactory. At the time of the visit, a music session was being held. People were observed to be given a choice as to whether they wished to attend and staff were sensitive about where it was held so that those that liked a quiet environment were not disturbed. Ten service users took part in the group. They all actively participated and looked to be enjoying it. Staff said that the music session takes place once a week. In the nursing unit staff were observed to provide activities for service users on a one to one basis. Staff said that religious preferences are observed- a multi denominational service is held in the home and two service users currently attend local church Westholme DS0000039597.V349437.R01.S.doc Version 5.2 Page 13 services. The manager said that the service has developed links with the local Alzheimer’s support group. He said that he aims to further improve in house activities, for example by creating a sensory garden in the enclosed courtyard. Relatives surveyed said in general that staff help their relative to keep in touch with them and that they are kept up to date with important issues. They confirmed that they could visit in private if they wish. These views were confirmed by a visitor to the home at the time of the visit. Through discussion with staff it was apparent that they understood the importance of good communication with service users family and friends. There was evidence that autonomy and choice is promoted, for example: Service users are entitled to bring some personal possessions with them to the home; Service users have access and are involved in their plans of care; They are also given a choice of food and are able to decide where they wish to eat their meals; The manager said that menus have been changed at the request of some service users to include particular food preferences. Time was spent with service users and staff over a lunchtime. Staff were observed to be interacting positively with service users. People were given plenty of time to eat their meals and those that needed it were given appropriate assistance. The annual quality assurance audit states that the home caters routinely for special diets. It also states that peoples nutritional needs are assessed and reviewed where this has been identified as a need. Relatives generally felt that food was satisfactory and on the day of the visit food was well presented. Westholme DS0000039597.V349437.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good Complaints and adult protection procedures are followed to ensure that people’s wellbeing is protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information on how to complain is available in the foyer of the home and is also part of the service users guide, which is available to all service users and their families. Surveys however, indicated that not all relatives were clear about the complaints procedure. The home keeps a record of complaints and also of positive comments. The record of complaints reflected that two complaints have been made in the last twelve months and that these had been responded to in an appropriate and timely way. Records also showed that any smaller concerns, for example, stated on relative’s questionnaires, had also been followed up. The annual quality assurance audit states that all staff are trained in adult protection matters and this was confirmed by staff who were asked about this on the day of the visit. There was evidence that staff had followed procedures appropriately to ensure that service users are safe. Westholme DS0000039597.V349437.R01.S.doc Version 5.2 Page 15 Westholme DS0000039597.V349437.R01.S.doc Version 5.2 Page 16 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 and 26 Quality in this outcome area is good Residents live in a comfortable environment, which has been adapted to meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In January 2007 the service application to vary its registration conditions to allow an increase the numbers and to include some nursing care accommodation was completed successfully. As part of this process the premises were assessed to ensure that they were suitable and this was found to be the case. No changes have taken place since this time, except that windows have been replaced to the front of the home. Westholme DS0000039597.V349437.R01.S.doc Version 5.2 Page 17 On the day of the visit the home was clean warm and tidy. Two service users asked said that they were comfortable in the home. Relatives surveyed agreed that bedrooms were comfortable, and that the home was clean. Laundry and sluicing facilities are appropriately sited and properly equipped. Hand washing facilities contained liquid soap and disposable towels and staff were observed to follow infection control procedures for example, by using protective clothing. Westholme DS0000039597.V349437.R01.S.doc Version 5.2 Page 18 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): 27,28,29,30 Quality in this outcome area is good Well-trained staff support current service users effectively. The service could further improve by recruiting more permanent staff. Recruitment procedures are thorough. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Nearly half of the relatives surveyed by the home felt that there was not always enough staff on duty. Staff felt that they are sometimes stretched, particularly at weekends and if there is a need to cover sickness. Staff generally felt that more permanent staff are needed, so that they can get to know service user and become familiar with their needs and ways in which they communicate their wishes. The annual quality assurance audit identifies that there has been a relatively high number of agency staff employed in the home in the last twelve months. The manager said this is to cover six care worker vacancies. Westholme DS0000039597.V349437.R01.S.doc Version 5.2 Page 19 The manager and a senior manager said they have taken the following measures to address this: They use the same agency staff wherever possible and only employ those who have been found to work well with service users; The service is actively trying to recruit new care workers; One of the nursing units has yet to open and will not do so until sufficient permanent staff are in post. The rota shows that there are additional staff on duty at peak times of activity during the day, Domestic staff would appear to be employed in sufficient numbers as good standards of hygiene were being maintained and standards relating to food were being met. All Relatives surveyed by CSCI felt that staff have the right skills and experience to look after people properly. Representative comments were “staff friendly and polite” and “staff are very kind and patient” According to the annual quality assurance audit 50 of staff have achieved an NVQ level 2 in Care This meets National Minimum standards. All staff surveyed said that they felt that their induction training covered everything that they needed to know to do the job when they started They also said that ongoing training is relevant and helpful to their role. Staff spoken with agreed with these views. Comments from staff included “Hampshire County Council has a very comprehensive training calendar”and “dementia training very helpful” The manager confirmed that all staff have had satisfactory pre employment checks and staff surveyed all agreed that proper checks had been carried out. Two staff records were checked for further evidence that robust recruitment procedures are being followed. All the necessary documentation was present although some had to be sent to the home as it was being held centrally. . Westholme DS0000039597.V349437.R01.S.doc Version 5.2 Page 20 Westholme DS0000039597.V349437.R01.S.doc Version 5.2 Page 21 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 and 38 Quality in this outcome area is good The home is well managed and the quality of the service is regularly monitored. Procedures are followed to help to protect service users health and safety. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is Mr Gerald Frizell and he successfully completed the registration process in January 2007 to be come registered manager for this service. Westholme DS0000039597.V349437.R01.S.doc Version 5.2 Page 22 He has over 32 years managerial experience working in the field of older persons and people with dementia related illnesses. Mr Frizell completed NVQ Level 4 in Management in 2004 and is a qualified nurse. He has undertaken a whole range of certificated training courses as well as management courses. Mr Frizell demonstrated a very good understanding of his role and staff surveyed were satisfied with the support given to them by the management team. One for example, said, “the manager is always available to see you and to discuss any difficulties” The manager or one of the assistant managers tours the building every day to see every service user. Any concerns are noted and discussed with staff on the unit. This tour was observed during the visit to the home. There was evidence that people are surveyed about their views on the home. Twenty relative surveys had been completed in the last 3 months and any comments made about how to improve the service had been addressed by the manager. The manager said that service users are mainly unable to complete survey forms because of their dementia. Staff are are looking at different ways to obtain their views, for example, they are considering pictorial survey forms. Monthly residents meetings are held. A monthly audit of the service is undertaken by a senior member of the organisation. Records of the reports made as a result of these visits were seen. The manager confirmed that secure facilities are provided for the safe keeping of money or valuables. The Annual Quality Assurance Audit demonstrates that safe working practices are observed and that safety systems and equipment within the building are appropriately maintained. Westholme DS0000039597.V349437.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 Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Westholme DS0000039597.V349437.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. 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. Refer to Standard Good Practice Recommendations Westholme DS0000039597.V349437.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Westholme DS0000039597.V349437.R01.S.doc Version 5.2 Page 26 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!