Inspection on 04/08/06 for Westholme

This inspection was carried out on 4th August 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

Westholme 29/11/07

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 4th August 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 Westholme DS0000039597.V300416.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.V300416.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 TO BE CONFIRMED Care Home 28 Category(ies) of Dementia - over 65 years of age (28), Old age, registration, with number not falling within any other category (28) of places Westholme DS0000039597.V300416.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th September 2005 Brief Description of the Service: Westholme is owned by Hampshire County Council and provides personal care and accommodation for up to 28 older persons. It is registered to accommodate older people who are over the age of sixty-five. Any within this number can have been diagnosed with dementia. The residential unit is currently being refurbished and so all service users have moved temporarily into a new wing. Service users will return to the original residential block when work has been completed and Hampshire County Council will apply to register the new wing for nursing care. 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 May 2006 are £434 per week. Westholme DS0000039597.V300416.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Visits to this service took place on 4 August 2006 and 8 August 2006. At the time of the visits, twenty-three service users were living at Westholme and two service users were having a short stay. Seven service users spoke about life in the home and commented on the quality of service provided. Other service users needs were such that they were unable to contribute verbally and so time was spent with them observing how staff interacted with them and how they were cared for. Other evidence gathered for this report was obtained through talking to the staff, talking with one visitor and two visiting professionals, touring the building and by looking at some paperwork in the home. Other evidence was gathered from a pre inspection questionnaire, which had been completed by the manager and sent to CSCI and from reports of monitoring visits to the home. The findings of the previous inspection report of September 2005 were also reviewed. What the service does well: What has improved since the last inspection? Westholme DS0000039597.V300416.R01.S.doc Version 5.2 Page 6 There were a number of areas that needed improvement in the environment of the original unit. This has been addressed as part of the current refurbishment programme. There is a new system in place for monitoring service users nutritional needs. This is of particular benefit to those who have been identified as being at risk in this area. 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. Westholme DS0000039597.V300416.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.V300416.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 and 6 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. There is good information available to current and prospective residents and their families about the service. Intermediate care is not provided. EVIDENCE: There is an up to date statement of purpose available for all prospective service users and their families. This gives details about the staffing levels and skills, the procedure for being admitted and other information about the service offered. A service user guide is provided and people are also given a sample contract, a copy of the complaints procedure and a copy of the most recent inspection report. People therefore have a lot of written information about the home. The manager said that people who have been admitted to the new wing are told that this is only a temporary arrangement and that when the residential unit has been completed existing residents will transfer over. There was nothing in writing about this in any of the documents provided and it was Westholme DS0000039597.V300416.R01.S.doc Version 5.2 Page 9 discussed with the manager that this information should be included so that it properly reflects the service offered. The statement of purpose says that all residents moving into the home do so through care management assessment, usually undertaken by a care manager in the local area office. Service users files seen during the visit contained a completed assessment of need, covering all aspects of health and personal care needs, although in some instances social interests and information about the service users previous life was limited. The home does accept emergency admissions and there is a procedure in place for them to follow to ensure that peoples’ needs are known and provided for. The home does not offer intermediate care. Westholme DS0000039597.V300416.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 and 10 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Care plans identify skills and needs and staff work effectively to them. Staff offer appropriate assistance to ensure that health care needs are met. Privacy and dignity is respected within the home. Policies and procedures for dealing with medicines safeguard service users. EVIDENCE: Three care plans were seen. These were very detailed and provided information for carers about what service users could do, as well as what they needed help with. Records showed that action identified as necessary in care plans, for example monitoring of fluid intake, was carried out consistently by staff. Care plans were seen to be kept in service users bedrooms and had been signed by the service user to indicate their agreement. One visitor spoken with said that they had been asked to provide information about their relatives’ former life and interests. Westholme DS0000039597.V300416.R01.S.doc Version 5.2 Page 11 Information about health needs is contained within the plan of care. A local GP visits every week. Health care professionals confirmed that they are able to see service users in private and that staff call on them for assistance appropriately. The home has recently started a nutritional screening programme for all service users and those that have been identified as needing additional assistance in this area were being monitored. Some care staff have received training in this area and catering staff have been given guidance on what food to prepare to provide the most nutrition. Staff were observed to treat service users respectfully and service users confirmed that this was always the case. Staff were also observed to knock on bedroom doors before entering. The home has a monitored dosage system for medication. No service user self medicates although a lockable space is provided in each bedroom so that service users could manage their own medication, if this is their wish and if they are able to do so safely. Medication administration sheets seen had been filled in properly. Staff are given guidelines about when to administer ‘when required’ medications. Staff asked were able to say when they would give, for example, pain relief and knew side effects of different drugs. Medical trolleys were safely and securely stored. Controlled medicines were also properly stored and recorded. Medicines needing to be stored in fridge were kept appropriately at the correct temperatures. A list of returned medications is also kept and this was seen to be up to date. Staff confirmed that they did not administer medication until they have completed a medication training course. Staff said that they are happy with the current system. Westholme DS0000039597.V300416.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home provides appropriate routines and activities to match interests and preferences. Food is good with sufficient choices to suit all. EVIDENCE: Staff were observed to give service users appropriate support at mealtimes. Service users were not hurried and were asked where they wished to sit. Service users asked said that they did not know what was on the menu that day. Food came from temporary kitchens in heated trolleys. It was seen to be hot when served. Staff had list of what service users wanted and said that service users had been asked about this previously. One staff member was observed to gently redirect a service user who was growing a little agitated. Staff were observed to work calmly and appeared confident in their role. One Service user spoken with said that they liked the food on offer and that they had enjoyed a recent puppet show. Visitors and service users asked said that the food was very good. One visitor said that they could eat with their relative as long as they gave notice to the cook. One service user, who was observed not to want dinner, was seen later to have banana and custard. Those that did not wish to eat were Westholme DS0000039597.V300416.R01.S.doc Version 5.2 Page 13 encouraged to do so and were given appropriate help. Staff said that activities had fallen off a bit since the move to the new accommodation and said that it can be difficult to co ordinate activities in small group settings. The manager agreed that more structure is needed in the current environment to co ordinate activities effectively. Visitors said always made to feel welcome by staff, that they were kept informed of their relatives progress and that there were no restrictions on visiting. They also said that they could visit in private if they want to. A Visitor also said that their relative was able to bring in their own possessions to their bedrooms and rooms seen had been personalised. Westholme DS0000039597.V300416.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 The quality in this outcome area is good. This judgement has been made by using available evidence, including a visit to the service. Complaints are dealt with promptly and effectively. Policies and procedures, which are understood and followed by staff, help to protect service users from abuse. EVIDENCE: A copy of the complaints procedure was seen in all bedrooms viewed and the manager said that this is provided to all as part of the admissions pack. No complaints about this service have been received either at the home or by The Commission for Social Care Inspection. Records showed that all staff have training in the protection of vulnerable adults. There are policies and procedures in place to protect vulnerable adults and staff spoken with demonstrated that they have a good understanding of them. Staff at the home handle small amounts of money on behalf of service users. All withdrawals to these accounts that were seen had been signed by two members of staff. The manager also conducts spot checks on the records of money held to ensure that they are accurate. Money was found to be securely and individually stored. Money held that was checked tallied with records. Westholme DS0000039597.V300416.R01.S.doc Version 5.2 Page 15 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 and 26 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The environment is comfortable and communal and individual areas suit needs of service users. EVIDENCE: The home was observed to be very clean and tidy on the day of the visit and service users asked said that this was always the case. There were names on every door and most bedroom doors had a different picture to help service users identify which room was theirs. The Manager said that photographs and names of staff would be displayed in corridor, to help service users and their visitors know who is who. Toilets were clearly marked. One service user however said that they could find their bedroom but cannot always find toilets. There is an enclosed courtyard garden and the home provides a smoking room upstairs. It was discussed with staff that it would take some time for those on first floor to get down to ground floor to access the garden area. The home is divided into small group living facilities with a number of living/dining rooms Westholme DS0000039597.V300416.R01.S.doc Version 5.2 Page 16 and toilet areas. Through talking with staff and observation it was evident that these arrangements can prove a challenge, in terms of providing activities. The laundry is temporarily sited but facilities are appropriate. The home is to be commended in the care that has been provided in the care of residents clothing. There are plentiful supplies of paper towels and liquid soap and staff were observed to wash their hands regularly. Westholme DS0000039597.V300416.R01.S.doc Version 5.2 Page 17 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 The quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. There are enough skilled staff on duty at all times to give appropriate support. Recruitment policies protect service users. EVIDENCE: Examination of the rota shows that there is at least one senior staff member on duty at all times and that each unit also has at least one care staff in attendance. The home also employs cooks, cleaners laundry staff and administrative staff. It was observed that for a short time no staff were supervising in one unit because they had to assist another member of staff with emergency in the adjoining unit. The only inconvenience for service users was that they had to wait for their lunch to be served The manager said that staff are flexible and so that any shortfalls in staffing numbers, caused by sickness or by staff going on training are adequately covered. This was found to be the case during the inspection and one visitor spoken with said that they generally found that there were enough staff on duty to care appropriately for their relative. The manager said that staff have a four day compulsory training course in dementia. All complete a generic induction programme, which includes moving and handling, first aid and health and safety. Every six months staff have Westholme DS0000039597.V300416.R01.S.doc Version 5.2 Page 18 updates in moving and handling training. There is always at least one person on duty day and night, fully qualified in first aid. Staff said that training provided helped them carry out their jobs effectively. There is a good record of staff training and of staff recruitment records. Two staff files checked contained a completed application form, two written references, evidence of identification and evidence that satisfactory Criminal Records Bureau check had been completed. Staff said that they have a six month probationary period and that they have regular supervision sessions with senior staff Westholme DS0000039597.V300416.R01.S.doc Version 5.2 Page 19 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 The quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. The home is well managed and peoples’ safety and welfare are appropriately protected. EVIDENCE: There is an acting manager who is on secondment in Westholme until early 2007.It is anticipated that a nurse manager will be appointed in the longer term The current manager has NVQ 4 in management and care and a City and Guilds in community care. She demonstrated a good understanding of her role and a commitment to providing a well run service. Residents meetings and staff meetings are held. Staff said that they always talk to relatives when they visit, consultation meetings are held about future development and letters are sent. Visitors confirmed that they have been kept Westholme DS0000039597.V300416.R01.S.doc Version 5.2 Page 20 informed. Questionnaires are completed by short term residents or their representatives. Manager looks at feedback and uses this to monitor the service delivery. Residents financial interests are protected, as discussed in a previous section. All staff training in health and safety issues is regularly updated and records showed that all equipment in the home is serviced and maintained appropriately. Westholme DS0000039597.V300416.R01.S.doc Version 5.2 Page 21 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 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.V300416.R01.S.doc Version 5.2 Page 22 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.V300416.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Westholme DS0000039597.V300416.R01.S.doc Version 5.2 Page 24 - 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!