Inspection on 10/08/05 for Westlands

This inspection was carried out on 10th August 2005.

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

Westlands 12/11/07

Westlands 11/09/06

Westlands 26/05/05

Westlands 01/11/04

Westlands 20/05/04

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

CARE HOME ADULTS 18-65 Westlands West Hill Road Woking Surrey GU22 7UL Lead Inspector Christine Bowman Unannounced 10 August 2005, 11:00 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. h58 h09 s13823 Westlands v243715 100805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Westlands Address West Hill Road, Woking, Surrey GU22 7UL Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01483 761067 Whitmore Vale Housing Association Janika Calleja Care Home 7 Category(ies) of LD Learning Disability, Male, 7LD(E) Learning registration, with number Disability Over 65, Male, 1 of places h58 h09 s13823 Westlands v243715 100805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: It is a condition of registration that of the 7 residents accommodated, one resident may be over the age of 75 years. Date implemented: 1 April 2002 Date of last inspection 26 May 2005 Brief Description of the Service: Westlands is a large detached house in a residential street within walking distance of the centre of Woking. It is on two floors, having five service users bedrooms on the first floor and two further service users bedrooms on the ground floor. Also on the ground floor is a large communal sitting/dining room, kitchen, utility room, activity room, sensory room, smoking room, toilet and office. Outside is a well-tended garden, with two terraced areas for outdoor entertainment, which is enclosed by a wooden fence. To the front of the home is a car parking area. Westlands benefits from having easy access to all the public services in Woking town. The service users catered for at the home are a group of seven men with learning disabilities, who were previously cared for in a long stay hospital. h58 h09 s13823 Westlands v243715 100805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second of two inspections for the year beginning April 2005 to March 2006 and it was unannounced. This report should be read in conjunction with the first report to obtain a more complete description of the service. The inspection began at 11.00 am and was four and a half hours in duration. The deputy manager was interviewed and a further three members of staff were interviewed briefly. One service user was at a day centre, one was just leaving for an appointment with his doctor and the remaining five were at home. It was difficult to ascertain the service users’ views because very little language was used and the service users do not easily accept strangers. The service user who was the most verbal throughout the last inspection was absent. The views of service users therefore are based on observations made throughout the day, conversations with members of the staff team and from records. What the service does well: Plans were in hand for house holidays, one service user was obviously excited by the proposed trips because he repeated several times, ‘New Forest’. He was smiling and his whole face was animated as he spoke. A member of staff helped him to explain and he clapped his hands. Westlands is good at ensuring their service users get a holiday. Observations of interactions between the staff team and the service users indicated that there was real understanding and empathy. There was a great deal of smiling from the service users when speaking with members of the staff team and the staff gave their full attention when communicating with the service users. The staff interpreted the emotional needs of the service users by observation of behaviour and reactions to triggers. Westlands offered a good variety of choice at meal times, special diets were catered for and fresh fruit and vegetables were available. h58 h09 s13823 Westlands v243715 100805 Stage 4.doc Version 1.40 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. h58 h09 s13823 Westlands v243715 100805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection h58 h09 s13823 Westlands v243715 100805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 and 5 The recently reviewed Statement of Purpose and Service User Guide contain sufficient information to enable new service users to make a decision about the suitability of the home. More work is required on the written contract of terms and conditions between the service user and the home. EVIDENCE: The Statement of Purpose had been reviewed in August 2005 was signed and dated and another review date had been set. The Service User Guide was well illustrated and appropriate for those with learning disabilities. It did not, however make reference to the complaints procedure or give the details of the local CSCI local office. Service user’s files were inspected and contracts of terms and conditions were viewed. The written contracts between the service user and the home need to be reviewed to ensure that the room the service user is entitled to occupy is specified and to include the fees charged. This contract should be in a format, which is accessible to those with learning disabilities. h58 h09 s13823 Westlands v243715 100805 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 10 A detailed code of conduct for staff and secure storage of personal information ensures that service users feel comfortable about their personal information being kept confidential. EVIDENCE: The code of conduct for the staff was viewed and it covered all issues associated with confidentiality, including the occasions when confidentially may be breached and the results of breaching confidentiality otherwise. It also stated that family and friends do not automatically have the right to information regarding the service user. There was however no confidentiality policy to be viewed on the day of the inspection. h58 h09 s13823 Westlands v243715 100805 Stage 4.doc Version 1.40 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13,14 and17 Appropriate community involvement and suitable leisure activities are available to the service users and menus show that a healthy and balanced diet is offered. EVIDENCE: One service user was attending a day centre on the day of the inspection. Various activities are offered at the day centre, the deputy manager stated and there is also the opportunity to go into town for a coffee. Another service user was waiting for a member of staff to return to take him into town to do some shopping and have lunch. One service user said, ‘New Forest’ and ‘holiday’. A member of staff explained that holidays had been planned and one group of service users were going to The New Forest and another group were going to The Isle of Wight. The new bus was very popular and when a member of staff was preparing to go to the day centre to pick up the service user who had spent the day there, some service users wanted to go along for the ride. h58 h09 s13823 Westlands v243715 100805 Stage 4.doc Version 1.40 Page 11 Menus were viewed and revealed that the diet offered is varied. The service users are enabled to choose what they wish to eat by selecting from picture cards the deputy manager stated. There is a roast dinner on Sundays and at some point during the week the choice offers a take-away meal. A cooked meal is provided at teatime and a snack meal at lunchtime. Over the weekend cooked breakfast is also offered on the menu. The service users are very individual in their taste and needs. Care plans state that two service users follow special diets, having seen the dietician and these are well catered for. One service user likes to take a nap in the late afternoon and occasionally chooses to take a meal in his room on a tray the deputy manager stated. Care plans showed that two service users need one to one supervision at the table or when eating elsewhere due to the fact that they eat very quickly and are in danger of choking if not prompted by the staff. A member of staff is always seated close to them when they are eating. On the day of the inspection one of the service users was smiling and looking excited because he was going on a one to one outing with a member of staff to do some shopping and have lunch in town. As he waited for the member of staff to return from another appointment, he was singing a tune. h58 h09 s13823 Westlands v243715 100805 Stage 4.doc Version 1.40 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 21 The staff at Westlands are good at monitoring the physical health of service users and show real understanding of each individual’s emotional needs. A comprehensive policy covering ageing, illness and death of a service user is available to inform the staff. EVIDENCE: On the day of the inspection one of the service users was just leaving with a member of staff for an appointment with his General Practitioner. The deputy manager stated that specialist help was sought from Community Health when it was required. A service user who had experienced difficulties whilst accessing dental treatment had a plan in place to support him for the next appointment. The service users whose files were viewed gave examples of behaviour associated with the emotions the service users were expressing. The SCATS team had been approached for advice and help with a service user whose behaviour was unpredictable. The policy covering the death of a service user inspected was very detailed and informative and covered all aspects of illness, ageing and death. There was, however no record in the service users files to indicate their wishes or evidence of discussions with relatives about their wishes concerning terminal care and death. h58 h09 s13823 Westlands v243715 100805 Stage 4.doc Version 1.40 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 Westlands is a home where the service users can be sure the staff will make every effort to understand their views and keep them safe. EVIDENCE: Interactions between the staff and the service users were respectful. The service users showed trust and their communications were given close attention by the staff, who showed understanding of the actions, single words and expressions of the service users. Work is continuing to improve the use of symbolic communication, the deputy manager stated. The key and co-key worker system allocated time for one-to-one activities with service users. The Service User Complaints Procedure had not yet to be updated to include the details of the CSCI local office, it is not sufficient for the service user to sign that they had been given this information. All the staff had recently attended the Protection of Vulnerable Adults training by ‘Weycare’ and had received a certificate of attendance. There was a local procedure to follow based on the Surrey Multi Agency Adult Protection Procedures and the staff were aware of the social services contact numbers. A policy covering aggression towards the staff was available and a policy on restraint, although the policy of Westlands is not to use restraint. The finances were of two service users were checked and both were correct. h58 h09 s13823 Westlands v243715 100805 Stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 28 Westlands has plans to improve the provision of bathrooms and upgrade other facilities at the same time. The shared spaces adequately supplement the service users’ individual bedrooms. EVIDENCE: All the service users had hand basins in their bedrooms and there were two bathrooms on the first floor, each with a shower and one with an assisted bath. The shower on the ground floor had been out of use due to being too small. Plans had been prepared for the creating of another bathroom on the ground floor for the two service users whose rooms are on the ground floor. Other plans included a lift to the first floor, a private office for the manager and some space for storage. The shower room was proposed to become a cloakroom. h58 h09 s13823 Westlands v243715 100805 Stage 4.doc Version 1.40 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,34,35and 36 Clear roles and multi-disciplinary teamwork ensure service users receive the care they need. Good recruitment procedures and a commitment to the training and supervision of staff give the team the support they need to deliver good care to the service users. EVIDENCE: Job descriptions were viewed in two staff files. All the staff had received a copy of the General Social Care Council code of conduct the deputy manager stated, service users were matched with staff for key working with whom they had a good rapport. There had been some staff changes but bank staff with knowledge of the service users had been available to support the team and a recruitment drive had supplied two full time night staff who were awaiting CRB clearance and one more person was yet to be interviewed for the senior support post the deputy manager stated. Two staff files were inspected. They were well organised and contained all the necessary recruitment data and evidence of a structured induction covering the first four weeks of employment. There were certificates covering all the mandatory training and also certificates for training in dealing with challenging behaviour, Makaton, epilepsy and the administration of rectal diazepam. h58 h09 s13823 Westlands v243715 100805 Stage 4.doc Version 1.40 Page 16 Two members of staff are currently registered on NVQ courses and the manager is completing the NVQ4 in management, the deputy manager stated. He also expressed a strong desire to be given the opportunity to access an NVQ course more in keeping with his role. There was evidence of regular supervision meetings. h58 h09 s13823 Westlands v243715 100805 Stage 4.doc Version 1.40 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39,40,41 and 42 Policies are in place to inform the staff and records are well maintained and safely stored to protect the rights of the service users. Good health and safety checks ensure Westlands is a safe environment for service users to live in. Relatives of service users are consulted about satisfaction with the service. EVIDENCE: The home had developed comprehensive and detailed policies, which were stored in two large files in the office. The staff were aware of the location of the files and signed that they had read them. Due to the large amount of information contained in these policies, a shortened version of the most relevant policies, procedures and codes of practise would be helpful to new and bank staff. Records viewed were well maintained, accurate, up-to-date and stored securely. h58 h09 s13823 Westlands v243715 100805 Stage 4.doc Version 1.40 Page 18 Health and safety issues continued to be regarded as high priority and a recent inspection from Environmental Health showed no areas of concern. Quality assurance questionnaires for service users could not be completed due to their communication difficulties the deputy manager stated, but there was evidence of questionnaires having been sent to relatives on their behalf. h58 h09 s13823 Westlands v243715 100805 Stage 4.doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 x x x 2 Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x x x x 2 Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x 3 3 x x Standard No 11 12 13 14 15 16 17 x x 3 4 x x 4 Standard No 31 32 33 34 35 36 Score 3 x x 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 4 x 2 Standard No 37 38 39 40 41 42 43 Score x x 3 3 3 3 x h58 h09 s13823 Westlands v243715 100805 Stage 4.doc Version 1.40 Page 20 No 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 1 Regulation 5(1)(e)(f) Requirement The Registered Manager must ensure that the Service Users Guide refers to the complaints policy and contains the details of the CSCI local office The Registered Manager must ensure that the service users complaints procedure is updated to include the correct name for the CSCI snd contact details Timescale for action 10/09/05 2. 22 22(7)(a) 10/09/05 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. 4. Refer to Standard 5 10 21 40 Good Practice Recommendations The contract of terms and conditions made between the home and the service user should include the bedroom to be occupied and details of the fees to be charged There should be a policy which specifically covers confidentiality There should be a record on the personal file of the service user of their wishes in the event of death.. In order for information contained in policies to be more accessible to new staff a shortened version of important policies should be made available to them. h58 h09 s13823 Westlands v243715 100805 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection The Wharf Abbey Mill Eashing Surrey GU7 2QN 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. 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