Inspection on 20/09/05 for Westlands

This inspection was carried out on 20th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 07/02/08

Westlands 03/01/07

Westlands 10/02/06

Westlands 02/03/05

Westlands 07/01/05

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Westlands Station Road Wem Shrewsbury Shropshire SY4 5BL Lead Inspector Pat Scott Unannounced Inspection 20th September 2005 11:50 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 Westlands DS0000020706.V252447.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Westlands DS0000020706.V252447.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Westlands Address Station Road Wem Shrewsbury Shropshire SY4 5BL 01939 232784 01939 235295 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) Coverage Care Shropshire Limited Miss Jane Louise Capewell Care Home 40 Category(ies) of Dementia - over 65 years of age (24), Old age, registration, with number not falling within any other category (16) of places Westlands DS0000020706.V252447.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Home is registered to accommodate a maximum of 40 Older People to include a maximum of 24 people with Dementia. 2nd March 2005 Date of last inspection Brief Description of the Service: Westlands is a residential Care Home registered with the Commission for Social Care Inspection to provide accommodation and personal care to a maximum of forty people over the age of 65, within this number a maximum of 24 people who have dementia may be cared for. The home does not provide Nursing care. The home is conveniently located close to the town centre in Wem, Shropshire. Accommodation is situated on the ground floor of the home and all service users are provided with a single bedroom. The rooms are attractively decorated and personalised. None of the rooms have an en-suite facility. Communal areas are bright well furnished and the décor of a high standard. The home is owned by Coverage Care (Shropshire) Ltd and the Registered Manager is Ms Jane Capewell Westlands DS0000020706.V252447.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 20 September 2005 commencing at 11.50 hrs. The National Minimum Standards for Care Homes for Older People focus on achievable outcomes for service users – that is the impact on the individual of the facilities and services of the home. Evidence was looked for that the standards were being met and a good quality of life enjoyed by service users through: • Discussions with service users, families and friends, staff and managers. • Observation of daily life in the home • Scrutiny of written records (including care plans for 4 service users). The statement of purpose was used to assess how far the home’s claims to be able to meet service user requirements and expectations were being fulfilled. Reports regarding an overview of the conduct of the home are sent to CSCI on a monthly basis by the Head of Operations for Coverage Care. These, as well as the risk assessment from the last inspection were taken into account to determine the core standards focused on and depth of inspection. The Commission does not currently have any concerns regarding this home. What the service does well: The home provides for the needs of elderly people including those with dementia through small group living. Service users were seen to be treated in a respectful and dignified way and some of those spoken with stated that they had no complaints and were happy to be living at such a friendly home. After appropriate risk assessment, service users are not discouraged or unduly restrained from undertaking activities solely for fear that for example, they may hurt themselves. The building is used for a number of purposes as it also incorporates day care facilities. The way in which this is managed protects the privacy of service users whilst allowing the building to be used in other ways. The home is not purpose built and service users on the dementia units are unable to access other parts of the home. Inevitably, service users come to a ‘dead end’ when walking around their unit. The experience and training of staff with dementia Westlands DS0000020706.V252447.R01.S.doc Version 5.0 Page 6 needs is such that this aspect is well managed. However, service users do have access to a large secure garden and courtyard area. Coverage Care provides training to a level that creates a trained and experienced staff team that is well managed as examination of files and in discussion with staff, the manager and duty manager showed. Staff were happy with the training they do to level NVQ 2 and 3, with ambitions to further their career in care. The home’s values and philosophy as stated in the statement of purpose, centre on promoting service users’ independence through enabling them to make their own decisions, encouraging their individuality, keeping up with family and community contacts and finding out if they are satisfied with the quality of life and care in the home. Ms Capewell’s style of management enables service users to be involved in any discussion about their care, to take part in any social or recreational activity of their choosing, choose how and where they spend their time and enable them to adjust to living in the ‘home’ environment. Both her and her duty manager were seen about the home during the inspection and talked openly with service users that wished to ask something of her. What has improved since the last inspection? What they could do better: It is considered that Westlands meets or exceeds the national minimum standards assessed. Please contact the provider for advice of actions taken in response to this Westlands DS0000020706.V252447.R01.S.doc Version 5.0 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Westlands DS0000020706.V252447.R01.S.doc Version 5.0 Page 8 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 Westlands DS0000020706.V252447.R01.S.doc Version 5.0 Page 9 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, 3 The homes statement of purpose and service user guide are good providing service users and prospective users with details of the services the home provides, enabling an informed decision about admission to the home. EVIDENCE: The information provided to service users gives details of needs assessment to be conducted prior to admission and examination of care plans on the units confirmed that this process had been carried out. The philosophy of the home is such that the service is tailored around the needs of service users and not the other way round. The statement of purpose and service users guide were on display in the foyer. Westlands DS0000020706.V252447.R01.S.doc Version 5.0 Page 10 The home provides respite care and a service user who was receiving such a break in the home stated that the transitions between the home and their own home were always fine and they usually enjoyed their stay. Westlands DS0000020706.V252447.R01.S.doc Version 5.0 Page 11 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, 10 There is a clear, consistent care planning system in place to adequately provide staff with the information they need to satisfactorily meet service users needs. Personal support in this home is offered in such a way as to promote and protect service users’ dignity and privacy in their daily life. EVIDENCE: Care plans looked at for 4 service users were consistently completed and had all the useful information in them that is necessary to enable a care worker to provide the right care for that individual in a way that meets their wishes and preferences. Care staff spoken with were aware of the plan’s existence and content. Ascertaining such information can be difficult when an individual has dementia or mental health problems and records provide evidence of consultation/communication with families and other supporters. The information that was read showed that individuals receive the level of care which their own situation requires. All care plans seen had been signed by the service user. Westlands DS0000020706.V252447.R01.S.doc Version 5.0 Page 12 Visits by other health care professionals are documented e.g. GP, CPN (Community Psychiatric Nurse). District nurses conduct incontinence assessments on a 6 monthly basis and provide the home with relevant information on how to meet those individuals incontinence needs. Regular monitoring and review of a service user’s condition takes place to ensure that the correct treatment and care is being given. Staff were heard talking with service users in a respectful manner and of noting their movement about the home in a discreet way. There was excellent rapport seen between staff and the people in their care. Westlands has scored a 4 for standard 10, the evidence for which is reflected throughout other standards in this report. Service users stated that they were aware of the information displayed on the notice board regarding healthcare advice. This included many advisory leaflets about falls, food labels, men and food, fats, salt and healthy eating. The home has demonstrated that it exceeds standard 8. Westlands DS0000020706.V252447.R01.S.doc Version 5.0 Page 13 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, 15 Staff have an excellent understanding of the service users support and leisure needs and use this to assist them to exercise choice and control in their lives. EVIDENCE: There is no imposition of rules or routines within the home. A service user commented that she had wanted to spend the morning in her room and that staff had been respectful of this. She stated that staff popped in from time to time and that she had never been left for long periods. Her call bell was within reach. Service users with dementia can move within the unit and gardens and were heard to be encouraged by staff to sit outside, as it was a warm, sunny day. Individuality is maintained as service users have their own rooms and places to withdraw to from busy active communal areas. Service users were extremely complimentary about the quality and choice of food. Menus seen, dining areas visited and the food provided at the time of inspection demonstrated that the standard of catering at Westlands continues to exceed the minimum standards. The meal that was observed was of extremely good quality, with choices. The selection of puddings and sweets Westlands DS0000020706.V252447.R01.S.doc Version 5.0 Page 14 was particularly good. A service user spoken with after their meal said that it was a “right good feed”. Westlands has achieved the Healthy Eating Gold Award from North Shropshire District Council. Many activities take place to meet individual needs and religious observance; there is an open visiting policy. Care plans detailed social needs and preferences how they spend their day. Service users stated they spent their time as they wished and were not forced by staff to participate in events or even to go out when they did not feel up to it. Westlands DS0000020706.V252447.R01.S.doc Version 5.0 Page 15 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): These standards were not assessed at this inspection EVIDENCE: Westlands DS0000020706.V252447.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 The standard of the environment within this home is very good providing service users with an attractive and homely place to live. EVIDENCE: A general tour of the bedrooms and communal spaces demonstrated that the home is purposely designed into small group units each with its own lounge/kitchenette and dining area. These were all in a good state of repair and comfortably furnished. It is easy for service users, elderly frail or those with dementia to find their way around their unit. There were paintings on display along a corridor wall that had been created by a service user in the past. She had been admitted to Westlands having developed dementia, and although unable to produce the same quality of art, she is still able to recognise the past work she has achieved. Westlands DS0000020706.V252447.R01.S.doc Version 5.0 Page 17 Westlands DS0000020706.V252447.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29, 30 The arrangements for the induction and training of staff are good with the staff demonstrating a clear understanding of their roles. There is a good match of well-qualified staff offering consistency of care within the home. EVIDENCE: Relevant training has been provided and staff spoken with confirmed this. Staff are offered financial support, subject to approval, for individual professional development. Staff observed carrying out their duties were seen to be responsive and understanding of individuals wishes and needs. The staffing establishment and rota are arranged so that there are enough senior staff and are deployed to give the cover required to meet the home’s stated aims. Training soon to take place includes: infection control, manual handling and care plans. Staff personnel files are kept at the home, 3 of these were examined and contained records of the thorough recruitment process and staff training achievements. Westlands DS0000020706.V252447.R01.S.doc Version 5.0 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): 31,32,38 The style of management in the home is one of openness and respect which enables service users, family, friends and staff to feel valued and that their opinions matter. The awareness of health and safety responsibilities by Management and staff is good ensuring that service users live in a safe environment. EVIDENCE: The manager possesses all the relevant qualifications required within the standards. Discussions demonstrated that she continues to strive for excellence and to provide person centred care. Service users spoken with said they would have no hesitation about talking to staff or the management about any concerns. Westlands DS0000020706.V252447.R01.S.doc Version 5.0 Page 20 Risk assessments were seen on files re falls and behaviour management of people with dementia. On a tour of the premises with the manager there was no doubt that the service users knew who she was. Monthly visits to the home are conducted by the Head of Operations for Coverage Care. Reports for these visits are received that give an overview of the conduct of the home and are taken into account before an inspection takes place. The report for 16th August 2005 detailed that health and safety checks had been carried out and no defects noted. Westlands DS0000020706.V252447.R01.S.doc Version 5.0 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 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 x 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 3 X X X X X X x STAFFING Standard No Score 27 3 28 x 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 x x x x x 3 Westlands DS0000020706.V252447.R01.S.doc Version 5.0 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 Westlands DS0000020706.V252447.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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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