Inspection on 26/05/05 for Westlands

This inspection was carried out on 26th May 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Westlands 12/11/07

Westlands 11/09/06

Westlands 10/08/05

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 26 May 2005, 08:00am 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. WESTLANDS h58 H09 S13823 Westlands v229477 260505 Stage 4.doc Version 1.30 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, 7 registration, with number LD(E) Learning Disability Over 65, Male, 1 of places WESTLANDS h58 H09 S13823 Westlands v229477 260505 Stage 4.doc Version 1.30 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 1 November 2004 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, a staff sleeping in room and two bathrooms on the first floor and two further service users bedrooms on the ground floor. Also on the ground floor is a large sitting/dining room, kitchen, utility room, activity room, sensory room, toilet and office. Outside is a well tended garden with two terraced areas for outdoor entertainment, the area is enclosed by a wooden fence. To the front of the home is a car park. Westlands benefits from easy access to all the public services in Woking town. The service users catered for at Westlands are a group of seven men with learning disabilities. WESTLANDS h58 H09 S13823 Westlands v229477 260505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which means that the home had not been informed that it was about to take place. It started at 8.30 am and took five hours to complete. In this home, the people who live there are referred to as service users by the staff. The men themselves just regard Westlands as their home. All seven of the service users were seen and spoken to. It was not possible to hold conversations with the service users but their opinions were gained from single word comments, observations, care notes and from speaking to the staff. The deputy manager was interviewed and discussions were held with four members of the care team. Records were inspected and a tour of the premises was undertaken. The atmosphere of the home was friendly and relaxed, some of the service users were preparing to go out to day centres, others were in their rooms, in the kitchen choosing their cereal, eating breakfast at the table, relaxing in the living room or having a bath. The staff team were going about their duties in a calm and purposeful manner. Interactions between the staff and the residents were very polite and the residents, were observed to be treated with respect. A high priority was given to safe procedures and the protection of the residents. The home was managed in an open and inclusive way. What the service does well: Westlands enables its service users to live full and happy lives in accordance with their wishes. The staff encourage service users to express themselves and support them to make decisions. Symbols were used to assist with decision making and a pictorial daily schedule had been devised to help a service user who was anxious about the future. Efforts are made to ensure that the service users who have family and friends outside the home are supported to keep contact with them. A service user was planning to visit his mother for tea on the day of the inspection and the home sent a member of staff to accompany him. There was a high regard for safety issues in the home. The procedures for the administration of medication, the storage of hazardous chemicals and the handling of money were sound. WESTLANDS h58 H09 S13823 Westlands v229477 260505 Stage 4.doc Version 1.30 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. WESTLANDS h58 H09 S13823 Westlands v229477 260505 Stage 4.doc Version 1.30 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 WESTLANDS h58 H09 S13823 Westlands v229477 260505 Stage 4.doc Version 1.30 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) 1,2 and 3 Sufficient information is available to enable prospective service users to decide whether or not this home will meet their assessed needs. EVIDENCE: Both a Statement of Purpose and a Service User Guide were attached to the notice board in the office. All the required information was contained in them but a review is recommended because some information needs to be updated. The Service User Guide has been made more accessible to those with communication difficulties. There had been no recent admissions to the home and all the men have been living here since the closure of the long stay hospitals in the area. Care plans inspected revealed that comprehensive assessments were completed prior to admission. Policies of the home state that an introductory package of visits and overnight stays together with a trial period three months is in place for any new prospective service users who might wish to live at Westlands. WESTLANDS h58 H09 S13823 Westlands v229477 260505 Stage 4.doc Version 1.30 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) 6,7,8,and 9 Individual care plans are updated regularly to reflect the changing needs of service users, support is available to empower service users to make their own decisions and to enable them to play their part in the running of their home and new activities are risk-assessed. EVIDENCE: Care plans inspected were detailed, covering all aspects of the service users assessed needs, and stating clearly where support was required and how that support was given. One service user’s review had been brought forward due to some uncharacteristic behaviour, which was well documented. Every avenue was being explored to ensure that he was receiving the community support available, and plans were in place to support him in the home. Means of communication were explained in the care plans, some service users were able to express themselves with single words, but others only used sounds and the home had developed symbols for use in making choices and on a daily plan for a service user who becomes anxious about the future. WESTLANDS h58 H09 S13823 Westlands v229477 260505 Stage 4.doc Version 1.30 Page 10 Whilst touring the premises, the deputy manager was approached by a member of staff. He explained that he was about to accompany a service user, who had decided that he would like to take a walk in the sunshine. Risk assessments show that service users need to be accompanied on all trips outside the home due to their vulnerability and lack of road safety. A service user came into the office looking for an envelope, he wanted to put a newspaper in it to take to the art tutor at the Art Venture Scheme. He no longer attends himself but likes to travel in the bus and regularly takes the newspaper to the tutor, who gives him in return cards and carrier bags for recycling. Service user meetings take place monthly and each week everyone gathers in the living room to decide on the menus for the next week. Sometimes the service users will enjoy helping with domestic chores, the deputy manager stated, and later a service user was observed helping a member of staff to move a cardboard box. Risk assessments for all activities were in service user’s files and these were signed and dated by staff members. WESTLANDS h58 H09 S13823 Westlands v229477 260505 Stage 4.doc Version 1.30 Page 11 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) 11,12,13,14,15,16 and 17 Westlands offers service users the opportunity to live full and varied lives in accordance with their wishes, respects their rights and promotes the acceptance of responsibility. EVIDENCE: After breakfast, on the day of the inspection, a member of staff drove some of the service users to their day placements at a Mencap day centre in Aldershot, and to an Art Venture Scheme. Another service user was preparing to spend the afternoon with his mother at her house. He was to be accompanied by a member of staff, who prepares a meal for them. . One service user repeated the words, ‘Frensham Ponds’ in an excitable tone and a member of staff explained that this service user is risk assessed to be accompanied by two members of staff for trips out, he has extra funding for sixteen hours to make this possible and he usually chooses to go to Frensham Ponds. WESTLANDS h58 H09 S13823 Westlands v229477 260505 Stage 4.doc Version 1.30 Page 12 Going out for meals in small groups was popular with most of the service users, the deputy manager stated and occasionally there was a whole house trip to the seaside. There was usually a celebration such as a birthday, which instigated trips like these, and most often the service users go out in small groups, shopping for personal items and stopping for a cup of tea. One service user said that he liked to go bowling and another likes to have a beer. All around the home and in service users own rooms were photographs of holidays they had enjoyed together, day trips and of relatives. WESTLANDS h58 H09 S13823 Westlands v229477 260505 Stage 4.doc Version 1.30 Page 13 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) 18,19 and 20 Policies and practise in the handling of medication protects service users and specialist help is sought when required. Key workers give personal support and ensure that service users’ physical, emotional and health needs are met. EVIDENCE: All service users are supported by key workers and co-key workers, whose role covers offering personal support, attending reviews, up-dating care plans and ensuring that care plans are followed, the deputy manager stated. From records inspected, it was evident that all service users were registered with the local G P, that appointments were made for regular visits to the dentist and optician and that referrals were made for specialist appointments when required. The home encourages contact with relatives and friends, and some of the service users have close bonds and enjoy each other’s company. One service user came into the office and he was saying, ”I like Billy, I do” Training records show that all staff have been trained in the administration of medication. Two staff always administer the medication together and a reduction sheet is filled in for all medication administered, this is signed and dated for each entry. This practise was observed. There is a record of a WESTLANDS h58 H09 S13823 Westlands v229477 260505 Stage 4.doc Version 1.30 Page 14 weekly stock take. At this time no service user was assessed to be able to retain and self-administer their own medication. WESTLANDS h58 H09 S13823 Westlands v229477 260505 Stage 4.doc Version 1.30 Page 15 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 service users can are assisted by staff who will make every effort to understand their views and keep them safe from harm. EVIDENCE: The staff were attentive to the needs of service users on the day of the inspection and understood their immediate needs without the use of language, efforts were also being made to help service users to express themselves with symbols. A complaints procedure has been devised which uses symbols, it does, however, need to be updated to include details of the CSCI. A copy of the Surrey County Council Multi Agency Adult Protection Procedures was available in the home and training records confirm that this training is regarded by the home as of utmost importance. One VAP instigated since the last inspection occurred outside the home and records show that Westlands staff followed correct procedures in protecting the service user involved. WESTLANDS h58 H09 S13823 Westlands v229477 260505 Stage 4.doc Version 1.30 Page 16 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) 24,25,26,27,28 and 30 Westlands offers service users a suitable, comfortable, clean and safe home to live in. EVIDENCE: At the centre of the home is a large combined sitting and dining room. It is furnished with comfortable, solid but domestic style furniture. There is enough space in this room for all seven service users to be comfortably accommodated at the same time. This room is light and airy and contains a large television and a music system. The vase of fresh flowers, adorning the fire place is continuously replenished by one service user, who enjoys this responsibility, the deputy manager stated. An extension leading off the sitting room provides space for activities such as art and craft to take place. A sensory room has also been created and a small smoking room. As well as the kitchen and office, also on the ground floor is a utility room, which is quite spacious and some of the service users take and collect their washing and one service user likes to put his washing in the machine. WESTLANDS h58 H09 S13823 Westlands v229477 260505 Stage 4.doc Version 1.30 Page 17 Everywhere the house was fresh and clean. Floor coverings were in need of replacement in some areas especially in the corridor near the back door. The service users’ bedrooms were well furnished, one was in need of redecoration. All bedrooms were personalised, one service user had a collection of metal cars on his window ledge, another was a great fan of Tom Jones and had a large number of compact discs, the deputy manager said that he often invites two of the other service users into his bedroom to socialise. A service user who wanted to show his own bedroom indicated that he had chosen a new chair. There are two bathrooms upstairs, one with an assisted bath. The downstairs shower was not in use but there are plans to build a new bathroom on the ground floor. Outside was an enclosed garden with terraced areas, which provide an extra room in the summer months. WESTLANDS h58 H09 S13823 Westlands v229477 260505 Stage 4.doc Version 1.30 Page 18 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) 32,33,34, and 36 This home ensures that the service users are protected and supported by following the recruitment policy and training, supporting and supervising staff to work cohesively as a team. EVIDENCE: The staff group at Westlands is settled, there are no vacancies at the present time and there have been no new staff since the last inspection. There are clear lines of responsibility and records show that staff supervision is taking place regularly. The staff files inspected contained all the documentation as required in schedule 2 of The Care Homes Regulations 2001. On the day of the inspection, the staff worked effectively as a team and sensitivity was shown in interactions with the service users, there was a great deal of warmth in the relationships between them. Looking through the utility room window there was a view of the garden and a service user was sitting in a chair in the sunshine. A member of staff approached him, took his hand and gave him a manicure, she smiled at him and chatted to him as she worked. WESTLANDS h58 H09 S13823 Westlands v229477 260505 Stage 4.doc Version 1.30 Page 19 WESTLANDS h58 H09 S13823 Westlands v229477 260505 Stage 4.doc Version 1.30 Page 20 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) 37,38 and 42 Westlands is a well managed and safe home for service users to live in. EVIDENCE: The manager has submitted an application to be registered and been approved and she is currently enrolled on a management course. She has created a positive and open atmosphere in the home and is well respected by the staff team. Licenses and certificates were displayed and health and safety issues highly prioritised. Care was taken in the storage of food, fridges and freezers having regular temperature checks, all jars and packaged food were labelled when opened and dated, frozen food was dated when bought and again when defrosted. The staff were mindful of infection control and careful to wear protective gloves and aprons. WESTLANDS h58 H09 S13823 Westlands v229477 260505 Stage 4.doc Version 1.30 Page 21 The COSHH cupboard was safely locked and tidy. On the inside of the door was a checklist of contents and their uses. This is audited weekly. Directional signs were displayed to indicate fire exits and the fire alarm system was tested frequently. WESTLANDS h58 H09 S13823 Westlands v229477 260505 Stage 4.doc Version 1.30 Page 22 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 3 3 3 x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 2 3 3 4 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 3 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 WESTLANDS Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 x x x 3 x h58 H09 S13823 Westlands v229477 260505 Stage 4.doc Version 1.30 Page 23 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 YA24 Regulation 23(2)(b) Requirement The Registered person must ensure that floor coverings are replaced in the corridor near the kitchen. The Registered Person must ensure that the service users bedroom at the end of the corridor on the first floor is redecorated. Timescale for action 26/08/05 2. YA25 23(2)(b) 26/08/05 3. 4. 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. Refer to Standard Good Practice Recommendations WESTLANDS h58 H09 S13823 Westlands v229477 260505 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Address 1 Address 2 Address 3 Address 4 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 WESTLANDS h58 H09 S13823 Westlands v229477 260505 Stage 4.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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