Inspection on 07/02/08 for Westlands

This inspection was carried out on 7th February 2008.

CSCI found this care home to be providing an Excellent service.

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 03/01/07

Westlands 10/02/06

Westlands 20/09/05

Westlands 02/03/05

Westlands 07/01/05

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Inspirations

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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 Key Unannounced Inspection 7th February 2008 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Westlands DS0000020706.V359604.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. Westlands DS0000020706.V359604.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Westlands Address Station Road Wem Shrewsbury Shropshire SY4 5BL 01939 232784 01939 235295 jcapewell@coveragecareservices.co.uk www.coveragecareservices.co.uk Coverage Care Services Ltd 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) 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.V359604.R01.S.doc Version 5.2 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. 3rd January 2007 Date of last inspection Brief Description of the Service: Westlands is a Care Home registered with the Commission for Social Care Inspection to provide accommodation and personal care to a maximum of forty older people including those with dementia. 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 home is owned by Coverage Care Services Ltd and the Registered Manager is Ms Jane Capewell Coverage Care Services Ltd make their services known to prospective service users in: The Statement of Purpose, Company Brochure and web site which also contain their contact e mail address. The inspection report is mentioned in the statement of purpose and summarised in the service user guide. It is also on display in all homes’ entrance halls with a note stating the document can be made available to copy and take away. Coverage Care Services rates are reviewed annually on 1st April each year and service users are notified one month in advance. The only additional charges to service users are for toiletries, hairdressing, newspapers and escorting to hospital for routine appointments. This is clearly laid out in the terms and conditions. Fees for Westlands 2007/08 are: £414-435. All service users pay monthly by standing order or by cheque usually on the 15th of the month. This is two weeks in advance and two weeks in arrears. Westlands DS0000020706.V359604.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A range of evidence was used to make judgements about this service. This includes: information from the provider in the annual quality assurance assessment, staff records kept in the home, medication records, survey results from people who use the service, discussions with the staff team, discussion with the manager, tour of the premises, previous inspection reports, quality assurance processes, Fire Authority reports, Environmental Health Office reports, observation of care experienced by people using the service. The quality rating for this service is *three star excellent service. This means the people who use this service experience excellent quality outcomes. What the service does well: What has improved since the last inspection? Staff understand the complexities of providing dementia care and how the condition affects each person as an individual. Staff have explored better ways of recording the dementia care they provide which demonstrates an evidence based approach to care. The recording of risk assessments is more robust. Westlands DS0000020706.V359604.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Westlands DS0000020706.V359604.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 Westlands DS0000020706.V359604.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standard 3. 6 is not applicable. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Written records for the re-assessment of service users demonstrate that the process is personalised so that consideration has been given to all aspects of care. EVIDENCE: Discussion with the management established that the service maintains preadmission and admission records. The assessment information informs the care plan based on the individuals needs. Re-assessments take place by appropriately trained persons such as social workers or the service’s management and steps are taken to resolve any problems. For example one service user had numerous falls from October 2007 to January 2008 and following a review by the Community Psychiatric Nurse was transferred to a Care Home with nursing as her needs outweighed those that Westlands could Westlands DS0000020706.V359604.R01.S.doc Version 5.2 Page 9 provide for. The manager had increased the ratio of staff temporarily at night and day until her transfer to the home. The manager keeps copies of the assessment summary and care plans of those carried out through care management arrangements. Westlands DS0000020706.V359604.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standards 7,8,9,10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The service aims to address and meet assessed need through the continued development of plans of care, so that service users are provided with person centred care. The manager understands the need to comply with safe medication systems and staff practice ensures that the home’s procedures are complied with and that service users health matters are always safely addressed. The actions of staff and their approach to care ensures that service users are treated with respect and their right to privacy is upheld. EVIDENCE: Care plans seen at the last key inspection detailed good information with clear direction to staff on how they are to deliver care. The recording is written in a way that demonstrates personal preferences and wishes are taken into account, and staff can provide a verbal account of this, and service user Westlands DS0000020706.V359604.R01.S.doc Version 5.2 Page 11 surveys state they do. New care plan documentation has been introduced to enhance the understanding of providing support for a person with dementia, while not undermining their remaining abilities. The welcome pack in each service users’ bedroom contains a photograph of that person’s keyworker together with a description of the role they have in the home. This is a significant improvement the service has implemented this year. Records of medication reviews in the care plans indicate staff awareness of each individual’s sensitivities to drugs and how this affects their mental wellbeing. There is excellent understanding of how a person’s physical deterioration can affect their behaviour. Weekly checks on staff practice ensure that policies are being adhered to. People who self medicate have a risk assessment in place. The service has improved the storage of medication on the units by purchasing more trolleys. Staff now receive formal training before administration of medication is considered to be included in their role. Records of risk assessments for bed rails and other interventions seen in the care plans demonstrate this aspect of care has improved. Nutritional risk assessments assist in identifying problems at an early stage and those at risk of becoming malnourished. Service users have a care plan which identifies their nutritional care needs and how they are to be met. Westlands DS0000020706.V359604.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standards 12,13,14,15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are provided with social activity and can keep in contact with family and friends. Social, cultural and recreational activities meet service user’s expectations through assessment, consultation and choice. Service users receive a healthy diet according to their assessed requirement and preference. EVIDENCE: The assessment process demonstrates that social/leisure pursuits are addressed prior to admission in a personalised way for the individual. Once living at the home, social activities are provided and the service shows that this is based on service user consultation through regular service user meetings regarding all aspects of living at Westlands. Planned activities are displayed around the home. Personal pictorial life records are given to service users following liaison with families. These show that staff are genuinely interested in the people they care for. Westlands DS0000020706.V359604.R01.S.doc Version 5.2 Page 13 Service users are actively encouraged to keep in contact with family and friends living in the community. Visitors are welcome at any time and facilities are available for them to have a drink or a meal. Service users can choose to entertain visitors in their own rooms or perhaps a lounge or garden area. The home clearly records and actions any restrictions, which the service user may make about who they wish to visit them. Service user meetings take place regularly and items discussed include: customer service, food, safeguarding adults, staff, activities and care plans. Meal times are considered a social occasion. The catering manager in the home is qualified and experienced in cooking for older people, is an important member of the care team and is well aware of the recorded dietary and cultural needs of each service user. There is commitment to involving service users in menu planning and making sure that they are able to enjoy the food they prefer and like. The menu is varied, balanced and nutritious. It has a number of choices including a healthy option, and includes a variety of dishes that encourage service users to try new and sometimes unfamiliar food. The home has the platinum healthy eating award. Food is served to meet the need of all service users including those who have swallowing or chewing difficulty. There are small, well equipped, service user kitchen areas around the home. A service user commented that ‘meals are of a very high standard and a lovely choice’ and ‘ten out of ten for presentation.’ Westlands DS0000020706.V359604.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standards 16,18 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The service has a complaint procedure which is accessible so that people who use the service have information of how to make complaints about the home. Training is provided so that service users are protected from abuse and have their legal rights protected. EVIDENCE: All surveys returned by service users stated that they would go to the manager or their keyworker if they had a problem. All expressed confidence that issues would be dealt with. Surveys stated that concerns spoken about by service users had been promptly dealt with and a satisfied outcome reached. Adult protection is discussed at service user meetings so that they are aware of the responsibility of the service in this area. A survey response to the question ‘Do you know who to speak to if you are not happy? Stated: ‘Anyone will listen, if they cannot deal with the problem or concern they will pass it on to someone who can.’ Westlands DS0000020706.V359604.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. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standards 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables residents to live in a safe, well-maintained and comfortable environment, which encourages independence. EVIDENCE: The management and staff encourage residents to see the home as their own home. It provides a very well maintained, safe, comfortable, attractive home which has all the specialist equipment and adaptations needed to meet individual service users’ needs. Areas for refurbishment are identified and plans put in place to deliver this. Westlands DS0000020706.V359604.R01.S.doc Version 5.2 Page 16 There is a selection of communal areas, according to the numbers of service users, this means that service users have a choice of place to sit quietly, meet with family and friends or be actively engaged with other service users. The home is very well lit, clean and tidy and smells fresh. The management has a proactive infection control policy and they work closely with external specialists, e.g. infection control, and their own staff to ensure that infections are minimised. A relative commented: ‘on our visits we always see the staff cleaning, it’s a credit to the dedicated staff’. Call bells were seen to be left within reach of residents and were noted to be responded to promptly. Westlands DS0000020706.V359604.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. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standards 27,28,29,30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff in the home are being trained and are in sufficient numbers to fill the aims of the home and meet the changing needs of service users. EVIDENCE: NVQ training is provided and 87 of staff have level 2 with 8 working towards it. The service’s corporate improvement plan set a level of 85 so the home’s management have exceeded this. The duty manager spoke of her enthusiasm for dementia care and the training that is being provided at an enhanced level. The service has a thorough recruitment procedure. The recruitment of good quality carers is seen by management as integral to the delivery of an excellent service. The service is highly selective, with the recruitment of the right person for the job being more important than the filling of a vacancy. The service sees induction and any probationary period as being an extension of recruitment. Induction has changed so that more time is spent being supervised in the home before they have the ‘corporate induction’. Staff Westlands DS0000020706.V359604.R01.S.doc Version 5.2 Page 18 surveys were complimentary about how ‘new’ staff are supervised and managed. Staff receive training in manual handling and health and safety so that they are able to respond well to service users who may be at risk of falling. Westlands DS0000020706.V359604.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. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standards 31,33,35,38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect and with effective quality assurance systems and audits in place, service users are assured that the overall conduct of the home is being well managed. EVIDENCE: The registered manager’s practice is service user focussed and shows a commitment to conducting regular service user meetings that are minuted. People who use the service say that they trust the staff and feel safe in the home. The registered manager works to improve services and provide an Westlands DS0000020706.V359604.R01.S.doc Version 5.2 Page 20 increased quality of life for residents with a strong focus on equality and diversity issues. The registered manager is person centred in her approach and people say that she is very approachable. A survey response stated: ‘staff are available when you need them, personally or at the end of the phone anytime of day or night and are always willing to talk and listen.’ The duty manager for the shift demonstrated her knowledge about dementia care and how the staff interpret this into providing excellent outcomes for service users. Representatives from Coverage Care are regularly on site to assist and support the manager. The service has its own quality assurance programme consisting of audits, surveys etc which continue to be fully implemented. Record keeping systems are good and improve as new formats are implemented. Staff have received all mandatory training and other specific to the service user group cared for. There is a detailed business and financial plan which gives a clear indicator of the success and efficiency of the business arrangements. The insurance cover in place ensures that the home is well able to fully meet any loss or legal liabilities. The manager continues to let us know about things that have happened since our last key inspection. The service has experienced a number of incidents of service users falling. The investigations into these have not concluded that lack of staff was a contributing factor. Issues have been managed well and full records kept. The home actively encourages service users who wish and are capable, to manage their own money and valuables, making sure they have the facilities to do this safely. The home has very efficient systems to ensure effective safeguarding and management of service user’s money including records keeping. Service users have access to their records whenever they wish. Westlands DS0000020706.V359604.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 4 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X 3 X X 3 Westlands DS0000020706.V359604.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 Westlands DS0000020706.V359604.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Westlands DS0000020706.V359604.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. 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