Inspection on 15/09/09 for Westlands Care Home

This inspection was carried out on 15th September 2009.

CQC found this care home to be providing an Poor service.

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 Care Home 04/12/09

Westlands Care Home 16/09/08

Westlands Care Home 26/09/07

Westlands Care Home 07/06/06

Westlands Care Home 06/12/05

Westlands Care Home 03/06/05

Westlands Care Home 10/02/05

Westlands Care Home 12/07/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 26/11/2009.

Key inspection report Care homes for older people Name: Address: Westlands Care Home 48 Oxford Street Wellingborough Northants NN8 4JH     The quality rating for this care home is:   zero star poor service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Keith Williamson     Date: 1 5 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 24 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Westlands Care Home 48 Oxford Street Wellingborough Northants NN8 4JH 01933274430 01933275882 westlands@regalcarehomes.com www.regalhomes.com Regal Care Homes Ltd Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Type of registration: Number of places registered: care home 28 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Westlands is a care home providing personal care and accommodation for 28 older people. The home is currently registered to provide care for up to 28 older people with up to 22 older people with dementia. The home is owned by Regal Care Homes Ltd. The Home is situated close to Wellingborough town centre and local amenities, shops and the local park. There is a small courtyard area outside the Home and a garden with seats. Peoples rooms are situated on all three floors of the building. A passenger lift provides access to part of the home. There are twenty single rooms with four Care Homes for Older People Page 4 of 24 Over 65 22 6 0 0 1 6 0 9 2 0 0 8 Brief description of the care home having en-suite facilities and four shared rooms. A copy of the most recent inspection report is also available on request. The current fees charged on a weekly basis are between £383.54 and £450.00. Care Homes for Older People Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: zero star poor service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The focus of the inspection is on outcomes for residents and their views of the service provided. The main method of Inspection used was case tracking which involves selecting a sample number of people and tracking the care they received through talking with them where possible, and looking at their records and accommodation, in this case two residents were chosen. This visit took place over one day, commencing at 9.30am and took six hours to complete. An opportunity was taken to talk with residents, manager and staff, look around the home, view records, policies and care plans. Residents were spoken with, and some made comments that have been included in this report. Information was obtained from the Annual Quality Assurance Assessment, which gives details about the home, and is filled in by the registered manager. A copy of the last Care Quality Commission (formerly the CSCI Commission For Social Care Inspection) report is displayed at the homes office, and copies of this report is available from the registered Care Homes for Older People Page 6 of 24 manager. The quality rating for this service is 0 star. This means the people who use this service experience poor quality outcomes. Care Homes for Older People Page 7 of 24 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. Care Homes for Older People Page 8 of 24 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 24 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff have developed a comprehensive admission pack, which is in a format suitable for peoples needs, enabling an informed decision regarding a stay at the home. Evidence: People can be assured their needs are assessed prior to moving to the home. We saw detailed assessments on people, which related to their care plan. People receive information prior to moving into the home in the form of an admission pack. This includes information on the home, a copy of the latest quarterly magazine, produced by the company and other information on local services such as advocates and solicitors. This pack is valuable in giving people enough information to consider a stay at the home. The home does not offer intermediate care, which is a specialist type of care and Care Homes for Older People Page 11 of 24 Evidence: support following a hospital discharge. Care Homes for Older People Page 12 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The current practice and lack of adequate recording puts people who use the service at risk Evidence: Care plans have a good level of detail, which enables staff to offer a good level of personal care for people. The recording of areas around personal and health care are good with a number of forms used to indicate health professionals visits or changes in peoples condition. Risks to people are dealt with in the form of risk assessments, which reduces the impact of potential incidents for people. Medication is poorly managed with missing signatures in the administration record, these are also called MAR charts. The policy and procedure are quite clear, in that two staff should sign for controlled medications. These are drugs that have special importance and need a higher degree of security. There was also missing signatures from the controlled drugs register, and the accounting of what medicine was in stock was incorrect. Care Homes for Older People Page 13 of 24 Evidence: People are treated with respect and dignity, staff were observed to knock and wait for a reply when entering bedrooms and to assist people with personal care. Care Homes for Older People Page 14 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are encouraged to make informed choices on their lifestyle in the home. Evidence: Activities are offered on a regular basis, and evidence of these is recorded on a photo board in the main hallway. Staff agreed they were able to undertake activities on most afternoons, though agreed the opportunity for these was less now the activity person had retired. The manager confirmed the company were looking at employing a replacement, though this is over and above the minimum standard. Meals are of a good quality, the cook stated she speaks to people and their relatives about what should be included in the menu. Menus are produced in advance in a four week system, are colour coded to signify the appropriate meal for the time of day laminated and displayed on a daily basis. A visiting relative agreed that they were asked what their mother may like as a change to the menu. Care Homes for Older People Page 15 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by staffs knowledge and actions around complaints and protection issues. Evidence: The complaints files were both looked at. These showed that complaints had been dealt with appropriately in a very quick timescale. The latest issue was still being investigated, the manager stated that this would be brought to a close shortly. There were no complaints made directly to the Care Quality Commission (CQC). Staff when questioned showed a good knowledge of complaint and protection issues. Care Homes for Older People Page 16 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a physical environment that is appropriate to the specific needs of the people who live there. Evidence: The home is comfortable, and retains many of the original features of this Grade 2 listed building. This in its self has presented some issues where improvements have been undertaken, and need to be re-done in a style more in keeping with the rest of the building. The home has been equipped with items designed to cut down on background odours, this has worked well improving the environment for all. The staff are very aware of the dangers of cross contamination and cross issues, and have routine tasks in place to deal with these. Laundry facilities are good, which also adds to the protection of people. Care Homes for Older People Page 17 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are not adequately protected due to poor access to staff files. Evidence: There was no access to the staff recruitment files on the day. This was due to the manager being off, and no back up system in place. This resulted in us being unable to confirm that staff are employed in line with current guidance, and have the appropriate proof of identity, references and legal checks in place prior to working with vulnerable people. Staff did indicate they went through the recruitment process prior to commencing their training induction. We did see the training plan, and staff confirmed what training they had undertaken recently. We spoke to a recently employed member of staff who had an excellent knowledge of the safety required working in the laundry area. A staffing rota is in place, staff and a relative when spoken with, felt there was enough staff to provide a good level of care to people. Care Homes for Older People Page 18 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The poor access to documents vital in the recruitment and protection process have the potential to place people at risk. Evidence: The registered manager has the experience, skills and knowledge to undertake running a home for older people. Quality assurance, which is where the staff gain knowledge from people how well the home is performing, or where it needs to develop, is in place. Quality assurance is built into many of the tasks and communication with residents and relatives. This demonstrates the manager and staff use these outcomes to improve the lifestyle of people in the home. Staff indicated supervision is in place, but not performed regularly. Staff supervision is where staff meet with a manager and their personal work practices are looked at, and future training needs planned for. Due to these records being unavailable it is not possible to ascertain if the current levels of supervision are adequate. Due to the manager being off, and no back up system in place, a large number of other staffing Care Homes for Older People Page 19 of 24 Evidence: records were unavailable. This resulted in us being unable to confirm the appropriate actions had been taken in recruiting and training staff. Health and safety is monitored, with staff performing a number of tasks ensuring the safety of people in the home. Care Homes for Older People Page 20 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 21 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 The registered person shall 23/10/2009 make suitable arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. This is to ensure that people are given the correct medications. 2 37 17 The registered person shall 23/10/2009 ensure that the records referred to in paragraphs1 and 2, are all times available for inspection by any person authorised by the commission to enter and inspect the care home. This is to ensure the safety of people in the home. Care Homes for Older People Page 22 of 24 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 8 15 When recording peoples weights it would be useful to record if the person was clothed, and the time of day. The list of main meals could be produced in a pictorial form, so people would have a full understanding of the meals on offer. The home currently has two complaint records, these could be compiled as one. 3 16 Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 24 of 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!