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Inspection on 06/12/05 for Westlands Care Home

Also see our care home review for Westlands Care Home for more information

This inspection was carried out on 6th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

There was a pleasant and relaxed atmosphere in the home. Staff on duty presented as competent and were aware of and responsive to residents needs. A resident confirmed that staff respected their independence and privacy. Residents spoken to confirmed that they were satisfied with the care provided and had good relationships with staff.

What has improved since the last inspection?

The refurbishment and re-decoration of the home has greatly improved the appearance of the home.

What the care home could do better:

No poor outcomes for residents were identified during this inspection however discussion with the registered manager confirmed that she is continuing to review the standard of care provided and in particular the level of individual detail within care plans which support the care provided.

CARE HOMES FOR OLDER PEOPLE Westlands Care Home 48 Oxford Street Wellingborough Northants NN8 4JH Lead Inspector Mrs Kathy Jones Unannounced Inspection 6 December 2005 18:35 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 Care Home DS0000050657.V263778.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 Care Home DS0000050657.V263778.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Westlands Care Home Address 48 Oxford Street Wellingborough Northants NN8 4JH 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) 01933 274430 01933 274430 Regal Care Homes Ltd Ms Tracy Burke Care Home 28 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (13) of places Westlands Care Home DS0000050657.V263778.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. One current named service user as identified in the service history log dated 14 April 2005 within the category of (PD) Physical Disability continues to be accommodated in the home. 03 June 2005 Date of last inspection Brief Description of the Service: Westlands is a care home providing personal care and accommodation for 28 older people over the age of 65 years. The home is currently registered to provide care for up to 15 older people with dementia and 5 older people with a physical disability. Westlands 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, which is accessible to Service Users and a garden, which is at present accessed by a flight of steps.Service Users rooms are situated on all three floors of the building. There is a passenger lift providing access to part of the home however access to the majority of bedrooms is via at least one step. There are twenty single rooms with four having en-suite facilities and four shared rooms. Westlands Care Home DS0000050657.V263778.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over approximately three and a half hours on the evening of a weekday. Prior to the inspection the Inspector spent one hour reading the last inspection report, the homes service history and planning the areas to be inspected. The inspection involved talking to residents about the care and support they receive, observing staff practice and the evening routine and reviewing a sample of resident’s records to see how their care is planned and supported. Discussions were held with staff about how they meet resident’s needs and their understanding of their responsibilities for safeguarding residents checked. Recruitment practices and induction training were checked through discussion with a relatively new member of staff. A sample check of the medication system was made and improvements to the communal areas of the home observed. What the service does well: What has improved since the last inspection? The refurbishment and re-decoration of the home has greatly improved the appearance of the home. Westlands Care Home DS0000050657.V263778.R01.S.doc Version 5.0 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. Westlands Care Home DS0000050657.V263778.R01.S.doc Version 5.0 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 Care Home DS0000050657.V263778.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): This section of the standards was not reviewed during this inspection. This section of the standards was not reviewed during this inspection. EVIDENCE: This section of the standards was not reviewed during this inspection. Standard 6 one of the key standards not inspected during the previous inspection is not applicable, as the home does not provide intermediate care. Westlands Care Home DS0000050657.V263778.R01.S.doc Version 5.0 Page 9 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, 9, 10 The overall care and management of medication is good with resident’s independence and dignity respected and health care services being accessed as appropriate. EVIDENCE: Residents spoken to during the inspection were satisfied with the care that they received. Observations of staff practice and discussion with them confirmed that they are aware of the individual support needs of residents. Care records for one resident were reviewed and sample checks made of other care plans to check how the care is planned and supported. A standard computer generated care plan format is used which has in the past been found to contain insufficient information about residents individual needs. However improvements were noted in the level of detail about individual care needs contained in the plans providing staff with clear instructions in providing consistent care. Westlands Care Home DS0000050657.V263778.R01.S.doc Version 5.0 Page 10 Appropriate assessments of resident health care needs were in place and records confirmed that relevant health care professionals are consulted regarding any health care concerns. Medication is securely stored and a sample check confirmed that good systems are in place for the safe management of medication. Generally the recording in relation to medication was good however one record was found to deviate from the normal practice of recording the quantity of medication received. The manager confirmed that staff practice in relation to recording and administering medication is regularly monitored in order to identify any areas for improvement. Staff were observed to be mindful of dignity issues during the inspection. Records for a resident confirmed that the level of privacy and independence had been discussed and agreed with him in relation to night time checks and staff access to his bedroom. Westlands Care Home DS0000050657.V263778.R01.S.doc Version 5.0 Page 11 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): 14 Resident’s independence is respected and they have a good level of choice and control over their lives. EVIDENCE: Discussion with a resident and review of the care files confirmed that they have a good level of choice and control over their lives. Routines in relation to getting up and going to bed are flexible. The resident has access to an advocate and maintains their independence in accessing local facilities. Resident’s preferences in respect of carers providing personal care are respected as far as possible. The quality of meals were not specifically inspected during this evening inspection however the inspector observed residents to be offered supper consisting of a hot drink with hot toast and pate. Staff confirmed that residents were offered different supper options. A cold drink was also offered to residents later on in the evening. Westlands Care Home DS0000050657.V263778.R01.S.doc Version 5.0 Page 12 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): 18 Staff have a good understanding of their responsibilities in protecting the residents they care for and aware of the process for reporting any concerns. EVIDENCE: During discussions with residents and staff they confirmed that they had no concerns about how residents are treated by staff in the home. Two members of staff were interviewed during the inspection and they were clear about their responsibilities and actions that they should take in reporting any concerns that they may have regarding the treatment of residents. A relatively new member of staff was able to confirm that prior to working in the home references and a criminal record bureau clearance had been taken up and that she had received induction into the homes policies and procedures. Westlands Care Home DS0000050657.V263778.R01.S.doc Version 5.0 Page 13 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): 20, 26 The home was clean and the recent re-decoration and refurbishment has greatly improved the appearance of the home and now provides residents with a comfortable and pleasant environment to live in. EVIDENCE: A full tour of the premises was not conducted however the communal lounges and entrance hall are much improved following the refurbishment which has included new carpets, curtains and furniture. Residents and staff appeared to appreciate the improvement in the environment. Unfortunately one of the lounges was temporarily out of action on the evening of the inspection due to a problem with the lighting resulting in one of the other lounges being quite busy. The registered manager advised that the electrician was returning the next day and hoped to resolve the problem quickly. Westlands Care Home DS0000050657.V263778.R01.S.doc Version 5.0 Page 14 The registered manager advised that the refurbishment of the bedrooms had now taken place, a bathroom re-fitted with another in the process of being refitted. Areas of the home seen were observed to be clean and tidy. Infection control procedures were not fully discussed however protective aprons; disposable gloves and alcohol gel were noted to be available for staff to reduce the risk of transfer of infection. Westlands Care Home DS0000050657.V263778.R01.S.doc Version 5.0 Page 15 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): 29, 30 Good procedures for the recruitment and induction of staff are in place providing some safeguards for residents. EVIDENCE: Recruitment procedures were assessed through discussion about the process with a relatively new member of staff. This confirmed that a thorough recruitment process is followed which includes obtaining references and criminal record bureau checks prior to staff working in the home. The member of staff was able to confirm that she had received a thorough induction training, which had included completion of a written programme. Prior to being included in the staff ratio the member of staff had also worked alongside an experienced member of staff. Westlands Care Home DS0000050657.V263778.R01.S.doc Version 5.0 Page 16 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): 33, 35 Systems are in place for reviewing the standards of care and for monitoring the management of resident’s personal monies. EVIDENCE: Systems are in place for reviewing the quality of care provided and seeking the views of residents and relatives and are being further developed to include the views of health professionals. Records were not reviewed during this evening inspection however copies of the collated responses have been periodically forwarded to The Commission for Social Care Inspection. The current form used to collate views on the care provided does not routinely include evidence of any the actions taken are collated. No issues of concern were identified however the manager confirmed that views are listened to and would be acted on. Westlands Care Home DS0000050657.V263778.R01.S.doc Version 5.0 Page 17 A representative of the responsible individual carries out unannounced visits each month to assess the standards of care. A copy of the report for a visit carried out on 30.11.05 identifies that a sample of residents and staff were spoken, a sample of records including maintenance records and residents care records reviewed. The manager has confirmed that small amounts of money are held on resident’s behalf to assist with the payment of things such as chiropody and hairdressing. Any money is securely stored and senior staff make any transactions with two signatures verifying each transaction. The manager advised that she carries out a check on each resident’s finances every month. The report of the unannounced visit by the responsible individuals representative on 30.11.05 confirms that monies held on behalf of three residents were checked and found to be correct. The manager confirmed that these are random checks. Westlands Care Home DS0000050657.V263778.R01.S.doc Version 5.0 Page 18 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X 3 X X X X X 3 STAFFING Standard No Score 27 X 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X X Westlands Care Home DS0000050657.V263778.R01.S.doc Version 5.0 Page 19 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 Care Home DS0000050657.V263778.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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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