Inspection on 26/01/09 for Westlands House

This inspection was carried out on 26th January 2009.

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 House 05/09/06

Westlands House 29/11/05

Westlands House 29/07/05

Westlands House 16/12/04

Westlands House 25/05/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Westlands House Headmoor Lane Alton Hampshire GU34 3EP     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Peter McNeillie     Date: 2 6 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Westlands House Headmoor Lane Alton Hampshire GU34 3EP 01420588412 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Ms Lesley Linda Tagima,Mr Anthony James Daly Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 35 Number of places (if applicable): Under 65 Over 65 0 0 dementia old age, not falling within any other category Additional conditions: 35 35 The maximum number of service users to be accomodated is 35 The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) Old age, not falling within any other category (OP). Date of last inspection Brief description of the care home Westlands is a privatley owned and managed home registered to provide accomodation, support and care for up to thirty five older persons some of whom may have dementia. The home which is a large extended converted house with on site parking,is situated in a pleasant rural location on the outskirts of the mid Hampshire town of Alton within easy travelling distance of Winchester, Portsmouth, Basingstoke, Care Homes for Older People Page 4 of 27 Brief description of the care home Aldershot and Guilford. All residents are who accomodated in single rooms with ensuite facilities can access all of the homes communal areas including a conservatory/lounge, dining room on the ground floor, a quiet lounge diner on the first floor and a large established safe garden. Care Homes for Older People Page 5 of 27 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: three star excellent 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: This report was written after taking into consideration a number of sources of information and evidence. These included a site visit to the premises, previous reports,sampling residents, staff training and recruitment records,talking with residents, staff and management and a response by the manager to a pre inspection Annual Quality Assurance Assessment. (AQAA). The responses to an in house satisfaction questionnaires completed by residents and residents representatives and a pre inspection CSCI satisfaction survey involving residents,residents representatives,staff, social care and health care professionals were also taken into consideration. During this inspection which took place on 26/01/09 between the hours of 9.00 am and Care Homes for Older People Page 6 of 27 1.00 pm all of the key standards for older persons were inspected. The results and findings contained in this report will determine the frequency and type of future inspections. At the time of our visit charges varied between three hundred and thirty pounds and six hundred and thirty pounds per week. 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 27 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 9 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a system of assessing and identifying residents needs which ensures residents safety and that their assessed needs can be met. Intermediate care is not provided so this standard does not apply. Evidence: The manager informed us that residents were only admitted in accordance with the homes pre admission policy and procedure that requires a detailed written assessment of needs and risks being carried out by a member of the homes management team in consultation with the prospective resident or their representative. A Sample of four residents pre admission assessments chosen at random were viewed. Care Homes for Older People Page 10 of 27 Evidence: All were produced in accordance with the policy and procedure previously referred to and took into consideration residents care, nutritional and communication needs, wishes, choices, aspirations as well as any attendant risks and confirmed that potential residents are consulted about and were involved in the assessment process. Where the resident is funded by a local authorities social services department this would also include an assessment by a care manager. As part of the admission process management also liaise with external health and social care professionals regarding any care needs, risks, equipment and aids, that need to be considered and included when developing a plan of care. Records also confirmed ongoing assessments of need and risk for all residents are carried out on a regular basis and care plans (Section 7-11 of this report refers) updated to reflect any changes. Intermediate care is not available in the home. Care Homes for Older People Page 11 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a well-developed system of planning and reviewing care, which reflects residents, wishes, and aspirations and ensures residents needs are met within a risk management policy involves residents or their representatives in decisions that affect them. Evidence: As part of our inspection plan, we viewed a random sample of four residents care plans chosen at random. All of the detailed care plans which included confirmation that residents or their representatives were involved in producing, were reviewed at least monthly and based on based on in house and care management pre admission assessments as described in the previous section of this report. CSCI pre inspection survey forms and records viewed confirmed residents or their Care Homes for Older People Page 12 of 27 Evidence: representatives were consulted about and participated in the production of the plan. Due to the high care needs of the residents we were unable to gain reliable verbal confirmation of participation. Responses to our pre inspection satisfaction survey, a current in house satisfaction survey by residents and their representatives confirmed they were very satisfied with the care and support they received and the manner in which it was delivered. They advised us they were contented, liked the staff and management and were treated with respect. Comments such as I am very happy, No complaints , Everything is very good I am unable to find any aspect of the home that needs improving, Home is run to a high level, visitors are always welcome. The best lovely are typical of the views of residents living in the home or visitors. Resident also confirmed that their individual privacy was respected and that staff always knock on their bedroom door and wait before entering, a practice we observed during this visit. In a response to the CSCI pre inspection survey, a health care professional stated, Always provide private rooms and draw curtains if appropriate. Residents right, and the opportunity to take risks are seen as fundamental. Residents were supported to make decisions for themselves within a risk assessment framework with the help of staff if required. This process identified individual risks and how they were to be managed. Staff who had a good understanding of the contents of the care plans and risk assessments were able to explain how the care plan was put into day-to-day practice. This was confirmed by a visiting health care professional and in a response to our pre inspection survey that also stated the homes Staff very polite, helpfull and professional towards visitors, Care service does well in respecting and meeting individual needs. Residents were able to see or consult with any health and social care professional of their choice when they needed to. Records were kept of appointments with GPs, dentist, optician, chiropodist and any other external health and social care professional and included details of any advice and treatment given. Records also confirmed apart from doctors, district nurses other specialists would be consulted as required. All medication which is dispensed by a pharmacist into a nomad system stored and administered in accordance with a medication policy and procedure by staff all of whom have received training in the administration, recording and the security required Care Homes for Older People Page 13 of 27 Evidence: when handling residents drugs and medication. The procedure also includes provision for these residents who wish subject to a risk assessment to retain responsibility for their own medication. At the time of our visit, following a risk assessment no resident was responsible for his or her own medication. In response to our questions relation to equality and diversity, in there AQAA, we were told: Equipment is provided to assist residents with disabilities. We have a mixed workforce from various backgrounds. Applicable policies and procedures are used within the home. We have monthly church services at Westlands which caters for clients whose faith is Church of England. One of our clients who is a Baptist has the opportunity to attend a local Baptist church. Two other clients who are Catholic have a visiting priest attend Westlands. There are no other faiths in the home at present. Care plan arrangements for residents final wishes have been incorporated in their care plan. Annual review of policies and procedures. List of difference church services available in and around Alton. Care of the dying policies and procedures take into account the wishes of the patient and any requirements of their religion. All residents are encouraged to attend outings regardless of their physical or mental disabilities. Care Homes for Older People Page 14 of 27 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. Activities, access to the community, family contacts, mealtimes and the provision of varied and nutritious meals were very well managed and reflected residents interests and choices. Evidence: To ensure a wide range of activities are available an activities coordinator is employed to arrange activities, which reflect residents, needs and wishes. Residents in their responses to our pre inspection survey and the homes internal survey expresses total satisfaction at the activities available and confirmed there was always somthing available they could take part in. During our visit we observed a group involved in a quiz, which they appeared to enjoy. Other activities on offer included, outside entertainers, pat dog, bingo, crafts, flower arranging, exercises. The surveys also confirmed, that participation was up to the individual and no one was forced to join in. To ensure activities are suitable and meet the need of residents the home has consulted with the local Alzheimers society and a number of web sites dedicated to Care Homes for Older People Page 15 of 27 Evidence: older persons. The manager informed us, a great deal of effort goes into using local facilities and inviting local groups into the home such as the local primary school who gave a carol concert. This has resulted in the home despite its rural location becoming an integrated part of the local community. Local clergy from a range of Christians denominations visit the home.We were informed if a resident from any other faith was resident arrangements would be made, to ensure their spiritual needs were met Responses by residents and advocates told us that residents are free to make decisions about their day to day lives such as, mealtimes, where meals are taken, visiting times, the right to receive and converse with visitors and to make and receive telephone calls in private. The quality, quantity, presentation and choice of food served came in for particular praise from the residents. A written daily menu based on residents likes and dislikes and a choice of meals was displayed. To ensure that residents can make a meaningful choice the home has developed a catalogue of picture to assist residents. However in addition, the manager acknowledged the need to ensure that the menu was displayed in format that all residents would understand and that this is of prime importance for persons with dementia who may find the addition of pictures would be beneficial to understanding what they are eating. A verbal undertaking was given by the manager to extend the use of pictures to the daily menu. We observed residents taking their mid day meal. This was conducted in a relaxed unhurried manner. Tea and coffee were available to residents and visitors at all times as was water and fruit squash. We observed staff encouraging residents to drink fluids to ensure they did not become de hydrated. Care Homes for Older People Page 16 of 27 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. The home has clear policies and procedures in place that ensures residents are protected from abuse. The complaints procedure was satisfactory with evidence that residents feel their views will be acted upon. Evidence: An Adult Protection policy and procedure designed to safeguard residents from abuse, which worked in tandem with the policy, and procedure produced by Hampshire County Council as the lead agency for the safeguarding residents was available. Management and staff spoken with and records viewed confirmed they had received training in recognising abuse and demonstrated they knew the outside lead agency responsible for the safeguarding of residents and the procedure to follow should they witness or suspect the abuse of any resident. The homes complaints procedure was which was also included in the service users guide included information on how to contact The Commission for Social Care Inspection was available was a record of complaints. Responses by residents or their advocates, staff and visitors spoken with confirmed they were aware of the complaints procedure and to stated they felt comfortable in Care Homes for Older People Page 17 of 27 Evidence: discussing any concerns they had with the homes management and confident any matters raised would be dealt with fairly and promptly. Care Homes for Older People Page 18 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A safe, well maintained, clean, suitably furnished home is provided for residents, which meets their needs. Evidence: On entering the home we were immediately made aware of an infection control policy in place due to the availability of antiseptic hand gel. Our initial feelings were how warm and welcoming the home was. The home which is a large converted property is located in pleasant a rural setting in its own grounds with ample parking within easy travelling distance to Basingstoke, Aldershot, Guilford, Winchester, Southampton and Portsmouth all of which can be accessed via major trunk roads or motorways. All areas of the well presented decorated home, very clean and free from unpleasant odours and obvious hazards. Those responsible for the high standard of cleanliness throughout the property are to be commended. Residents confirmed to us in our pre inspection survey the home is always clean and smells fresh. Furniture was comfortable, homely and in a good state of repair and met residents individual and collective needs and the decor with many photographs interesting and stimulating. Apart from personal mobility aids a number of communal aids had also been provided to assist residents to access all of the communal areas including the well-tended, large Care Homes for Older People Page 19 of 27 Evidence: established and safe garden. These included special baths hoists, grab rails, toilets, chairs etc all of which had been taken into consideration at the initial pre admission assessment as describe in sections 1 to 6 of this report. A rolling programme of maintenance and refurbishment is in place to ensure that the building is well maintained, decorated and kept safe by the homes own maintenance personnel who are also to be commended for the condition of the building. Care Homes for Older People Page 20 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs are met by sufficient numbers of staff who are recruited and selected using a procedure designed to protect all residents. Evidence: The manager informed us, the planned daily staffing levels for the home each day is: 8.45am to 2pm. The Manager, five carers plus a cook, laundry assistant, two cleaners one administrator, one activities coordinator (part) and one handyman. 2pm to 8pm The Manager (for part) plus four carers, one administrator (for part), one activities coordinator (for part), 8pm to 10pm two carers. 10pm to 7.45am three waking night carers plus on call emergency arrangements. At the time of our visit, in our view the number of management, care and support staff available met residents needs, a view supported by the manager, visitors and visiting health care professionals. We were informed that all staff are employed in line with a recruitment and selection policy and procedure designed to protect residents. To test this we viewed four staff recruitment and training files selected at random. Care Homes for Older People Page 21 of 27 Evidence: All files viewed included evidence that supported what we had been told, that staff are employed in accordance with a robust recruitment, equal opportunities and selection procedure designed to protect residents. This involves the completion of an application form, the signing of a rehabilitation of offenders declaration, an interview, and satisfactory Criminal Record Bureau (CRB) disclosure, Protection of Vulnerable Adults (POVA) and reference checks. Following their appointment all staff are subject to an in house induction and skills for care induction procedure and other training that include first aid, handling medication, moving and handling, safeguarding, infection control and dementia. As past of their terms of employment all staff are expected to attend an NVQ training course to at least level two in care. We viewed training records that indicated 13.3 of had been trained to NVQ level two, 40 to NVQ level three with a further 20 on a level two course and 6.7 on a level three course giving a total of 80 either qualified or on a course. This is far in excess of the expectations of the standards. A visiting health care professional described the staff as suberb, caring, kind excellent views also expressed in our satisfaction surveys and in thank you letters to the home in which the staff were described as understanding, sympathetic kind and patient Care Homes for Older People Page 22 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management of the home ensures the health, safety and welfare of residents and staff are promoted and the home is run in the best interests of the residents, whose views about living in the home are formally sought. Evidence: From all of the information we received and our observations we concluded that the home is well managed by a manager who has worked at Westlands House for the last five years as a carer, deputy manager and now manager and was likely to be registered within days of our visit. Apart from her experience, she holds an NVQ qualification in care at level four and during our visit was advised she had been awarded her registered managers award also at level four. Residents in our survey, staff and visitors were full of praise for the manager and the way in which the home is managed. Care Homes for Older People Page 23 of 27 Evidence: In talking with the manager and staff it was evident that clearly defined management structure was in place. All of the staff spoken with staff was aware all of their responsibilities and the limits of their authority. Staff informed us the homes management were supportive, approachable and accessible and willing to listen to any ideas they may have for the improvement of the service. As part of the homes quality monitoring system, residents and residents representatives, staff and visiting health and social care are invited to participate in very regular satisfaction surveys. The views expressed in the surveys are seen as key in highlighting areas that may require improvement or attention and the future development of this service. Results from the last survey in January 2009 indicated a very high level of satisfaction by residents in all areas such as complaints, maintenance of the building, activities, meals (quality and choice) personal privacy and dignity, staffs abilities and overall care. These results mirrored the responses from our own pre inspection satisfaction survey. We were informed that monies of only one resident was being held for safekeeping. Records and receipts viewed agreed and reconciled with the cash balances held. Following the last inspection a requirement was made that all designated fire doors must be kept closed unless secured with an approved device.This requirement has been complied with. An in house health and safety policy was in place to ensure the day-to-day safety of staff and residents. Procedures include, health and safety checks, the regular servicing of equipment, staff training in the techniques of moving and handling infection control, control, first aid, health and safety, procedures to follow in the event of fire (including evacuation), in addition all staff are issued with protective gloves and aprons and have access to antiseptic hand gel and soap. We were informed that all of the hot water supplies to baths were fitted with thermostatic controls set at 43 degrees centigrade and all radiators and hot pipes were covered to prevent a resident or staff being burnt. Care Homes for Older People Page 24 of 27 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 25 of 27 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 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 Care Homes for Older People Page 26 of 27 Helpline: 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 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. 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