Inspection on 29/11/05 for Westlands House

This inspection was carried out on 29th November 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.

Other inspections for this house

Westlands House 26/01/09

Westlands House 05/09/06

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Westlands House Headmoor Lane Alton Hampshire GU34 3EP Lead Inspector Marilyn Lewis Unannounced Inspection 29th November 2005 10:00 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 House DS0000012233.V270053.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 House DS0000012233.V270053.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Westlands House Address Headmoor Lane Alton Hampshire GU34 3EP 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) 01420 588 412 Ms Lesley Linda Tagima Mr Anthony James Daly Ms Lesley Linda Tagima Care Home 33 Category(ies) of Dementia - over 65 years of age (2), Old age, registration, with number not falling within any other category (33) of places Westlands House DS0000012233.V270053.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. No more than two service users in DE(E) at one time. Date of last inspection 29th July 2005 Brief Description of the Service: Westlands House is a former private residence that has been converted into a care home for older people and those over the age of sixty-five years with dementia. The home provides accommodation for thirty three residents. All resident’s bedrooms are single rooms with en-suite facilities. Residents have access to two lounges and a separate dining room. The home is situated in large gardens, in a pleasant rural location on the outskirts of Alton, Hampshire. Westlands House DS0000012233.V270053.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 29th November 2005. The inspector toured the home and met with nine of the twenty three residents, three staff members, the registered manager and a GP. Care plans were sampled for three residents and records were seen for medicines, staff training, complaints, accidents, fire safety and fire drills. This was the second unannounced inspection for the year 2005/2006 and information on standards not assessed on this occasion can be found in the inspection report dated 29/07/05. What the service does well: On the day of the inspection Westlands House had a warm, relaxed atmosphere even though major refurbishment work was taking place. The nine residents spoken to during the visit were all satisfied with the care provided at the home and there were comments of ‘it’s lovely here’ and ‘the staff are really very caring’. No one is admitted to the home without a full care needs assessment being undertaken and prospective residents know that the home can meet their needs. Good care plans provide staff with all the information they require to fully support the residents throughout their stay at the home. Residents’ health is protected by the home’s clear procedures for dealing with medicines and the good liaison between GPs and staff at the home. Residents know any complaints will be taken seriously and they are protected by staff awareness of abuse issues. Major refurbishment is underway to provide residents with accommodation of a high standard that includes single rooms with en-suite facilities, pleasant communal rooms and accessible gardens. Specialist equipment such as hoists is provided, for all residents assessed as requiring it, to maximise their independence. Residents’ needs are fully met by the number and skill mix of staff at the home and staff receive the training and support required to do their job. Westlands House DS0000012233.V270053.R01.S.doc Version 5.0 Page 6 The home is run in the best interests of the residents who are protected by the home’s clear financial procedures and by staff who receive appropriate supervision and use safe working practices. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Westlands House DS0000012233.V270053.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 House DS0000012233.V270053.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): 3 and 4 No one is admitted to the home without a full care needs assessment being undertaken and prospective residents know that the home can meet their care needs. EVIDENCE: The registered manager undertakes a full care needs assessment for each prospective resident prior to offering a place at the home. The assessment covers all aspects of care needs including personal, emotional and social needs. Assessments seen for three residents who had recently been admitted to the home were good and contained details of the resident’s past medical history, medication and history of falls. Relatives are encouraged to participate in the assessment process and relevant information from care managers and health professionals is included in the completed report. The full care assessment forms the basis for the individual care plans. The registered manager has experience in providing care for people over 65 years and those over 65 with dementia. Ms Tagima holds the Registered Westlands House DS0000012233.V270053.R01.S.doc Version 5.0 Page 9 Managers Award and is an NVQ assessor. The home has a stable workforce with new staff being recruited to ensure the needs of the increasing number of residents can be fully met. The registered manager is operating a system of recruiting new staff members who receive induction training and training in mandatory topics such as moving and handling before additional new residents are admitted to the home. Staff at the home receive training in all aspects of care. The registered manager has attended training in dementia care and other staff members are due to receive training in January 2006. Advice is sought from GPs and other health professionals such as district nurses and occupational therapists as required. Westlands House DS0000012233.V270053.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11. Good care plans provide staff with the information required to fully support the residents throughout their stay at the home and the residents’ health care needs are fully met and protected by the home’s clear procedures for dealing with medicines. EVIDENCE: Care plans were sampled for three residents. The plans were good and provided clear information for staff on the care needs of the residents and the actions required to meet those needs. Risks assessments, including assessments for mobility, nutrition and pressure areas were contained in the care plans. The documents showed evidence of monthly review and involvement of the resident or their relatives. Care plans seen indicated that advice was sought from GPs and other health professionals as required by residents. A GP visiting the home at the time of the inspection said that staff were good in following through with any instruction and advice given. He also said that staff were very aware of the needs of the residents. Westlands House DS0000012233.V270053.R01.S.doc Version 5.0 Page 11 Opticians and dentists visit annually and on request and a chiropodist attends to residents on a six weekly basis. The registered manager said that advice was sought from occupational therapists as required. The home has clear procedures in place for dealing with medicines. Medication records seen had been completed appropriately. Records for controlled medicines seen, matched the stock held. At the time of the inspection there were no residents who self-administered their medicines. Only staff who have received training in the administration of medicines are able to do the medicine round. Up to date information on medicines used in the home was available for staff. During the inspection staff were seen to knock on doors before entering rooms and to speak to residents in a friendly, respectful manner. Three residents spoken to said that staff always treated them with respect. The home has policies in place for caring for the dying that indicate the resident and their family would be treated with sensitivity and respect. The registered manager said that family and friends are able to visit as they wish and are able to stay overnight if required. Staffing levels are increased during the times when a resident is very ill, to allow a staff member to spend additional time with the resident, if family members are not in attendance. Advice and support is provided by the resident’s GP and district nurses, who visit on request, to inform staff on care issues such as care of the mouth when it is not possible for the resident to take fluids. Westlands House DS0000012233.V270053.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were assessed during the last inspection and are included in the inspection report dated 29/07/05. Westlands House DS0000012233.V270053.R01.S.doc Version 5.0 Page 13 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): 16 and 18 Residents know that any complaints will be taken seriously and they are protected by staff awareness of abuse issues. EVIDENCE: The home has a complaints procedure in place that indicates who will investigate the complaint and timescales for the process. The registered manager said that no complaints had been received in the last twelve months. Two residents were asked about the procedures for making a complaint. Both knew how to make a complaint but said that they had no reason to do so. The two residents said that they thought the registered manager would take any complaints or concerns seriously and would carry out an investigation. Clear procedures are in place for staff to follow should abuse be suspected. All staff receive training in abuse issues during induction and in training sessions specifically dealing with abuse awareness. Two staff members spoken to during the inspection were aware of the procedures to be followed and indicated that they would ‘whistle blow’ should they have any concerns. Westlands House DS0000012233.V270053.R01.S.doc Version 5.0 Page 14 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): 19, 20, 21, 22, 23, 24, 25 and 26 Refurbishment of the home is being undertaken to provide a high standard of clean, safe, accommodation for residents who are all provided with single bedrooms, sufficient bathroom and toilet facilities, specialist equipment as required, pleasant communal rooms and large gardens that are accessible to all. EVIDENCE: The home is currently undergoing major refurbishment to increase the number of residents to be accommodated to thirty- three. A two- storey extension has been built to one side of the property providing sixteen single rooms with ensuite facilities and two assisted bathrooms. A lift and an additional stairway have been provided in the extension area allowing residents access to all areas of the home. The extension has been completed and residents from some of the rooms on the other side of the home have been moved into the new rooms while their own rooms are refurbished. The refurbishment of the original rooms has allowed some of the rooms to be enlarged and for new windows to be Westlands House DS0000012233.V270053.R01.S.doc Version 5.0 Page 15 fitted, with patio doors provided for the some of the ground floor rooms. All residents will be accommodated in single rooms when the refurbishment programme has been completed. The lounge on the ground floor has been enlarged and a very large conservatory has been built to run along the rear of the house. The conservatory can be accessed from the ground floor lounge and the dining room. The laundry room has also been rebuilt and hand washing facilities will be available for staff in the laundry room when it has been completed. The refurbishment programme is due to continue until mid 2006. The plans include the building of a new corridor area at the front of the home that will allow access to the office without having to go outside or walk through the kitchen area. The refurbishment of the home is providing an environment fitted to a very high standard. Residents have been consulted throughout the work and have been able to select the décor for their own rooms and for new furniture provided. The registered manager is very sensitive to the needs of the residents which was indicated by the redecoration and purchasing of new furniture for a resident who ‘was feeling down’. Under floor heating has been installed in the new extension and residents are able to control the temperature of their own room. This was evident during the tour of the home when the temperature in the rooms varied considerably. Specialist equipment such as hoists is provided to assist residents with poor mobility and ramps and grab rails are fitted where required. A call alarm system is fitted throughout the home and during the inspection call bells were seen to be available for residents. Westlands House has large gardens that are accessible to residents including those who use wheelchairs. A large patio area has been built to the rear of the property and small patio areas have been provided for residents with rooms fitted with patio doors. A variety of seating is provided around the garden. A summerhouse situated in the garden to the side of the property is to be a ‘tuck shop’ when work on the property has been completed. The registered manager said that this would enable residents, who wished, to purchase small items such as toiletries during the shop open hours. A footpath is being built from the home to the summerhouse, to allow all residents access to the building. Although major work is being undertaken at the home areas accessed by the residents looked clean and well maintained at the time of the inspection. Residents spoken to during the visit said that they had not been disturbed by the building work. It was evident while touring the home that the safety of the Westlands House DS0000012233.V270053.R01.S.doc Version 5.0 Page 16 residents was being considered, with access to ‘work in progress’ areas restricted until the area was safe for staff and residents to access. Westlands House DS0000012233.V270053.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 and 30. Residents’ needs are met by the number and skill mix of staff who are employed at the home and who receive the training and support required to do their jobs. EVIDENCE: The registered manager has arranged for new residents to move into the additional rooms in stages to allow for the recruitment and training of the extra staff required to meet their needs. The home employs the registered manager, a senior carer who undertakes some management duties, three senior carers and seven carers. Another carer is due to commence work at the home the following week. Separate staff are employed for administration, catering, laundry and domestic duties. The home is currently advertising for an activities co-ordinator. The senior carer with management responsibilities holds NVQ level 3 and is going on to do NVQ level 4 in the New Year. Two of the care staff members hold NVQ level 2 or above and the registered manager said that all the other carers are commencing NVQ training in January 2006. The registered manager is an assessor and arrangements are being made for the senior carer/management to undertake training to become an assessor in 2006. New staff members complete an induction programme and all staff have received training in moving and handling, food hygiene, first aid, abuse awareness and fire safety. Arrangements are in place for training in health and Westlands House DS0000012233.V270053.R01.S.doc Version 5.0 Page 18 safety. Training sessions have also been arranged in January 2005 on dementia care. Two staff members spoken to during the inspection said that they were encouraged by the registered manager to attend training sessions and to gain qualifications. Westlands House DS0000012233.V270053.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 34, 35, 36, 37 and 38 The home is run in the best interests of the residents who are safeguarded by the homes clear accounting and financial procedures and they are protected by staff who are appropriately supervised and who follow safe working practices. EVIDENCE: The registered manager said that questionnaires are provided for residents and their relatives every three months, to obtain their views on the quality of care and the services provided at the home. Relatives are invited to attend reviews of their resident’s care plan and residents and visitors are also able to put comments in the internal post box. The registered manager operates an ‘open door’ approach to management that allows residents, visitors and staff the opportunity to meet with her at any time. She meets with residents on a one to one basis daily and group meetings are also held. The registered manager said that the meetings are used to provide the residents with the opportunity to discuss issues such as the Westlands House DS0000012233.V270053.R01.S.doc Version 5.0 Page 20 refurbishment work, colour schemes for the rooms and entertainment. Records of meetings seen indicated that comments are acted on and feedback is given quickly. The registered manager is also one of the registered providers. She meets with the second registered provider annually to discuss a business and financial plan for the home. A bookkeeper is employed to maintain the financial records which are then forwarded to an accountant. Frequent meetings are held throughout the year to evaluate the quality of the service. However the commission does not receive the required monthly reports to confirm quality assurance visits are being undertaken by the registered provider. No residents’ money is held at the home. Any expenses incurred such as for hairdressing or chiropody are billed monthly to the relatives or person responsible for the residents finances. Receipts are kept for all transactions. Staff receive formal supervision at least six times a year. Supervision is undertaken by the registered manager and the senior carer/management. The supervision meetings are arranged to suit both parties and records are kept. Topics for discussion include the staff member’s strengths and weaknesses, care issues and training requirements and opportunities. The home has clear policies and procedures on all aspects concerning the provision of care including health and safety, staff recruitment, admission procedures and confidentiality. Policies and procedures seen had been reviewed annually. Health and Safety information is on display around the home. Staff receive training in moving and handling, first aid and food hygiene. On the day of the inspection a fire safety officer was undertaking a fire safety check and risk assessment of the home following the building of the extension. At the time of the last inspection records for staff attendance at fire drills were unclear and did not confirm that all staff had attended drills. Records seen on this occasion indicated that all staff had received fire safety training and attended fire drills. The kitchen looked clean and in good order with food stored appropriately. Hazardous substances such as cleaning fluids were stored securely. Westlands House DS0000012233.V270053.R01.S.doc Version 5.0 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 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 3 3 3 3 2 3 Westlands House DS0000012233.V270053.R01.S.doc Version 5.0 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. 1. Standard Regulation 26(5)(a) Requirement The registered provider must supply the commission with a copy of the written monthly report on the conduct of the home. Timescale for action 31/01/06 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 House DS0000012233.V270053.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Westlands House DS0000012233.V270053.R01.S.doc Version 5.0 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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