Inspection on 14/06/07 for Westleigh

This inspection was carried out on 14th June 2007.

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 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

Westleigh 24/01/06

Westleigh 20/10/05

Westleigh 10/02/05

Westleigh 05/10/04

Westleigh 11/01/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Westleigh 109 Walton Road Stockton Heath Warrington Cheshire WA4 6NR Lead Inspector David Jones Unannounced Inspection 14 and 21st June 2007 10:00 th Westleigh DS0000027003.V333309.R01.S.doc Version 5.2 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 Westleigh DS0000027003.V333309.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. 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. Westleigh DS0000027003.V333309.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Westleigh Address 109 Walton Road Stockton Heath Warrington Cheshire WA4 6NR 01925 860584 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) Warrington Community Care Ms Alison Edwards Care Home 18 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (18), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (18) Westleigh DS0000027003.V333309.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 18 service users to include: * Up to 18 service users in the category of MD (mental disorder, excluding learning disability or dementia 40-65 years of age). * Up to 18 service users in the category of MD(E) (mental disorder, excluding learning disability or dementia over 65 years of age). 24th January 2006 Date of last inspection Brief Description of the Service: Westleigh House is a care home operated by Warrington Community Care that provides a long-term home for people who have suffered, or are suffering from an enduring mental illness. The care home is located in a pleasant and popular residential area of Warrington known as Stockton Heath. It provides spacious and well-maintained accommodation. There are 18 single bedrooms, two of which are being used to provide double accommodation for two people who wish to share. There are four lounges including one which is designated the smoking lounge. Thirteen WC’s, three bathrooms and two shower rooms. Information about Westleigh House including copies of the most recent inspection report is made available to each of the people who live at the home and can be acquired by contacting the home on the telephone number given above. Information provided by the registered manager on the 4 April 2007 confirms that fees range from £326 to £369 per week There are no additional charges other than hairdresser, toiletries, and other sundry items charged at cost. Westleigh DS0000027003.V333309.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection of Westleigh House was unannounced. It included a visit to the home that took place on the 14th and 21st June 2007 taking 7 hours and 55 minutes in total. The visit was just one part of the inspection. Before the visit, the manager of the home was asked to complete a questionnaire to provide CSCI with up to date information about the home. CSCI questionnaires were also made available for the people who live at the home, their families and health and social care professionals and their views have been taken into account. Other information received since the last key inspection was also reviewed. During the visit, various records were looked at; a tour of the home was carried out. Observations were made of how staff interacted with and provided support and care for the people who live at the home. A number of people, who live at the home, visiting relatives, care staff and a visiting health care professional were spoken with. They gave their views and these have been included in this report. What the service does well: People who are considering moving to a Westleigh House are able to visit the home and are provided with the information they need to help them with their decision-making. They have their needs assessed before they move in so they know that the home will be suitable to meet their needs. Care staff work with the individual and their representatives to develop a plan of care that meets their individual needs and personal preferences so they receive care in the way they prefer and their needs are met. The principles of privacy and dignity are promoted so people feel respected and valued. A visiting psychiatrist described Westleigh House as an excellent home and spoke highly of the staff team and the standard of care provided. Managers and care staff were said to be knowledgeable, sensitive and skilled in their approach. They work in partnership with health care professionals and support the individual in a person centred way so their health care needs are met. People who live at Westleigh House are able to make choices about their life style and say they are happy with the range of activities on offer including the music group, art and aromatherapy classes which are popular. The atmosphere is relaxed and sociable. Staff tend remain in the background and encourage the people who live at the home to answer the door and welcome visitors to the home. This shows respect for the people who live at Westleigh House and reinforces their rights and the fact that it is their home first. Westleigh DS0000027003.V333309.R01.S.doc Version 5.2 Page 6 No complaints have been received by the home but managers and staff have a positive attitude about receiving complaints and there is a complaints procedure so people are able to express their concerns and know that they will be taken seriously and acted upon. A competent person manages the home and staff are skilled, well supported and receive training so they have the skills they need to meet the needs of the people who live in the home. All staff have either achieved an NVQ at level 3 or above or are working toward the qualification. One of the people living at the home said the “staff are very good, very kind. They are very well trained and always treat us with respect”. The people who live at the home, their relatives and health and social professionals are asked about the quality of care, facilities and services provided so the home is run in their best interests. What has improved since the last inspection? What they could do better: Information including the statement of purpose, service users guide and complaints procedure should be made available in user-friendly formats including large print, with illustrations or on an audiotape where required so all the people who live at the home can access the information as independently as possible. Risk assessments that result in limitations of freedom of movement or power to make decisions of any individual should be reviewed to make sure they provide all background information including the reason why the limitation is made, so the individual’s rights are promoted and the decision is reviewed if circumstances change. Develop care plans to help people who may lack motivation, to explore and take advantage of opportunities for recreation and leisure and to maintain and develop independent living skills so they receive the encouragement and stimulation they need to live a fulfilled lifestyle. Provide domestic kitchen facilities so the people who live at the home are able to maintain and develop domestic living skills if they wish. Westleigh DS0000027003.V333309.R01.S.doc Version 5.2 Page 7 Offer the people who live in the home with a choice of meal on the day it is to be served so their quality of life is improved and they can choose a meal according to the weather and what they fancy on the day. Stock records of all medicines administered by staff must be made so people are protected and medicines can be checked and accounted for. Ensure staff receive the training they need in respect of the Mental Capacity Act 2005 and equality and diversity so they have the knowledge they need to promote rights and meet the needs of all people. An electrical wiring certificate should be acquired from the relevant approved electrical contractor to confirm that the electrical wiring systems have been serviced and are safe. Keep receipts when money is spent on an individual’s behalf and check balances of money held on the change of each shift so the individual is protected and staff are errors are corrected. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Westleigh DS0000027003.V333309.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Westleigh DS0000027003.V333309.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. New people who are interested in moving to Westleigh House have their needs assessed and are provided with the information about the care, facilities and services provided so they know how the home will meet their needs before they make a decision about moving in. EVIDENCE: People who are interested in moving to Westleigh House are provided with a statement of purpose and service users guide so they have the information they need to make an informed choice about coming to visit the home. Both the statement of purpose and service users guide contain information about the home including the philosophy of care and facilities and services provided. In addition they have access to past CSCI inspection reports and the home’s quality assurance reports, which contain the views of other people living at the home to help them with their decision-making. All people living at the home said that they had enough information about the home to make a decision about moving in. Significant time and effort is spent making the process of moving in personal and sensitive to the needs of the individual. People who are thinking about moving in are encouraged to visit and test the home before making final decisions about moving in so they know it is suitable to meet their needs. One of the people living at the home said “they were able to get use to the home first by visiting”. They explained that they did not have confidence at first but Westleigh DS0000027003.V333309.R01.S.doc Version 5.2 Page 10 visiting and getting to know the home and the other people who lived there helped them to make the right decision. Some parts of the service users guide need updating so people thinking about moving in have up to date and accurate information so confusion and misunderstandings are avoided. The manager advised that some of the people who live at the home have difficulty reading and understanding formal documents so consideration is being given as to how to make the information more accessible and meaningful to them. The use of large print, audiovisual media, illustrations and photographs should be explored to find the best way of presenting the information so all people who live at the home are helped to understand it. It is important that the information is presented in such a way that is meaningful and interesting. Assessment and admissions procedures are well established so all new people wishing to move to the home have their needs assessed before they make any decisions about moving in. The care records of three people living at the home were read during the visit. These contained assessments based on the person’s abilities and needs in coping with everyday living, and plans of care for any needs identified at the assessment so the person moving in knows how their needs are to be met. Westleigh DS0000027003.V333309.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each person living at the home is involved with the development of their individual care and support plans so they receive the care and support they need in the way they prefer. EVIDENCE: People who live at Westleigh House are involved in the planning of their care and support so they are helped to maintain control of their lives and develop a lifestyle that reflects their needs and personal goals. Care and support plans reflect the individual’s needs and aspirations are developed and agreed with them so they receive care and support in the way they prefer. Risk assessment is at the centre of the home’s assessment and care planning processes. Management and staff understand the importance of people being supported to take control of their own lives, and to encourage and enable them to exercise their rights and make their own decisions and choices. There are many examples where individuals are being helped to manage risk in the interests of a fulfilling lifestyle including going out into the local community and Westleigh DS0000027003.V333309.R01.S.doc Version 5.2 Page 12 engaging in activities and social events. Limitations on freedom of movement or power to make decisions are only made in agreement with the individual and in their best interests when there is a risk to health or personal injury to the individual or others. However some risk assessments needed development because they confirmed action taken to prevent accident or injury but did not explain the nature of the risk or reason why. For example one risk assessment concluded that a person living at the home should not have access to the kitchen without supervision but did not provide the reason why. It is important that the reason for any limitation on an individual’s freedom of movement is confirmed in writing so it can be reviewed to make sure it is required in the best interests of the person or others and their rights promoted and preserved. All people living at the home spoke highly the standard of support, care and facilities and service provided. They take the initiative to meet visitors at the front door and welcome them in. They are involved with the running of the home and are consulted on the quality of meals, standard of care and facilities and services provided. The home operates a system of “cluster meetings” whereby a deputy manager will meet on a regular basis with an identified group of residents. Together they discuss any matters that are important to them. Minutes of the meetings are kept in the home. Residents said that they value and enjoy the cluster meetings. Westleigh DS0000027003.V333309.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Person Centred Plans set out each individual’s needs and aspirations so that staff can offer appropriate support to achieve their individual goals. EVIDENCE: People who live at Westleigh House are able to make choices about their life style and say they are happy with the range of activities on offer including the music group, art and aromatherapy classes which are popular. The atmosphere is relaxed and sociable. Staff tend remain in the background so as to encourage the people who live in the home to take the initiative to answer the door and welcome visitors to the home. This shows respect for the people who live at Westleigh House and reinforces their rights and the fact that it is their home first. It was noted that some of the people who live at the home are content to watch TV throughout the day and evening and according to staff do not show interest in doing much else. Staff advised that they have limited time to work with individuals on a one-one basis, which is required when people appear to lack motivation and require additional support. Staff said meeting peoples Westleigh DS0000027003.V333309.R01.S.doc Version 5.2 Page 14 needs in this respect is especially difficult when there are only two staff on duty and domestic tasks need completing such as cooking and serving the evening meal. Care staff have the right skills to help people to explore opportunities for leisure, social interaction and occupation in the local community and resources permitting they produce goal plans with the individual so they get the support they need to achieve their aspirations. The manager advised that this is being addressed by the home’s person centred care and support planning systems so available resources are focused on enabling the people who live in the home to pursue a fulfilling lifestyle. Independence is promoted. People have varying degrees of responsibility to undertake domestic tasks around the home according to their abilities needs and wishes. One of the people spoken with is particularly keen on developing independent living skills. Arrangements have been made for this person to do his or her own washing and ironing. They have also expressed a wish to develop their cooking skills but people who live at the home do not have access to the main kitchen so are unable to get involved in meal preparation. There are no other facilities for people to practice and develop culinary skills in the home. Consideration should be given to developing opportunities for people to practice and develop these skills so they can receive the help they need to achieve their goals and aspirations. Staff support the people to maintain family links, friendships and personal relationships. They are able to entertain their guests in private if they wish and visiting relatives say they are always made welcome. All people spoken with were happy about the standard of food. Individual likes and dislikes are known and catered for. Menus seen indicate that a varied and nutritious diet is on offer. Choice is offered with every meal but a choice of main meal must be made the day before the meal is served. The deputy manager said this is to help the cook plan and defrost the required amount of food for each meal. It is recommended that consideration is given as to whether this is really necessary. The cook has a good working knowledge of each individual’s personal preferences and should be able to estimate the amount of food required for each meal within reason. Choice would be better promoted if people were able to choose their main meal on the day it is to be served so they could enjoy making a choice according to the weather and what they fancy on the day. Westleigh DS0000027003.V333309.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home receive effective personal health care support in a person centred way, so they receive the care they need in the way they prefer and their health care needs are met. EVIDENCE: A large number of people who live at the home joined in the inspection process speaking openly and positively about the standard of care and support they receive. Two gave detailed accounts as to how staff had helped and supported them to achieve and maintain good health. Personal health care needs including specialist health care and dietary requirements are clearly recorded in each individuals person centred plan. Care records provide an overview of each person’s health care needs and act as an indicator of change in health requirements. People who use the service are encouraged to manage their own health care and are supported to make and maintain contact with their respective health care professionals. They are able to choose their own GP and have access to all NHS facilities in the local community. A visiting psychiatrist described Westleigh House as an excellent home and spoke highly of the staff team and the standard of care provided. Managers and care staff were said to be knowledgeable, sensitive and skilled in their approach. They work in Westleigh DS0000027003.V333309.R01.S.doc Version 5.2 Page 16 partnership with health care professionals and support the individual in a person centred way so their health care needs are met. Medicines management and administration was checked. A monitored dosage system was used throughout the home. No errors were noted on medicine administration records. Stock records of medicines provided in their original packages were not kept so staff were unable to make stock checks to ensure that medicines are administered appropriately. The manager confirmed that arrangements will be made to keep stock records for all medicines received by the home so effective medicines audits can be carried out on a regular basis. Managers administer all medicines with the exception of inhalers. The manager advised that she is in the process of developing risk assessments to determine whether individuals may be able to take part in the management of their own medicines. It is important that this work is completed so those people who have capacity are able to maintain indepence and manage their medicines as far as they are able. Westleigh DS0000027003.V333309.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are able to express their concerns and have access to an effective complaints procedure. They are safeguarded from abuse, and have their rights protected. EVIDENCE: Managers and staff have a positive attitude toward receiving complaints and people who live at the home say staff listen and act on what they say. No complaints have been received since the date of the last inspection. People who use the service are supplied with a complaints procedure that sets out how to make a complaint and the action that will be taken by the home in response. Most of the people spoken with and those responding to the survey were aware of how to make a complaint. The manager advised that some of the people who live at the home have difficulty reading and understanding documents written in a standard format so staff will go through any such document with them on request. The complaints procedure needs to be produced in a variety of formats which may include large print, illustrations, audio and photographs so all individuals have access to the information they need to make a complaint. The complaints procedure is available in the home and is made available to other interested parties or professionals on request. Robust procedures for responding to suspicion or evidence of abuse or neglect are in place including whistle blowing as in accordance with the Public Interest Disclosure Act 1998 so staff have the guidance they need in the event of suspicion or evidence of abuse. The manager has provided the staff working at the home with training in adult safeguarding procedures so they know when incidents must be referred to the local authority and ensure that vulnerable Westleigh DS0000027003.V333309.R01.S.doc Version 5.2 Page 18 people are safeguarded from abuse and potential for abuse. All staff are to receive refresher training in adult protection in 2007. Westleigh DS0000027003.V333309.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides the people who live in it with well-maintained, comfortable, clean and hygienic accommodation that meets their needs. EVIDENCE: Westleigh House is located in a residential area of Warrington known as Stockton Heath. It is a large detached property that has been extended to provide appropriate living space for the 18 people living as one group. People who live at Westleigh House like the way it is laid out one said that it is wonderful. However, consideration should be given to the long-term needs of people living in large groups. Good practice suggests that people living in care homes may benefit from living in smaller self-contained groups where they can enjoy maximum independence in a discrete non-institutional environment. The registered persons should consult the people who live at Westleigh House to seek their views and if appropriate explore what could be done to facilitate group living including the provision of domestic kitchen facilities so people can develop their culinary skills and cook meals for themselves if they wish. There are pleasant well-maintained gardens for all to enjoy. Preparations were being made for the national ban on smoking in all public places that due to Westleigh DS0000027003.V333309.R01.S.doc Version 5.2 Page 20 come into effect on 1st July 2007. Management are taking advantage of an exemption that applies to personal care homes and have designated a ground floor room as the smoking room. People who live at the home said they are quite happy with this arrangements many of them enjoy a cigarette on the covered veranda at the front of the home and they will be able to continue to do this. The home is clean and well maintained throughout all people responding to the survey said the home is always clean and fresh. Systems are in place regarding food hygiene and infection control so people are protected from infection and food contamination. Westleigh DS0000027003.V333309.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34 35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are skilled, well supported and have access to effective training so they have the skills right skils to meet the needs of the people who live in the home. EVIDENCE: Staff were seen to conduct their work with care, good humour and respect for the people who live at Westleigh House. The staff group present as an effective team, they work together with the benefit of shared aims and objectives and are clear about their individual roles and responsibilities. People who live at the home and visiting relatives speak highly of the staff team saying they are competent and skilled. One of the people living at the home said the “staff very good, very kind. They are very well trained and always treat us with respect”. A visiting health care professional said, “the home is excellent managers and staff are knowledgeable, sensitive and skilled in their approach”. They work in partnership with health care professionals so the health care needs of the people are met. Information provided by the manager and reading of staff training records confirmed that the home operates an effective staff-training programme. Of the ten care staff nine have achieved an NVQ at level 3 or above and one is Westleigh DS0000027003.V333309.R01.S.doc Version 5.2 Page 22 working toward the qualification. Deputy managers are trained or being trained to NVQ level 4 in management and care and complete the registered managers award. Training needs are identified via appraisal and personal development plans are in place for each staff member. There has been no training in relation to the new Mental Capacity Act that came into affect in April 2007 but the manager stated that this is planned for 2007. Some staff where knowledgeable about equality and diversity and where able to discuss this in relation to the development of person centred care planning in the home. Other staff spoken with had only a basic awareness about equality and diversity and would benefit from further training so they know the arrangements for ensuring equality, valuing diversity and developing services to meet all peoples needs irrespective of their race, ethnic origin, disability, gender or sexual orientation. Feedback from people who live at the home, their relatives and health care professionals indicates that staff are employed in appropriate numbers to ensure the well being of residents. However the availability of care and support staff is reduced when they are required to do domestic tasks such as cooking the evening meal which occurs two evenings a week when the cooks are not on duty. Staff spoken with are of the view that this impinges on the time they should be spending working with the people who live at the home. The manager should review staff deployment to ensure that there is a sufficient number of staff on duty at all times to meet the needs of the people who live at the home and ensure their well being. All staff spoke highly of the manager indicating that communication in the home is good, they have regular supervision and regular staff meetings so the people who live at the home benefit from a well informed and appropriately supported staff team. Arrangements for the recruitment of new staff are thorough so vulnerable people are protected from abuse. Westleigh DS0000027003.V333309.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live in the home benefit from the management of the home, which is based on openness and respect. EVIDENCE: The registered manager is a qualified nurse S.E.N. (Mental), experienced in the field of mental health and has achieved the Registered Manager’s award and an NVQ level 4 in care. Staff speak highly of the manager saying she is a good leader, and very supportive. Effective quality assurance procedures are in place that are based on seeking and acting on the views of the people who live at the home, their relatives and the health and social care professionals who support them. Feedback is actively sought from residents, relatives and health and social care professionals about the standard of support; care; facilities and services provided by anonymous survey questionnaires and by quality audits conducted by the Care Co-ordinator. The findings of the home’s quality assurance processes are published in quality summaries so the people who live at the Westleigh DS0000027003.V333309.R01.S.doc Version 5.2 Page 24 home and their representatives know that their views are taken seriously and acted upon. The manager leads a strong staff team who have been trained to a high standard. She is person centred in approach and her management style is based on openness so staff receive the guidance they need to do their jobs effectively and people receive care that meets their needs in the way they prefer. The manager ensures that people who live in the home are able to control their own money, except where they state that they do not wish to or they lack capacity and other arrangements are made. They may deposit small amounts of money with the home for safekeeping. The records made regarding the handling of money on behalf of the people who live at the home need improving to ensure accountability. For example the sum of money held for one person did not tally with their records. Further enquiries identified that an error had been made and one individual’s money had been put into another’s tin. Where money is spent on behalf of individuals, as is the case when cigarettes are purchased on their behalf, receipts should be acquired, numbered and saved so effective auditing can be carried out. Warrington Community Care seeks to ensure the health and safety of all employees and residents. There is a health and safety policy, which confirms individual and management responsibilities for managing health and safety and ensuring safe working practices. The registered manager ensures that risk assessments are carried out for all safe working practice topics and significant findings are recorded and reviewed so staff and people who live at the home are safe. Routine maintenance checks are carried out on all appliances and services. However there is no certificate to confirm that the electrical wiring systems have been serviced. The manager said she knows this work was completed in February 2007 but a certificate has not been received from the housing association that owns and maintains the premises. Precautions are taken against the risk of fire including routine fire drills and Fire Awareness training for staff and people who live in the home know what to do in the event of a fire. Westleigh DS0000027003.V333309.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 2 3 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 2 X LIFESTYLES Standard No Score 11 2 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 X 4 X 2 3 X Westleigh DS0000027003.V333309.R01.S.doc Version 5.2 Page 26 No Are there any outstanding requirements from the last inspection? 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 YA20 Regulation 13 (2) Timescale for action Ensure that stock records are 31/07/07 made and maintained of all medicines coming into the home so arrangements for administration of medicines can be audited effectively and the well being of the people who use the service assured. Ensure that comprehensive 31/07/07 records are made and maintained of all money deposited in the home by the people who use the service to ensure accountability and the protection of the individual. Requirement 2 YA41 17 (2) Schedule 4 paragraph 9 Westleigh DS0000027003.V333309.R01.S.doc Version 5.2 Page 27 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA1 Good Practice Recommendations Information including the statement of purpose, service users guide and complaints procedure should be made available in user-friendly formats including large print, with illustrations or on an audiotape where required so all the people who live at the home can access the information as independently as possible. Risk assessments that result in limitations of freedom of movement or power to make decisions of any individual should be reviewed to make sure they provide all background information including the reason why the limitation is made, so the individual’s rights are promoted and freedom of movement is only limited where absolutely necessary. Develop care plans to help people, who may lack motivation, to explore and take advantage of opportunities for recreation and leisure and to maintain and develop independent living skills by developing person centred plans with them, so they receive the encouragement and stimulation they need to live a fulfilled lifestyle. Offer the people who live in the home with a choice of meal on the day it is to be served so their quality of life is improved and they can choose a meal according to the weather and what they fancy on the day. Provide domestic kitchen facilities so people are able to maintain and develop domestic living skills if they wish. Review staff rotas to make sure that staff are employed in sufficient numbers to meet the needs of the people who live at the home, at all times. Ensure all staff receive the training they need in respect of the Mental capacity Act 2005 and equality and diversity so they have the knowledge they needs to promote rights and meet the needs of all people. 2 YA9 3 YA11 4 YA17 5 6 YA24 YA33 7 YA33 Westleigh DS0000027003.V333309.R01.S.doc Version 5.2 Page 28 8 YA42 The electrical wiring certificate should be acquired from the relevant approved electrical contractor to confirm that the home’s electrical wiring systems have been serviced and are safe. Westleigh DS0000027003.V333309.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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