Inspection on 11/10/07 for Westmeade

This inspection was carried out on 11th October 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 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

Westmeade 27/10/06

Westmeade 27/02/06

Westmeade 29/09/05

Westmeade 18/01/05

Westmeade 03/06/04

Similar services:

Chesham House

Argyll House

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

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

CARE HOME ADULTS 18-65 Westmeade 69 Westmeade Close Cheshunt Hertfordshire EN7 6JP Lead Inspector Julia Bradshaw Unannounced Inspection 11th October 2007 10:00 Westmeade DS0000019616.V353903.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 Westmeade DS0000019616.V353903.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. Westmeade DS0000019616.V353903.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Westmeade Address 69 Westmeade Close Cheshunt Hertfordshire EN7 6JP 01992 629963 01992 629963 FP 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) Mrs P Lopez Dr S Collen M/s Donna Griffiths (not registered) Care Home 3 Category(ies) of Learning disability (3), Mental disorder, registration, with number excluding learning disability or dementia (3) of places Westmeade DS0000019616.V353903.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for 3 people mental disorder (only when asociated with a learning disability) 27th October/13th November 2006 Date of last inspection Brief Description of the Service: Westmeade is a three-bedded semi-detached house and is located in a quiet close on a modern residential estate in Cheshunt. The house is domestic in design, style and décor, with a small office on the first floor. There is a pleasant garden to the rear. It is close to the town centre with its shops, leisure facilities, railway station, bus service and other amenities. The home provides accommodation for three women with learning disabilities and associated mental health support needs. The service offered is specialised and individually tailored to meet the complex needs of the individual service users. The home is staffed twenty-four hours a day. Information regarding the service can be obtained from the Statement of Purpose and Service User Guide. These documents, up to date fee information and a copy of the most recent CSCI inspection report can be obtained from the manager on request. Westmeade DS0000019616.V353903.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was another positive inspection with all of the standards inspected being met. The inspector made three visits to the home in September and October. The first two visits were unsuccessful as none of the service users were at home. The inspector therefore contacted the home and arranged a third visit, which took place on the 11th October 2007. However again, there were no service users at home on this pre-arranged visit. Therefore this inspection is also using information based on the feedback from the previous inspection and service users questionnaires. Documentation examined included all three-service users’ care plans, the Statement of Purpose, Service User’s Guide, staff recruitment, supervision and training records and quality monitoring records. A tour of the premises was made, taking in all the bedrooms and all communal areas. The inspection indicated that the home was running well, with a calm atmosphere and being cared for by confident, well-trained and highly motivated staff. Where information has remained the same following the last inspection this has been carried forward to this report. What the service does well: People living at Westmeade are offered a caring, comfortable and safe environment in which to live. There are some detailed and comprehensive policies and procedures in place to ensure that any service users needs are fully assessed and met and there is a regular review process to ensure that these standard are maintained. The home has in place effective paper work regarding initial assessments of service users, risk assessments and care plans. These documents appear to be very effective for the home and the service users. Commendable amounts of positive feedback have been received from service users/carers, regarding the management of the service and the quality of care staff. Complaints/concerns are dealt with effectively by the service with well documented records maintained. Westmeade DS0000019616.V353903.R01.S.doc Version 5.2 Page 6 There is an individual daily programme of events and activities for each of the service users. Escorted transport is made available to the service users to ensure that college; family visits and other activities are readily available. There is no registered manager at present and the acting manager has the ongoing, effective support of a senior manager in the organisation. 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. The summary of this inspection report can be made available in other formats on request. Westmeade DS0000019616.V353903.R01.S.doc Version 5.2 Page 7 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 Westmeade DS0000019616.V353903.R01.S.doc Version 5.2 Page 8 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 –5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Adequate information about the philosophy of care and operation of the home is available to prospective and current residents. Admissions are made on the basis of detailed assessments of the individuals’ needs and aspirations so that it is clear that the home can provide a suitable service. EVIDENCE: The Statement of Purpose and Service User’s Guide contains the required information about the service provided. These documents are updated annually or when the circumstances of the service/home change. The home should be congratulated on producing the Service User Guide in pictorial format. These documents are made available to all prospective and current residents and their representatives and enable them to make an informed decision about whether the home would be suitable. Full assessments are made of every prospective service user’s needs, abilities, personal preferences and aspirations prior to admission so that it is clear that Westmeade DS0000019616.V353903.R01.S.doc Version 5.2 Page 9 the home will be able to meet the individual’s requirements. The admissions procedure also includes a series of planned trial or familiarisation visits to allow the service user to experience the atmosphere and way of working in the home before making any firm commitment to a ‘permanent’ stay. Contracts are in place for all service users living at Westmeade and had been signed. Westmeade DS0000019616.V353903.R01.S.doc Version 5.2 Page 10 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 –10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a good system in place to ensure that staff involve service users in making decisions about their lives on an individual basis and as a group. EVIDENCE: Each service user has an individual care plan. There are new person centred plans in place which are at present being completed and staff are supporting the service users to ensure that they feel involved with filling in the required information. Communication aids such as symbols, photographs and jargon free words are being used and every aspect of the service users life, needs and wishes are being recorded. These documents are an excellent example of providing evidence that service users have been fully involved in this process. Service users are consulted on the running of the home through informal and formal meetings. Westmeade DS0000019616.V353903.R01.S.doc Version 5.2 Page 11 Staff work with service users to assist them to lead safe and enjoyable lives, consulting them as appropriate over decision making and offering guidance where needed. The standard of risk assessments within the home is excellent. All assessments had been updated since the last inspection took place. Westmeade DS0000019616.V353903.R01.S.doc Version 5.2 Page 12 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 – 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal development opportunities are encouraged for all service users ensuring interactions with the outside community are supported. Service users are provided with a varied and wholesome diet. EVIDENCE: There is an extensive programme of activities devised for each service user. Each person has a weekly timetable and is involved in drawing this up. Service users go to different colleges and day centres so that their individual learning needs can be met. Leisure time is flexible so that service users can choose what to do and whom they want to be with. Friendships are encouraged and staff support people in Westmeade DS0000019616.V353903.R01.S.doc Version 5.2 Page 13 making arrangements for friends and families to meet at the home or in another setting. Menus are varied and each service user is involved in choosing what to eat. Staff encourage residents to prepare drinks, snacks and meals and sit with them in a family-like setting. The home provides annual holidays and were in fact, away from the home when the inspector visited in September and therefore the inspection was reschedules for October. Holidays this year included a trip to Dorset for 2 people and one service user went to Bude in Cornwall. The home has good links with other service users living within the same organisation and are encouraged to socialise between each other’s homes. Staff also support service users in trips to the coast, cinema, aquarobics, swimming and regular trips to the cinema. Westmeade DS0000019616.V353903.R01.S.doc Version 5.2 Page 14 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 –20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The current medication practices and maintenance for medication are sufficient and adequate to ensure the residents safety. Service users emotional and physical needs are being met. EVIDENCE: The current arrangements for the storage and handling of medication are adequate and meet the current standards. There are detailed procedures in place, including information sheets on individual medication prescibed. The medication cupboards are situated within the main office and therefore easily accessible for staff. There is currently no Controlled medication held in the medication cupboards, however there is a robust procedure in place for the administration of these medications, if required. There were no gaps in the recording of medication. The home has a contract with a local pharmacy who supplies all medication in weekly dossette packs. Westmeade DS0000019616.V353903.R01.S.doc Version 5.2 Page 15 Full details of the personal and healthcare support required were contained in the care plans examined, including the individual preferences of service users. Daily records showed that staff continuously monitored individual progress. The member of staff spoken with demonstrated a good understanding of individual needs and how to act to meet them. A key worker system is operated to ensure extra individual attention and help service users participate in the care planning process. Risk assessments in place indicated a structured approach to maintaining individual safety. The home receives support from outside health professionals such as community learning disability nurses and local psychiatric services are involved to provide specialist advice, when required. Westmeade DS0000019616.V353903.R01.S.doc Version 5.2 Page 16 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 – 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure within the home is sufficient and adequate in order for the service users to feel that their individual views are listened to. Robust policies, procedures and training are in place to ensure service users are protected and safe. EVIDENCE: The home has a detailed complaints procedure in place. A record is maintained of any complaints made detailing actions and outcomes as necessary. All service users have been informed about the complaints procedure. This is also on display within the home. There have been no complaints since the last inspection was carried out. The home should be congratulated on producing the complaints procedure in a user-friendly format. A detailed procedure is in place to ensure that service users are protected from abuse and harm. Staff receive suitable and adequate Safeguarding Adults (Protection of Vulnerable Adults) training. Staff employed within the home are all subject to enhanced Criminal Records Bureau (CRB). Westmeade DS0000019616.V353903.R01.S.doc Version 5.2 Page 17 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 –30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment of Westmeade is homely and welcoming and provides a safe environment for residents to live in. EVIDENCE: There have been some areas of improvement to the home since the last inspection took place. There have been new fire doors fitted throughout, double-glazing has been fitted, and new carpet has been fitted to the lounge. The home is light and airy and the staff have created a welcoming environment for both service users and visitors. The manager and staff should be congratulated in supporting service users in creating individualised and comfortable bedrooms that reflect their personal interests and hobbies. The toilet and bathing facilities are suitable to meet the individual needs of the service users. A programme of repair and replacement is in place, and this is incorporated in the maintenance plan. Westmeade DS0000019616.V353903.R01.S.doc Version 5.2 Page 18 The hot water temperatures were checked and recorded within safe limit. The maintenance of the home is well managed and carried out on a regular basis. The manager and support staff are responsible for maintaining health and safety checks and standards. All records were up to date and the standard of recording was excellent. Fire records were checked. There was a current fire risk assessment in place. The last fire drill was carried out on the 10/02/07.All weekly/monthly fire checks had been completed for the week ending 13/09/07. Westmeade DS0000019616.V353903.R01.S.doc Version 5.2 Page 19 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 –36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff know and support the aims and values of the home and know how their roles contribute to achieving them. There are sound recruitment practices in place that protect the interests of service users. EVIDENCE: There is a loyal core staff team that appear to have a good understanding of the current service users needs and abilities. The current staffing arrangements are one manager and six full time support staff. There is a minimum of one to two staff on duty plus the manager. There are clearly defined job descriptions and person specifications in place. All staff have received a series of mandatory training courses in order for them to meet the needs of the service users. Training in epilepsy, safeguarding adults, Westmeade DS0000019616.V353903.R01.S.doc Version 5.2 Page 20 food hygiene and fire training have been carried out since the last inspection was carried out. The company has rigorous recruitment procedures that involve the thorough vetting of applicants. Two staff files examined contained photographs of the person, application forms, two positive references and CRB disclosures. All new staff receives structured induction and the company provides good access to training according to the training matrix provided by the manager. The current manager is doing her NVQ level 4. Westmeade DS0000019616.V353903.R01.S.doc Version 5.2 Page 21 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 –42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run, with service users benefiting from the support and guidance of the manager and the committed and enthusiastic staff team. EVIDENCE: The management/staff approach of the home appears to create an open and positive atmosphere. Staff spoken to commented that they feel supported and feel the home is well managed. A clear commitment is made to equal opportunities within the home. Adequate training is being provided to ensure all staff have the necessary underpinning knowledge to carry out their role effectively. The manager is currently working towards her NVQ level 4. Six staff have NVQ level 2. Westmeade DS0000019616.V353903.R01.S.doc Version 5.2 Page 22 Quality assurance systems are in the process of being further developed in order to assure that the service users views underpin all self-monitoring, review and development of the home. The service users questionnaires are also used. CSCI service users questionnaires were also sent out in October 2007. Service user meetings also occur. All records are secure and were up to date and held in accordance with the Data Protection Act 1998 ensuring that service users rights and best interests are safe guarded by the homes polices and procedures. Records regarding staff were inspected and contained all the necessary information. Westmeade DS0000019616.V353903.R01.S.doc Version 5.2 Page 23 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 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 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 3 3 LIFESTYLES Standard No Score 11 3 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 3 x 3 3 3 3 3 3 x Westmeade DS0000019616.V353903.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Westmeade DS0000019616.V353903.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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. Extracts may not be used or reproduced without the express permission of CSCI Westmeade DS0000019616.V353903.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!