Inspection on 27/10/06 for Westmeade

This inspection was carried out on 27th October 2006.

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 11/10/07

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 Patricia Rogan Key Unannounced Inspection 27th October 2006 5:00pm Westmeade DS0000019616.V317682.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.V317682.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.V317682.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 Care Home 3 Category(ies) of Learning disability (3), Mental disorder, registration, with number excluding learning disability or dementia (3) of places Westmeade DS0000019616.V317682.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 associated with a learning disability) 27th February 2006 Date of last inspection Brief Description of the Service: Westmeade is a three bedroomed semi-detached house and is located in a quiet close on a modern residential estate in Cheshunt. 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 house is domestic in design, style and décor, with a small office on the first floor. There is a pleasant garden to the rear. 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. Westmeade DS0000019616.V317682.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an inspection of the key standards and the overall quality of this service is good. The inspection was in two parts, with a visit to the home during the late afternoon and evening. This provided an opportunity to meet with the service users and staff. The care plans, risk assessments and other records were inspected. The second part of the inspection was an interview with some of the people who are involved with the residents and the home and a discussion with one of the the proprietors. What the service does well: 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.V317682.R01.S.doc Version 5.2 Page 6 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.V317682.R01.S.doc Version 5.2 Page 7 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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admissions procedure ensures that service users aspirations and needs are assessed prior to a decision being made that the placement is suitable. EVIDENCE: An inspection of the admissions procedure sets out the areas which need to be covered when an assessment is being carried out. Discussion with the manager further evidenced the understanding of the need to involve service users and their families in the assessment process in order to ensure that the service users wishes are recorded and acted upon. Westmeade DS0000019616.V317682.R01.S.doc Version 5.2 Page 8 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 and 9 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 ones 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 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. Two residents were spoken with during the inspection and they are encouraged to express their opinion and when their needs change, the care plans will be amended. Formal meetings do not take place because the residents prefer the informal meetings which take place every day around the dining table and during times of relaxation, however, comments are noted and where necessary, are acted upon. Westmeade DS0000019616.V317682.R01.S.doc Version 5.2 Page 9 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): 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. Social activities are well organised, creative and provide stimulation and interest for the service users. Meals are nutritious and offer a healthy and varied diet and prepared by the service users with assistance of staff. EVIDENCE: There is an extensive programme of activities. Each resident has a weekly timetable and was involved in drawing up the timetable. 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 who they want to be with. Friendships are encouraged and staff support the service users in making arrangements for friends and familes 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 the residents in a family-like setting. Westmeade DS0000019616.V317682.R01.S.doc Version 5.2 Page 10 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. The service users are involved in decsions about how they would prefer to have assistance with personal support and this is recorded. Service users complex physical and emotional needs are met by skilled staff. There is a medication policy in place and staff are trained to administer these. EVIDENCE: Discussion with the service users and staff showed that the service users felt supported by staff who knew them. Individualised care plans set out how personal care needs could be met and had been amended as needs changed. Staff were seen to speak with residents in a friendly and approachable manner. A service user began discussing personal issues with a member of staff who showed due regard for the service users views whilst being respectful and enabling. The administration of medication policy is well set out and staff have been trained to administer medication in the correct manner to safeguard service users. Westmeade DS0000019616.V317682.R01.S.doc Version 5.2 Page 11 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. There is a policy in place for regular group service user meetings. Daily one to one discussions with each service user takes place and this is the preference of the service users. There are policies and procedures in place for the protection of the service users from abuse, self-harm or neglect. EVIDENCE: The service users said they felt that the staff listened to them when they had a problem or could not sort something out. During the inspection, a resident was trying to arrange to meet a friend. The staff were understanding, explaining carefully what the service user needed to do in order to make the arrangements and supported her as she did so. Individual risk assessments are carried out for outings and for procedures within the home in order to minimise risk or harm to the service users. These risk assessments are reviewed as needs change. The manager is aware of the adult protection procedure and the handbook is readily accessible for all staff if guidance is needed. Westmeade DS0000019616.V317682.R01.S.doc Version 5.2 Page 12 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Westmeade is well maintained and is domestic in appearance. There are regular health and safety checks to ensure a safe environment is maintained. EVIDENCE: The residents said they liked living in Westmeade. There are personal items around the communal rooms and in the bedrooms. One resident said she would never want to live anywhere else because this was her home. The decor and the furniture is comfortable and homely and the grounds are pleasant and well maintained. There is just one area of the exterior of the premises which seemed a little dark and this was possibly because of the overhanging tree. An audit of the illumination around the exterior would be helpful to ensure the safety of the service users, staff and visitors to the home. Westmeade DS0000019616.V317682.R01.S.doc Version 5.2 Page 13 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): 32, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Recruitment policies and procedures are in place to protect the service users and to ensure that staff who are appointed are competent and qualified. All staff have an induction programme and through daily and individual supervision, other learning needs are identified. EVIDENCE: The recruitment policy is followed correctly by carrying out Criminal Record Bureau checks and verification of work history and references. Interviews are carried out by two members of staff to ensure that prospective employees will be suitable to work in Westmeade. new employees are supervised in their practice until they are considered full competent to support service users with complex needs. In addition to the induction programme, if other learning needs are identifed, plans are put in place for this need to be met. Westmeade DS0000019616.V317682.R01.S.doc Version 5.2 Page 14 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, 38, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users benefit from a well run home. The acting manager is very well supported by the area manager and proprietor. Service users opinions are recorded and show a close involvement in running the home. Well set out policies and procedures ensure that service users rights and health and safety is protected. EVIDENCE: The registered manager moved to another home in the group. The acting manager is an experienced senior care worker who is due to complete her manager training in 2007. There was a delay by the college in the commencement of this training but daily support is provided by a senior manager and the proprietors. Additional support and advice is available from Westmeade DS0000019616.V317682.R01.S.doc Version 5.2 Page 15 other registered managers in the group. She is respected by the staff and the home is well run with satisfaction expressed by the two residents during the inspection. The policies and procedures which are in place to ensure the home is safely maintained are updated as needed The proprietor is ensuring that internet access is available in the home in the near future so that the latest legislation on supporting people with a learning disability and training opportunities are available to the staff team. Staff have training in health and safety procedures with the additional focus on supporting people who can present with challenging behaviour. Fire drills are carried out and vehicle checks and driver/escort skills are maintained to ensure the well being of the service users. Westmeade DS0000019616.V317682.R01.S.doc Version 5.2 Page 16 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 x 2 3 3 x 4 x 5 x 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 x 26 x 27 x 28 x 29 x 30 x STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 3 3 x x 3 x Westmeade DS0000019616.V317682.R01.S.doc Version 5.2 Page 17 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. 1 Refer to Standard YA42 Good Practice Recommendations An audit of the illumination of the exterior premises would be helpful to ensure that service users, staff and visitors have well lit access to and from the premises. Westmeade DS0000019616.V317682.R01.S.doc Version 5.2 Page 18 Commission for Social Care Inspection Hertfordshire Area Office 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.V317682.R01.S.doc Version 5.2 Page 19 - 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!