Inspection on 06/12/07 for Westminster Croft

This inspection was carried out on 6th December 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

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Westminster Croft 3 Westminster Croft Brackley Northants NN13 7ED Lead Inspector Irene Miller Unannounced Inspection 6th December 2007 08:30 Westminster Croft DS0000070268.V355440.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 Westminster Croft DS0000070268.V355440.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. Westminster Croft DS0000070268.V355440.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Westminster Croft Address 3 Westminster Croft Brackley Northants NN13 7ED 01280 705348 01280 840049 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) www.grooms-shaftesbury.org.uk Grooms-Shaftesbury Ms Jill Lammond Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Westminster Croft DS0000070268.V355440.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. A maximum of three (3) service users in the category of LD may be accommodated in the home at any time. No one in the category of LD may be admitted to the home when three (3) service users in this category are already registered. Date of last inspection: Not applicable as this is a new registration Westminster Croft DS0000070268.V355440.R01.S.doc Version 5.2 Page 5 Brief Description of the Service: Westminster Croft is a care home, which is registered to provide personal care and accommodation for three people with a learning disability. The service is one of six homes in the area, which were owned by the Shaftsbury Society until June 2007 when they merged with John Grooms. The owners are now Grooms – Shaftesbury. The home is a detached four bedroomed property situated in a residential area of Brackley in Northamptonshire and is within walking distance of Brackley Town Centre. The local community resources include shops, pubs, restaurants, gymnasium and a public swimming pool. All of the bedrooms are on the first floor; the smallest of the bedrooms is used as the staff office and sleep in room for the night support worker. There is a lounge diner, kitchen and utility area on the ground floor. There is a bathroom on the first floor and a toilet /shower room on the ground floor. To the front of the property there is a well-maintained garden with a single driveway and garage, and to the rear of the property there is a raised garden with flower borders and patio area. Fees currently range from £1,331.50 to £1,621.05 per week depending on the level of staff support required by the service user. Daily newspapers, clothing, toiletries, activities and holidays are at an additional cost. Information on the range of services and support provided at the home is within the homes statement of purpose and service user guide that were available within the lounge of the home. Westminster Croft DS0000070268.V355440.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. Standards identified as ‘key’ standards and highlighted through the report were inspected. The key standards are those considered by the Commission to have a particular impact on outcomes for people living at the home. Inspection of the standards was achieved through review of existing evidence, preinspection planning, an unannounced inspection visit to the home and drawing together all of the evidence gathered. During the visit time was spent speaking with the people living at the home to seek their views on the service provided and observations of the interactions between the people that live at the home and staff were made The care of the three people living at the home was looked at in depth this involved looking through written information available on their care, such as their individual care plans (a care plan sets out how the home aims to meet the personal, healthcare, social and spiritual needs of the individuals living at the home). Sample checks were carried out on the homes policies and procedures, staff training records, and the homes medication and quality assurance systems. Records in relation to the health and safety and the general maintenance and upkeep of the home were viewed, and general observations on the environment were made. The Commission for Social Care Inspection sent out to the home an Annual Quality Assurance Assessment form (AQAA) for completion by the registered manager, the AQAA had been returned to the Commission for Social Care Inspection prior to this visit, and this provided information on the care provided at the home and the management, administration and quality assurance processes. Time was spent prior to the visit reviewing the AQAA, and the homes service history, the service history details all contact with the home including notifications of events reported by the home, telephone calls, letters, and details of any complaints and concerns received since the date of registration, which was June 2007. What the service does well: Westminster Croft DS0000070268.V355440.R01.S.doc Version 5.2 Page 7 The management of the home is open and transparent, and there is a commitment to ensure that the home is run with the full involvement of the service users. In discussion with the service users and on viewing the care plans it was confirmed that the service users are fully involved in putting together their care plans with the support of the staff. Within the care plans there was clear information for permanent and agency staff to follow, that included the service users communication methods, likes and dislikes and level of support required. The staff team are experienced and committed to meeting the needs of the service users. The service users appeared relaxed and good relationships were observed. Service users are encouraged and enabled to take responsibility and have some independence in their daily routines. 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. Westminster Croft DS0000070268.V355440.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 Westminster Croft DS0000070268.V355440.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): Standard 1 & 2 Quality in this outcome area is good. The admission process provides assurances that the needs of people admitted to the home can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The statement of purpose and service user guide, were available for service users and visitors to access, the statement of purpose provides information about the service provided for prospective and existing service users, it was available in a written format but is also available in a pictorial formats if required. The service user guide had been recently reviewed and updated to include information on fees and additional charges to ensure people understand what is included in the fee and what additional costs they are likely to have. The people living at the home have lived there for a number of years, however the information provided within the AQAA demonstrated that the admission process included a full assessment of the service users needs and several visits Westminster Croft DS0000070268.V355440.R01.S.doc Version 5.2 Page 10 to the home to allow the prospective service user the opportunity to meet with the people living at the home and decide if the home will be right for them. Westminster Croft DS0000070268.V355440.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): Standards 6,7 & 9 Quality in this outcome area is good. Residents are encouraged and supported in expressing preferences and making choices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Within the care plans viewed there was evidence that the service users are fully involved in putting together their care plans with the support of their keyworker their views had been sought and wishes identified There was clear information about each of the service users needs and preferences likes and dislikes and the level of support required by staff. During the visit the staff member on duty was observed to consult with and support the service users in making their own choices. It was evident from the observations that the member of staff and the service users know each other very well, there was a mutual respect. Westminster Croft DS0000070268.V355440.R01.S.doc Version 5.2 Page 12 The daily routines were flexible and each of the service user take an active part in the household chores according to their capabilities levels. One of the service users had taken on the role of placing the order for the daily supplies of bread, milk and potatoes, through writing out the order for the daily delivery from the local dairy. There was a chart available within the kitchen of the days when each service user is responsible for cleaning their bedrooms and general household cleaning chores, such as vacuuming and dusting. The service users were observed to all help in clearing the breakfast table and in getting ready for the their day at the links day centre, it was evident that the service users got on well with each other and were seen to work as a team. Within the care plans viewed there was records of when infringed rights that had been agreed with and signed by the service users. This was the right for staff to enter the resident’s bedrooms in the event of a fire and for fire prevention and maintenance checks to take place. Westminster Croft DS0000070268.V355440.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): Standards 12,13,15 & 16 Quality in this outcome area is good. The people living at the home are supported to lead a lifestyle, which meets their social and personal preferences. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two service users were seen to be preparing for their day at the Links day centre, one of the service users had a day off and was planning to go Christmas shopping. In discussion with the staff and the service users it was established that there was close friendships with the people that live in the other five homes owned by Grooms Shaftsbury. One of the service users was looking forward to going to a birthday party that was taking place at one of the other homes in the Westminster Croft DS0000070268.V355440.R01.S.doc Version 5.2 Page 14 evening. The staff member was seen to support the service user in arranging for a Taxi for the evening. Within the care plans there was records of service users going shopping, to the local pub, visiting family and friends, swimming, keep fit, yoga and visits to the library and bank. In discussion with the service users they confirmed that they are supported to maintain contact with their families, and one service user talked of looking forward to a visit to Lapland at Christmas with his family. In discussion with the staff they explained that there has been problems with accessing the use of the company car to take service users on social outings and shopping. The staff explained that there used to be two cars shared between the six homes, and that the cars had been returned to the leasing companies. On the day of the visit the car was booked in for its MOT staff expressed concern as to the cars reliability due to its age, as it is approximately fifteen years old and in such high demand. The staff explained that the car is used on a first come first served basis, however priority is given for any medical appointments. The car booking log was viewed and it was evident that there had been occasions when the car had been booked and had subsequently had to be cancelled due to having to prioritise its use. The service users and staff spoke of enjoying their summer holiday at Blackpool, they talked of going to shows such as Bobby Crush, The minstrels and of going to the circus, whilst on holiday. The menus are planned with them on a weekly basis, and take into account individual food preferences and nutritional needs, the service users are encouraged to be involved in shopping for food and in preparing and cooking meals according to their level of capability. Westminster Croft DS0000070268.V355440.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): Standards 18,19 & 20 Quality in this outcome area is good. The people living at the home receive the personal and healthcare support that they require. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans viewed had very clear information on the support each service user requires, and observations during the visit indicated that the staff enable each service user to be as independent as possible. Within the care plans there was records of when service users had been seen by their general practitioner and health care monitoring by the practice nurse. There was records of service users attending dental, eye and chiropody appointments. On the day of the visit the service users spoke of having appointments to see the chiropodist at the local health centre on the afternoon. Westminster Croft DS0000070268.V355440.R01.S.doc Version 5.2 Page 16 Appointments and advice are sought from other health care professionals as required such as a Consultant psychiatrist and the Community Learning Disability Nurse. All of the service users living at the home are reliant on staff to administer their medication and the organisation take any discrepancies in the recording of medication very seriously. It has been the organisations practice to inform CSCI of instances where a staff member may have failed to sign for medication and also a safeguarding adults referral having been made. Whilst acknowledging the seriousness of the safe administration of medication to service users, where it is clear that a service user has not missed their medication or been placed at risk, this should be dealt with through individual staff supervision, and training to ensure the staff are competent to administer medication to service users. In an effort to improve in this area a medication handover form has been devised to ensure that the staff check the medication administration records on a daily basis at the beginning and end of every shift. A sample check of the medication administration records (MAR) sheets indicated that the records were well maintained, and the medication was stored securely. Advice was given that on opening liquid medication that the date of opening be indicated on the bottle. One service user had two bottles of the same medication in use and advice was given to ensure that stock rotation be exercised.. Westminster Croft DS0000070268.V355440.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): Standards 22 & 23 Quality in this outcome area is good. People living at the home can be assured that their rights are promoted and protected and any concerns or complaints they may have will be listened to and acted upon. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Commission for Social Care Inspection have received no complaints about the service. The complaints procedure ensures that service users are supported and feel able to raise any concerns, which are taken seriously and acted on. In discussion with the staff it was confirmed that they were aware of their responsibilities for safeguarding the people in their care and reporting any concerns that they may have. Information was available at the home on the Northamptonshire County Council Safeguarding Adults procedures for reference in the event of concerns of any abuse being raised. It has been the organisations policy to notify CSCI and safeguarding of all errors found in the medication administration records, for example adult protection referrals having been made for instances when a staff member may have failed to sign for medication such as eye and ear drops, creams and lotions. The registered manager needs to be mindful that whilst CSCI and Westminster Croft DS0000070268.V355440.R01.S.doc Version 5.2 Page 18 safeguarding must be informed of serious medication errors, the overuse of implementing a safeguarding adults referral for all medication errors, regardless of the risk to the individual service user has the potential to reduce the significance of the adult protection process. Westminster Croft DS0000070268.V355440.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): Standards 24 & 30 Quality in this outcome area is good. People living at the home are provided with a clean, comfortable and homely environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is of domestic layout situated in a residential estate on the fringe of Brackley Town Centre and local community resources. All areas of the home were clean, tidy and well maintained, on the day of the visit the dishwasher which was out of order, the staff member confirmed that steps were in hand to arrange for an engineer to come out with a view to it being repaired or replaced. Westminster Croft DS0000070268.V355440.R01.S.doc Version 5.2 Page 20 Each service user has their own single bedrooms, which are all located on the 1st floor, the bedrooms were clean and personalised with items that expressed the individuality and lifestyle of each of the service users who all said that they were happy with their rooms. An occupational therapist assessment had taken place for one service user who is experiencing a decrease in their mobility and through this input an additional banister/grab rail had been fitted to the staircase and a grab rail had been fitted outside the front entrance door. The bathroom is on the first floor and a shower is available on the ground floor cross infection procedures are in place and each of the service users had their own bath mats and towels to further reduce any likelihood of cross infection. Westminster Croft DS0000070268.V355440.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): Standards 32,34 & 35 Quality in this outcome area is good. The staff are sufficiently trained and competent within their roles to meet needs of the people living at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Observations and discussion with the services users and staff indicated that there is sufficient staff to meet the current needs of the service users. The agency staff used are all familiar to the service users and have in some cases worked regularly at the home over a number of years. Observations made during the visit and in discussion with the service users they said they were happy with the staff team, the interactions between staff and service users indicated that there was good relationships and mutual respect. Westminster Croft DS0000070268.V355440.R01.S.doc Version 5.2 Page 22 The staff recruitment files were not available to view during the inspection visit as the registered manager was not available, however information provided through the Annual Quality Assurance Assessment (AQAA) and evidence from previous inspection reports indicated that the staff recruitment systems were robust. Time was spent talking with a new member of staff who verbally confirmed that they had provided the organisation with information for pre employment checks to be carried out such as clearance through the criminal records bureau (CRB) and details of referees from their previous employment. Induction training was provided that covers the organisations policies and procedures and training in moving and handling, first aid, medication, food hygiene and fire safety in discussion with the staff it was confirmed that the staff receive training appropriate to meet the needs of the service user. Westminster Croft DS0000070268.V355440.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): Standards 37,39 & 42 Quality in this outcome area is good. The home is managed in a manner that promotes and safeguards the health, safety and welfare of the people who live and work at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has the necessary skills and experience to manage a home for people living with a learning disability and is committed to ensuring that the home is run and managed in a way that fully involves the service users who live at the home. The management and administration processes are open and transparent, monthly visit take place by a representative from within the organisation to Westminster Croft DS0000070268.V355440.R01.S.doc Version 5.2 Page 24 monitor the quality of the care and support provided at the home and to check on compliance in meeting the National Minimum Standards and the Care Standards Act 2000 Regular meetings take place with service users and the care plans and risk assessments are regularly reviewed with the service users involvement. Staff confirmed that the registered manager provides one to one supervision, and that staff meetings take place regularly, and there was records available of training and minutes of staff meetings that had taken place. Westminster Croft DS0000070268.V355440.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 3 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 3 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 X 3 X X 3 X Westminster Croft DS0000070268.V355440.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection This is the first inspection under the homes new registration. 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 Westminster Croft DS0000070268.V355440.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Text phone: 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 Westminster Croft DS0000070268.V355440.R01.S.doc Version 5.2 Page 28 - 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!