CARE HOME ADULTS 18-65
Westminster House Westminster Lane Newport Isle of Wight PO30 5DP Lead Inspector
Annie Kentfield Unannounced 10 May 2005 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 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 Stationary 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 House H55 H04 S32663 Westminster House V218473 100505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Westminster House Address Westminster Lane, Newport, Isle of Wight, PO30 5DP Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01983 526310 01983 520372 sandra.weller@iow.gov.uk Isle of Wight Council Mr Jeremy Ernest Baker Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Westminster House H55 H04 S32663 Westminster House V218473 100505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 2/2/2005 Brief Description of the Service: Westminster House is a local authority owned respite care facility situated on the outskirts of Newport, offering both day and residential respite care to adults with a learning disability. There are in excess of 75 people using the service over a twelve-month period and the philosophy of the service is to provide an accessible and flexible respite service that meets the individual needs of the service users, and the needs of the carers. Westminster House H55 H04 S32663 Westminster House V218473 100505 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place between 1.30pm – 5.30pm and included a partial tour of the premises, inspection of some of the records and discussion with service users and staff, including the registered manager. The last inspection in February made two requirements, with regard to the garden, and the replacement of some of the carpets and both requirements have been met within the agreed timescale for action. There were no requirements from this inspection. What the service does well: What has improved since the last inspection?
Since the last inspection the garden has been transformed into a useable and attractive feature that can be used by all of the service users, when the work is complete. Grass has been laid, seats and sun shades purchased and the improvement has clearly delighted those service users that the inspector spoke
Westminster House H55 H04 S32663 Westminster House V218473 100505 Stage 4.doc Version 1.30 Page 6 to. Further work is planned to plant some shrubs and flower beds and to create a safe and accessible pathway round the garden. Having a garden that staff and service users can use as they wish has greatly enhanced the facilities provided. A planting weekend is planned and service users who are resident at the time will be invited to help with the work and join a barbecue. Seven of the bedrooms and the front entrance have had new carpets fitted to replace old and worn flooring and this is a big improvement. 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. Westminster House H55 H04 S32663 Westminster House V218473 100505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Westminster House H55 H04 S32663 Westminster House V218473 100505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2,3,4 Wherever possible prospective service users are invited to visit Westminster House before deciding to use the service. All prospective service users have a comprehensive assessment of care need in liaison with all persons involved in their care. Staff have the skills and experience and communication skills to deliver the services and care that the home offers to provide. EVIDENCE: There are procedures for health and social care professionals to refer people to the service on the basis of a care management assessment and staff then undertake their own assessment to ensure that all needs are identified and can be met by the staff team. The staff team collectively have a wide range of skills and experience and specialist training and communication skills to meet the individual needs of everyone using the service. Staff have always been willing to undertake specialist training in order to meet the specific needs of the people for whom the service is intended. The referral and assessment procedures have undergone recent review and development and although this process is ongoing, the manager and staff have developed this as a team project and recognise the need to design an assessment and care planning process specifically to meet the needs of a
Westminster House H55 H04 S32663 Westminster House V218473 100505 Stage 4.doc Version 1.30 Page 9 respite care service that is very different to the needs of longer term residential care. Westminster House H55 H04 S32663 Westminster House V218473 100505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7.8,9 Every service user has an agreed plan of care. Staff respect service users’ right to make decisions. Service users are offered opportunities to participate in the day-to-day running of the service and to contribute to the development of the service. EVIDENCE: Two service user files were looked at and they contained information about the referral, assessment and other information necessary to guide staff on the care to be provided. Because individual service users use the service regularly or less frequently, care plans are reviewed and updated either as needs change or as and when the respite care service is used. As noted in the previous section, care files have been reviewed and are still being developed but staff felt that they have now got a system that works well and all necessary information is easily accessible for staff. The risk assessment and management process is also undergoing review and development. A system of delegated responsibilities for staff to update and review care plans and risk assessments as a team is in place. Important day-to-day changes or essential information is left in the Communication Book, to be read when new staff come on duty. Westminster House H55 H04 S32663 Westminster House V218473 100505 Stage 4.doc Version 1.30 Page 11 Service users are consulted with on their choices and preferences in the routines of daily living and have the opportunity to contribute to the day-today running of the home through the Service User Forum. The Forum has developed a role in influencing decisions about the service and an involvement in the selection of staff. This is an important developmental process and the manager is clear that the role of the independent advocate in the process is essential. On the day of this inspection there were a number of service users who had come to Westminster House for the evening to have a meal together and then meet as the Forum and it was clearly an enjoyable social occasion for all of the service users. Westminster House H55 H04 S32663 Westminster House V218473 100505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 -17 Service users’ rights to privacy and dignity are respected. Service users have the opportunity to take part in the leisure and social activities of their choice. Service users are offered meals of their choice in an attractive and homely setting and at flexible times. EVIDENCE: Service users can continue to take part in their usual daily activities if they choose whilst staying at Westminster House and many of the service users are out during the day at various activities, returning to Westminster House in the evening for a meal. The philosophy of care is “choice” and activities in the home depend on what service users choose to do; TV, music, games, or going out to the cinema, theatre, or a pub meal or take-away. On all occasions when the inspector has visited Westminster House, staff sit with the service users, talking or engaged in activities. Family and friends are always welcome to visit. Privacy is respected by staff and service users and bedrooms are lockable and only entered with permission from the service user. Service users said that staff always respect privacy.
Westminster House H55 H04 S32663 Westminster House V218473 100505 Stage 4.doc Version 1.30 Page 13 Special dietary needs are carefully assessed and catered for and this is recognised as an area of particular importance for all service users. Mealtimes are flexible but usually the main meal during the week is in the evening when most of the service users are at home. Meals are taken in the dining area next to the kitchen and service users spoken to were very happy with the meals provided. Westminster House H55 H04 S32663 Westminster House V218473 100505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 and 20 Staff provide sensitive and flexible personal care and support. There are policies and procedures in place for the administration and dispensing of medication, including self-medication if appropriate. EVIDENCE: Service users’ preferences about times for getting up/going to bed and other activities are respected and this was confirmed by service users in discussion with the inspector. Staff have received the appropriate training in the use of any specialist aids or equipment that may be required to assist service users with their personal care. The administration and dispensing of medication procedures were inspected with one of the duty managers. The fitting of a door to the medication room was identified last year as essential to ensuring that medication was properly checked and administered without the distraction of visitors and the telephone and this has worked well. Service users can self-medicate subject to a risk assessment and a lockable drawer is provided in bedrooms. Medication is dispensed in disposable containers and stored in individually named containers. There were no controlled drugs being stored. Records inspected were up to date and all medication is individually recorded in the service users’ care plans. Westminster House H55 H04 S32663 Westminster House V218473 100505 Stage 4.doc Version 1.30 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 Service users are protected from abuse, neglect and self-harm. EVIDENCE: It is evident that there are policies and procedures in place to protect service users and staff are aware of these. Westminster House H55 H04 S32663 Westminster House V218473 100505 Stage 4.doc Version 1.30 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 - 30 The environment is homely, comfortable, clean and tidy. There are specialist aids and equipment and an en-suite bathroom in one of the bedrooms and two assisted bathrooms on the ground floor. EVIDENCE: Service users spoken to were happy with their bedrooms and thought the home was a very nice place to stay. Service users were pleased with the rooms that had new carpet and other new furnishings. There is a range of open-plan communal space on the ground floor that appears to meet the needs of the service users, and if service users want a quiet area to use, the office/meeting room on the first floor can be used but is not accessible for all service users as there is no passenger lift. One bedroom has overhead tracking for a hoist, specially fitted bed and an ensuite shower and toilet. One other ground floor bedroom has a specially assisted bed. In practice this usually means that service users who need to use this specialist facility can only do so when these rooms are available. The main front and back doors are accessible for wheelchair users. There is no call alarm system.
Westminster House H55 H04 S32663 Westminster House V218473 100505 Stage 4.doc Version 1.30 Page 17 There are sufficient toilet and bathing facilities on the ground and first floors and there are laundry facilities separate to the kitchen, on the ground floor. At all visits to the home it has been found to be very clean and tidy and there are policies and procedures in place to maintain good hygiene. Bedrooms provide a bed and sufficient storage space for short periods of respite and all bedrooms have their own television. Until the recent work on the garden, this space offered limited opportunity for service users to use the outdoor space and service users are clearly delighted with the improvements that have been made. Westminster House H55 H04 S32663 Westminster House V218473 100505 Stage 4.doc Version 1.30 Page 18 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 The staff team are skilled and experienced and keen to do training that will enable them to fully meet the individual care needs of the service users. EVIDENCE: There is a staff training and development plan that includes ongoing access to achieve an NVQ in care. The manager has developed a staff training matrix to ensure that all staff receive training in all of the mandatory areas of health and safety and safe working practice and this is regularly updated. The manager explained that he is currently seeking access to Learning Disability Award Framework accredited training at the right level for the staff team. Staff are also offered training in specialist areas or care interventions in order to meet particular assessed needs of individual service users. Westminster House H55 H04 S32663 Westminster House V218473 100505 Stage 4.doc Version 1.30 Page 19 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38,42 Service users benefit from the open, positive and inclusive management approach of the home. The health, safety and welfare of service users are promoted and protected, EVIDENCE: The manager confirmed that the home meets all of the requirements of the relevant health and safety legislation. Advice has been sought on reviewing the Fire Safety Risk Assessment and this is being updated. Staff receive the appropriate training in all aspects of safe working practice for the safety of service users and staff. Comments from service users, staff, and visitors and from observation, demonstrate that service users benefit from an open and positive management approach. The manager and staff are always available and welcoming for service users or visitors.
Westminster House H55 H04 S32663 Westminster House V218473 100505 Stage 4.doc Version 1.30 Page 20 Westminster House H55 H04 S32663 Westminster House V218473 100505 Stage 4.doc Version 1.30 Page 21 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 3 3 x Standard No 22 23
ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 4 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x 4 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Westminster House Score 3 x 3 x Standard No 37 38 39 40 41 42 43 Score x 4 x x x 3 x H55 H04 S32663 Westminster House V218473 100505 Stage 4.doc Version 1.30 Page 22 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 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 Good Practice Recommendations Westminster House H55 H04 S32663 Westminster House V218473 100505 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Mill Court Furrlongs Newport Isle of Wight, PO30 2AA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
© This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Westminster House H55 H04 S32663 Westminster House V218473 100505 Stage 4.doc Version 1.30 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!
