Inspection on 18/01/06 for Westminster House

This inspection was carried out on 18th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Westminster House 20/11/07

Westminster House 06/02/07

Westminster House 10/05/05

Westminster House 02/02/05

Westminster House 15/09/04

Westminster House 17/03/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Westminster House Westminster Lane Newport Isle of Wight PO30 5DP Lead Inspector Annie Kentfield Unannounced Inspection 18th January 2006 12:30 Westminster House DS0000032663.V251378.R01.S.doc Version 5.1 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 House DS0000032663.V251378.R01.S.doc Version 5.1 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 House DS0000032663.V251378.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Westminster House Address Westminster Lane Newport Isle of Wight PO30 5DP 01983 526310 01983 520372 jeremy.baker@iow.gov.uk 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) Isle of Wight Council Mr Jeremy Ernest Baker Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Westminster House DS0000032663.V251378.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home currently includes 4 pre-existing residents in the LD/E category. 10th May 2005 Date of last inspection 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 DS0000032663.V251378.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second unannounced inspection in the inspection year and took place in the afternoon. The inspection included a tour of the premises and discussion with some of the staff and the registered manager and looked at some of the home’s records. The inspector also spoke to two service users who stay in the home on a regular basis. Most of the standards were assessed at the previous inspection and this inspection looked at some of the ‘key’ National Minimum Standards. Inspection comment cards were left for service users and visitors to complete and return if they wished to. What the service does well: What has improved since the last inspection? Since the last inspection the newly landscaped garden has been further developed and is attractively laid out with lawn and plants, barbecue, and seating areas suitable for service users including those who use wheelchairs. The service has also purchased and installed another electric bed and installed sensory lighting systems in one of the ground floor bedrooms. Westminster House DS0000032663.V251378.R01.S.doc Version 5.1 Page 6 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 DS0000032663.V251378.R01.S.doc Version 5.1 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 Westminster House DS0000032663.V251378.R01.S.doc Version 5.1 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 the following standard(s): 2 and 4 (all of the key standards were assessed at the previous inspection) Assessing the needs of prospective service users is a lengthy process and continues after the service user has started to use the service. However, time must be allocated to ensure that all care needs are properly recorded in the individual care plan. Service users are encouraged to visit the home and meet the other service users and staff as many times as they wish before using the service for the first time. EVIDENCE: Following a referral for the respite service, the initial assessment is done by one of the senior staff or duty managers. Wherever possible the assessment of the prospective service user takes place in the first instance, in their own home. Service users are then encouraged to visit Westminster House and meet other service users and staff and stay for a meal or a cup of tea. At the time of the inspection, one service user was visiting for the evening with a view to moving from children’s services to adult services and had visited the home several times already with a carer. Some of the records looked at during the inspection contained more information than others and it was clear that additional time is needed to bring all of the individual care files up to date and to ensure that all assessments are Westminster House DS0000032663.V251378.R01.S.doc Version 5.1 Page 9 complete and recorded in writing. The assessment process gathers together a lot of information – from the service user and their family, and also from any other professionals involved in the care of the service user and all of this information forms the individual service user care plan. Many of the service users have complex physical, emotional and social care needs that require staff to use specific aids and equipment to meet care needs and to be aware of special dietary requirements and communication needs. The manager and staff are aware of the need to complete assessments and care plans and have already discussed ways of doing this in a recent staff meeting. The amount of referrals has increased because there are a high number of younger service users who are in the transitional process between the children’s and adult services. The manager and staff also have a policy that new service users spend 1:1 time with a senior member of staff when they first use the service in order to properly get to know service users and to continue the person centred approach to meeting all of their care needs. This has an impact on staff time and particularly the time of the duty manager who has a number of key responsibilities in each working period. The manager and staff are aware of these issues and are taking steps to address them; such as allocating a set period of time to ensure that all assessments are completed within a designated period of time. Westminster House DS0000032663.V251378.R01.S.doc Version 5.1 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 the following standard(s): 6 (all of the key standards were assessed at the previous inspection) All service users have an individual care plan based on their care needs assessment. Some care plans were more detailed than others and time must be allocated to ensure that all care plans are up to date and specific enough to guide staff on the care to be provided. Risk assessments and risk management plans must be developed on an individual basis. EVIDENCE: Inspection of care files showed that some care plans were incomplete for new service users. The reasons for this have already been discussed under Standard 2. Although it was evident that staff are very knowledgeable about the individual care needs of all of the service users, the care plans do not reflect the high level of care being provided and the time that staff spend with service users each day, and action must be taken to address this. In discussion, it was also agreed that all risk assessments and management plans for identified risks must be individually recorded and reviewed on a regular basis. Westminster House DS0000032663.V251378.R01.S.doc Version 5.1 Page 11 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 the following standard(s): 14 (all of the standards were assessed at the previous inspection) People using the service have the opportunity to take part in leisure and social activities of their choice. EVIDENCE: 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. Staff spend as much time as possible with the service users. Since the last inspection, more computer facilities and game facilities have been provided in the lounge areas, as these are very popular with service users. Service users are supported to continue to attend their regular daytime activities whilst staying at Westminster House and many of the service users are out during the day and come back to Westminster House in the evening for a meal and to stay. One service user spoken to said that staff are always kind and help them to shop etc. and they enjoy the break from their usual routine. Westminster House DS0000032663.V251378.R01.S.doc Version 5.1 Page 12 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 the following standard(s): 19 (the other standards were assessed at the previous inspection) Service users are in the home for short periods of time. The home is reliant on up-to-date information about health and medication being provided by carers. EVIDENCE: The manager and staff demonstrate a good knowledge of the service users care needs and liaise with families and other people involved in the care of the service users to ensure that all care needs are met during periods of respite care. One member of staff explained how various specialist equipment in the home is operated and confirmed that staff never use any equipment or hoists unless they have been trained to do so and have regular updates in training. The member of staff also said that the home can seek advice at any time if there are any problems or care needs change; from either service users’ families or care professionals. The policy of the home is that medication is only checked and administered by the senior person or duty manager. Medication is checked in when a service user arrives for respite and checked out again when they leave and this can sometimes be a lengthy procedure taking up a large part of the time for the duty manager. The manager explained that arranging the programme of respite stay periods requires a detailed knowledge of service users’ individual Westminster House DS0000032663.V251378.R01.S.doc Version 5.1 Page 13 care needs and ensuring there are always sufficient staff on duty to always meet those care needs. Many of the service users have complex physical and emotional care needs but the manager is very clear that the service employs staff who are experienced and skilled to meet these care needs and there is a commitment to ongoing training and development. Many of the staff have specialist communication skills, including the manager and spend time getting to know the service users in order to best understand how they prefer to communicate their wishes and preferences. Westminster House DS0000032663.V251378.R01.S.doc Version 5.1 Page 14 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 the following standard(s): 22 Service users feel their views are listened to and acted on. EVIDENCE: The service user led Forum meets every month and has developed a system of feeding back to the manager any issues or concerns. Details of the Forum meetings are produced for all service users using computer facilities in the home. Service users decided that they prefer the Widget 2000 (individualised characters) programme and this is used in all information produced for service users. A questionnaire in graphic and written format is given to service users when they use the respite care service and any comments are always noted. Westminster House DS0000032663.V251378.R01.S.doc Version 5.1 Page 15 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 the following standard(s): 24 - 30 The home is very clean and tidy and aims to provide a relaxed and friendly ‘home’ environment for people using the service. With the number of people using the service, the furniture and fittings have a very heavy use and it is recommended that an ongoing programme of regular replacement be put into place. EVIDENCE: The communal areas of the home on the ground floor are open plan with smaller areas arranged to provide privacy and allow for different activities such as TV, games, computers etc. Although service users spoken to thought the home was nice and comfortable, some areas are looking tired and worn and some of the sofas and dining chairs need replacement. Because of the heavy use they get, some of the dining chairs have broken and miss-matching chairs have been brought in temporarily. Replacement of furniture should be regularly accounted for in the budgets for the home. The home also has very limited storage space and seats from the minibus had to be stored in the sitting room when the minibus was being used to transport wheelchair users. The bedrooms are decorated and furnished comfortably and two of the ground floor bedrooms have electric beds and other equipment for service users who need assistance with mobility. Although the home is not fully accessible as Westminster House DS0000032663.V251378.R01.S.doc Version 5.1 Page 16 there is no passenger lift, the ground floor entrances are accessible and there are sufficient toilet and assisted bathing facilities. Since the last inspection one bedroom has had sensory lights installed and staff say that residents really like this. There are plans to replace the cookers in the kitchen. The home is well supported by the League of Friends and they had recently purchased several items for the home to be used by the service users including a new football table. There are plans to enhance the newly landscaped garden area even further and this feature has greatly increased the amount of useable space for service users and there are outdoor tables and chairs suitable for all service users. Westminster House DS0000032663.V251378.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34 and 35 Service users are protected by the home’s recruitment procedures and by competent and qualified staff. EVIDENCE: Recruitment procedures are managed through the Local Authority Human Resources Department and the manager confirmed that it is the Local Authority policy that new staff do not start working in the home until all the required checks have been completed and are satisfactory, this includes criminal record checks. Records are not kept in the home and a copy of the current guidance on the storage of recruitment records will be discussed in separate correspondence with the registered manager. The manager is committed to ensuring that staff employed in the home are experienced and skilled and receive ongoing training and regular updates on safe working practice. The manager explained that the home has been accepted as a placement for European social work placements and it is hoped that the first student will start in September 2006. Four of the staff are currently doing the European Computer Driving Licence with a view to working with service users on developing computer skills. Two of the staff are currently enrolled on the NVQ health and social care course. All staff are expected to achieve a relevant care qualification and the manager is Westminster House DS0000032663.V251378.R01.S.doc Version 5.1 Page 18 looking at accessing specific Learning Disability Framework training at the right level for the staff in the home. Staff spoken to felt that they had sufficient training to meet the care needs of the service users and two of the staff are qualified manual handling instructors. Staff said that the home has a clear manual handling policy and they had also been given training and guidance on using oxygen cylinders. Staff meet on a regular basis and there are systems in place for regular supervision. Westminster House DS0000032663.V251378.R01.S.doc Version 5.1 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 and 39 Service users benefit from a service that is well managed and the interests and rights of the service users are given priority. EVIDENCE: The registered manager is very experienced and qualified and since the last inspection has completed the Registered Manager Award; and already has a number of care and management qualifications. The manager aims to lead by example and is very clear about working together with all of the staff as a team for the benefit of the service users. The manager and staff are always available for service users and their relatives and carers and work hard to try and address issues as they arise so that the respite care provided is a positive experience for everyone who uses it. The views and experience of the service users underpin the way the service is run as evidenced by the Service User Forum. Health and safety and safe working practice are regularly reviewed and staff confirmed that fire drills take place unannounced to include all service users and staff. Westminster House DS0000032663.V251378.R01.S.doc Version 5.1 Page 20 At the end of last year there was an inspection of Learning Disability Services on the Isle of Wight and Westminster House was one of the services visited during the inspection. A report of this inspection is now available. Westminster House DS0000032663.V251378.R01.S.doc Version 5.1 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 Standard No Score 1 X 2 2 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 X ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 3 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 X X 4 X 4 X X X X Westminster House DS0000032663.V251378.R01.S.doc Version 5.1 Page 22 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA2YA6 Regulation 14 and 15 Requirement The update of the assessment and care planning process must be completed to ensure that all care files contain a written plan of the care to be provided with care plans and risk management plans regularly reviewed. Timescale for action 30/04/06 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 YA24 Good Practice Recommendations It is recommended that the service have a planned programme of replacement for furniture and fittings to ensure that at all times the home is well maintained and fit for purpose. Westminster House DS0000032663.V251378.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Southampton, Portsmouth and Isle of Wight Ground Floor Mill Court Furrlongs Newport, IOW 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 DS0000032663.V251378.R01.S.doc Version 5.1 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. 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