Inspection on 06/12/05 for Westminster House Care Ltd

This inspection was carried out on 6th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Westminster House Care Ltd 27/11/07

Westminster House Care Ltd 18/12/06

Westminster House Care Ltd 18/07/05

Similar services:

Chesham House

Argyll House

Dorset Lodge

Acacia House

Falcon House

Dial House Nursing Home

Cromwell Avenue (9)

Abbey Lodge

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

CARE HOMES FOR OLDER PEOPLE Westminster House Care Ltd 41 Westminster Drive Westcliff On Sea Essex SS0 9SJ Lead Inspector Nicola Dowling Unannounced Inspection 6th December 2005 10:00 X10015.doc Version 1.40 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 Care Ltd DS0000062663.V272877.R01.S.doc Version 5.0 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 Older People. 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 Care Ltd DS0000062663.V272877.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Westminster House Care Ltd Address 41 Westminster Drive Westcliff On Sea Essex SS0 9SJ 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) 01702 333034 01702 333034 Westminster House Care Ltd Mrs Sally Ann Ayittey Care Home 12 Category(ies) of Dementia - over 65 years of age (12), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (12) Westminster House Care Ltd DS0000062663.V272877.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th July 2005 Brief Description of the Service: Westminster House is a care home offering accommodation for up to twelve older people who have dementia or a mental disorder. Westminster House is situated in a residential area of Westcliff on Sea and the premises are in keeping with the houses in the locality. Accommodation comprises of a large lounge with dining area. There are twelve single bedrooms situated on the ground and first floor. There is a five person passenger lift. The home has a non-smoking policy and staff and residents that wish to smoke make use of the garden. Westminster House Care Ltd DS0000062663.V272877.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over one day and the manager and proprietor were present. The inspection consisted of a tour of the home, talking with staff, residents and others, observing the care given, and reading of documents. A resident’s friend that was visiting the home commented on how good he thought the care was at the home despite the furniture and decor being worn in places. What the service does well: What has improved since the last inspection? What they could do better: Westminster House Care Ltd DS0000062663.V272877.R01.S.doc Version 5.0 Page 6 Residents support plans do not explain the physical needs of the residents in sufficient depth and the recording of medication in a resident’s drug chart was inaccurate. A gazebo is provided in the garden for smokers. This area is cold in the winter-time for those residents that smoke. There was also a lack of handwash and paper towels in the communal toilets that leave residents’ and staff unable to maintain hygiene standards. 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 Care Ltd DS0000062663.V272877.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Westminster House Care Ltd DS0000062663.V272877.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Residents are assessed by a competent person before they are accepted into the home. EVIDENCE: When a new resident is referred to the home, the home’s manager or proprietor visits the resident for an assessment before they are admitted to Westminster House. There was evidence of an assessment and of a discharge summary from the hospital to support this. There have not been any new residents admitted to the home since the last inspection and the home is currently full. Westminster House Care Ltd DS0000062663.V272877.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 9 and 10 Areas of medication practice are unsafe and there is a lack of detail in support plans for physical care, however residents rights and privacy is respected. EVIDENCE: The residents all had a support plan that identified their mental health care. However the support plans did not show in sufficient detail how to manage the residents’ physical care. For example weight loss has been recorded but there is no written plan regarding the steps to take to manage this area of care. The staff were aware of this problem but there is a lack of written guidance on what to do about it. On checking residents’ medication charts it was found that a medication had been given and not recorded. Also the medicine keys were held on the same bunch as the general house keys. This is unsafe practice and the manager was made aware of this immediately. Resident’s were seen to open their own mail and had their own clothes on. Staff reported that residents are seen by visiting professionals in the privacy of their own room. Westminster House Care Ltd DS0000062663.V272877.R01.S.doc Version 5.0 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13 Relatives are welcomed into the home. EVIDENCE: The home encourage relatives and visitors. A visitor spoken to at the inspection said that he was always welcomed into the home. There is no private visitors room, however families can see their relatives in the residents bedrooms if they want privacy. There is no set visiting times and staff are always available to speak with relatives. The proprietor and a staff member were in the process of organising a trip the next day for one resident to visit a family grave that was many miles away. This trip was meaningful to the resident’s spiritual needs and occurs throughout the year. Westminster House Care Ltd DS0000062663.V272877.R01.S.doc Version 5.0 Page 11 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: Inspected at last inspection and not inspected at this inspection Westminster House Care Ltd DS0000062663.V272877.R01.S.doc Version 5.0 Page 12 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 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 and 26 Furnishing and décor in areas of the home worn and the smoking area outside is cold. The standard of hygiene in the communal toilets and bathrooms is inadequate. EVIDENCE: The home have invested in a new washing machine and drier for the laundry and the clinical waste is kept secure and out of the reach of the residents. During a tour of the home it was found that the toilets and bathrooms were either without hand wash or paper towels. This leaves residents and staff unable to maintain standards of hygiene. The home are constantly maintaining the property and redecorating. Two residents rooms have been redecorated and the lounge area was in the process of redecoration, however the manager hoped to have this room finished by Christmas. Radiators on the upstairs landing have not been covered. These radiators are not currently used and have not been covered because the covers would protrude too much and block wheelchair access. Westminster House Care Ltd DS0000062663.V272877.R01.S.doc Version 5.0 Page 13 There is no smoking in the home and for staff and residents that do smoke a gazebo has been provided outside at the back of the property. This area is cold and there is no lighting or heating provided. This was discussed with the manager who will investigate other options for a warmer all weather outside area. Westminster House Care Ltd DS0000062663.V272877.R01.S.doc Version 5.0 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 30 The home are maintaining their commitment to training staff. EVIDENCE: On the day of inspection an NVQ assessor was in the home working with staff. Currently the home has 11 staff out of 17 undertaking NVQ in care. This qualification covers many areas of care including abuse. There was evidence that staff have gone on other training courses such as mental illness. Also any new staff receive a standard induction to the home. Westminster House Care Ltd DS0000062663.V272877.R01.S.doc Version 5.0 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 35 and 38 Safety records were up to date and financial records are improving. The home is working towards a self-review of the home’s performance that will indicate that residents’ views are heard and acted on. EVIDENCE: As yet there is no written evidence that the home have undertaken an audit for the purpose of quality assurance. This is an area where the home are going to develop a format to follow which will allow them to measure their success in meeting the aims and objectives set out in their statement of purpose. Financial records for the residents were in the home however the documentation of these still did not provide a clear audit trail. Not all expenditure had a receipt to accompany it and the written records were not clear. A sample of safety records was checked. Portable appliance testing is now due. A service certificate for the hoist was unable to be found which the Westminster House Care Ltd DS0000062663.V272877.R01.S.doc Version 5.0 Page 16 manager will follow up. Other safety records including, gas fire equipment and the electrics were all up to date. The fridge and freezer temperatures were also checked and it was noted that the fridge temperatures were rising above 5 degrees Celsius. This was reported to the manager who agreed to monitor these records to ensure that food was stored at the correct temperature. Westminster House Care Ltd DS0000062663.V272877.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 2 x x x x x x 2 STAFFING Standard No Score 27 x 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 2 x 2 x x 2 Westminster House Care Ltd DS0000062663.V272877.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? yes 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 OP7 Regulation 15(1) Requirement The Registered Person must detail the management of physical care in the resident’s plan of care. The registered person must maintain safe practice for the recording of medication and the safe keeping of medicine keys. The Registered Person must maintain a good standard of furnishings and décor in the home The Registered Person must plan for a warm and weather proof area for residents that smoke. The Registered Person must ensure that suitable hand-wash and towels are provided in the toilets and bathrooms. The registered person must develop a quality assurance system for reviewing and improving the quality of the care provided. Timescale of 31.08.05 and 28.01.05 not met. The Registered Person must maintain clear records of money borrowed by residents from the DS0000062663.V272877.R01.S.doc Timescale for action 24/01/06 2 OP9 13(2) 24/01/06 3 OP19 23(2)(d) 24/01/06 4 5 OP20 OP26 23(2)(e) 13(3) 24/01/06 24/01/06 6 OP33 24 24/01/06 7 OP35 Schedule 4 (8) 24/01/06 Westminster House Care Ltd Version 5.0 Page 19 home. 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 38 Good Practice Recommendations The home should monitor the fridge temperature records to make sure food is stored at the correctly Westminster House Care Ltd DS0000062663.V272877.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Care Ltd DS0000062663.V272877.R01.S.doc Version 5.0 Page 21 - 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. 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