Inspection on 26/04/07 for Westmorland Court Nursing Home

This inspection was carried out on 26th April 2007.

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 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

Westmorland Court Nursing Home 04/02/10

Westmorland Court Nursing Home 07/11/08

Westmorland Court Nursing Home 06/03/06

Westmorland Court Nursing Home 08/12/05

Westmorland Court Nursing Home 10/02/05

Westmorland Court Nursing Home 09/08/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Westmorland Court Nursing Home High Knott Road Arnside Cumbria LA5 0AW Lead Inspector Mrs Margaret Drury Unannounced Inspection 26th April 2007 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 Westmorland Court Nursing Home DS0000006160.V331948.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 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. Westmorland Court Nursing Home DS0000006160.V331948.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Westmorland Court Nursing Home Address High Knott Road Arnside Cumbria LA5 0AW 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) 01524 761291 01524 762640 westmorland.healthcare@btopenworld.com Westmorland Healthcare Limited Mrs Esther Jane Weatherill Care Home 34 Category(ies) of Dementia - over 65 years of age (12), Old age, registration, with number not falling within any other category (34) of places Westmorland Court Nursing Home DS0000006160.V331948.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 34 service users to include: up to 34 service users in the category OP (Old age, not falling within any other category) up to 12 service users in the category DE (E) (Dementia over 65 years of age) up to 2 service users under the age of 65 years. The category DE(E) does NOT apply to nursing places. The home should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 6th March 2006 2. 3. Date of last inspection Brief Description of the Service: Westmorland Healthcare Ltd operates Westmorland Court Nursing Home. The registered manager is Mrs Jane Weatherill. The home is in a quiet setting in Arnside, about half a mile uphill from the village centre. There are mature gardens and ramped access for wheelchairs. There is a dining area, a large lounge, a conservatory and two smaller lounges. Bedrooms vary from 10 to 17 square metres. There are 28 single and 4 twin bedrooms. The upper floors have views over the Arnside estuary to the Lakeland fells. The property is a large detached, three-storey Victorian house, which has been extended and adapted for its current use. The top floor is used for staff accommodation. There is a passenger lift, handrails and spacious assisted bathrooms. The fees charged by the home range from £454.00 to £493.00 per week as at the date of the inspection. An additional charge is made for personal toiletries, newspapers, magazines, hairdressing, chiropody and beauty therapy. Westmorland Court Nursing Home DS0000006160.V331948.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit, which forms part of the annual key inspection, took place over one day in April with Marian Whittam accompanying the lead inspector. Pre- inspection information on residents, fees, staffing and services provided by the home, requested in advance by CSCI, was returned before the visit. Information was also gathered from returned questionnaires sent to residents and families. This information provided opinions about the home and the level of care provided. The morning was spent looking around the home talking with residents in the lounges and the conservatory. The manager was spoken with at length and also the Head of Care. Time was also spent observing activities on the lounge and work practices, and looking at care plans. Some residents were happy to talk about their experiences of living in the home but there were no visitors available to speak with during the visit. An inspection of medication handling and records was carried out during this visit. The afternoon was spent speaking with the cook and care staff and some of the residents. What the service does well: Westmorland Court provides a safe and comfortable environment in a building suited for it’s stated purpose. The residents benefit from a trained, experienced and stable staff team who, together with the manager and other members of the senior team, deliver an extremely high standard of care. There is an in-depth admission process with all prospective residents fully assessed prior to admission. Arrangements are made for anyone wishing to move into the home to visit and enjoy a meal and meet the residents and staff. There is an excellent social programme that includes activities in the community that have resulted in residents making friends with people that do not live in Westmorland Court. In house activities and outings are also provided. Dietary needs of residents are well catered for with a balanced and varied selection of good quality food and home cooked meals. The home has an excellent set of policies and procedures that ensure the safety and wellbeing of the residents and staff. Westmorland Court Nursing Home DS0000006160.V331948.R01.S.doc Version 5.2 Page 6 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. Westmorland Court Nursing Home DS0000006160.V331948.R01.S.doc Version 5.2 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 Westmorland Court Nursing Home DS0000006160.V331948.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4 & 5 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has a comprehensive admission procedure that ensures a full assessment of needs is completed prior to admission. Information provided guarantees all that use the service know the home will meet their needs EVIDENCE: Clear and comprehensive information is readily available about the home for prospective residents and their families in the statement of purpose and service users guide. This documentation ensures all interested parties know what the home can provide. The registered manager assesses all new residents prior to their admission and this is used as a basis for the plan of care. No resident is admitted without the needs assessment that is provided by the social worker as this also assists with the preparation of the initial care plan. Westmorland Court Nursing Home DS0000006160.V331948.R01.S.doc Version 5.2 Page 9 Prospective residents and their families are invited and encouraged to visit the home to view the facilities and meet the staff and those living in Westmorland Court. This also gives an opportunity to enjoy a meal and the “activity of the day”. Residents who spoke with the inspector said how much they appreciated seeing the home before they moved in. The manager told the inspector that the residents could visit as often as they wished in order to give them time to “make one of the biggest decisions of their life”. Westmorland Court Nursing Home DS0000006160.V331948.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The care planning records and assessments provide staff with the information they need to meet resident’s healthcare personal and social care needs. The systems for the administration of medicines are excellent and monitored in order to meet resident’s medication needs. EVIDENCE: All residents have a clear and easily followed individual plan of care, based on the initial assessment. Each plan sets out the health, personal and social care needs of the residents and this information ensures staff are aware of the level necessary to meet these needs. The manager or one of the qualified nurses reviews all care plans monthly and any identified changes are incorporated into them. However, if any changes in the care needs are noted in between the reviews the care plans are updated immediately. Care plans are regularly audited by the manager and then discussed during staff supervision and Westmorland Court Nursing Home DS0000006160.V331948.R01.S.doc Version 5.2 Page 11 appraisal.. This system ensures the highest level of personal and social care is provided to those living in the home. Doctors from the local surgeries visit the home every week in order to monitor the healthcare needs of the residents. District nurses also visit to attend to and to monitor the healthcare needs of the residential residents. Inspection of the medicines and records evidenced a very well organised system. Policies and procedures were readily available for staff handling medication to access and read and further guidance from the manager is always available. There was evidence of good practice with regards to the receipt and disposals of medication and all controlled drugs are handled and recorded in a safe and appropriate manner. All medication records were correctly completed and these together with the medicines held are audited on a regular basis. A qualified nurse and then the manager audit all controlled drugs monthly as a further safeguard for the residents. Observations during the visit showed that staff treated the residents with care and consideration. Many of the staff do not have English as their first language but nearly all of them were seen to communicate with the residents effectively and well. Westmorland Court Nursing Home DS0000006160.V331948.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are able to make choices about their life style and to retain their independence for as long as possible. Social and recreational activities meet the residents’ expectations and needs. EVIDENCE: The home promotes the individual resident’s right to live a life that is fulfilling and meaningful. Residents have a choice of activities that are varied and stimulating. The inspector was given a copy of the annual plan of activities that showed a varied programme for the residents to enjoy. Regular outings are arranged and staff take residents out for walks in the warm weather. Regular film afternoons are enjoyed and visiting entertainers are also popular. There are activities arranged for most days although the residents who spoke with the inspector were quick to point out that they did not have to take part unless they wished to. Easter bingo had been organised for a “fund raiser” and all families and friends were invited. One recent activity was the “feeding of 2 hand reared lambs that were brought into the home for the residents to see. Westmorland Court Nursing Home DS0000006160.V331948.R01.S.doc Version 5.2 Page 13 There was a photographic record of the event and this will be put on display in the home for visitors to see. It was noticeable during the visit that the atmosphere in the home was warm friendly and open with lots of chitchat. Regular Communion services are arranged by the near-by Anglican Church and there are some residents who are able to attend their own churches if they wish. The inspector was able to speak to the chef who has been appointed since the last inspection visit. She had previously been employed at the home and had recently moved back into the area and was delighted to be working at Westmorland Court again. She was extremely happy and really liked talking to the residents and knew them all individually. New menus are currently being prepared with suggestions having been made by the residents themselves. Almost all the food is home prepared and all said they enjoyed their meals, as there was always an alternative if the main meal was not suitable. Special menus, including diabetic and vegetarian are available when required. Westmorland Court Nursing Home DS0000006160.V331948.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are able to express their concerns through an effective and accessible complaints procedure. Residents are safeguarded by an efficient adult protection policy. EVIDENCE: The home has a clear complaints procedure and logs complaints for investigation and the procedure is readily available to residents. The complaints procedure is displayed on the home’s notice board and in the service user guide provided to each resident on admission to the home. Residents spoken with said they were confident that the staff and owners would listen to them and deal with any complaints they made. One resident said that they had no complaints but would speak with the manager if they had, as she in the home every day. Staff training records show that training on abuse and adult protection has been given to staff and the Cumbria multi agency guidance is available in the home. The home has clear policies and procedures in place for adult protection; identifying and reporting abuse, POVA procedures and whistle blowing. The manager conducts regular training sessions on adult protection with all staff looking at various scenarios to provide a wide aspect of the subject. Staff who spoke to the inspectors confirmed that training is given and Westmorland Court Nursing Home DS0000006160.V331948.R01.S.doc Version 5.2 Page 15 are aware of what to do should abuse be suspected and expressed confidence in the manager to support them in raising any issues about care. Westmorland Court Nursing Home DS0000006160.V331948.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20,23, 24, 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enable the residents to live in a safe, well-maintained and comfortable environment, which encourages independence EVIDENCE: The owners of Westmorland Court ensure that the physical aspect of the home provides an environment appropriate to meet the needs of the residents. The home is well maintained, warm and comfortable with a staff team that encourages all residents to see the home as their own. There is an annual repair and maintenance plan and the manager was able to confirm that the maintenance and upkeep of the building is always up to date. Three lounges, a dining room and a conservatory provide communal space and these amenities give ample space for enjoying organised activities and for Westmorland Court Nursing Home DS0000006160.V331948.R01.S.doc Version 5.2 Page 17 sitting quietly reading or chatting with friends. The home has extensive and well-kept gardens, which provide an excellent amenity for the residents during the warmer weather. One of the smaller lounges is ideal for residents to use for private visits with family or friends if they wish. Westmorland Court has thirty-one rooms, all for single occupation, four of which have en-suite facilities. All of the residents’ rooms are well appointed with many of them having lovely views over the Lakeland Fells. The residents have personalised their rooms with furniture, pictures and photographs brought from their own homes. Laundry facilities are provided and situated away from the main living and food preparation areas. Westmorland Court Nursing Home DS0000006160.V331948.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff in this home are trained, skilled and in sufficient numbers to provide a high level of care and support those living in Westmorland Court. EVIDENCE: Westmorland Close has a full recruitment and selection policy managed by the administrator and registered manager. The registered providers see the recruitment of good quality staff as essential to the delivery of an excellent service. Application forms are completed, references taken up and interviews arranged. All new staff are appointed after all the required legal checks have been completed and no new member of staff works without a mentor until their induction programme has been completed. The staffing ratio is excellent, with the home maintaining good staffing levels at all times. There is a good skill mix of qualified nurses and care staff. and there are, currently, almost 70 of the care staff trained to National Vocational Qualification (NVQ) levels 2 and 3. This level of staffing ensures those living in the home are safeguarded at all times. There is an ongoing staff training programme with excellent records of training completed and updates due. All mandatory training is up to date, including manual handling, food hygiene, and risk assessment covering environmental Westmorland Court Nursing Home DS0000006160.V331948.R01.S.doc Version 5.2 Page 19 issues and substance/ cleaning products. Training planned for the future includes, care of the dying, dementia and protection of vulnerable adults. All of this results in a diverse staff team that has the balance of skills and experience to meet the needs of people living in the home. Discussions with the staff evidenced that they all work as a team and support each other, although they are aware of their own roles and responsibilities. The home has recently appointed a head of care who is well experienced in the care of older people. She has particular responsibility for those residents needing residential care only. Westmorland Court Nursing Home DS0000006160.V331948.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 & 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect. There is an effective quality assurance system that ensures residents are fully satisfied with the care and support they receive. EVIDENCE: The registered manager has the required qualifications and experience, and is highly competent to run the home and ensure it meets its stated aims and objectives. She has the best interests of the residents at heart and has a clear vision of the future that is based on the home’s values and priorities. She has a high profile within the home and those residents who spoke with the inspector said she “is very approachable and I can speak to her when I want to”. There Westmorland Court Nursing Home DS0000006160.V331948.R01.S.doc Version 5.2 Page 21 is a very open atmosphere in the home that stems from the manager and the senior team and is much appreciated by those living in Westmorland Court. Quality audit questionnaires are completed by relatives/visitors, professional agencies and residents, after which the manager prepares an audit report and looks closely at any issues raised. The manager and head of care speak regularly with residents on an individual basis in order to gain their opinions about the running of the home. The home has efficient systems for effectively safeguarding individual’s personal money. The records pertaining to the cash held on behalf of residents were examined and found to be correct, with money signed in and out and a regular audit completed by a member of the senior team. All receipts for goods purchased are retained for reference. Staff supervision take place every 2 months with records held on file. The meetings give opportunity for staff to discuss the policies and procedures that are in place, the care plans and also to talk about any training needs they may have. Annual appraisals are also in place. There are working practices in place to minimise the risk of accidents and the home has a comprehensive range of policies and procedures to promote and protect residents and staff. The manager and senior team have a good understanding of health and safety issues and risk assessments covering all aspects of the running of the home. All equipment is maintained under annual service agreements. Westmorland Court Nursing Home DS0000006160.V331948.R01.S.doc Version 5.2 Page 22 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 4 X 4 4 4 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 4 10 4 11 N/A DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 4 4 4 X X 3 4 4 4 STAFFING Standard No Score 27 3 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 4 X 3 4 X 4 Westmorland Court Nursing Home DS0000006160.V331948.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Westmorland Court Nursing Home DS0000006160.V331948.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Westmorland Court Nursing Home DS0000006160.V331948.R01.S.doc Version 5.2 Page 25 - 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!