Random inspection report
Care homes for older people
Name: Address: Westmorland Court Nursing Home High Knott Road Arnside Cumbria LA5 0AW three star excellent service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Jenny Donnelly Date: 0 4 0 2 2 0 1 0 Information about the care home
Name of care home: Address: Westmorland Court Nursing Home High Knott Road Arnside Cumbria LA5 0AW 01524761291 01524762640 westmorland1@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Westmorland Healthcare Limited care home 48 Number of places (if applicable): Under 65 Over 65 0 48 dementia old age, not falling within any other category Conditions of registration: 48 0 The registered person may provide the following category of service only: Care home with nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE The maximum number of service users who can be accommodated is: 48 Date of last inspection Brief description of the care home Westmorland Healthcare Ltd operates Westmorland Court Nursing Home. The registered manager is Mrs Jane Weatherill. The property is a large detached, threestorey Victorian house, which has been extended and adapted for its current use. It 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 are a three lounges, a
Care Homes for Older People Page 2 of 9 0 7 1 1 2 0 0 8 Brief description of the care home conservatory and two dining areas for people to use. There are 44 single and 2 twin bedrooms, some of which have en suite facilites. There is a passenger lift, handrails and spacious assisted bathrooms. The fees charged by the home range from £525.00 to £567.00 per week. Additional charges are made for personal toiletries, newspapers, magazines, hairdressing, chiropody and beauty therapy. Written information about the service and copies of inspection reports are on display in the care home. Care Homes for Older People Page 3 of 9 What we found:
We made an unannounced visit to the service at 3pm, and stayed until 5pm. We toured the home, spoke with some of the people living there and some staff. We looked at a selection of care records and observed how staff were working and watched the evening meal being served. The home is registered for a maximum of 48 people; there were 39 at the time of our visit. We had learnt during a recent phone call to the service that the registered manager was on sick leave. The manager was still off at the time of our visit. One of the nursing staff was covering for her and acting in an on call capacity when she was not on duty in the home. The nurse told us she had taken some duty calls during this period and had been able to advise or reassure staff. Both the administrator and nurse on duty told us the home owner, Mr Kularatnam had visited the home during the managers absence, and was due again the following week. They told us he telephoned the home regularly and they could call him if they needed to, saying they had spoken with him twice that morning. Mr Kularatnam telephoned whilst we were in the home and told us of his plans for providing more robust management cover for the following week, should the registered manager remain away. We looked at staffing levels for the home and saw there was one nurse, six care assistants, the cook, two kitchen assistants and the handyman on duty. The administrator was due to leave at 3pm, but stayed a little later. Rotas showed that a second nurse had been on duty until 2pm, and rotas confirmed the staffing numbers described above had been maintained. Discussion with the nurse on duty and some of the care staff further confirmed this was the homes usual staffing. We were told when there were more people in residence, the second nurse stayed until 6pm, and there was an additional carer. The nurse on duty told us Mr Kularatnam was considering re-introducing the extra nurse hours as they were close to having 40 residents. When the new extension to the home was registered, we agreed with the proposed staffing levels of 2 nurses and 7 care staff for 48 people, but the home has not yet reached full occupancy. We observed staff working and saw that 2 care assistants worked in the new part of the home where 10 people were living, and the other 4 care assistants worked in the main house with the other 29 people. Staff were working calmly and in an organised way and we judged that peoples needs were being met. We were told that one nurse had left the home in December, and a part time nurse and two relief nurses were awaiting criminal records bureau clearance before they were offered work in the home. We watched the evening meal being served, and saw there was a kitchen assistant working in each of the two areas of the home, serving the food, whilst care staff supported people to eat. We saw that people were given a choice of food, offered an alternative if they did not want their first choice and we saw staff supporting and encouraging people who were reluctant to eat. Hot and cold drinks were served, and the meal time was calm and unhurried, with some cheerful chatter taking place between residents and staff. We looked at the menus and saw a good variety of traditional meals were offered. The main meal was served at lunch time, with a lighter evening meal of soup, sandwiches,
Care Homes for Older People Page 4 of 9 salads, jacket potatoes or savouries on toast, with a dessert. We talked with the cook about menu planning and supplies. We learnt that they were considering changing their food supplier back to one they had used in the past. The cook told us he was under no pressure to cut back on the quality or quantity of items ordered. The kitchen had been inspected by environmental health in May 2009 and given a 5 star excellent rating for food safety. We selected some care records to look at, choosing those of people with wound care or special nutritional needs. The care plans we saw were detailed and had been kept under review and updated as necessary. There was good information on wound care, with photographs, detailed wound assessments and clear treatment plans in place. There was evidence these treatment plans had been kept under review to ensure healing was taking place. For people with special nutritional needs, we saw weight records were held separately to the care plan, so the care plan was not always up to date with the latest information. We also found information about the type, and use of, any prescribed supplementary feeds was kept in the kitchen, and this was not always included in the care plan in sufficient detail. We saw that everyone had their weight monitored, and any significant weight loss was reported to the persons doctor so a dietician referral could be requested. We had missed the afternoon activity by the time we arrived in the home. Although the activity organiser was on leave, we were told that care staff maintained the advertised activity plan, and a musical movement session had taken place. People we spoke with told us they were quite content in the home, the staff are nice and the food is good. The home had recently reported an outbreak of infection to us and we looked at the way this had been managed. There were clear policies and procedures for managing outbreaks of infection and staff had received training on these. The problem occurred when a number of new people were admitted from hospital in the same week, and all came down with symptoms during their first few hours in the home. We saw that the people affected had instructions in their care plans to manage and contain their illness. People had been seen by their doctor and the local infection control team nurse had been informed. The home was temporarily closed to visitors. Samples had been sent for analysis and a 24 hour gastric bug was thought to be the cause. There have been no further cases since. We looked at infection control practices and saw that all toilet, bathroom and sluice areas were provided with good hand washing facilities. There were dispensers with liquid soaps, alcohol hand gels, paper towels and clinical waste bins. We saw stocks of gloves and aprons for staff, in toilets and linen cupboards, although there were none in the sluice. Staff told us they carried supplies in their pockets at all times and replaced them as needed. There was hand gel at the front door for visitors to use before entering the home. The home was clean, fresh and hygienic throughout. What the care home does well:
The service continues to provide good outcomes for the people living in the home. There was adequate management cover and support for staff during the absence of the registered manager. The owner was keeping in close contact with the home during this period and making more robust plans should the managers absence continue.
Care Homes for Older People Page 5 of 9 There were sufficient staff on duty to meet peoples needs and consideration was being given to increasing the nursing hours as occupancy increased. Robust recruitment procedures were adhered to. People looked well cared for and expressed their satisfaction with the care and attention they were receiving. We observed staff spending time and engaging with people. The provision of food was good, with people being offered choices and other alternatives. The presence of the two kitchen assistants to help with serving meals and drinks, enabled care staff to spend time supporting people who needed help to eat. This was done in a discreet and patient way. Care records were detailed and up to date and guided staff in what care and support people needed and wanted. Management of wound care was good. Infection control practices in the home were good, and helped reduce the risk of, or spread, of infection. The recent infectious outbreak had been well managed and quickly contained. The home was warm, clean and comfortable. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 9 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 9 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 8 of 9 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 9 of 9 - 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!
