Inspection on 06/03/06 for Westmorland Court Nursing Home

This inspection was carried out on 6th March 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 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 26/04/07

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 Jenny Donnelly Unannounced Inspection 6th March 2006 09:30 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.V282905.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 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.V282905.R01.S.doc Version 5.1 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.V282905.R01.S.doc Version 5.1 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. 8th December 2005 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 20 single and 2 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. Westmorland Court Nursing Home DS0000006160.V282905.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place throughout the morning and lunch time period. The home was fully occupied, and staffed accordingly. As part of the inspection a tour of the building was completed, records relating to staff recruitment, training, maintenance and residents’ care were inspected. Conversations took place with residents, staff and management, both in communal groups and in private. General observations were made around the home throughout the inspection. Any key standards not inspected on this occasion, were checked and found satisfactory at the last inspection in December 2005. What the service does well: What has improved since the last inspection? The home had a development plan, which included staff training, decoration, maintenance, repairs and renewals. This was ongoing throughout the year, and the manager had continued with this since the last inspection. All beds were being upgraded to electric profiling nursing beds, and five of these were now in place. The remainder are to be purchased over the next year, at two each month. Following that, the corridor carpets throughout the home are to be replaced. Westmorland Court was already accredited to run adaptation training for overseas nurses, but is now also accredited as a suitable training placement for student nurses. This demonstrated that the home meets the nursing care and education standards required by the universities. In addition to this the manager is working towards an Investors in People award. Westmorland Court Nursing Home DS0000006160.V282905.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. Westmorland Court Nursing Home DS0000006160.V282905.R01.S.doc Version 5.1 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.V282905.R01.S.doc Version 5.1 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): EVIDENCE: No standards in this section were assessed. Westmorland Court Nursing Home DS0000006160.V282905.R01.S.doc Version 5.1 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 and 8 Residents received a very high standard of nursing and health care at Westmorland Court, which promoted their well being and quality of life. EVIDENCE: Care plans were very good at the last inspection, so only two were examined at this time. These were individual to the resident, up to date, and reflected changes in the persons’ condition or care needs. Care plans set out exactly what level of care or assistance each resident needed, and stated when and how that was to be delivered. The plans made reference to residents’ personal preferences, and clearly highlighted any important aspects of care or safety. The nursing staff I spoke with were knowledgeable about the residents, and knew who had specific health needs. Records showed that residents had received attention from their doctor or specialist as needed. The reason for, and the outcome, of these consultations had been recorded, and the care plan updated accordingly. There was evidence that residents personal wishes about their health care and suggested treatments had been listened to and taken into account. Records of wound care were particularly good. There were detailed assessments and photographs of any wounds/pressure sores a person had on Westmorland Court Nursing Home DS0000006160.V282905.R01.S.doc Version 5.1 Page 10 arriving in the home, followed by a detailed treatment plan and regular evaluation on the healing progress, and treatment changes. Residents said they felt very well cared for, stating, “They look after everyone beautifully”, “we get everything we need”, “all the staff are so helpful”, “we have a bath or a shower at least twice a week”. Westmorland Court Nursing Home DS0000006160.V282905.R01.S.doc Version 5.1 Page 11 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 and 14 Residents were enabled to maintain contact with friends an family, and were helped to make choices in their daily lives. EVIDENCE: Residents were able to receive their visitors at any time suitable to them. The home received a lot of visitors, and most were well known by the staff. It was evident that visitors knew the manager well, and popped in to chat with her socially, as well as to seek information. Visiting could take place in the communal lounges, the resident’s bedroom or in the quiet lounge/meeting room. Contact was maintained with the outside community, with regular visits from the church, various in house entertainers, and the hairdresser. A Holy Communion service took place during this inspection. Most residents at Westmorland Court were highly dependant on the staff to do everything for them. However, there was evidence that residents could make choices in their daily lives, and these were respected by staff. Records showed peoples’ care preferences, such as what time they liked to get up and go to bed, whether a bath or shower was preferred and whether they liked to spend time in the lounges or in their bedroom. Some residents were more able, and went out of the home when they wanted, into the village to get bits of shopping. Westmorland Court Nursing Home DS0000006160.V282905.R01.S.doc Version 5.1 Page 12 Staff were observed offering choices at meal and drink times, and asking residents what they wished to do. Residents confirmed that staff asked about their preferences and wishes. During the inspection, repairs were being done to the lift, so some residents did have to stay upstairs, when they would have liked to come down. On the whole this did not cause any problem, and staff were sited upstairs to be with these residents. Westmorland Court Nursing Home DS0000006160.V282905.R01.S.doc Version 5.1 Page 13 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): 18 Staff were suitably trained and supervised to protect residents from abuse. EVIDENCE: The home had information for staff on the subject of abuse, and this was available in their staff handbook. The information covered the management of aggressive behaviour by residents towards staff, as well as suspected abuse towards residents. The home used the local multi-agency guidelines, to follow in the case of a suspected or alleged abuse. Staff had attended a three-hour training session on abuse, from an external trainer in January this year. The manager was also applying to attend a key trainers course, so she would be qualified to deliver this training herself. The home had not received any complaints since the last inspection, when the complaints procedure was inspected and found satisfactory. Westmorland Court Nursing Home DS0000006160.V282905.R01.S.doc Version 5.1 Page 14 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 Residents lived in a safe well-maintained building, and benefited from regular equipment upgrades. General hygiene and infection control procedures were good, making the home pleasant to live in, and reducing residents’ risk of catching infections. EVIDENCE: Further to the last inspection, the home had received five new electric profiling nursing beds. These were being purchased at two each month, until all beds have been replaced. The bed manufacturer’s representative had been to the home, to demonstrate the beds features to staff. The home was in a good state of décor and repair throughout, with the exception of the corridor carpets, which were looking rather worn. The carpet on the ground floor corridor, was replaced last year, but sadly had not worn well and needed replacing again. The manager said the carpets in all corridors were to be replaced once the new beds had been purchased, and she had viewed professional heavy-duty carpets for this purpose. Westmorland Court Nursing Home DS0000006160.V282905.R01.S.doc Version 5.1 Page 15 No recommendation is made on this item, as the carpets were serviceable and safe, and the manager had the matter in hand. The standard of hygiene in the home was good. A housekeeper was employed for five days a week, with care staff doing basic cleaning at the weekend. The homes’ laundry was equipped with two washing machines and two tumble driers, and catered for residents’ personal clothing and towels only. All bedding was sent out to a professional laundry service. This system worked well for the home in saving staff time, and allowing greater care to be taken with residents’ clothing. There were good facilities around the home for staff to wash their hands, and these were supplied with liquid soaps and paper towels as recommended for reducing cross infection. Toilets seats and handrails were wiped down with disposable cleaning wipes after each use. Staff had good knowledge of general infection control procedures, and had access to the right equipment to do their jobs. The home had a contact for the disposal of clinical waste, and had proper sluice facilities for washing bedpans and commode pots. Westmorland Court Nursing Home DS0000006160.V282905.R01.S.doc Version 5.1 Page 16 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): 28, 29 and 30 Residents are protected and supported by the homes safe recruitment practices, and the excellent standard of staff training provides a competent and experienced staff team. EVIDENCE: The home had a commitment to staff training and this had direct benefits to residents in the standard of care they received. All care staff (100 ) held a care qualification, this was either an NVQ at level 2 or 3 in care, or the carer was a registered nurse in their own country, and this is an excellent achievement. From a review of training records and through discussion with staff it was seen the following training events had taken place since the last inspection. Basic life support, abuse, moving and handling, eye care, fire drills, dementia awareness and food hygiene. There was a thorough induction programme for new staff, comprising of a workbook to be completed and signed off with the manager. Two staff had attended a mentoring course, the maintenance man had completed a health and safety certificate, and the chef holds an intermediate food hygiene certificate. The home is affiliated with a university, to offer adaptation training to overseas nurses (so they can become registered nurses in the UK). The home has also been accredited as an approved training placement for local student nurses. This demonstrates that the homes standard of care, record keeping and training meets a high standard. Such accreditation is kept under periodic Westmorland Court Nursing Home DS0000006160.V282905.R01.S.doc Version 5.1 Page 17 review by the university. The manager is now in the process of applying for the Investors in People award, which is excellent. The home had comprehensive recruitment procedures, and a review of staff files showed these had been adhered to. All staff had undergone the necessary checks into their qualifications, work experience and character prior to being employed. Westmorland Court Nursing Home DS0000006160.V282905.R01.S.doc Version 5.1 Page 18 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): 35, 36 and 38 Residents benefited from living in a very well managed home. Record keeping, finances, the safety of the building and working practices were closely monitored with a high standard being maintained. EVIDENCE: Where the home held money on behalf of residents for safekeeping, this was well managed. The money was stored separately and securely along with individual records sheets for each residents. The money and records of four residents were checked, and found accurate. The manager and administrator periodically audited the records and money to ensure any errors were promptly rectified. The staff received regular formal supervision in the form of an appraisal. These took place every two months as required, and the manager kept a list Westmorland Court Nursing Home DS0000006160.V282905.R01.S.doc Version 5.1 Page 19 and booked these sessions in advance. Staff confirmed that these appraisals took place regularly and covered their working practice and training needs. The health and safety of residents and staff was being promoted in the home. Records showed that staff had received mandatory training in moving and handling, fire safety, chemical safety and food hygiene. The building and its equipment had been regularly serviced and safety records were available for the fire equipment, lift, hoists, central heating and electrical appliances. The manager undertook regular reviews of the premises and met with the maintenance man monthly to plan the works required. The registered manager was well supported by the homeowners, who visited regularly and provided a report of their visits to the inspector. Westmorland Court Nursing Home DS0000006160.V282905.R01.S.doc Version 5.1 Page 20 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 X 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 3 X 3 Westmorland Court Nursing Home DS0000006160.V282905.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? N/A 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.V282905.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 Westmorland Court Nursing Home DS0000006160.V282905.R01.S.doc Version 5.1 Page 23 - 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!