Inspection on 08/12/05 for Westmorland Court Nursing Home

This inspection was carried out on 8th December 2005.

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 06/03/06

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 8th December 2005 11:30 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.V272214.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. Westmorland Court Nursing Home DS0000006160.V272214.R01.S.doc Version 5.0 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 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.V272214.R01.S.doc Version 5.0 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. 10th February 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.V272214.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place between 11.30am and 4.15pm. The registered manager arrived on duty part way through the inspection, and two of the company representatives also called in as they were passing. The inspection comprised of a tour of the building, inspection of care plans, medicines, the medicine records and the homes’ quality surveys. I spoke with some residents in the lounge and with others privately in their bedrooms. I also spoke with the manager, administrator and several staff. At the time of my arrival most residents were up and about having had their morning tea and coffee. Staff were putting up Christmas decorations, and residents were enjoying watching this. What the service does well: 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 Westmorland Court Nursing Home DS0000006160.V272214.R01.S.doc Version 5.0 Page 6 contacting your local CSCI office. Westmorland Court Nursing Home DS0000006160.V272214.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 Westmorland Court Nursing Home DS0000006160.V272214.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 New residents were fully assessed before being offered a place in the home. This ensured Westmorland Court would be able to meet their individual needs. EVIDENCE: All new residents had been assessed by the home before being offered a place. The assessments seen on file were detailed and covered all aspects of the persons’ health and social care needs. Information had also been collected where appropriate from the persons’ social worker, family, the hospital or community nurse. These assessments enabled both the staff and the new resident to be certain that Westmorland Court would be suitable for their needs before they moved in. It also allowed the manager to arrange for any additional equipment, or staff training, that may be necessary. Where there was any delay between the pre-admission assessment and the person coming to the home, the assessment had been updated. Westmorland Court Nursing Home DS0000006160.V272214.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, 8, 9 and 10 Residents benefited from a very good standard of health, personal and social care at Westmorland Court. The management of medicines was safe, and residents felt they were treated with dignity and respect. EVIDENCE: I studied a sample of four care plans in detail. 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 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. The nursing staff I spoke with were knowledgeable about the residents, and knew who had specific needs. They were able to tell me without checking, who had wound dressings and when they were due to be checked, who had a catheter, who was awaiting test results, and who had hospital appointments pending. Westmorland Court Nursing Home DS0000006160.V272214.R01.S.doc Version 5.0 Page 10 Residents said they felt well cared for, “I have two baths every week”, “they bring my cup of tea in the morning”, “they do everything for me”. I observed staff speaking kindly to residents and being patient and unhurried. Residents said this was normal, and they were “treated very well”. Health 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. Inspection of the medicines showed them to be well organised, with good systems in place for ordering and receiving new stock and disposing of unwanted items. The medicine records for residents were clear and accurate. Staff had received training on the medicines system, and demonstrated a good knowledge and understanding of the implications of certain medicines and any specific monitoring required. Medicine storage was safe and secure. Sets of Guidelines published by the Nursing and Midwifery Council on medicines and record keeping were on display for staff to refer to. Westmorland Court Nursing Home DS0000006160.V272214.R01.S.doc Version 5.0 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): 12 and 15 Residents were able to exercise choice in their daily routines and were provided with opportunities for social stimulation and meaningful activity. The provision of meals was good, with plenty of variety and choice. EVIDENCE: Residents told me they were “very satisfied” and “quite content” with life at Westmorland Court. Residents were able to get up and go to bed when they wished, and opt in or out of activities and entertainment, as they wanted. One lady said, “ I have everything I need here. It’s all very clean and I’m quite fussy”. Another resident said, “if you have to live in a home – you’d do alright here”. Since the last inspection the registered manager had changed the daily activity routine. An activity used to take place every afternoon, but staff found residents were too sleepy to partake. Activities now took place during the morning on three days a week. These included skittles, art, craft and clay work. Some residents had enjoyed making clay decorations for the Christmas tree. There was a separate television lounge, so residents did not have to watch it, if they didn’t want to. Some residents chose to stay in their bedrooms and watch their own television or listen to the radio. Westmorland Court Nursing Home DS0000006160.V272214.R01.S.doc Version 5.0 Page 12 The home continued with their set events throughout the year including a trip to the local Wildlife Oasis, a tea dance, a firework display and a hot pot supper. Sadly, fewer residents were willing to go out of the home now, so the manager had revised some events to take place in-house. Instead of residents going out for an annual Christmas party meal; a party with entertainment and a buffet was taking place in the home. And rather than hiring a minibus to tour the Christmas lights and have a fish and chip supper, the manager took the residents that wished to go, in her car. The manager had worked hard to ensure that the residents who enjoy going out, have not lost out through lack of interest by others. Residents said the meals were good. “The food is like I cooked at home”, “there’s always plenty of different vegetables”. The daily menu was written up on a chalkboard, but the cook knew who liked what, and prepared alternatives as needed. Plenty of staff were in the dining room at mealtimes to give assistance, and the home had plate guards and adapted cutlery for those who needed it. Soft or pureed diets were provided as needed, and the cook was aware of people needing special diets, such as diabetic or high protein. Westmorland Court Nursing Home DS0000006160.V272214.R01.S.doc Version 5.0 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): 16 Residents and visitors were able to complain or comment on the service, and be taken seriously. EVIDENCE: The home had a complaints procedure on display, which explained how and who to make any complaint to. It also gave the contact details of CSCI, so people could contact the homes’ inspector if they wanted to. The manager kept records of complaints made, the investigation and the outcome. Since the last inspection, the manager and owners had met with the family of one resident who raised numerous concerns. The inspector was informed of this and provided with notes of the meeting at the time. The family did not complain to CSCI about this, and the matter was resolved. From discussion with residents and visitors it was clear that people knew who the manager was, and felt they could talk to her about anything that concerned them. Visitors were seen to pop in and out of the office for a chat, and relations with the manager and staff appeared friendly. Westmorland Court Nursing Home DS0000006160.V272214.R01.S.doc Version 5.0 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, 20, 21 and 22 Residents lived a well-maintained building, providing a warm, comfortable and homely atmosphere, suitably adapted for the elderly physically frail. EVIDENCE: The layout of the home was suitable for it’s use, and the building had been well maintained. The decor and furnishings were of good quality, and repairs and replacements were ongoing as needed. Communal space comprised of a very large dining lounge, a conservatory, and two smaller lounges. The large dining lounge was separated into an eating and a living area. The television was in one of the smaller lounges. New floor covering had been laid in the dining area, and new carpets provided throughout the ground floor lounges and corridors. Bathrooms were spacious and well equipped with specialist baths and showers. There were also plenty of spacious toilets sited around the home. Westmorland Court Nursing Home DS0000006160.V272214.R01.S.doc Version 5.0 Page 15 The home had a large passenger lift to take wheelchair users (and beds) to the upper floors. The home had experienced problems with the lift recently, when they had to wait for spares parts to come from abroad. The interim arrangements had inconvenienced some residents, but had ensured their safety. Westmorland Court was well designed with wide corridors; grab rails in all corridors and toilets, and adapted bathing facilities. The home was equipped with bath hoists, freestanding hoists, and adequate storage areas. All beds were fitted with low-grade pressure reducing mattresses, and there was a good stock of high-grade airflow mattresses. The manager had ordered 33 new nursing beds, to be purchased over the next eighteen months. There was a clear commitment to continued investment in the upkeep of the building and equipment. Westmorland Court Nursing Home DS0000006160.V272214.R01.S.doc Version 5.0 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): 27 Residents’ needs were being met satisfactorily with the staffing levels and skill mix provided. EVIDENCE: The home worked to a set staff rota, and maintained satisfactory staffing levels at all times. There was a good skill mix of registered nurses and care staff. Some of the “care” staff were overseas nurses, completing adaptation courses to get their nursing qualification recognised in this country. The manager was accredited to run this adaptation training. Residents benefit by being cared for by a diverse staff team who work well together. Residents stated that staff were “very kind”, “patient” and “respectful”. One resident said, “the staff are all very nice – anyone who doesn’t like them, must take a lot of pleasing”. New staff said they had been made welcome at Westmorland Court and had received a lot of help settling in. Staff were knowledgeable about residents needs and preferences, and spoke about people with kindness and affection. There were plenty of staff visible around the home, and the main lounge was never seen unattended. Westmorland Court Nursing Home DS0000006160.V272214.R01.S.doc Version 5.0 Page 17 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): 31, 32 and 33 Residents benefited from living in a well managed home, where their views were listened to and acted on. EVIDENCE: The registered manager Mrs Jane Weatherill had been in post since April 2001. She is a registered nurse and midwife, with much experience of caring for older people. She had competed an NVQ level 4 in management, and undertaken periodic training courses. The homeowners, who frequently visited the home to spoke with residents and visitors, supported the manager. Residents and staff gave very positive feedback about the manager and owners of the home. Residents and staff knew the managers and owners by name and said they could talk to them easily. During the day I saw visitors popping into the office for a chat with the manager and administrator. The atmosphere was friendly and inclusive. Westmorland Court Nursing Home DS0000006160.V272214.R01.S.doc Version 5.0 Page 18 There was a quality assurance system in place. This was based on collecting the views of residents and their families. The latest quality survey yielded 15 responses, mostly giving very positive feedback. Where individual concerns or requests had been made, the manager had responded to these in person (if there was a name of the form). The manager also carried out her own quality audits to check that standards were maintained, as she wanted. These covered care plans, medicines and the building and furnishings. The owners and manager actively sought to continually monitor and improve the service offered to residents at Westmorland Court. Westmorland Court Nursing Home DS0000006160.V272214.R01.S.doc Version 5.0 Page 19 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 3 3 3 X X X X STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 3 X X X X x Westmorland Court Nursing Home DS0000006160.V272214.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? No 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.V272214.R01.S.doc Version 5.0 Page 21 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. 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