Inspection on 01/05/07 for Weston House

This inspection was carried out on 1st May 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Weston House 06/06/06

Weston House 25/01/06

Weston House 29/06/05

Weston House 16/11/04

Weston House 27/06/04

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Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Weston House Green End Whitchurch Shropshire SY13 1AJ Lead Inspector Joy Hoelzel Key Unannounced Inspection 1 May 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 Weston House DS0000059419.V335206.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. Weston House DS0000059419.V335206.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Weston House Address Green End Whitchurch Shropshire SY13 1AJ 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) 01948 663052 01948 668030 weston.house@hotmail.co.uk Springcare (Weston) Limited Mrs Joanne Elizabeth Barber Care Home 38 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (3), Learning disability (1), Learning disability of places over 65 years of age (1), Old age, not falling within any other category (32) Weston House DS0000059419.V335206.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 6th June 2006 Brief Description of the Service: Weston House is registered to provide personal care to 38 older people. Springcare (Weston), a company that operates a number of care homes both in the local area and nationally, owns Weston House. The home has been converted from a large three-storey building situated in the centre of Whitchurch. It is within easy walking distance of the local shops and other amenities. Accommodation is in either shared or single rooms, a number of which have en-suite facilities. There are 3 communal lounges, a conservatory and two dining rooms. The upper floors may be accessed via a shaft lift and there is a small garden to the rear of the property for the use of residents. Weekly fees range from £365.00- £385.00 Information of the home and the provision of the service are available in the statement of purpose and service user guide, both documents have recently been revised and are readily available. Commission for Social Care Inspection Reports for this service are available from the provider or can be obtained from www.csci.org.uk Weston House DS0000059419.V335206.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced key inspection is the first of the statutory inspections for 2007/08 and took place over three hours on Tuesday 1st May 2007. It was conducted by one regulation inspector. Twenty-three of the thirty-eight National Minimum Standards for older people were inspected on this occasion. Thirty people are currently living at the home, and were observed to be accessing all areas of the home. Staffing numbers were appeared to be at satisfactory levels. Four case files were selected for case tracking, relevant documents and procedures were inspected, together with a selection of staff personnel files. A full tour of the premises was conducted. Discussions were held with people living, working and visiting the home. A pre inspection questionnaire has been completed by the registered manager and will be used to support the evidence recorded in this report. Five survey cards have been completed by relatives/representatives of the pole living at the home. The comments made will be included in this report. What the service does well: The home provides a homely environment for the current residents. The manager and staff have a good understanding of the individual needs of the people living at the home. The manager and staff are aware of equality and diversity and its implications even if very few individuals with recognised diversity issues are in receipt of a service. All individuals have a comprehensive plan of their care needs and are fully involved with the process should they wish to be so. The home has a very active social and recreational programme. People living at the home stated ‘I like it here’, ‘ the food is good, ‘ staff are good’, ‘ a home from home’, ‘ I like it here nothing is quite like your own home though but the gardens are lovely, they take us out and about and the food is good’. Weston House DS0000059419.V335206.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. Weston House DS0000059419.V335206.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 Weston House DS0000059419.V335206.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): OP 1,3,6 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has developed a comprehensive Statement of Purpose and Service User Guide, which is very specific to the resident group. The assessment focuses on achieving positive outcomes for people and this includes ensuring that the facilities, staffing and specialist services provided by the home meet the needs of the individual. EVIDENCE: The statement of purpose and service user guides were supplied on request both documents appear to contain the required information and have recently been reviewed. Weston House DS0000059419.V335206.R01.S.doc Version 5.2 Page 9 The case file of a person who most recently made the decision to move into the home included a pre admission assessment conducted by the manager and letter from the previous placement containing information as to the assessed care needs. The care plan was dated the day prior to admission, the manager explained that the person and family visited the home and requested an early admission date. This was arranged for the following day. Staff had the opportunity to formulate a plan of care with the person and their family in preparation for their arrival. The home does not offer an intermediate care service. Weston House DS0000059419.V335206.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): OP 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home have an individual plan of care that clearly records their personal and healthcare needs and detail how they will be delivered. The home has developed efficient medication policy, procedure and practice guidance. Staff encourage and support people to manage their own medication. EVIDENCE: Four care plans were selected for inspection and included people with varying lengths of stay at the home. Each plan fully assesses all activities of daily living; specific care plans are then developed following identification of any concerns or problem areas. The plan Weston House DS0000059419.V335206.R01.S.doc Version 5.2 Page 11 is based on the need, the aim, the action to be taken and the date of the next review. All four were very clear, concise, easy to understand, reviewed at least monthly and with the agreement of the person where appropriate and/or relative. Where a risk has been identified, following assessment, a specific plan of care has been formulated offering full details for the action to be taken by staff to reduce the risk. One person was at risk of developing pressure areas due to deterioration in their physical condition, a plan had been developed for the involvement with the district nurse, specialist equipment to be used and the increased interventions required by the staff. Another case file included the management of a specific medical condition; further details were required to ensure staff had all information for monitoring this condition. This was discussed with the manager at the time of the inspection and an assurance was given that the plan would be revised. One case file included an assessment for a person to administer his or her own medication. This person gave a good account of their medication management and stated that ‘while I am able to continue to do it I will, it helps me to stay independent’. Medication is administered using the monitored dose system with the additional use of bottles and boxes. Senior care staff administer the medication with the registered manager supervising the procedures. The controlled drugs (CD) register records the amount of medications and corresponded accurately with the amount of medications stored in the controlled drugs cabinet. The CD register and Medication Administration Record appear to be completed correctly. Insulin that is in use is being stored in the fridge contrary to the manufactures instructions. This was discussed with the registered manager and alternative arrangements for the correct storage was implemented. The care staff were observed to be assisting service users with personal care discreetly and in a manner which promotes service users’ dignity. Weston House DS0000059419.V335206.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): OP 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. The home seeks the views of the residents and considers their varied interests when planning the routines of daily living and arranging activities both in the home and the community. EVIDENCE: A social activities organiser is employed for four hours each weekday. A fellowship group had been arranged during the morning of the inspection followed by morning coffee and general discussions. Weekly trips out are arranged in the company minibus to places of interest Local shops are very close by and reasonably accessible. One person commented that they enjoy participating in some of the activities but at times preferred the tranquillity of their private room. Weston House DS0000059419.V335206.R01.S.doc Version 5.2 Page 13 Another person stated that they were looking forward to going shopping with their relative later on in the day. Visitors are welcome at times suitable for the people living at the home. A small sitting area is available if preferred rather than the bedroom for private visiting. Information on friends and family visiting is included in the statement of purpose and service user guide. Additional comments in the survey included ‘‘ staff always pleasant nothing is too much trouble’, ‘ it is well run’, ‘ well fed, put on activities, organise trips out’, ‘would like more social activities’. During the tour of the premises many of the private rooms were highly personalised one person stated that having ‘bits around makes it feel like home’. Two dining rooms are available and used for mealtimes. Both are well furnished and equipped. The manager discussed the recent changes being introduced with the menu following discussions and suggestions with people living at the home, The meal was well presented with people stating that it was enjoyable and in sufficient quantity. Weston House DS0000059419.V335206.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): OP 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure is included in the statement of purpose and service user guide and is displayed in a number of areas within the home. Residents and others involved with the home understand how to make a complaint and are clear about what will happen if a complaint is made. EVIDENCE: A concern was raised with Commission for Social Care Inspection from an environmental health officer. This was fully documented by the home the manager offered a good explanation of the concern and the action taken. No further complaints have been received. A referral was made to the vulnerable adults team in December 2006, following strategy meetings and discussions the case is now closed with no further action taken. Staff have had recent training in adult protection procedures. The home offers a facility for residents to deposit personal monies for safekeeping; records relating to this have been maintained and fully receipted. The statement of purpose and service user guide both include details of the complaint procedures. Weston House DS0000059419.V335206.R01.S.doc Version 5.2 Page 15 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): OP 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a physical environment that is appropriate to the specific needs of the people who live there and encouraged to personalise their bedrooms. The shared areas provide a choice of communal space with opportunities to meet relatives and friends in private. EVIDENCE: The home has a renewal and improvement plan for 2007/08 for the fabric and decoration of the building including improving the outdoor area to be made more accessible and for the purchase of garden furniture. The immediate rear garden is well maintained. Weston House DS0000059419.V335206.R01.S.doc Version 5.2 Page 16 The fire safety officer visited on 07/03/07 the pre inspection questionnaire indicates that the recommendations made have been complied with. The communal and private areas are well furnished and appear to be well maintained. All areas very clean. The manager explained of some difficulties arising from the property being a listed building, hence the delay in the refurbishment of the shared rooms and the laundry. There are plans for a central laundry for all the homes within the company. Not all bedrooms have been supplied with a lockable storage facility, the manager explained the reason for the delay and a further date for compliance was agreed. The chemical storeroom has been re-sited and the bathrooms refurbished. One empty bedroom had been redecorated in preparation for a new occupant. Not all areas where personal care is undertaken have been supplied with suitable hand wash facilities (liquid soap, paper towels or lidded disposal bin) at the point of the delivery of care for general hygiene purposes and for the effective control of infections. Weston House DS0000059419.V335206.R01.S.doc Version 5.2 Page 17 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): OP 27,28,29,30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The service has staff available at all times to support the needs, activities and aspirations of the people using the service in an individualised and person centred way. Staff within the organisation receive relevant training that is targeted and focused on improving outcomes for people who use services. EVIDENCE: A rota is maintained of the staffing levels for each week. The manager stated the usual staffing levels are maintained for the morning are one senior and three care staff, during the afternoon and evening one senior and two care staff reducing to one senior and one care staff at night. Ancillary staff are additional. Staff commented that they thought the staffing levels were sufficient at the present time. Weston House DS0000059419.V335206.R01.S.doc Version 5.2 Page 18 All areas of the home were spotlessly clean; the staff responsible for the household cleaning should be commended on maintaining such high standards Records indicate that only three of the current staff group do not have an National Vocational Qualification (NVQ) in care. One member of staff described the training programme and stated that she had recently completed NVQ level 3. Two staff personnel files were selected for inspection and included proof of identity, criminal record bureau disclosures and/or pova fist checks, and two references. Accreditations and certificates for training are included in the file. The manager stated that mandatory and specialist training is arranged for all staff throughout the year. Weston House DS0000059419.V335206.R01.S.doc Version 5.2 Page 19 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): OP 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is person centred in her approach, and leads and supports a strong staff team who have been recruited and trained to a high standard. The home has a consistent record of meeting relevant health and safety requirements and legislation, and closely monitoring its own practice. Weston House DS0000059419.V335206.R01.S.doc Version 5.2 Page 20 EVIDENCE: Jo Barber successfully completed the formal application for the registered managers position in July 2006, she is currently working towards the Registered Managers Award. She demonstrated a good knowledge of the people living at the home and conditions and dilemmas associated with ageing. People living and working at the home spoke positively about her style of management. One staff said that she was ‘very good and knew the home as she previously worked in a care capacity’. The manager has supernumery time, ensuring that all records relating to the service are well organised, in date, complete and easy to understand. Quality assurance and monitoring continue on an annual basis with questionnaires distributed to relatives and people at the home. Monthly visits continue from the area manager with a written report made as to the findings of the visit. Staff meetings are arranged regularly and service users formal meeting arranged six monthly. The manager explained that there is ample opportunity for discussion at the fellowship groups and informal chats. Monthly manager audit checks carried out care planning, medication safekeeping money etc. The home offers a facility for residents to deposit personal monies for safekeeping; records relating to this have been maintained and fully receipted. Health and safety checks carried out weekly, monthly and annually with full records kept. Weston House DS0000059419.V335206.R01.S.doc Version 5.2 Page 21 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 3 X 4 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 2 X X X 2 X 2 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 X 3 X 4 X X 3 Weston House DS0000059419.V335206.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP20 Regulation 16(1) Requirement All refurbishment of the shared facilities provided in the home must be completed. Previous timescale of 30/09/06 not met. All residents’ bedrooms must have locking storage facilities for personal effects. Previous timescale of 30/09/06 not met. Timescale for action 30/06/07 2 OP24 16 (2) (c) 31/08/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP26 OP26 Good Practice Recommendations Arrangements for the company’s central laundry provision should be made without delay. Suitable hand wash facilities should be available at the point of the delivery of care. Weston House DS0000059419.V335206.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 Weston House DS0000059419.V335206.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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