Inspection on 10/08/05 for Weston House

This inspection was carried out on 10th August 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 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 07/09/07

Weston House 26/09/06

Weston House 28/02/06

Similar services:

The Lodge Nursing Home

Bracken House

Sunnycroft

Field Farm House

Edgeview Nursing Home

Church Terrace Nursing & Residential Home

The Forbury

The Maples

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

CARE HOMES FOR OLDER PEOPLE Weston House Weston Road Stafford St16 3TF Lead Inspector Joanna Wooller Announced 10 August 2005 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 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 E51-E09 S63822 Weston House V239212 100805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Weston House Address Weston Road Stafford ST16 3TF Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01332 296200 Methodist Homes for the Aged CRH 48 Category(ies) of DE(E) - 48 registration, with number MD - 48 of places Weston House E51-E09 S63822 Weston House V239212 100805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: PD from the age of 60 years. Date of last inspection 11th March 2005 Brief Description of the Service: Weston House is now owned by the Methodist Homes for the Aged. It is a care home, which provides 24hour-nursing care for 48 mentally infirm and mentally ill service users. The home was first opened on 1st March 1993 and taken over by MHA in April 2005. MHA was created in 1943 and is a registered charity. The home is divided into four house groups. Each house group provides a comfortable, homely atmosphere for the individuals. Within each house group there is a fully fitted kitchenette where relatives and visitors are invited to help themselves to refreshments. The lounges were sensitively organised to allow service users space and choice of where to sit. The dining areas were also well arranged to allow a feeling of space. Each service user has their own bedroom, which has en-suite facilities. Each service user is encouraged to bring in their own personal possessions to personalise their bedrooms, which assists them to settle easily into their new home. Each bedroom has a TV aerial point, if the individual wishes to have their own TV and also a telephone socket too. Three hot meals are served daily, which were freshly prepared and cooked by the newly employed fully trained Chef and his assistants. Laundry services are also undertaken within the building. Weston House E51-E09 S63822 Weston House V239212 100805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This routine announced visit was made on 10th August 2005 @ 09.30hrs. The inspection was undertaken using the National Minimum Standards for Older People as a reference. The total time spent for the inspection, including pre and fieldwork, amounted to 11hrs. The Care Manager Jan Coulston was present at the home supported by her Assistant Manager. The inspection included the following elements; A tour of the building, Observation and inspection of records relating to provision of care, Discussions with several service users, Discussions with all the staff members on duty, Observation and sampling of other services provided such as catering and laundry, Inspection of the managerial aspects such as staffing issues, quality assurance and health & safety. Since the last inspection on 11th March 2005; there had been no changes to the management of the home, no complaints had been received and no additional visits had been necessitated. The home is in a transitional phase since being taken over by MHA and new documentation; policies and procedures are being gradually introduced into the home. This was taken into account during the inspection as it will take time for the new systems to be introduced and managed. The inspector recommended that staff must be included in all training sessions and relatives kept informed of any changes brought in by MHA. A computerised system as been introduced in to the home and this also will take time to become accepted by the staff as the norm. It was evident that aspects of care had been well addressed. Service user plans had been well written but will be transferred in the near future on to MHA documentation. Health, personal and social care needs had been identified and well documented. It was evident that privacy, dignity and choice aspects for service users were being upheld and the staff were able to discuss these needs. One complaint had been received in the home since the last inspection, and policies and procedures seen covered these issues. Weston House E51-E09 S63822 Weston House V239212 100805 Stage 4.doc Version 1.40 Page 6 The home was evidenced to be fit for purpose and provided a safe environment for the service users and staff. A homely atmosphere had been created, and the premises were generally clean and tidy. Adequate areas for service users were provided including; communal space, dining/activity space, bathing/toilet facilities, and bedrooms. Services and facilities, including catering and laundry, were adequately provided. Health and safety aspects had been given priority and no shortfalls were noted. Staffing levels and skill mix were assessed to meet the identified needs of the existing service users. Recruitment and retention of staff aspects were good with little staff turnover. Staff training had been given priority, with induction training being followed by NVQ training, and staff were receiving regular supervision. The home appeared to be managed well by a competent care manager. General management aspects were good with quality assurance taking place. Records had been correctly filed and stored. Assurances were given regarding the positive financial viability of the home, and that suitable accounting/business procedures are adopted. What the service does well: What has improved since the last inspection? The requirements and recommendations from the last visit have all been met. Weston House E51-E09 S63822 Weston House V239212 100805 Stage 4.doc Version 1.40 Page 7 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. Weston House E51-E09 S63822 Weston House V239212 100805 Stage 4.doc Version 1.40 Page 8 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 Standards Statutory Requirements Identified During the Inspection Weston House E51-E09 S63822 Weston House V239212 100805 Stage 4.doc Version 1.40 Page 9 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 standard(s) 1 and 3 Individual health, personal and social cares needs had been established and were being met by staff, which individually and collectively had the necessary skills and experience. EVIDENCE: The Statement of Purpose was identified as one area that is to be developed in relation to the transition with the new company, MHA. A template has been received in the home, which is to be personalised. Along with other policies and procedures the systems will need to be introduced in to the home with guidance from the MHA managers. The documentation seen by the inspector on the day of the visit evidenced that service users had been assessed prior to admission and they had been enabled to make a choice about the home. All involved had the opportunity to visit the home prior to choosing to stay. The community care plans provided by the social worker were also used, as part of the individual needs assessment process. The records seen and a discussion with the staff evidenced that care staff, individually and collectively, had the necessary experience and skills to meet the assessed needs of the current service users. Weston House E51-E09 S63822 Weston House V239212 100805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10 The assessed health and personal care needs of service users had been well documented and were being met, with good standards of care being delivered. There was a safe system for the receipt, storage, administration and disposal of medicines. Service users were witnessed to be treated with respect, privacy and dignity, during the caring process. EVIDENCE: The service user plans and associated documentation was well written, meaningful and reflected the current condition of residents. The documentation seen and a discussion with both service users and staff members evidenced that health and personal care needs were being well met. NHS facilities and professionals including community nurses, medical consultants and clinical nurse specialists had all been accessed when required, and these events were seen recorded. Local GP practice and a local pharmacist service the home, and there is a good working relationship with them. Records of their visits and outcomes were seen documented. Weston House E51-E09 S63822 Weston House V239212 100805 Stage 4.doc Version 1.40 Page 11 It was observed that a safe system was in place, and that the comprehensive medicines policy documentation seen was being complied with. During the inspection it was observed that privacy and dignity were being afforded to residents, and there was very good interaction with staff. Care staff were seen knocking on doors before entering. The service users spoken to were clean, tidy and wearing their own clothes. They enjoyed talking to the inspector and loved to be involved with the inspection. Weston House E51-E09 S63822 Weston House V239212 100805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 to 15 Service users were satisfied with their lifestyle in the home, and they had been able to exercise choice and influence decisions affecting them. Contact had been maintained with relatives and friends. Opportunities to access the local community had been made available. Catering aspects were very good with balanced nutritious meals being served with service user choice being noted. EVIDENCE: Contacts had been maintained, where possible, with relatives and friends and this was seen documented. Service users spoke to the inspector about their visitors. Short trips out to the community had been well organised and transport provided. The staff showed the inspector the activities folder, which evidenced the activities both inside and outside the home. Service users spoke of the places visited and also the entertainment within the home. Table top activities were completed on a weekly basis along with progressive mobility, the hairdresser and church services. Service users said they enjoyed their meals and choices offered. The menus and catering records were examined and evidenced that the dietary requirements were being met. Weston House E51-E09 S63822 Weston House V239212 100805 Stage 4.doc Version 1.40 Page 13 The newly appointed experienced cook was arranging the kitchen as preferred and changing suppliers to accommodate quality and value in the budget. Fresh fruit and vegetables were evident in the store as were home baked caked and pastries. The cook had been baking scones and preparing fresh vegetables during the morning and also baking in preparation for later in the week. The mid day meal had been enjoyed by service users. The staff spoke to each resident on a daily basis to establish his or her choice of food for the day, and this was seen documented. Many service users were unable to make a decision regarding choice of meal, due to their condition, and the inspector saw them being supported by staff who were knowledgeable of their individual likes and dislikes. Weston House E51-E09 S63822 Weston House V239212 100805 Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Complaints are listened to and resolved using the home complaints policies and procedures. Staff training protected service users from all aspects of abuse. EVIDENCE: An examination of the complaints book, the relevant policy and procedure documentation, and a discussion with staff evidenced that complaints and concerns were listened to and dealt with in the correct manner. Since the last inspection one complaint had been recorded and brought to the attention of this commission. Many ‘thank you’ and complimentary cards were seen from appreciative relatives. No incidents of neglect or abuse of any kind has been reported. The abuse policy documentation seen, and a discussion with staff confirmed that residents are protected from all forms of abuse. Documentation seen evidenced that the above issues had been discussed at length during staff induction, training and on-going supervision. During this transitional stage the new complaints procedure and relevant policies and procedures are to be introduced into the home. Once the management and staff are familiar with the details relatives and representatives are to be informed of the changes. Weston House E51-E09 S63822 Weston House V239212 100805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 22 and 26 Weston House provides a safe and adequately maintained environment for service users. The home was generally clean and tidy, and had a very comfortable atmosphere. EVIDENCE: A tour of the building, including a check on the maintenance documentation, confirmed that the home was fit for purpose, clean and tidy. The duty rosters evidenced that adequate ancillary staff were employed. Staff when asked told the inspector of their knowledge on infection control, and showed him the relevant documentation. Adequate hand washing facilities were available throughout the home. The laundry facilities were seen to be fully compliant and well managed. Weston House E51-E09 S63822 Weston House V239212 100805 Stage 4.doc Version 1.40 Page 16 The records evidence that maintenance of the premises was now being given priority. Painting and re-decorating was planned to continue. Several corridors and lounges had been redecorated. Hot water temperature checks were found to be too high and work is to be arranged to review the system. Emergency lighting and fire alarm tests were seen up to date and correct. There are no outstanding issues known from the Fire Prevention or Environmental health departments. The following maintenance issues were raised: • • • Some lights were in need of repair or replacement in bathrooms and ensuites. One shower was in need of repair in relation to the drainage hole. Two areas were identified to have malodours as identified. Weston House E51-E09 S63822 Weston House V239212 100805 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30 The assessed needs of service users had been met by an adequate number of suitably trained staff. Recruitment procedures had been correctly addressed which had contributed to the protection of service users. Staff training had been given priority. EVIDENCE: Staffing levels were being maintained as 1st April 2002 and following a discussion with the manager and her staff it was agreed that the shift cover was above adequate for the existing service users needs. The homes recruitment policy, procedures and documentation were examined and recruitment issues had been handled correctly. Staff had been subject to POVA/CRB comprehensive checks, and these were seen recorded. Staff asked stated that they had job descriptions and contracts of employment. Training had been given priority and the training records of individuals were seen. The records evidenced that all staff had benefited from ‘in house’ and external training, which had covered the needs of the registered client group. Staff told the inspector that they had been encouraged to study. Training had been provided for staff in the awareness and management of dementia related conditions, and staff outlined this to the inspector. Student nurse are now working in the home from the local university, supervised and supported by the senior nurses on the units. Weston House E51-E09 S63822 Weston House V239212 100805 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 36, 37 and 38. The home appeared to be well managed and quality assurance was in place. Financial aspects were correctly addressed and recorded with safeguards to residents. Health and safety issues had been given a high priority and managed well. EVIDENCE: The manager is to be registered with the CSCI in the near future. An interview date has been arranged for the beginning of September. The manager is half way through completing the NVQ 4 in management course and her deputies will both be commencing the course in the near future. Weston House E51-E09 S63822 Weston House V239212 100805 Stage 4.doc Version 1.40 Page 19 From observations made and following a lengthy discussion with the manager and several staff, it was evident that the home was being run in the interests of service users. Quality assurance, including feedback from residents and their representatives, was seen documented and MHA will be introducing new systems to document their quality audit. Documentation seen evidenced that the views of visiting professionals had also been established, and included in the review process. A check on the records and a discussion with representatives evidenced that all service users had the opportunity to handle their own finances and all residents and families had chosen to do so. Day to day monies of residents were checked and money held reconciled with the ledger. Inventories of valuables and belongings brought into the home were seen recorded. No health and safety issues were noted during this inspection, including a tour of the home. The documentation seen for checks and examination of plant and equipment was all correct and up to date. The manager and staff spoken to confirmed that health and safety issues are given a high priority. Weston House E51-E09 S63822 Weston House V239212 100805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 4 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION 2 3 x 3 x x x 1 STAFFING Standard No Score 27 4 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 4 3 3 3 x x 3 3 3 Weston House E51-E09 S63822 Weston House V239212 100805 Stage 4.doc Version 1.40 Page 21 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. Standard 19 26 26 Regulation 16 16(2k) 13(4a) Requirement Several areas identified in the report require attention by the maintenance person. Malodours are to addressed as soon as possible. Hot water temperatures are to be regulated appropriately. Timescale for action 1 Month 1 Week 1 Month 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 27 31 Good Practice Recommendations Staff are to receive relevant training for instruction relating to service users with challenging behaviour. The manager ensures that the new policies, procedures and documentation introduced by MHA is distributed appropriately to all staff, service users and their representatives, including the Statement of Purpose. Weston House E51-E09 S63822 Weston House V239212 100805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Stafford - Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Weston House E51-E09 S63822 Weston House V239212 100805 Stage 4.doc Version 1.40 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. 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