Inspection on 06/06/06 for Weston House

This inspection was carried out on 6th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 01/05/07

Weston House 25/01/06

Weston House 29/06/05

Weston House 16/11/04

Weston House 27/06/04

Similar services:

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 Janet Adams Key Announced Inspection 6th June 2006 11:00 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.V288037.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.V288037.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 01829 731800 Springcare (Weston) Limited Care Home 38 Category(ies) of Dementia (4), Learning disability (1), Learning registration, with number disability over 65 years of age (1), Old age, not of places falling within any other category (32) Weston House DS0000059419.V288037.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th January 2006 Brief Description of the Service: Weston House is registered to provide personal care to 38 older people. 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. The home is in the process of being refurbished to a very good standard. Accommodation is in either shared or single rooms, a number of which have en-suite facilities. There are 3 communal lounges, a conservatory and a dining room. 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. The range of fees currently charged are between £297.30 and £350 per week. Springcare (Weston), a company that operates a number of care homes both in the local area and nationally, owns Weston House. A new manager, Joanne Barber has recently been promoted to this role, and is being supported by an area manager for the company. She is not yet registered with CSCI (The Commission for Social Care Inspection.) Weston House DS0000059419.V288037.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection by one inspector lasting six hours. It included observing activity within the home, inspecting the premises, an ‘in depth look’ at records for residents and staff, observing, talking and listening to nearly all of the 30 people living there, a few visitors, and the staff on duty at the time of the inspection. Discussions were carried out in private with people on their own, or together in groups in the lounges. Everyone was happy to share valid comments, which are included in the main body of the report. Sixteen residents also made some written comments for the inspector. All of these were complimentary. The home manager Mrs Barber was on duty at the time of the inspection. Everyone, including residents and staff were very welcoming and helpful throughout. A total of 28 out of a possible 38 National Minimum Standards for Older People were assessed on this occasion. What the service does well: What has improved since the last inspection? Weston House DS0000059419.V288037.R01.S.doc Version 5.2 Page 6 The management style of Weston House appears to be growing from strength to strength. With the day to day the leadership of their manager there have been many improvements to management systems in the home. Recent changes to records shows they are well organised and robust, making Weston house a safer place to live, visit and work. As a result of the improvements a total of 16 of the 23 statutory requirements made at the last inspection in January have now been met. In fact the home now excels in some of these areas. These include improvements in the way the home deals with residents finances, staff recruitment training and development, (Over 70 of carers are NVQ 2 qualified.) The home is to be commended for so many noteworthy changes in a relatively short period of time. Along with other minor works, progress with the home upgrade has resulted in a ground floor bathroom being refurbished as well as redecoration of the dining room. 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 DS0000059419.V288037.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.V288037.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 4. The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. There is a good range of information available to help people decide whether Weston House will meet their needs. The comprehensive assessments carried out before they move in makes sure the home can meet the personal needs of the individual. EVIDENCE: All of the necessary information available for anyone thinking about moving into Weston House has been updated and gives an accurate reflection of the services it offers. The Statement of Purpose and the Service User Guide were nicely worded with easy to read text, and are on display in the reception area of the home beside the latest CSCI (Commission for Social Care Inspection) inspection report. Weston House DS0000059419.V288037.R01.S.doc Version 5.2 Page 9 From the four sets of resident’s records looked at it was noteworthy to see that appropriate assessments had been carried out in enough detail to assure residents, their relatives and staff that the home could meet their needs. Observations and discussions with nearly all of the residents confirmed they were very happy living at Weston House. A comment written by one of the residents which reflects the other residents and relatives opinions as well as inspection observations states: ‘All I can say about this home is, that if it carries on like it is, I will be a very happy man’. Weston House DS0000059419.V288037.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 &10 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. The good care planning and medication system shows all details which mirror all of the professional, individual, respectful standards of care resident’s say they receive and were seen to get. EVIDENCE: Comments received from the residents living at the home all agreed that they liked living at Weston House, felt well cared for and the staff respected their privacy. Information in five sets of care records looked at was all up to date with necessary relevant details about the people concerned. Efforts are made to involve all individuals in this process. The home now uses additional forms which ensure attention to detail is paid to make sure the small but important issues in a person’s day to day lifestyle are met; - a ‘personal preference’ questionnaire when the move in, an information Weston House DS0000059419.V288037.R01.S.doc Version 5.2 Page 11 how people like their oral hygiene and dental care carried out, and a form which accounts for a history of a person’s social activities. Likewise, medication records and systems looked at show the home manages this important responsibility in a safe, effective manner. The drug fridge has been located to the ground floor office since the last inspection, - this now enhances this procedure. A welcome addition to the care team, which has had a very positive impact on the resident’s lifestyle, is the company physiotherapist. This person was observed to be helping several residents ‘work out’ in a pleasant professional manner. Many residents commented that his visits were very popular. Discussion with this person confirmed he visited the home once a fortnight and on an ‘on call’ basis, and once settled into his role he hoped to coach staff how to encourage residents with their exercise routines in between his visits. Weston House DS0000059419.V288037.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14, & 15 The quality outcome in this area is excellent. This judgement has been made using available evidence including a visit to this service. Full involvement with individuals living at Weston House raises staff awareness to promote choice and control over their lives wherever possible within a stimulating, homely atmosphere. EVIDENCE: Similar findings as seen at the last two inspections in June 2005 and January 2006 confirm the home continues to excel in providing a stimulating lifestyle to match the wishes, choice and feelings of the people living there. The home was again seen to be a hive of activity. Upon arrival to the home a large gathering of residents had just carried out a service of prayer, which they had planned and organised themselves. Other residents who preferred their own company were busy with their own pastimes in their bedrooms. The entertainer booked for the afternoon activity session had a good size audience to keep him busy. Weston house has its own minibus and employs a full time activity organiser, who ensures peoples needs and interests are explored. A notice board details up to date information about the range of activities that are available for Weston House DS0000059419.V288037.R01.S.doc Version 5.2 Page 13 residents to take part in if they choose. All activities listed appeared appropriate for the residents within the home. Discussion with residents confirmed that the outings remain ever popular. It is noteworthy that when the activity organiser is on holiday, the laundry assistant ‘steps into her shoes’ to drive the minibus to ensure residents still have their weekly outings. Several people spoken to commented they were looking forward to a return visit to an ice cream farm the next day. Weston House DS0000059419.V288037.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 &18 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. Improvements in systems means resident well-being is now fully protected through the home’s complaints procedure that compliments the home’s systems to protect residents from abuse. EVIDENCE: From the information seen available, it was seen that the home team have the necessary resources to promote the well being of the people at Weston House on a day-to-day basis. The manager supplied information before the inspection to confirm that there had been one complaint in the past 12 months. Very clear, easy to understand complaints information is available in the reception area, and is backed up by a good system for the manager to record, investigate and monitor any complaints. Recent experiences at the home show that the Registered Provider ensures an open transparent approach to maximise independence and reduce risks of the people living there. One resident who does not have any significant family support gets the help of a professional advocacy service. Adult protection training is held every 6 months in the home to ensure staff have access to ongoing ‘refresher’ training for this issue. Weston House DS0000059419.V288037.R01.S.doc Version 5.2 Page 15 Improvements to the way the home manages residents’ monies by the introduction of a well designed form seen in care records clearly show that this important issue is handled properly. Weston House DS0000059419.V288037.R01.S.doc Version 5.2 Page 16 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): 19,20,21,22,24,25, & 26 The quality outcome in this area is poor. This judgement has been made using available evidence including a visit to this service. The ongoing refurbishment continues to improve the living environment within the home. Very slow progress with this means some aspects of the day to day lifestyle of the people living there remain compromised because of the lack of basic facilities in some parts of the home. EVIDENCE: The ongoing refurbishment programme in the home has resulted in further improvements to the surroundings for the people living, visiting and working there. The main dining room has been redecorated, and it was reported that the workmen were due within days to remove an old nurse call system so that the ‘Chapel’ lounge area of the home can have its décor completed. It is noteworthy that the home team have taken residents wishes and feelings into account whilst the work has been undertaken to keep their disruption to a minimum. Weston House DS0000059419.V288037.R01.S.doc Version 5.2 Page 17 Although the majority of bedrooms seen were very smartly presented, some bedrooms were seen to need action –some have yet to be redecorated. Others still do not have locking facilities for personal property. In addition, one had an unguarded radiator, as did the radiator in the conservatory, which is awaiting its cover being installed. As well as the above findings, some aspects of the day to lifestyle of the people living there remain compromised because of the lack of basic facilities in some parts of the home. As reported after the January 2006 inspection, the main area of concern is a lack of bathing facilities for the 30 people living there. On the ground floor, two bathrooms and a walk in shower room are being used. The seat of the bath hoist in one of these is awaiting an upgrade to make it safer and easier to clean. On the first floor, one bathroom is out of use as it is in the process of being converted to a shower room. The bathroom next door which is awaiting refurbishment was seen to have deteriorated further and is not fit to use, resulting in one bathroom being suitable for residents to use in this part of the home. Control of infection matters were seen to be in hand. The manager is currently drawing up an action plan in response to the infection control audit carried out by the Health Protection Agency in February this year. It was seen that a lot of actions had already been carried out. This will be explored in full at the next key inspection. It is also noteworthy to comment that the home has effectively managed two recent infection control incidents in the home since the last inspection in a most professional manner. Reorganisation of the outbuildings is in progress to make way for the refurbishment of the laundry. The chemical store has been moved to the old staff rest room, in readiness for the laundry to be made bigger. Due to the shortage of space, one freezer is still stored temporarily in the outbuilding allocated for chemical storage. Correspondence received form Shropshire Fire and Safety Service alongside observations on the inspection day confirm the bedroom adjacent to the manager’s office is now suitable to use. Timescales have now been provided by the company about the outstanding works to be carried out, and a completion date for September has been given. Weston House DS0000059419.V288037.R01.S.doc Version 5.2 Page 18 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): 27,28,29, & 30 The quality outcome in this area is Excellent. This judgement has been made using available evidence including a visit to this service. Robust recruitment and training systems continue to show the home exceeds many aspects of these standards resulting in knowledgeable team being able to meet the needs of the people living at Weston House. EVIDENCE: Staff rotas for the period covering the month of the inspection were looked at, alongside the staff seen on duty at the time of this inspection confirms that adequate numbers and skill mix of staff are on duty at all times. The company now has its own relief bank, which has a ‘pool’ of staff who work between the 11 homes to cover any gaps in the care team rota. Many of the names of staff and people seen on duty were recognised as those met by the inspector at earlier inspections. The manager confirmed that the staff team was settled, and many had worked at the home for several years. Only two permanent staff have left the home since the last inspection – both have relocated out of the area. It is commendable to see that over 70 of the carers in the home are NVQ Level 2 qualified. Personnel and training records for three staff members were looked at in depth alongside the details in a new training folder, which has also been devised Weston House DS0000059419.V288037.R01.S.doc Version 5.2 Page 19 recently. These show the home has very thorough systems to recruit, train and develop the team. Weston House DS0000059419.V288037.R01.S.doc Version 5.2 Page 20 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): 31,33,35 & 38 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. The Registered Provider has ensured the staff team have been properly supported and supervised during recent managerial and environmental changes. Improvements to the safe working systems now maximise the health, safety and welfare of residents, staff and visitors. EVIDENCE: The monitoring and support of the area managers during the times of change has made sure the home is managed satisfactorily whilst the recently appointed manager settles into her role. Further evidence seen during the inspection shows that the new manager has embraced her role with enthusiasm and professionalism. Recordkeeping has vastly improved in all areas explored during the inspection. Throughout the inspection she was very knowledgeable about the challenges her role entailed, Weston House DS0000059419.V288037.R01.S.doc Version 5.2 Page 21 and she makes sure everyone is kept up to date with all the changes by the regular meetings that have been organised. The home has lots of ways of making sure the opinions and suggestions of all who live and work there are taken seriously and are acted upon during these times of change. Many policies and procedures are available and have been kept up to date, or further improved, including the one for handling residents’ finances. As a result a robust system is now in place, which exceeds the minimum standard required. Weston House DS0000059419.V288037.R01.S.doc Version 5.2 Page 22 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 3 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 2 2 1 2 X 2 2 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 3 X 4 X 4 3 X 3 Weston House DS0000059419.V288037.R01.S.doc Version 5.2 Page 23 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 OP19 Regulation 16 (1) 23 (2)(b) Requirement The homes planned refurbishment and redecoration must be expedited within the timescales provided to CSCI. (Previous timescales of 20/12/04 and 30/11/05 not met) All of the bathrooms in the home must be refurbished and redecorated as a priority. (Previous timescale of 31/1/05 not met) All refurbishment of the shared facilities provided in the home must be completed. All residents’ bedrooms must have locking storage facilities for personal effects. All radiators accessible to service users, especially in bedrooms must have a low surface temperature or be guarded. The homes laundry must have wall and floor coverings which are readily cleanable (Timescale DS0000059419.V288037.R01.S.doc Timescale for action 30/09/06 2 OP21 16 (1), 23 (2) (j) 06/07/06 3 OP20 16(1) 30/09/06 4 OP24 16 (2) (c) 30/09/06 5 OP25 23(2)(p) 30/09/06 6 OP26 13(3) 23 (2b,c) 30/09/06 Weston House Version 5.2 Page 24 of 28/2/05 not met) 7 OP38 13 (6) Freezers for food storage must not be located in chemical storage areas. (Previous timescale of 30/11/05 not met) 30/09/06 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 Weston House DS0000059419.V288037.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 DS0000059419.V288037.R01.S.doc Version 5.2 Page 26 - 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. 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