Inspection on 22/11/06 for Westonville Lodge

This inspection was carried out on 22nd November 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 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

Westonville Lodge 19/11/08

Westonville Lodge 09/11/05

Westonville Lodge 05/07/05

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Westonville Lodge 24 Royal Esplanade Westbrook Kent CT9 5DX Lead Inspector Tina Thomas Key Unannounced Inspection 22nd November 2006 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 Westonville Lodge DS0000062883.V307457.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. Westonville Lodge DS0000062883.V307457.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Westonville Lodge Address 24 Royal Esplanade Westbrook Kent CT9 5DX 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) 01843 220669 01843 220669 Susan Helen Neal Care Home 10 Category(ies) of Old age, not falling within any other category registration, with number (10) of places Westonville Lodge DS0000062883.V307457.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th July 2005 Brief Description of the Service: Westonville Lodge is a small residential home registered to provide residential care and support for up to ten service users who require varying degrees of assistance. The home is located in a residential area of Margate, in close proximity to the sea front and local amenities. There is on road parking to the front and side of the building. The statement of purpose gives information about the home and the service provided there. A copy can be obtained from the home. The most recent inspection report is on display and can be seen in the home. The Registered Provider Mrs Susan Neal is also the homes Manager. Currently the scale of fees is between £319.47 and £360 per week. Hairdressing, chiropodist, newspapers and toiletries are at an additional charge. Westonville Lodge DS0000062883.V307457.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection. The inspection process took place over a period of time, information was gathered, and it concluded with a site visit conducted over two days. The first day was the 22nd November 2006 and the second day was 9th January 2007. Judgements were made by taking into account evidence from a range of documentation, a tour of the home, discussion with service users, staff and the Provider. What the service does well: What has improved since the last inspection? Since the last inspection the providers have improved the environment. The Provider has replaced the hot water tanks and piping throughout the home. Thermostatic valves have been placed on radiators. The home has a new kitchen with new appliances and a new bathroom suite on the ground floor. The dinning room has had new furniture as has the lounge. Some bedrooms have been repainted and some bedrooms have been recarpeted The provider has purchased new garden furniture. Westonville Lodge DS0000062883.V307457.R01.S.doc Version 5.2 Page 6 The activities plan has been improved and the staff and service users continue to strengthen this together. New policies have been created and old policies reviewed by the Provider/ manager. 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. Westonville Lodge DS0000062883.V307457.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 Westonville Lodge DS0000062883.V307457.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): 1,3 and 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who use this service need more fuller information about the home in order to make an informed decision about whether the service is right for them. Sometimes prospective service users needs are not fully assessed before they move into the home. People are made very welcome on admission. EVIDENCE: The homes Statement of Purpose(SOP) and Service User Guide is of good quality and informative. However, it is not made clear that some service users have dementia. Westonville Lodge DS0000062883.V307457.R01.S.doc Version 5.2 Page 9 The home must seek clarification regarding their registration and amend the SOP accordingly. The document is written clearly in plain English and available to all. Susan Neal the Provider/Manager also produces a monthly newsletter that is given to service users and their relatives. Susan Neal conducts all the pre admin assessments. Three pre admin assessments were viewed. Two were of good quality and in line with the national minimum standard, one was not of sufficient quality and may have resulted in a service users being admitted out of category. Four service users were spoken with regarding their experience of choosing the home. Two said that they had little input into choosing the home, it was done by their next of kin. One said that they had chosen the home, but had come to it whilst it was under the management of the previous owners. Another said that they had started going to Westonville Lodge for coffee mornings and had become friendly with another service user. When they became ill themselves and needed some care, they phoned the home and asked if the home had any vacancies. They described the assessment process and moving home as a positive event. They were welcomed into the home with fresh flowers in their room. They said it was a ‘great relief’ for them. Staff spoken with were aware of the admissions process. The home does not offer intermediate care. Westonville Lodge DS0000062883.V307457.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): 7-10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Although improving and developing, the practice regarding the planning and delivery of care means that all services users can be sure that their health and personal care needs will be fully met. EVIDENCE: Care plans viewed were well written, and well documented. They gave clear instruction to staff as to how to meet service users needs. Suitable risk assessments were in place and amongst others included, manual handling, nutritional, deterioration of skin, and risk of falls. They identified risks and showed how to minimise or alleviate them. They were suitably and regularly reviewed. Westonville Lodge DS0000062883.V307457.R01.S.doc Version 5.2 Page 11 Entries in care plans showed that service users had access to G.Ps and specialist services. Attention is paid to service users well being and needs, through assessments, such as nutrition and falls risk assessments. Service users discussed how they received personal care in the privacy of their own rooms or the bathroom. They described how they tried to do as much as they could but felt comfortable to ask staff to help them in some areas. The home has suitable equipment and aids for the promotion of tissue viability. One required a battery for his hearing aid, he mentioned it to staff and it was changed immediately. Service users agreed that staff were kind and respectful. They agreed that they wore their own clothes that were always nicely laundered. One service users said ‘when I came here I was made to feel like my life was still of some value’ Medication was being stored appropriately and medication administration records were up-to-date and accurate. The medication policy has been updated to include procedures for service users who choose to self-medicate. Westonville Lodge DS0000062883.V307457.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): 12-15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are offered a wide range of stimulating and motivating activities. Service users, families and friends from the local community are included and contribute to the homes many events. Meals and mealtimes are an enjoyable, social occasion for service users. EVIDENCE: Service users have opportunity to join in activities inside and outside the home. Service users are involved in choosing activities. Activities are discussed at residents’ meetings. Service users choice of activities is recorded. The Provider has been creative with activities, events including religious, cultural, and sporting events are regularly celebrated. The service users Westonville Lodge DS0000062883.V307457.R01.S.doc Version 5.2 Page 13 contribute by making table decorations etc. As an outside activity the providers instigated and Olympics day, with activities that service users could join in. The home has regular coffee mornings for service users, friends, families and local people. The Provider produces a monthly newsletter for service users, friends and relatives. Service users said that their relatives and friends were always made welcomed. One relative phoned during inspection to find out what was for dinner the following day, and booked a lunch for during their visit. Copies of menus were seen. Service users spoken with said that they discuss menus in residents meetings. They said that the food was always ‘lovely’. They confirmed that they had choices, and felt comfortable to ask for what they wanted in the knowledge that it would be provided. Service users spoken with confirmed that they are treated with dignity and respect. They confirmed that they have choice over what time to go to bed, how to dress, and what to eat. They confirmed that they were encouraged to bring items to the home so that they could personalise their rooms. Conversation with staff and the provider identified that the ethos in the home is to make people feel valued and to enjoy, as far as possible, their lives. Westonville Lodge DS0000062883.V307457.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): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users feel safe and listened to. EVIDENCE: A complaints procedure was available to all service users and this was included in the service user guide. Service users spoken with all felt safe, listened to, and able to speak to the staff and manager if they were not happy about anything to do with their care. The home has a complaints policy and a complaints book, but they have no ongoing complaints. The home has a whistle-blowing policy. Staff knew where to find these. Service users have regular meetings that are recorded and actioned, so as to be able to air their views and influence the manner in which the home is run. Discussion with staff demonstrated that they have a good level of understanding regarding adult protection. Staff have all had adult protection training. Westonville Lodge DS0000062883.V307457.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): 19,22,23,25Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has invested substantially in maintenance and improvement. However, there remain some areas where service users could be potentially at risk. EVIDENCE: The home was clean and odourless throughout. The home is suitable for its purpose. The home has large gardens that are enjoyed by service users for various activities. New garden furniture has been purchased this year. The Provider has invested substantially in maintenance and improvement. Amongst many improvements, the dinning room and lounge have new furniture, the home has a new kitchen. The laundry room has a new washing machine. Westonville Lodge DS0000062883.V307457.R01.S.doc Version 5.2 Page 16 The home has adequate equipment to enable service users to be independent. The Provider has purchased a new chair lift, allowing people to access their bedrooms with ease. The home has a walk in bath, and another with a bath hoist. The downstairs bathroom has been completely refitted. Service users bedrooms were personalised. Service users spoken with discussed that the Providers had encouraged them to bring mementos of home i.e. photos with them. All service users bedrooms have locks, if they choose to use them. Some bedrooms have been repainted and recarpeted recently. The home has one double room, which is shared by two people that have made and active choice to do so. The Provider has replaced the hot water tank and all pipe work throughout the home has been replaced. Each service users has a radiator in their bedroom. All radiators have been recently fitted with thermostatic valves. Some radiators in bedrooms and other parts of the home have not been covered. This could put service users at risk from burns and scalds. The laundry room is in the bathroom, which isn’t ideal. There is nowhere else for it to be sighted. This does mean that clean linen is in a ‘dirty’ area, although there isn’t a toilet in the bathroom. Staff use billy bags to prevent cross infection and are provided with aprons and gloves and are aware of infection control procedures. Westonville Lodge DS0000062883.V307457.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): 27-30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has robust recruitment policies and procedures. Plans to improve some areas of training should result in better outcomes for people using the service. EVIDENCE: On the first day of inspection the home was being managed by a senior carer. There were 10 residents with 2 care staff. The senior carer in charge was trained to NVQ level 2 and nearly completed level 3. There was also a cleaner and a cook on duty. Care staff demonstrated a good knowledge of the service users. There is a stable staff team with some staff having worked at the home for many years. Staff worked in an unhurried manner service users spoken with agreed that staff never rushed them, and always had the time for a few words. The staff rota showed that there was always sufficient staff on duty. The Provider ensures that either herself or a senior carer are available at all times in the event of an emergency or important decision making. Westonville Lodge DS0000062883.V307457.R01.S.doc Version 5.2 Page 18 50 of staff are trained in care at NVQ Level 2 or above. The home currently has no trainees. The manager confirmed that new staff would be completing an induction inline with skills for care and the new induction standards. Files were seen for two members of staff. All relevant checks and documentation including CRB and POVA first checks had been obtained. The Provider has recently implemented a declaration of health form for staff. Mrs Neal felt that the home had moved forward with the training. Any new staff will be enrolled on an induction programme in line with skills for care. Most staff have had undertaken a significant amount of training including NVQ. The Provider has a training plan and is currently sourcing training opportunities. There are some deficits in mandatory staff training that the Provider is aware of. Some require manual handling training, and most require first aid training. 50 of staff are now trained to NVQ level 2 and some to level 3. The Provider must ensure that all staff have mandatory training. Staff said that they had ‘loads’ of training since Mrs Neal had become the Provider. Staff spoke enthusiastically regarding training. Westonville Lodge DS0000062883.V307457.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): 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. This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of the service users. Some areas need improving to ensure health and safety. These areas are already included in the Providers development plan and will shortly be addressed. EVIDENCE: Service users spoken to knew the management structure of the home, and felt the provider was excellent. Some service users who had been resident prior to Westonville Lodge DS0000062883.V307457.R01.S.doc Version 5.2 Page 20 the owners being in place expressed that there had been an improvement in the way the home is run. They spoke affectionately of Mr and Mrs Neal. Some of the service users meet together regularly at residents meetings and suggest ideas of what they would like at the home, to the provider. Staff appreciated the amount of work that Mr and Mrs Neal had undertaken since they had become the providers. They discussed changes in the environment, policies and procedures and care planning. Staff said supervision was now happening regularly and that it was well organized and clearly recorded. The home has a Quality assurance form which is sent out to family, friends, service users and staff. The home also judges quality assurance through staff supervision, and resident and staff meetings. The Provider uses this information to feed into the homes development plan. Service users control their own money when they are able. The systems for holding service users money was scrutinised and found to be sound. The health and safety of the service user is generally protected. The providers have undertaken some large tasks in the home to ensure this i.e. the changing of water tanks and piping throughout the building, installing a new chair lift, replacing worn carpet. There are still some areas that need improvement, as mentioned previously in the report, some radiators still need covering, and some staff need training in manual handling and first aid. Apart from the above mentioned items, the provider endeavours to ensure the compliance of relevant legislation. The home has suitable risk assessments. The home has policies and procedures which staff understand. They are generally of good quality. Signed and dated and have a review date. Some have been updated in the past month. Including the complaints procedure, aggression to staff and missing from home. The provider has arranged for the fire risk assessment to be reviewed and updated. Westonville Lodge DS0000062883.V307457.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 2 x 2 x x x 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 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x 3 3 x 2 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 2 Westonville Lodge DS0000062883.V307457.R01.S.doc Version 5.2 Page 22 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. 1 Standard OP1 Regulation 4 Requirement 4. - (1) The registered person shall compile in relation to the care home a written statement (in these Regulations referred to as the statement of purpose) which shall consist of (a) a statement of the aims and objectives of the care home; (b) a statement as to the facilities and services which are to be provided by the registered person for service users; and (c) a statement as to the matters listed in Schedule 1. The home must make clear the in the Statement of purpose, the people to whom they over a service. Timescale for action 28/02/07 Westonville Lodge DS0000062883.V307457.R01.S.doc Version 5.2 Page 23 2 OP25 13 (4)(a) 4) The registered person shall ensure that (a) all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety; The Provider must ensure that all radiators are covered. 31/03/07 3 OP30 18.1 18. - (1) The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of service users (a) ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users; (b) ensure that the employment of any persons on a temporary basis at the care home will not prevent service users from receiving such continuity of care as is reasonable to meet their needs; (c) ensure that the persons employed by the registered person to work at the care home receive (i) training appropriate to the work they are to 28/02/07 Westonville Lodge DS0000062883.V307457.R01.S.doc Version 5.2 Page 24 perform; and (ii) suitable assistance, including time off, for the purpose of obtaining further qualifications appropriate to such work. All staff must have all mandatory training. Deficits in manual handling and first aid were noted. 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 Westonville Lodge DS0000062883.V307457.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Westonville Lodge DS0000062883.V307457.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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!