Inspection on 01/06/07 for Westport Care Centre

This inspection was carried out on 1st June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Westport Care Centre 26/10/08

Westport Care Centre 03/05/06

Westport Care Centre 22/12/05

Westport Care Centre 15/08/05

Westport Care Centre 11/01/05

Westport Care Centre 15/09/04

Westport Care Centre 06/02/04

Westport Care Centre 25/09/03

Westport Care Centre 14/07/03

Westport Care Centre 30/05/02

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

CARE HOMES FOR OLDER PEOPLE Westport Care Centre 24-26 Westport Street Stepney London E1 0RA Lead Inspector Anne Chamberlain Unannounced Inspection 09:45a 1st June 2007 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 Westport Care Centre DS0000010309.V340837.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. Westport Care Centre DS0000010309.V340837.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Westport Care Centre Address 24-26 Westport Street Stepney London E1 0RA 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 020 7790 1222 020 7423 9701 Ferrolake Ltd Post vacant Care Home No. of places registered (if applicable) 44 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (1), Old age, not falling within any of places other category (88) Westport Care Centre DS0000010309.V340837.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. As agreed on the 6th September 2006, one (1) named service user with a mental disorder can be accommodated. The CSCI must be informed when this service user no longer resides at the home. 3rd May 2006 Date of last inspection Brief Description of the Service: Westport Care Centre is a registered residential care home which caters for 40 older people of both gender who require care and support. It also offers respite services dependant on the availability of beds. The premises are a purpose built three-storied building. All bedrooms have ensuite toilet and shower facilities. A range of communal areas including a smoking room and a patio garden are available. Parking spaces are available underneath the building. The home is conveniently situated close to public transport links and other local amenities. The Registered Provider is Ferrolake Ltd. The fees are £504 weekly. Westport Care Centre DS0000010309.V340837.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection followed on a random inspection which was carried out on 4th January 2007. It was unannounced and was of key standards and the requirements made on the previous random inspection. The inspection was conducted on one day over nine hours. The inspector was assisted by the new manager. She spoke with three residents and three staff members and consulted one stakeholder, on the telephone. The inspector viewed files for four residents and their three keyworkers, as well as policies, procedures and key documentation. She inspected the arrangements for administering medication and toured the premises including the patio garden. She ate the lunch which was being provided on that day. The inspector would like to take this opportunity to thank the residents staff and manager of the home for their support and co-operation with the inspection. What the service does well: Residents and a stakeholder consulted spoke well of the home. A resident said I love it here, the carers are so kind I could not find fault with them. A stake holder said I recommend the home, I have a high opinion of it and I enjoy going there. I think the staff try very hard to accommodate peoples different needs. The inspector was impressed with the ethos of the home which appeared empowering. She felt that residents were supported in their choices and encouraged to maintain their independence. The management of the home is clearly well structured with various regular audits to ensure quality and good standards of recording. Although the new manager had been in the home only two weeks she understood the systems and could find almost everything the inspector needed. She also had a good grasp of the current functioning of the home, the level she wants take it to and how she plans to do it. Westport Care Centre DS0000010309.V340837.R01.S.doc Version 5.2 Page 6 The manager spoke highly of the staff including the receptionist/administrator as she found them, and the inspector felt that she will give strong leadership which will be appreciated. What has improved since the last inspection? What they could do better: The inspection resulted in sixeen legal requirements and four good practice recommendations. There are a number of environmental issues which need to be addressed for the comfort and well being of the residents. The replacement of beds is a priority to ensure a comfortable nights sleep for everyone. The renovating of the patio garden needs to be done as soon as possible to make the best of the summer weather. Residents need to be encouraged to use the garden so they can benefit from fresh air and sunshine and a change of scene. The garden space was mentioned as a recommendation in the report of the inspection of 3rd May 2006. Improvements in the décor and soft furnishing will be good for morale among residents and staff. Residents must be encouraged to say if they would like culturally appropriate food and then it must be provided. Information and choice around culturally appropriate food was listed as a requirement in the report of the inspection of 3rd May 2006. Westport Care Centre DS0000010309.V340837.R01.S.doc Version 5.2 Page 7 Keyworking is important to ensure that residents have all the home comforts possible and the manager must monitor staff performance of this role. The practice of residents paying for mini cabs to visit general practitioners and for staff time as escorts to routine hospital appointments, needs to be reviewed, and the organisation needs to decide if this is really necessary. Staffing levels must be kept under review. The statement of purpose and service user guide need updating. 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. Westport Care Centre DS0000010309.V340837.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Westport Care Centre DS0000010309.V340837.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3 and 6. People who use the service experience good quality outcomes in this outcome area. This judgement has been made using available evidence including a visit to this service. There is a statement of purpose specific to the home. Admissions are not made to the home until a full needs assessment has been undertaken. Rehabilitation care is not undertaken. EVIDENCE: The home has produced a satement of purpose which the inspector viewed. Amendments are needed as some of the factual information is incorrect, for example the managers name. The inspector noted that the document advises residents that the home can only launder clothing at 60 degrees Celsius. The Westport Care Centre DS0000010309.V340837.R01.S.doc Version 5.2 Page 10 manager agreed that this is unrealistic and will be amended to 40 degrees Celsius (see requirements). The home has produced a service user guide which also has inaccuracies. The manager undertook to have these amended (see requirements). The inspector discussed with the manager the pre admission assessment process. The manager said that she prefers prospective residents to visit the home, so that they can make a more informed choice and also so that she can make an assessment of their mobility and general functioning, within the care home environment. The inspector viewed examples of these pre admission assessments on the files of residents and felt that they are adequate. On admission a more detailed assessment is undertaken. The manager explained that the home does not offer intermediate care. They offer respite care. Westport Care Centre DS0000010309.V340837.R01.S.doc Version 5.2 Page 11 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): 7,8,9 and 10. People who use services experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Needs are well set out in an individual plan, health care needs are met and medication is administered carefully. Residents are treated with respect and afforded privacy. EVIDENCE: From the assessments undertaken with residents a service user plan is developed and the inspector saw examples of these on the files of residents. They were comprehensive and included afterlife plans. Westport Care Centre DS0000010309.V340837.R01.S.doc Version 5.2 Page 12 Staff go through care plans with residents to ensure they understand them and where possible residents sign them. The manager stated that care plans are reviewed every month, but the inspector could not evidence this on the files. The manager said that the local authority are most conscientious about carrying out a reviews of placements annually and care plans are updated following any significant change. The care plans are separate for individual areas of care so this facilitates easy amendment. Relatives are encouraged to contribute to care plans. The manager is aware of the relevance of the The Mental Capacity Act 2005 and will be planning how to incorporate its requirements into the assessment and care planning processes. A number of the residents have health care needs which are addressed with the assistance of outside professionals. The manager stated that the home works with general practitioners, district nurses, tissue viability specialist nurses, audiology etc. On the day of the inspection the chiropodist was working at the home. She uses a pleasant room which doubles up as the hairdressing salon. The resident who was having her toenails cut was not enjoying the experience and the inspector suggested to the manager that some pleasant distracting music might help. The manager agreed. The inspector learned from a resident that if a resident needs to travel to his general practitioner surgery and family cannot transport, the costs of the transport (a minicab) are to be paid by the service user. The resident told the inspector you cant afford to go too often. The inspector felt this is quite poor practice as the resident could be deterred from reporting symptoms for reasons of economy. The inspector recommends that the manager address this issue with her senior managers to see if the charging is really necessary (see recommendations). The manager showed the inspector a London Taxicard Scheme leaflet and advised that she is applying for all the residents. This may provide a transport solution. Under the heading Fees, the service user guide states that payment will be required for staff escorts to hospital for routine appointments, where a relative or friend cannot accompany the resident. The inspector suggests that this practice also be reviewed to see if the costs could not be absorbed by the flat weekly fee (see recommendations). The inspector viewed the arrangements for the administration of medication. Westport Care Centre DS0000010309.V340837.R01.S.doc Version 5.2 Page 13 She viewed the medication policy, a copy of which is kept at the front of the medication folder. Medication is stored in two trolleys. The inspector suggest that that these trolleys are numbered for the floors they service. Each service user has their own section in the medication folder with their photograph, consent form and Medication Administration Records (MAR). With the charts were photocopies of old prescriptions. The manager felt that these were quite unnecessary and added confusion and said she would arrange to have them removed. The MAR charts were neatly kept and no errors were noted. However the sheets have unnecessary times printed which tend to make them confusing. The manager said she would try to get these deleted. She also suggested and the inspector agreed, that practice would be improved by a space at the back of the sheet where comments could be added to explain entries which are not straightforward signatures. The reasons for PRN (or as required), medications being administered, could also be given there. The home uses a bubble pack system for medication and the inspector checked several lots of remaining medication for the four residents she was casetracking. There were no discrepancies. The manager stated that there is a full medication audit once a month and a pill count once a week. Evidence of both practices was viewed. The home has one resident who self medicates. The risk assessment for this was seen by the inspector. The organisational policy states that the risk assessment must be reviewed on a monthly basis. It was last done a year ago. The risk assessment must be reviewed (see requirements). The policy also states that a record must be kept of administration. The manager stated that at present the resident does not keep a record. She will change the practice so that a care worker hands the resident her medication, observes her taking it and completes a record. This will be acceptable and the new risk assessment can reflect the altered practice. The inspector felt that the home had a sound approach to medication practice. The inspector noted that the care plan records how a resident prefers to be addressed. The manager stated that staff always knock on doors and their general attitude is respectful. A resident told the inspector that the carers are so patient. While the inspector was with this resident a carer knocked on her door to ask her if she would like a cup of tea. Westport Care Centre DS0000010309.V340837.R01.S.doc Version 5.2 Page 14 The manager said service users can move freely between floors and their mail is handed to them unopened. She commented that she is stopping the practice of tables being laid an hour before a meal. The inspector thought this demonstrated a respectful, person centred approach. Westport Care Centre DS0000010309.V340837.R01.S.doc Version 5.2 Page 15 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): 12,13,14 and 15. People who use the service experience adequate quality in this outcomes area. This judgement has been made using available evidence including a visit to this service. Residents have autonomy and choice and the home provides opportunities for residents to enjoy social activities inside and outside of the home. Meals are appealing and taken in pleasant surroundings. There is however room for improvement in the above areas and care must be taken to ensure that residents do not have unmet needs. EVIDENCE: The home retains an activities co-ordinator and the inspector interviewed her and viewed the schedule of activities for this year. It included activities in the home a.m. and p.m. on weekdays, birthday parties for every resident, barbecues and a monthly visit by an entertainer. There are also outings, the next one being a trip to Margate. Mothers day and Fathers day are celebrated Westport Care Centre DS0000010309.V340837.R01.S.doc Version 5.2 Page 16 and the activities co-ordinator said the kitchen is always very co-operative about providing celebration cakes. The inspector was told that a nun comes in every Sunday to undertake a religious service. The hairdresser visits fortnightly. At present no resident attends a day centre. The inspector chatted with one resident who said that he would like to go out for some fresh air in his wheel chair. It seems that this which should have been followed up. The manager undertook to try to re-establish the link and arrange for the resident to attend the day centre if he would like to. The inspector suggested that short trips in the wheelchair might also be undertaken, and a requirement has been made (see requirements). The activities co-ordinator told the inspector that she had never attended any training for her role and would like to. The manager must arrange this (see requirements). The inspector was pleased to see one resident coming and going all day. This person likes to take responsibility for making sure the gates to the underground car park are not obstructed. He also likes to go to the shop for newspapers etc. The inspector observed this resident chatting with the receptionist and coming into the managers room if the door was open, to speak to her or the inspector. The manager stated that service users go to their banks with staff, shopping and to the pub if they would like to. The stakeholder spoken to by the inspector confirmed that visits to the pub had been incorporated into the programme of a resident. He said that the home promotes independence. The inspector felt that the atmosphere in the home is relaxed and residents feel free move around the home and to come and go within their abilities. There is a pay phone in a private room in the home. However one resident who is a wheelchair user, told the inspector he would like to have a telephone in his room. The manager undertook to follow up this request (see requirements). The manager stated that residents have a choice about whether they wish to hold a key to their bedrooms. A resident told the inspector he goes to bed when he wishes to. Some residents have family who assist them to handle their money, others are assisted by the home and sign for their money. Westport Care Centre DS0000010309.V340837.R01.S.doc Version 5.2 Page 17 The manager stated that there are two choices for lunch and residents are asked in the morning which they would prefer. The inspector sampled a lunch dish and found it nicely prepared, tasty and hot. The storage arrangements for dry goods in the kitchen larder are sound in that they are covered but two foodstuffs are kept in dustbins which looks rather offputting. The manager agreed to replace these dustbins with metal lidded containers like the two already in use. The manager said that she is planning some structural rearrangements in the kitchen. She is also planning an increase in the catering staff. The dining rooms were pleasant with tables properly laid. One residents spoken to told the inspector that he would like some food from his own culture. The inspector felt this lack could be due to inadequate assessment or assessments not being updated regularly. Whatever the reason the manager agreed to ensure that the food become available for this resident (see requirements). A resident told the inspector he would like to have fruit and snacks in his room. The inspector noticed that this person had a very small amount of diluted fruit juice in a jug and hardly any left in a bottle. The manager said that keyworkers assist service users with day to day shopping. The inspector felt after interviewing keyworkers that they were just a little vague about the keyworking role. The manager agreed to address this with keyworkers emphasising their keyworker responsibilities to them (see requirements). The inspector noticed that it gets very hot on the upper floors of the home and stressed to the manager that in hot weather people will need to havefans and jugs of iced water in their rooms. The inspector felt that the service users generally had a wholesome diet served in pleasant surroundings. Westport Care Centre DS0000010309.V340837.R01.S.doc Version 5.2 Page 18 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. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Complaints are properly dealt with and residents are protected and safeguarded from abuse. EVIDENCE: The inspector viewed the policy and procedure for complaints. There is a short version of the procedure which needs amendment as it does not give the new address for the Commission for Social Care Inspection (CSCI). The last complaint logged was on 15/2/06 and this appears to have been resolved effectively. However the inspector found that two logs were being kept for complaints and asked the manager to combine them. There is an organisational policy for the protection of vulnerable adults which the inspector viewed. It refers appropriately to the local authority procedure with which it works in conjunction. The inspector also viewed an internal form which the manager would complete which requires the time and date the Westport Care Centre DS0000010309.V340837.R01.S.doc Version 5.2 Page 19 matter is referred to social services. The manager stated that she will be requesting a copy of the local authority policy in its revised form, which is coming out in July 2007. The manager was able to explain satisfactorily to the inspector how she would deal with an allegation of abuse. She said that Tower Hamlets have an alert form. The inspector viewed a copy of the whistleblowing policy and a carer interviewed confirmed that he understood his duty under the term. Westport Care Centre DS0000010309.V340837.R01.S.doc Version 5.2 Page 20 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): 19,20,21 and 26 People who use the service experience adequate quality in this outcome in this area. This judgement has been made using available evidence including a visit to this service. There are a number of issues regarding the décor and furnishing of the home which need to be addressed. EVIDENCE: The inspector toured the premises. There are many shortfalls in décor which need to be addressed. The worst example of this was a skylight which was boarded over in a temporary way. Paintwork needs freshening and some door plates are broken and need replacing (see requirements). Westport Care Centre DS0000010309.V340837.R01.S.doc Version 5.2 Page 21 The home has a smoking room but this needs an extractor to be fitted (see requirements). Under the new Smoke-free (Premises and Enforcement Regulations) 2006, which come into force on 1st July 2007, the manager will need to fit a mechanical closer to the door of the smoking room. The manager is aware that the beds with which the home is furnished are poor. They have very shallow mattresses. She is planning to purchase new divan beds, beginning with the rooms which are vacant. The inspector asked two residents she chatted with if they would like a divan bed with a deeper mattress and they said they would. One resident showed the inspector how she uses a bath towel to provide a bit more cushioning on her mattress. The manager agreed that in addition to the vacant rooms she will order divan beds for the two residents who have asked for them. The manager must give the other residents a choice of a new divan bed and provide them as quickly as possible (see requirements). The dining rooms in the home are light and airy and well furnished. However at present the activity co-ordinator stores her things in an open cupboard in the dining room. Also the residents art work is pinned up around the room. This combination gives the dining room a rather inappropriate nursery look. The room would be much improved by the addition of a closed cupboard for the activity items and a cork board for the artwork. The curtains in the home are past their best, especially the net curtains, which seemed to be hung in non-matching pairs. The manager told the inspector she will be ordering and hanging new curtains as soon as possible. Also the carpets will be cleaned throughout the home. The inspector viewed the kitchen premises. The kitchen has no natural light and is gloomy. Freezer and refrigerator are kept in a larder room which is very warm. The freezer is old and needs replacing. There is another cooler room which forms part of the kitchen premises where dry goods are stored. The manager has a plan to re-organise these rooms which the inspector feels will be a great improvement. The inspector viewed the patio garden. This could be a really nice sitting area for residents but needs to be made safe for them (see requirements). The rusty railings to be repainted. The drainage gulley to be covered over to be level access. Flimsy plastic furniture not suitable for older people, to be replaced with wooden furniture. Westport Care Centre DS0000010309.V340837.R01.S.doc Version 5.2 Page 22 There was an unpleasant odour in a ground floor toilet which the manager and inspector agreed was probably ingrained in the tiling grout. The manager said she would try to eliminate the odour by jet washing the tiling (see requirements). The inspector visited the laundry room which is spacious and equipped with washing machines and driers. She was pleased to see a staff member ironing clothes for residents. The inspector suggests a clothes rail and hangers would be really useful for hanging the garments after ironing (see recommendations). The home was generally clean and pleasant Westport Care Centre DS0000010309.V340837.R01.S.doc Version 5.2 Page 23 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, 28, 29 and 30. People who use the service experience adequate quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The staff are competent and dedicated but their full training cannot be evidenced, and the staffing ratio is low. EVIDENCE: There are currently thirty-one residents in the home. There are six staff on shift, one senior and one carer to each floor. A carer commented that she would like more staff to be on duty as some residents need two people to assist them, and for that period the full staff complement for the floor is then engaged. The manager stated that this staffing level is sufficient because tasks which require two staff take short amounts of time and all the staff work hard and make themselves available for residents. The stakeholder spoken to by the inspector stated that he found the staff friendly, helpful and flexible. Westport Care Centre DS0000010309.V340837.R01.S.doc Version 5.2 Page 24 Should the numbers increase at the home the staffing level must be reviewed (see requirements). The inspector viewed three staff files. All the staff had NVQ qualifications and the manager stated that staff are allowed paid leave to pursue NVQs. The manager described the recruitment process which sounded safe and robust and was borne out by the files inspected. The chiropodist will be undertaking footcare training with the staff in June 2007 and some will be attending Adult Protection training in June 2007. After inspecting three staff files the inspector was satisfied that induction and relevant training courses are offered to staff. However the manager was not able to evidence that core training for example, manual handling and health and safety, are renewed every year. The manager must ensure that core training is renewed by staff every year and can be evidenced (see requirements). Westport Care Centre DS0000010309.V340837.R01.S.doc Version 5.2 Page 25 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, 36 and 38. People who use the service experience good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager of the service had been in post for just two weeks at the time of the inspection. She is experienced in social care and appeared confident and competent. The manager is permanent but is not yet registered with CSCI. The manager must forward her application to the commission without delay (see requirements). Westport Care Centre DS0000010309.V340837.R01.S.doc Version 5.2 Page 26 The manager was able to show the inspector the results of a meal satisfaction survey. However this had been undertaken across several homes so was not specific to Wesport Care Centre. The inspector saw a sample of a recent satisfaction survey which had gone to head office. The manager stated that stakeholders and relatives are surveyed as well as residents. The inspector suggests that in future a couple of completed forms from every survey are photocopied to provide evidence of quality assurance for inspections. The inspector viewed the business plan in draft on screen. The inspector was satisfied that the organisation takes quality assurance seriously. However she would like to see and recommends, an in house survey which collects the views of the residents regarding their care and comfort (see recommendations). The manager explained to the inspector how the home assists residents with their finances. There is a folder with ledger sheets and every individual has one. Income in the form of pensions is paid into head office. The receptionist/administrator who is responsible for personal finances claims whatever money is required by the resident. When they sign for their money it is subtracted from the balance. When carers undertake shopping they produce the receipts which are stored in envelopes. Loose monies are kept in individual wallets. The inspector viewed the balance sheets which appeared to be carefully and accurately kept. The manager stated that supervision should be six times per year for carers. The inspector viewed the evidence of staff supervision for three carers which varied and showed that in two cases regularity has faltered. The manager said she will prioritise those who have had least supervision. As previously mentioned the manager must ensure that staff understand the responsibilities of their keyworker role. The inspector saw evidence that personal development plans are used for appraisal. However none of the staff had had appraisal. Annual appraisal must be introduced for staff. (see requirements). The pre-inspection information submitted to the inspector contained useful information regarding health and safety checks. In addition the inspector checked the evidence that the home has regular fire drills and checks the alarms and fire doors on a rotating weekly basis. The inspector viewed the arrangements for the storage of substances hazardous to health. The manager stated that she wants to update the risk assessments for the substances the home uses but that this is a lower priority. Westport Care Centre DS0000010309.V340837.R01.S.doc Version 5.2 Page 27 The inspector viewed the substances which are locked away and the file of data sheets and was satisfied that the arrangements are quite safe. When viewing the kitchen the inspector found that the cook keeps a tiny quantity of everything which has been served for 48 hours. This is good practice as the sample can be analysed if anyone develops food poisoning. The water in the kitchen tap is quite hot and the manager must post a sign above the sink to warn users of the risk of scalding (see requirements). The home keeps an purpose made accident book. The level of accidents appears low. The inspector felt that the health. Safety and welfare of residents and staff is promoted and protected. Westport Care Centre DS0000010309.V340837.R01.S.doc Version 5.2 Page 28 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 2 3 x x 3 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 2 13 2 14 x 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 2 2 x x x x 2 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 2 x 3 x 3 2 x 2 Westport Care Centre DS0000010309.V340837.R01.S.doc Version 5.2 Page 29 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. 2. 3. 4. Standard OP1 OP1 OP9 OP12 Regulation 4 5 13 (2) 12 (3) Requirement The statement of purpose must be amended to be accurate. The service user guide must be amended to be accurate. The risk assessment for the resident who self medicates must be reviewed. The care plan of the service user who told the inspector he would like to go out, must be amended to record this, and the need addressed appropriately. The manager must arrange for the activities co-ordinator to have formal training for her role. The manager must ensure that telephone facilities suitable to the needs of residents, and which can be used in private are provided. The manager must ensure that culturally appropriate food is available to residents, and that they know this. The manager must address the shortfalls in décor and bring the home up to a good standard of decoration. DS0000010309.V340837.R01.S.doc Timescale for action 31/07/07 31/07/07 31/07/07 31/07/07 5. 6. OP12 OP13 18 (1)(c) (i) 16 (2) (b) 01/10/07 01/08/07 7. OP15 16 (2) (i) 01/07/07 8. OP19 23 01/08/07 Westport Care Centre Version 5.2 Page 30 The manager must have an extractor installed into the smoking room. The manager must order divan beds for the two residents who have asked for them. She must give the other residents a choice of a new divan bed and provide them as quickly as possible. The manager must ensure that the patio garden is made safe for residents. The manager must do all she can to eliminate the unpleasant odour in the ground floor toilet. Should more people be admitted to the home the manager must review the staffing level. The manager must ensure that staff are appropriately trained for the tasks they are asked to perform (previous timescale 31/03/07). The manager must submit her application to be registered by CSCI without delay. The manager must ensure that keyworkers fully understand their responsibilities in that role. The manager must introduce the annual appraisal of staff. The manager must post a sign over the kitchen sink to alert users to the risk of scalding. 9. 10. 11. 12. OP20 OP21 OP26 OP30 23 23 18 18 (1)(c)(i) 01/09/07 31/07/07 01/07/07 01/10/07 13. 14. OP31 OP36 8 18 (2) 01/07/07 01/07/07 15. OP36 18 (2) 01/10/07 16. OP38 23 01/08/07 Westport Care Centre DS0000010309.V340837.R01.S.doc Version 5.2 Page 31 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. OP8 2. 3. 4. OP8 OP21 OP33 Refer to Standard Good Practice Recommendations The manager should discuss with her senior managers whether it is necessary to charge residents for mini cabs to see their general practitioners. The manager should discuss with her senior managers whether it is necessary to charge residents for staff time to escort them to routine hospital appointments. The inspector suggests a clothes rail and hangers would be really useful for hanging garments after ironing. The manager should undertake an in house survey which collects the views of the residents regarding their care and comfort. Westport Care Centre DS0000010309.V340837.R01.S.doc Version 5.2 Page 32 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford London 1G1 4PU 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. 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