CARE HOMES FOR OLDER PEOPLE
Westport Care Centre 24-26 Westport Street Stepney London E1 0RA Lead Inspector
Helen Fontaine Unannounced Inspection 15 August 2005 at 10:00am
th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Westport Care Centre G57 G06 S10309 Westport Care Centre V244355 150805 Stage 4.doc Version 1.40 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 Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 7790 1222 020 7423 9701 dianejay@excelcareholdings.com Excelcare Holdings Basilide Sonia Ramier Care Home 44 Category(ies) of Old age, not falling within any other category registration, with number (88) of places Westport Care Centre G57 G06 S10309 Westport Care Centre V244355 150805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: NONE Date of last inspection 11th January 2005 Brief Description of the Service: Westport Street Care Centre is a registered residential care home that caters for 44 oder person of both gender that require support and care. It also offers respite services dependant on the availability of beds. The home has a block purchase contract with Tower Hamlets for all the beds. The premises are a large three-storied building that is purpose built and well maintained. All bedrooms have en-suite toilet and shower facilities. Thirty-eight bedrooms are single and three bedrooms are registered as bouble. A range of communal areas including two smoking rooms and a patio garden are available. Parking is available underneath the building. The home is conviniently situated close to public transport and other local amenities. The Registered Provider is Excelcare that owns and manages serveral other registered care homes in the area. Westport Care Centre G57 G06 S10309 Westport Care Centre V244355 150805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The Unannounced Inspection took place over 4 hours and was carried out as part of the usual yearly inspections. There were twelve Requirements and three Recommendations from the previous Inspection, eight Requirements and two Recommendations had been addressed within the time scale set in the previous inspection. Inspector did a tour of the building and a number of records were inspected. Five residents and one member of staff were spoken to and other residents and staff were spoken to during the tour of the building. The Registered Manager was on holiday, the Team Leader and then later during the inspection the Service Manager were present. What the service does well: What has improved since the last inspection?
There are now systems in place for making sure that all the services received from other Health professionals is evidenced. The safekeeping and administration of medicines is improved and the Team Leaders are keen to develop this further. There is clear evidence that staff are trained in measures to prevent Service Users being harmed or abused. There are clear training schedules for staff and the member of staff spoken to, is undertaking their NVQ. The home now has a Registered Manager in post and the receptionist has developed procedures for the dealing with Residents money. All records required by legislation are appropriately kept and there is clear evidence that fire alarms are tested on a weekly basis.
Westport Care Centre G57 G06 S10309 Westport Care Centre V244355 150805 Stage 4.doc Version 1.40 Page 6 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. Westport Care Centre G57 G06 S10309 Westport Care Centre V244355 150805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Westport Care Centre G57 G06 S10309 Westport Care Centre V244355 150805 Stage 4.doc Version 1.40 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 standard(s) 3 The needs of the Service Users are assessed before moving into the home, however the assessment paper work had not been completed. EVIDENCE: The admissions procedure was in place but the documentation was not adequate to guide staff on the actions to be taken to ensure that new residents needs can be met. The team Leader spoken to was able to provide significant information about Residents needs, but these had not been recorded. This failure could have serious repercussion for the health and welfare of the Residents concerned. Individual records are kept for each of the Residenst and inspection of the records for the two of the most recent admissions did not have full assessment information. Westport Care Centre G57 G06 S10309 Westport Care Centre V244355 150805 Stage 4.doc Version 1.40 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9 and 10 Westport have continued to improve arrangements to ensure that the health care needs of resident are identified and met. However there are shortfall that have a potential to place residents at risk. EVIDENCE: Individual Care Plans are available and these are now very accessible and nicely presented. However quite a bit of the Care Plan remains uncompleted, with areas that could potentially place residents at risk. During the Inspection the Team Leader on duty was able to give verbal information for the areas not completed. All documentation for the recording of services from other Health Care professional, was clearly evidenced in the new systems developed by the home. The recording, handling of safe administration and disposal medication was observed to be appropriate. It was suggested that a clearer system of receipt of medication was developed, that would allow an easier audit of the medication. Westport Care Centre G57 G06 S10309 Westport Care Centre V244355 150805 Stage 4.doc Version 1.40 Page 10 During the tour of the home it was noted that staff treated the Service Users with respected. A Resident spoken to during the inspection said that the staff were very kind and that they had their room to go to if they wanted. The pay phone is now available on the first floor, it had been previously in the basement and was a Recommendation from the previous inspection. Westport Care Centre G57 G06 S10309 Westport Care Centre V244355 150805 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,14 and 15 Social activities were organised, that provided some stimulation but could be more creative. Residents did have some choices and control over their lives. Meals are nutritious and balanced and offer a healthy and varied diet. EVIDENCE: During the inspection the activities folder was looked at and there were activates as well as some pictures of a recent outing. Although these did offer the Service Users stimulation and interest, some work to develop some creative activities would be beneficial. It was noted during the inspection Service Users coming and going from the reception area and one Resident seen out going to the local shop. Service Users spoken to said “I can use the smoking room, the lounge or my room”, it was observed that the Service users moved around the home freely. During the inspection a number of Residents were spoken to and all said that they liked the food. The kitchen was inspected and the fridge’s and freezers had a good stock and variety of food. Westport Care Centre G57 G06 S10309 Westport Care Centre V244355 150805 Stage 4.doc Version 1.40 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Complaints are handled properly and residents did have the confidence that their concerns were listened to and taken seriously. There was a Vulnerable Adult procedure that ensure that the people living in the home are protected from abuse. EVIDENCE: It was observed in the reception area that there was the last Commission for Social Care Inspection report and a complaints form. Policies and procedures documentation for complaints and one complaint looked at from a family member was fully documented and investigated. A member of staff spoken to was clear that any complaints were responded to. The minutes of a meeting for Carers was looked at, here families were able to express concerns with responses from the Registered Manager. There was also minutes of the Residents meetings, where concerns of the Residents were explored. The procedure for Vulnerable Adults was inspected and the home has its own internal procedure. Westport Care Centre G57 G06 S10309 Westport Care Centre V244355 150805 Stage 4.doc Version 1.40 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 There remains areas of the home that have offensive odours, especially around the ground floor of the home. EVIDENCE: It was noted during the tour of the home that there was an offensive odour, around the reception area and lounge area of the ground floor. The other three floors of the home were odour free and the cleaner was observed to be going around keeping rooms clean. The home is still reviewing its ironing equipment in accordance with the recommendation made at the previous inspection. Westport Care Centre G57 G06 S10309 Westport Care Centre V244355 150805 Stage 4.doc Version 1.40 Page 14 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29 and 30 The home operates a thorough recruitment procedure based on equal opportunities and ensuring the protection of residents. EVIDENCE: During the inspection staff files were looked at and two of the files inspected were for new members of staff. Two references were seen on the file and a current CRB issued for the appointment of these members of staff. All induction forms were seen and in place, but some of the forms were not complete. Staff files also showed that staff were being appropriately trained, a member of staff spoken to is now undertaking their NVQ. The staff member spoken to, said that they did not have the time to spend with the Residents that they would have liked to. Although the member of staff felt that there was enough staff to meet need, a little more time with the Service Users would be very beneficial. Westport Care Centre G57 G06 S10309 Westport Care Centre V244355 150805 Stage 4.doc Version 1.40 Page 15 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,35,36,37 and 38 The Manager is now Registered with the Commissions fitness procedure to manage the home. There are now systems in place to deal with Service User money, the system in place for supervision is not being used and documented. EVIDENCE: The Manager has now Registered with the Commission through the fitness procedure to manage the home. The Registered Manager was on holiday at the time of the inspection, the Team Leaders were covering and the Service Manager arrived during the inspection. The necessary procedures are now in place to deal with Service Users money, Residents are able to access their weekly allowance. The home encourage the Service Users to keep some money to cover the whole week, any excess is put in an account with the company.
Westport Care Centre G57 G06 S10309 Westport Care Centre V244355 150805 Stage 4.doc Version 1.40 Page 16 Procedure are in place for documenting supervision and the staff files looked at did have some supervision notes. However the supervision did not take place as often as the agreement had stated and some of the notes were very short, not covering areas that the agreement had stated. Westport Care Centre G57 G06 S10309 Westport Care Centre V244355 150805 Stage 4.doc Version 1.40 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 3 15 3
COMPLAINTS AND PROTECTION 1 x x x x x x x STAFFING Standard No Score 27 x 28 x 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x x x 3 1 3 3 Westport Care Centre G57 G06 S10309 Westport Care Centre V244355 150805 Stage 4.doc Version 1.40 Page 18 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15.1 Requirement Timescale for action 15/11/05 2. OP14 12 13.3 (b) 3. OP26 16(2)(k) 4. OP36 18(2) The Registered Person(s) must ensure that all service users files evidence an updated individual care plan. The previous target expired on 31/03/05 other previous 30/11/04 15/11/05 Registered Person(s) to ensure that any activities in which service users engage in are assessed for risks and that the servie users freedom of movement is limited only through the risk assessment process. The previous target expired on 31/03/05 other previous 31/12/04 The Registered Person(s) must 15/11/05 ensure that all the areas of the home are free from offensive odours. The previous target expired on 31/01/05 The Registered Person(s) must 15/11/05 ensure that all staff receive regular, formal supervision that is documented and that is available for inspection. The previous target for compliance with this
Version 1.40 Westport Care Centre G57 G06 S10309 Westport Care Centre V244355 150805 Stage 4.doc Page 19 Requirement expired on 31/03/05 and previous to that 30/11/04 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP9 OP26 Good Practice Recommendations The recording of medication is developed further. The inspector repeated for the second time the recommedation that the ironing equipment is reviewed. Westport Care Centre G57 G06 S10309 Westport Care Centre V244355 150805 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Gredley House 1-11 Broadway London E15 4BQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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