CARE HOMES FOR OLDER PEOPLE
Westport Care Centre 24-26 Westport Street Stepney London E10RA Lead Inspector
Seka Graovac Unannounced Inspection 3rd May 2006 09:00 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 Westport Care Centre DS0000010309.V291082.R01.S.doc Version 5.1 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.V291082.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Westport Care Centre Address 24-26 Westport Street Stepney London E10RA 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) 020 7790 1222 020 7423 9701 Ferrolake Ltd Basilide Sonia Ramier Care Home 44 Category(ies) of Old age, not falling within any other category registration, with number (44) of places Westport Care Centre DS0000010309.V291082.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 22nd December 2005 Brief Description of the Service: Westport Care Centre is a registered residential care home that caters for 44 older people 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. All bedrooms have en-suite toilet and shower facilities. Forty bedrooms are single and two bedrooms are registered as double. A range of communal areas including two smoking rooms and a patio garden are available. Parking is available underneath the building. The home is conveniently situated close to public transport and other local amenities. The Registered Provider is Excelcare holdings that owns and manages several other registered care homes in the area. Westport Care Centre DS0000010309.V291082.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and lasted approximately five hours. The previous inspection had been conducted in December 2005 and at that time ten requirements and two recommendations were made. The main aim of this inspection was to assess the home’s progress towards securing a full compliance with the key National Minimum Standards for Care Homes for Older People and Care Homes Regulations. The inspector had a tour of the premises. She met with many service users and the staff on duty and had short conversations with them. She checked the home’s records, such as: staff and service users’ individual files, health and safety related documentation and other records. The Registered Manager arrived soon after the inspection started and the inspector engaged in various discussions with her about the procedures and practices at Westport Care Centre. What the service does well:
Copies of the updated and comprehensive Statement of Purpose and Service User’s Guide were available at the reception of the home. They contained appropriate information about the service provided at Westport Care Centre and were compliant with legislative requirements. The Registered Manager also stated that these documents were last time reviewed in April 2006 and that they were included in the home’s Welcome pack available in each bedroom. Weekly plans of activities were displayed in the main areas of the home indicating that there was something going on every day in the home. A special activities programme was also available showing that there were parties and special events organised as well, on a monthly basis. The special events included going to Hackney Empire to see a pantomime and a day trip to the seaside. Service users’ legal rights were protected. The Registered Manager stated that all service users were registered to vote and that the coming local election was discussed at the service users’ meeting. The home had appropriate complaints and safeguarding procedures in place. The service users who spoke to the inspector were positive about the care they received at Westport Care Centre. They expressed no concerns in their conversations with the inspector.
Westport Care Centre DS0000010309.V291082.R01.S.doc Version 5.1 Page 6 Service users were adequately supported by the Centre’s staff who were thoroughly vetted. The inspector viewed individual staff files for one senior health care assistant, one health care assistant and one domestic staff. All of them contained two written references, identity records and Criminal Records Disclosures. Copies of staff training and qualifications certificates were also available in their files. Training plan for the home was in place. The inspector was informed that the organisation had a training manager. A staff member told the inspector that she was happy working at Westport Care Centre. What has improved since the last inspection?
Following the improvement meetings that the Commission for Social Care Inspection had with Excelcare, the inspector was told that an independent consultant was called in to work alongside the Registered Manager for a number of weeks and provide extra support and expertise in care management. The Registered Manager stated that another consultant did a full audit of Westport Care Centre’s compliance with the National Minimum Standards for Care Homes for Older People in March 2006. The home had a block contract with Tower Hamlets Social Services and their monitoring officers visited and produced the reports on a monthly basis. So the home has had a lot of input from various sides since the previous inspection. The inspector would like to recognise a significant improvement made in the home’s ability to meet the National Minimum Standards. Business and development plan for the home was available emphasising further improvements. Out of twelve requirements that had been made at the previous inspection, the home successfully dealt with eleven of them. A report on service users’ satisfaction with the service at Westport Care Centres was displayed in the reception area. The inspector was also shown further evidence of positive feedback received from other stakeholders, such as: relatives and the General Practitioner of service users in the home. Regulation 26 provider’s reports were also available. The inspector checked files for two service users that lived at Westport Care Centre and also for one person that came to the home on a regular respite basis. All viewed files contained comprehensive care and support needs assessments. Westport Care Centre DS0000010309.V291082.R01.S.doc Version 5.1 Page 7 The viewed files also contained individual care plans signed by the service users themselves. The plans were regularly reviewed and audited. The Manager told the inspector that the home was trying to emphasise the positive aims of the care planning process and recognise even more the people’s abilities and independence. District nurses were in the home conducting continence assessments on the day of the inspection. The home had good relationship with the health services and facilitated service users’ good health and wellbeing. Since the previous inspection and the related requirement made, the home’s staff stopped making judgements about the wounds and made appropriate referrals to the district nursing services Viewed records of one-to-one meetings between the staff and their line managers indicated that the staff were appropriately supervised. Disciplinary actions were taken when it was needed. The office was well organised and the appropriate records were kept as required The inspector also checked health and safety related records and found them to be satisfactory. The home was free of offensive smell. What they could do better:
Quality of health and personal care at Westport Care Centre was compromised by the covert administration of medication practice in the home. The inspector was most concerned that the senior staff member administered medication to a service user without the service users’ knowledge. The staff explained to the inspector, that she hid it in this service user’s porridge as otherwise the service user would not want to take it. The covert administration of medication must stop! The Registered Manager was not aware of this practice in the home, although the staff member told the inspector, that this lady’s medication was always administered in that way. The service user had the appropriate care plan that indicated that the service user would be offered the prescribed medication and explained the consequences of not taking it, but the care plan was not followed at the time of the inspection. The Registered Persons must ensure that the appropriate medication administration practices are implemented at all times in the home. The prescribed medicine must not be administered covertly. In addition to the restated requirement regarding the home’s dealing with medication, four further breaches of legislation were identified at this inspection.
Westport Care Centre DS0000010309.V291082.R01.S.doc Version 5.1 Page 8 The inspector also recommended that the practice of healthcare assistants conducting pressure sore risk assessments by using the Waterlow form, originally standardised for the use by qualified nursing staff only is reviewed. Neither the staff or the Registered Manager knew what the medical diagnostic terms on this form meant. The inspector has engaged in an ongoing debate with the Excelcare about this issue following the inspection. The inspector made a requirement regarding raising a level of cultural and religious sensitivity related to food. The Registered Persons must ensure that service users are given more culturally sensitive information and choice about the food. The Registered Persons also must ensure that all opened packages of perishable food are labelled and dated. The inspector also recommended that catering staffing resources are reviewed and that the organisation considers increasing a number of catering staff on duty. One requirement and two recommendations were made regarding the environment. The Registered Persons must clear the basement parking facilities in interest of safety of people using it. The inspector recommended that the environment is further improved and developed for the benefit of service users and visitors. The inspector felt that the home had quite institutional feel and recommended that the management looks into ways to make it more homely and nicer for service users. The inspector also recommended that the home’s outside area is further developed. At the time of the inspection, that area was completely bare, without any plants, not even grass. It would be of great benefit to service users who rarely go out of the building, if this area could be developed into a real garden. The Registered Persons must ensure that the Registered Manager has the appropriate qualifications as required by legislation. She must commence the appropriate training by the end of this calendar year. 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 DS0000010309.V291082.R01.S.doc Version 5.1 Page 9 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.V291082.R01.S.doc Version 5.1 Page 10 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 (standard 6 not applicable) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home had appropriate information about its service available. The service users’ support and care needs were assessed prior to their admissions being confirmed. EVIDENCE: Copies of the updated and comprehensive Statement of Purpose and Service User’s Guide were available in the reception area of the home. They contained appropriate information about the service provided at Westport Care Centre and were compliant with legislative requirements. The Registered Manager stated that these documents were last time reviewed in April 2006 and that they were included in the home’s Welcome pack available in each bedroom. The inspector checked files for two service users that lived at Westport Care Centre and also for one person that came to the home on a regular respite
Westport Care Centre DS0000010309.V291082.R01.S.doc Version 5.1 Page 11 basis. All viewed files contained comprehensive care and support needs assessments. Westport Care Centre DS0000010309.V291082.R01.S.doc Version 5.1 Page 12 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. Quality of health and personal care was compromised by the covert administration of medication practice in the home. EVIDENCE: The inspector viewed individual service users’ files for three people and found that they had comprehensive individual care plans signed by the service users themselves. The notes also included the information about the service users’ wishes regarding their death. The plans were regularly reviewed and audited. The Manager told the inspector that the home was trying to emphasise the positive aims of the care planning process and recognise even more the people’s abilities and independence. District nurses were in the home conducting continence assessments on the day of the inspection. The home had good relationship with the health services and facilitated service users’ good health and wellbeing. Since the previous inspection and the related requirement made, the home’s staff stopped making
Westport Care Centre DS0000010309.V291082.R01.S.doc Version 5.1 Page 13 wound assessments and made the appropriate referrals to the district nursing services. However, the healthcare assistants were still using nursing assessment forms such as Waterlow, originally standardised for the use by qualified nursing staff only. The inspector recommended that this practise is reviewed. Neither the staff or the Registered Manager knew what the medical diagnostic terms on Waterlow form meant. The inspector has engaged in an ongoing debate with the Excelcare about this issue, following the inspection. However, the inspector was most concerned that the senior staff member administered medication to a service user without the service users’ knowledge. The staff explained to the inspector, that she hid the medicine in this service user’s porridge as otherwise the service user would not want to take it. The covert administration of medication must stop! The Registered Manager was not aware of this practice in the home, although the staff member told the inspector, that this lady’s medication was always administered in that way. The service user had the appropriate care plan that indicated that the service user would be offered the prescribed medication and explained the consequences of not taking it. The Registered Persons must ensure that the appropriate medication administration practices are implemented at all times in the home. The prescribed medicine must not be administered covertly. Westport Care Centre DS0000010309.V291082.R01.S.doc Version 5.1 Page 14 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. Service users were supported to live fulfilling lives and enjoy their meals. However, they must be given more culturally sensitive information and choice about the food. EVIDENCE: Weekly plans of activities were displayed in the main areas of the home indicating that there was something going on every day in the home. A special activities programme was also available showing that there were parties and special events organised as well, on a monthly basis. The special events included going to Hackney Empire to see a pantomime and a day trip to the seaside. Service users were having their breakfast when the inspector arrived. They seemed in a good mood and told the inspector that they enjoyed their cooked breakfast. They could choose how they wanted the eggs: scrambled or fried. Some of them told the inspector that the sausages were the best. Westport Care Centre DS0000010309.V291082.R01.S.doc Version 5.1 Page 15 The inspector visited the kitchen in the basement of the building. It was clean and well organised. A domestic assistant with an interest in cooking was acting up as a cook while the chef was on leave. She showed weekly menus to the inspector. She was cooking cottage pie with cabbage and cauliflower. The other option on the menu for lunch was tuna salad. She appeared rather busy as after having made cooked breakfast for everybody who wanted it, she had to prepare lunch for forty people. While she was pealing potatoes and talking with the inspector, several trolleys full of dirty dishes arrived from upstairs, for her to wash and put away. At the same time, a delivery of food arrived that she had to deal with. The inspector thought that it was rather a lot for one person to do. Perhaps, not surprisingly, under the circumstances, the acting cook was not very much aware of service users’ special needs. She knew that some service users were diabetic. While she was going to bake a pineapple turnover cake for other service users on that day, people who suffer from diabetes would always have a piece of fruit or a yoghurt, the inspector was told. The acting cook stated that nobody wanted halal or kosher meals or were on any other special diet. This was later contradicted by the Registered Manager. The Manager told the inspector that an elderly Muslim gentleman wanted to eat halal food. She also believed that all the meat bought by the home was halal, although she was not certain. She also stated that this had never been discussed with the service users. The inspector made a requirement regarding raising a level of cultural and religious sensitivity related to food. The Registered Persons must ensure that service users are given more culturally sensitive information and choice about the food. In addition to that, the inspector made another food related requirement as she found some opened packages of meat and cheese being stored together on the same shelf of the fridge unlabelled and undated. The Registered Persons must ensure that all opened packages of perishable food are labelled and dated. The inspector also recommended that catering staffing resources are reviewed and that the organisation considers increasing a number of catering staff on duty. Westport Care Centre DS0000010309.V291082.R01.S.doc Version 5.1 Page 16 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users’ legal rights were protected. The home had appropriate complaints and safeguarding procedures in place. EVIDENCE: The Registered Manager stated that all service users were registered to vote and that the coming local election was discussed at the service users’ meeting. The appropriate policies and procedures regarding dealing with complaints and potential protection issues were in place. The inspector was informed that there have been no protection issues raised since the previous inspection. The manager was dealing with the only complaint that has been raised since the previous inspection. A service user complained that she was made to wait too long for staff to help her. The Manager stated that the majority of staff did have recent POVA (Protection of Vulnerable Adults) training, and that more related training was scheduled for this year. The service users who spoke to the inspector were positive about the care they received at Westport Care Centre. They expressed no concerns in their conversations with the inspector. Westport Care Centre DS0000010309.V291082.R01.S.doc Version 5.1 Page 17 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The environment was fit for its purpose. However, the inspector recommended that it is further improved and developed for the benefit of service users and visitors. The basement parking facilities must be cleared in the interests of health and safety. EVIDENCE: The inspector parked her car in the home’s parking facilities in the basement. The parking was secured from the outside. However, it was very untidy and dangerously full of clatter and scattered various items that the home did not need any longer such as a hoover, broken wheelchairs, zimmer frames and other items. As the home is situated in an area with parking restrictions, it is likely that visitors who drive would have to use these facilities. In the past the inspector refrained from making a related requirement as she was told that it was rubbish awaiting to be collected. However, these collections seemed to
Westport Care Centre DS0000010309.V291082.R01.S.doc Version 5.1 Page 18 have never happened and over the years it has got much worse. The Registered Persons must clear the basement parking facilities in interest of safety of people using it. The inspector conducted a partial tour of the home. All areas seen were clean and free from mal-odours. However, the inspector felt that the home had quite institutional feel and recommended that the management looks into ways to make it more homely and nicer for service users. The inspector also recommended that the home’s outside area is further developed. At the time of the inspection, that area was completely bare, without any plants, not even grass. It would be of great benefit to service users who rarely go out of the building, if this area could be developed into a real garden. Westport Care Centre DS0000010309.V291082.R01.S.doc Version 5.1 Page 19 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users were adequately supported by the Centre’s staff who were thoroughly vetted. EVIDENCE: The service users made positive comments about the staff in their conversations with the inspector. The Registered Manager stated that the care team consisted of fifteen care staff. Seven of them have achieved a National Vocational Qualification (NVQ) level 2, three staff were working towards NVQ level 3 and one staff was studying to become a registered nurse. Copies of staff training and qualifications certificates were available in their files. Training plan for the home was also available. The inspector was informed that the organisation had a training manager. A staff member told the inspector that she was happy working at Westport Care Centre. The inspector viewed individual staff files for one senior health care assistant, one health care assistant and one domestic. All of them contained two written references, identity records and Criminal Records Disclosures.
Westport Care Centre DS0000010309.V291082.R01.S.doc Version 5.1 Page 20 Westport Care Centre DS0000010309.V291082.R01.S.doc Version 5.1 Page 21 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 37 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The home’s compliance with the key National Minimum Standards has significantly improved since the previous inspection. However, the Registered Manager must be appropriately qualified. EVIDENCE: The Registered Manager had two years of experience of care management. She had a Diploma in Accountancy, Access to Social Work training and NVQ in Care level 2. She was not qualified on appropriate level either in care or management. Further more, at the time of the inspection, she was not enrolled on any qualifying training. Westport Care Centre DS0000010309.V291082.R01.S.doc Version 5.1 Page 22 The Registered Persons must ensure that the Registered Manager has the appropriate qualifications as required by legislation. She must commence the appropriate training by the end of this calendar year. Since the previous inspection and the improvement meetings that the Commission for Social Care Inspection had with Excelcare, the inspector was told that an independent consultant was called in to work alongside the Registered Manager for a number of weeks and provide extra support and expertise in care management. The Registered Manager stated that another consultant did a full audit of Westport Care Centre’s compliance with the National Minimum Standards for Care Homes for Older People in March 2006. The home had a block contract with Tower Hamlets Social Services and their monitoring officers visited and produced the reports on a monthly basis. Regulation 26 provider’s reports were also available. A report on service users’ satisfaction with the service at Westport Care Centres was displayed in the reception area. The inspector was also shown further evidence of positive feedback received from other stakeholders, such as: relatives and the General Practitioner of service users in the home. So the home has had a lot of input from various sides since the previous inspection. The inspector would like to recognise a significant improvement made in the home’s ability to meet the National Minimum Standards. However, five requirements were made at this inspection and the home must continue to improve. Business and development plan was available emphasising further improvements. Viewed records of one-to-one meetings between the staff and their line managers indicated that the staff were appropriately supervised. Disciplinary actions were taken when it was needed. The office was well organised and the appropriate records were kept as required. This included the records of service users’ money that was held by the home. The inspector also checked health and safety related records and found them to be satisfactory. Westport Care Centre DS0000010309.V291082.R01.S.doc Version 5.1 Page 23 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 3 3 3 Westport Care Centre DS0000010309.V291082.R01.S.doc Version 5.1 Page 24 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13 Requirement The Registered Persons must ensure that the appropriate medication administration practices are implemented at all times in the home. The prescribed medicine must not be administered covertly. The previous target for the full compliance with this requirement expired on 31/01/06. The Registered Persons must ensure that service users are given more culturally sensitive information and choice about the food. The Registered Persons must ensure that all opened packages of perishable food are labelled and dated. The Registered Persons must clear the basement parking facilities in interest of safety of people using it. The Registered Persons must ensure that the Registered Manager has the appropriate qualifications as required by legislation. She must commence the appropriate training by the
DS0000010309.V291082.R01.S.doc Timescale for action 31/05/06 2. OP15 12 30/06/06 3. OP15 16 31/05/06 4. OP19 23 30/06/06 5. OP31 9 31/12/06 Westport Care Centre Version 5.1 Page 25 end of this calendar year. 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. Refer to Standard OP9 Good Practice Recommendations The inspector recommended that the practice of healthcare assistants conducting pressure sore risk assessments by using the Waterlow form, originally standardised for the use by qualified nursing staff only. Neither the staff or the Registered Manager knew what the medical diagnostic terms on this form meant. The inspector has engaged in an ongoing debate with the Excelcare about this issue following the inspection. The inspector recommended that catering staffing resources are reviewed and that the organisation considers increasing a number of catering staff on duty. The inspector felt that the home had quite institutional feel and recommended that the management looks into ways to make it more homely and nicer for service users. The inspector also recommended that the home’s outside area is further developed. At the time of the inspection, that area was completely bare, without any plants, not even grass. It would be of great benefit to service users who rarely go out of the building, if this area could be developed into a real garden. 2. 3. 4. OP15 OP19 OP19 Westport Care Centre DS0000010309.V291082.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection East London Area Office Gredley House 1-11 Broadway Stratford London E15 4BQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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