Inspection on 26/10/06 for Westward

This inspection was carried out on 26th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Westward 07/03/06

Westward 01/09/05

Westward 28/02/05

Westward 08/12/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Westward 2 Henty Avenue Dawlish Devon EX7 0AW Lead Inspector Susan Samways Unannounced Inspection 26th October 2006 11:00 Westward DS0000003857.V308995.R01.S.doc Version 5.2 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 Westward DS0000003857.V308995.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 Adults 18-65. 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. Westward DS0000003857.V308995.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Westward Address 2 Henty Avenue Dawlish Devon EX7 0AW 01626 867065 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) Mrs Cathy Hillidge Mrs Cathy Hillidge Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Westward DS0000003857.V308995.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 07/03/06 Brief Description of the Service: Westward is a large, detached house, in the seaside town of Dawlish. The home is situated within a residential area and has views overlooking the sea. The home is situated close to local amenities and services are easily accessible either on foot or by local public transport. The home is arranged over two floors and can be accessed by stairs. A double storey extension has been completed to a high standard. This has provided additional bedrooms with en-suite facilities. There are car parking facilities in Henty Avenue. The home provides accommodation which reflects the assessed needs as well as the choices/personal preferences of each resident whilst maintaining a homely atmosphere. Westward is registered with The Commission for Social Care Inspection to provide care for up to six adults with a learning disability, who may also have challenging behaviour. The Registered Person and staff team aim to provide each resident with 24hour care and support and assistance in developing their self-esteem and independence as far as is practicable. Fees range from £800 to £1500 depending on the assessed needs of each resident. Westward DS0000003857.V308995.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection which lasted for five hours. The registered provider/manager and the operations manager were present throughout the inspection. All the residents were away on holiday with staff and in their absence the opportunity was being taken to redecorate their rooms. Prior to the inspection a pre-inspection questionnaire, completed by the registered provider, was received as were survey forms from all five of the residents. During the inspection care plans, staff files and other records were examined and a member of staff who called in was spoken to. What the service does well: As the residents were all away on holiday at the time of the inspection it was not possible to speak to them. However, they had all completed survey forms and these indicated that they were happy living at Westward. They said that the staff treated them well, that they were listened to and that they knew who to speak to if they weren’t happy. They also said that they were able to choose how they spend their time but acknowledged that they had jobs to do around the house. Three said that their ability to choose what they did was dependent on whether they were well. Records showed that the residents are involved in the running of the home and are consulted about decisions which affect their lives. They are able to participate in a wide range of social, educational and independent living activities and are encouraged to maintain contact with family and friends. The assessments, care plans and risk assessments for each of the residents are detailed and informative and are regularly reviewed. Other professionals are involved in these as required. The manager is very experienced and the staff team is well trained. The recruitment procedure for new staff is thorough which safeguards residents. Staff receive regular supervision and annual appraisals. Westward provides residents with a homely environment which is well decorated and furnished. Residents choose the décor and furnishings for their own rooms. The residents said that the home is always clean Westward DS0000003857.V308995.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Westward DS0000003857.V308995.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Westward DS0000003857.V308995.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3,4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A comprehensive assessment of prospective residents, a detailed Service Users’ Guide and the opportunity for trial visits provide sufficient information to enable all those concerned to make the decision as to whether Westward is an appropriate home for them. EVIDENCE: A new resident had been admitted since the last inspection. The registered provider/manager said that she had been approached by the resident’s parents and that the resident had spent a few holidays at Westward over a period of about a year before the offer of a permanent place was made. She also said that the other residents were asked if they were happy about them moving in. The resident stated in their completed questionnaire that they had spent time at Westward, that they had had sufficient information about the home and that it had been discussed with them whether Westward was the right home for them. Westward DS0000003857.V308995.R01.S.doc Version 5.2 Page 9 The files for two of the residents were examined one of which was the new resident. Westward has its own assessment which had been completed and reviewed and included information from other sources such as GP and social services. The new resident’s file contained a detailed assessment from their local social services department and information from the resident’s parents. The home’s assessment and care plan were still being completed as the registered provider stated that they allow at least six months to get to know a new resident. The registered provider was very clear about the care the home is able to provide and therefore the nature of the residents for whom they could provide support and this is reflected in the Statement of Purpose and the Service Users Guide. Records showed that staff training is focused on these areas and all staff are expected to complete a course of study regarding challenging behaviour. Westward DS0000003857.V308995.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that their care plans clearly identify their needs and how they will be met. Residents are encouraged to participate in all aspects of the running the home. EVIDENCE: The files for two of the residents were examined. These were well organised into sections so information could easily be found. The sections included a profile of the resident, assessment, care plan, risk assessments, daily records, medical history, family history and a record of events and incidents. The care plan and risk assessments are regularly reviewed. The frequency of the reviews is determined by the activity concerned and the response of the Westward DS0000003857.V308995.R01.S.doc Version 5.2 Page 11 resident. They can vary from weekly to six monthly, the interval before the next one being agreed at each review. The care plans include the residents’ daily routines, the activities they participate in, their preferences and the support they will require and how that will be managed. A daily diary is completed for each resident including any GP or consultant appointments and any other health events. Records showed that residents are encouraged to make decisions about their lives and the level of support to be given to enable them to do this. The registered provider was able to give examples of situations when residents’ behaviour was unacceptable and detrimental to their or others well-being and the action that had been taken to address it. Residents stated in their completed questionnaires that they have choice as to how they spend their time. Some acknowledged that this is restricted when they are not well. They also stated that they participate in the day-to-day running of the home and a rota for jobs around the house was seen on the kitchen wall. Records confirmed that there are regular, documented meetings involving residents and staff regarding life in the home. Part of the philosophy of care at Westward is to enable residents to be as independent as is practical, within the scope of individual assessed care needs and care plans. Records and assessments seen confirmed that residents are supported in taking risks. Detailed risk assessments have been completed for all potentially hazardous activities and these identify the level of support or intervention by staff which is required to minimise the risk and promote residents’ independence. These are regularly reviewed at a frequency determined by the level of risk and the resident’s behaviour. All risk assessments and reviews are kept in the residents’ files. Westward DS0000003857.V308995.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good staff support enables residents to access social, educational and work opportunities both in the home and in the local community and to develop independent living skills. EVIDENCE: Residents are encouraged by staff to participate in activities which will assist in developing their social, emotional, communication and independent living skills. This was evident from the care plans and risk assessments seen in the residents’ files. One resident works in the local authority gardens while others attend a local college for courses such as healthy living, cookery, money management, using public transport and arts and crafts. Good use is also made of community facilities such as the library, cinema, theatre and leisure Westward DS0000003857.V308995.R01.S.doc Version 5.2 Page 13 centre as well as going to the shops, the pub and attending any special events in the town. Residents are also encouraged to take part in physical activities such as swimming and cycling. At the time of the inspection all the residents were away on holiday. A member of staff who had been with them for the first part of their holiday said that they were enjoying it and that it was good to see them in a different environment. The member of staff also commented that Westward was a positive place for the residents to live and that they were encouraged to make the most of the opportunities they had. The residents’ files include information about their family and friends and the assessment process includes the degree of involvement they wish to have with them. Discussion with the registered provider showed that the importance of supporting the residents to maintain positive relationships with their family and friends is recognised and residents are encouraged to maintain family contacts. The registered provider stated that residents’ family and friends are welcome to visit and that visits could be in private if they wished. Residents are encouraged to practise independent living skills. As well as attending appropriate college courses each resident has an agreed rota listing their responsibility for tasks such as cleaning communal areas and individual bedrooms, doing the laundry and assisting with food preparation and cooking. Records showed that residents are actively involved in all aspects of the provision of meals. They take it in turns to choose the meals for a day. They are then supported by staff according to their level of ability to plan the menu, budget and shop for the ingredients, prepare, cook and serve the meals. One resident, when well, can cook a whole meal independently, just requiring confirmation from staff that it is fully cooked. One of the residents has a visual impairment and they have their own equipment for use in the kitchen. Residents’ nutritional needs are assessed and regularly reviewed and any risk factors are recorded in individual care plans. Westward DS0000003857.V308995.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive care and support and have their health care needs met in a way which promotes privacy, dignity and independence. EVIDENCE: The registered provider stated that limited assistance with personal care is required by the current residents although prompting is sometimes needed. However, more help is required if they are not well, the extent of which is determined by staff as when they are not well the residents do not necessarily recognise that they need assistance. Times for getting up in the morning were seen to be flexible although the registered provider stated that prompting is given if a resident has an early appointment to attend. Records showed that all residents are registered with a G.P. and access other local health services as required. The registered provider stated that residents Westward DS0000003857.V308995.R01.S.doc Version 5.2 Page 15 are encouraged to manage their own healthcare but support to attend appointments is provided if requested or identified through a risk assessment. Medication is all kept in a locked box in the staff office. Records are kept of all medication received, administered and leaving the home or disposed of to ensure that there is no mishandling. An individual record is kept for each resident of current medication. At the time of the inspection no resident was self-medicating. The registered person has completed written risk assessments for each individual resident, kept on their individual care plans, as evidence to support this decision. Westward DS0000003857.V308995.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents know how to make a complaint and are confident that they will be listened to. Staff training in the protection of vulnerable adults protects residents from abuse. EVIDENCE: All the residents had completed a survey about their life at Westward. In it they said that the staff treated them well, that they felt listened to and that they knew how to make a complaint. One said that there was information about how to make a complaint in their room. The registered provider stated that no formal complaints had been received in the previous 12 months. Dayto-day problems are sorted out as they arise. No complaints about Westward have been received by the Commission for Social Care Inspection in the last year. The home has policies and procedures regarding the protection of vulnerable adults, a copy of the Alerter’s Guide and the ‘No Secrets’ video. All staff are required to watch the video and discuss the content. Since the last inspection all the staff have attended training in recognising abuse of vulnerable adults. Westward DS0000003857.V308995.R01.S.doc Version 5.2 Page 17 There are also policies and procedures regarding the management of physical and verbal aggression by residents, risk assessments for identified potential problems and detailed records of any incidents that occur and the action taken particularly if this has involved the use of physical interventions. The use of different interventions is agreed with relevant professionals and forms part of the care plan. All staff are expected to undertake training in managing challenging behaviour. All residents have support in managing their finances. Each resident has either a bank account or a savings account and sign for any transactions. Their personal allowances can be held in individual lockable boxes which are stored for them if they wish. Most have this arrangement, one resident does when not well and therefore not able to manage. Residents sign for money taken from the boxes and receipts and records for all major purchases are kept. Westward DS0000003857.V308995.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,26,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Westward provides residents with a homely, comfortable and safe environment in which to live. EVIDENCE: At the time of the inspection all the residents were away on holiday and the registered provider and the operations manager were redecorating the residents’ bedrooms. They stated that the residents had chosen the décor and furnishings for their rooms. The new resident had chosen new furniture for their bedroom and this was due to be ready on their return from holiday. The home is decorated and furnished in a homely way. The communal space includes lounge, dining room and games room as well as a large kitchen and utility room which has a domestic size washing machine and tumble dryer. Infection control policies and procedures are in place and records show that staff receive appropriate training. Westward DS0000003857.V308995.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff have the skills, training and understanding to meet the needs of residents. EVIDENCE: The home has a core team of experienced staff who provide care and support for the residents. Since the last inspection no staff have left but two new staff have been recruited which has eased the pressure on the registered provider who had been working long hours to ensure adequate staff cover. Two staff files were examined which showed that a good recruitment procedure had been followed. This included a completed application form, two references, proof of identity and police check. The questions asked at interview were also recorded and the registered provider said that these included questions from residents. Records showed that staff have followed a detailed induction programme and completed basic training including manual handling, First Aid, food hygiene and Westward DS0000003857.V308995.R01.S.doc Version 5.2 Page 20 infection control. All staff have had training regarding recognising abuse of vulnerable adults and were due to have training in breakaway techniques three weeks after this inspection. One member of staff is undertaking NVQ level 2 in care, others have already achieved it and two have level 3. Staff receive regular formal supervision from the registered provider, which is recorded, but it was also stated that other sessions can be arranged on request. All staff have annual appraisals. A member of staff spoken to said that they enjoyed working at Westward and that they felt well supported. Westward DS0000003857.V308995.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can have confidence that the home is well run and that staff are trained in safe working practices. EVIDENCE: The registered provider also fulfils the role of the registered manager. She is an experienced registered nurse and has many years experience of running care homes. Throughout the inspection she demonstrated an in depth knowledge of the requirements for running a care home and clearly knew the residents very well. A member of staff described her as very supportive. Westward DS0000003857.V308995.R01.S.doc Version 5.2 Page 22 The home has a quality assurance policy and the registered provider was able to describe how quality monitoring is carried out in the home. These include informal feedback from residents which is dealt with immediately taking into consideration the effect decisions might have on other residents, formal feedback through the use of surveys, the views of relatives and other interested parties and the regular review of policies and procedures. The results of surveys need to be shared with all interested parties including the Commission for Social Care Inspection. The home has a comprehensive Health and Safety policy, which ensures that, as far is reasonably practicable, the health, safety and welfare of both residents and staff are protected. The registered provider has completed environmental risk assessments. Fire Safety checks are made at the required intervals and recorded in a logbook and all fire alarms are checked weekly, recorded and signed as checked. Annual fire safety training sessions are provided for all staff including the registered provider and annual checks on all fire equipment are carried out. Gas safety checks were completed 21/08/06. Training records confirmed that staff have had training in fire safety, manual handling, food hygiene, infection control, drug awareness, control and restraint and breakaway techniques, and COSHH (Control of Substances Hazardous to Health) awareness. Refresher training is arranged as required. Westward DS0000003857.V308995.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 x 2 3 3 3 4 3 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 3 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 2 x x 3 x Westward DS0000003857.V308995.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 YA39 Good Practice Recommendations The registered provider should ensure that the results of quality monitoring surveys are shared with all interested parties including the Commission for Social Care Inspection. Westward DS0000003857.V308995.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Westward DS0000003857.V308995.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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