Inspection on 20/06/06 for Westwinds

This inspection was carried out on 20th June 2006.

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

Westwinds 10/02/10

Westwinds 13/09/07

Westwinds 14/10/05

Westwinds 18/04/05

Westwinds 23/09/04

Westwinds 07/04/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE West Winds North Shore Workington Cumbria CA14 3YP Lead Inspector Nancy Saich Unannounced Inspection 20th June 2006 09:30 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 West Winds DS0000038992.V291300.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. West Winds DS0000038992.V291300.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service West Winds Address North Shore Workington Cumbria CA14 3YP 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) 01900 870880 Keycare Services Miss Alison Adair Care Home 14 Category(ies) of Dementia (3), Old age, not falling within any registration, with number other category (11) of places West Winds DS0000038992.V291300.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home is registered for a maximum of 14 service users to include: up to 11 service users in the category OP (Older People not falling in any other category) The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 14th October 2005 Date of last inspection Brief Description of the Service: West Winds is situated in a residential area of Harrington. It is near to the harbour and within walking distance of the village amenities. The home has been adapted and extended to provide residential care for up to fourteen older adults, three of whom may have dementia. Keycare Services, who also operate three domiciliary care agencies in Cumbria, owns the home. The previous manager has left the home and a new manager; Maude Wilson is in the process of registering with the Commission for Social Care Inspection. Information about the service may be obtained from the home. Charges are as follows: Older Adults £ 317 to £385 per week. Older Adults with dementia £ 422 per week. West Winds DS0000038992.V291300.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the ‘key inspection’ for the home. Nancy Saich the lead inspector sent out questionnaires to residents and visitors and also visited the home. During the visit she spoke to residents and to staff and looked around the home. She also looked at how settled residents were and how staff treated them. She read files and other documents that backed up what was said and what she saw. She judged that things had improved in the home and that the new manager was working steadily on improving the way the home operates. Residents in the home were generally very satisfied with the care and services provided. What the service does well: The home is good at making sure they only admit new residents who will fit in with the group of people who have Westwinds as their home. They make sure that they can care for new people properly before they come into the home. They give residents a chance to visit and plenty of time and information to make their decision. The home is good at making sure that residents get the right kind of health care. A number of people said their health was better since they came to the home. There were positive responses from doctors and nurses who come to the home. People with dementia get the right kind of support. The staff look after residents medicines properly. Staff were good at attending to the residents needs. One person who visits the home said “the staff are the nicest people…anything she asks for she gets and nothing is ever a bother to anyone…”. A resident said, “I have no complaints of any sort, every one is nice to me and helpful if I need something.” All the questionnaires said very similar things and no one had any problems with the staff team. Residents said they could spend their time very much as they wanted. Most people enjoyed the company of other residents but could spend time in their room if they wanted. They had different activities in the home and everyone spoke about a recent party to celebrate a hundredth birthday. The person whose day it was said “the home was bursting at the seams with all my friends”. They said they also went out to local tea dances and to church or to shop. The inspector saw photographs of parties and trips out and residents spoke about how much they enjoyed these. The home deals with complaints in a prompt and efficient way. No one had any complaints on the day. The home is staffed with well-trained and well-motivated staff. There are always two carers on each shift and the residents think that this is a good ratio. The new manager had taken on some new staff and had done this correctly. West Winds DS0000038992.V291300.R01.S.doc Version 5.2 Page 6 The home is safe and well maintained. Things like food hygiene and infection control are being done correctly so that residents live in a safe and comfortable home. 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. West Winds DS0000038992.V291300.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection West Winds DS0000038992.V291300.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home now makes sure that they can meet the needs of new residents and that they will fit in with the existing group. EVIDENCE: The inspector met with two new residents and spoke to visiting relatives. They said that someone had visited them before they came to the home and that they had been encouraged to look around the home. The inspector also looked at the files for these residents and found very detailed assessments that helped staff decide that they could meet the person’s needs and that the new resident would fit in with existing residents. West Winds DS0000038992.V291300.R01.S.doc Version 5.2 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 the following standard(s): 7,8,9,10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The home needs to improve the way they plan how staff care for residents so that all the residents get the best possible care at all times. EVIDENCE: Every person in the home had very good plans that showed what he or she wanted. Residents knew about these ‘person centred’ plans and said they had been involved in writing them. They gave a good picture of the person when they first came to the home. The home keeps daily notes and also keeps a daily record of things that happen to the residents on each shift (this book is discussed under the standard about records). The staff use this book to alert each other about problems and issues for residents. This information needs to be part of the planning for care and the inspector could not find working plans that told staff exactly what to do for residents who had a change to the things they needed. The home needs to make sure that the care plans continue to show what people want but also show what people need. This is very important for all the West Winds DS0000038992.V291300.R01.S.doc Version 5.2 Page 10 residents but especially for people with dementia who cant tell staff if they are not doing it right! It is also important that plans are in place so that all staff approach problems and difficulties in the same way that the resident accept and that the manager of the home has agreed is the right way forward. Residents themselves said that they were happy with the way they were cared for, as did relatives and other visitors who were seen on the day or who had returned questionnaires. Residents said they saw the doctor or the nurse when they needed. The inspector spoke to a district nurse on the day who was treating the residents and who came regularly. The community psychiatric nurse came to visit people with dementia or other mental health problems and who gave staff directions and support. Residents medicines were being looked after properly and the inspector found that the home used medicines wisely. They do not rely on powerful medicines unless they have had good advice from health professionals. The staff are trained in how to give medication and were seen doing it properly. Residents said that the staff were very helpful and kind and that “nothing was too much trouble for them”. The inspector watched the interactions between staff and residents and she thought the staff were kind and polite. Residents felt that they were treated properly and no one had any issues with staff. West Winds DS0000038992.V291300.R01.S.doc Version 5.2 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 the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home is good at providing residents with the kind of lifestyle they want and need. EVIDENCE: The inspection started just after nine in the morning and a number of people had already had breakfast but other residents were still in bed or getting ready in their own time. The residents said they got up and went to bed as they wished and that they could spend their days how they wanted. Most people like to spend time in the lounge and they said they were a friendly group of residents. Residents said they were treated as individuals and had the kind of life they wanted. They said they went out to local entertainments and to shop or just to go for a drive. The inspector saw photographs of a recent hundredth birthday party. The person whose birthday it had been said she had a ‘lovely day’ and that the ‘house was bursting at the seams’ with friends and relatives. There were also photographs showing a trip to the seaside and residents at a tea dance. The residents said they went out around the harbour on good days and could go to the pub for a drink if they wanted. West Winds DS0000038992.V291300.R01.S.doc Version 5.2 Page 12 Several people spoke about the vicar and the priest coming to the home and at least two people go out to church services. One person goes out every day to help out at a local business. There were lots of visitors in the home on the day and they all felt the manager and staff made them very welcome. The residents stated that they had enough choice in their lives and there was evidence that showed that staff did ask and offer different things to both individuals and to the whole group of residents. The new manager had some ideas about how she would give residents even more choices and options. She said she was looking at how things are done in the home and was going to ask the residents about whether they felt the home was run for their benefit. The inspector enjoyed a pleasant lunch with the residents. Everyone was very complimentary about the food in the home. They said they had the kind of meals they wanted and had plenty of choice. The inspector saw the cook asking people what they wanted for their meal. One or two people though that portions at meal times were a bit big. The manager said that she was going to look at ways that the residents could be supported in serving themselves with things like vegetables and sauces. The inspector will look at this again at the next visit. Apart from these minor things the inspector thought that residents were well fed with good quality foods. This showed in how well the residents looked and several people said that the food had helped them to feel better after they had come in to the home. West Winds DS0000038992.V291300.R01.S.doc Version 5.2 Page 13 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, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home is good at listening to residents and making sure they are protected from abuse. EVIDENCE: The inspector spoke to residents, visiting professionals and relatives. She also had responses from questionnaires that all fed into the judgement about these two standards. Residents said they could make complaints to the manager or to the directors of the company who visit regularly. They also said that if anything abusive was going on they felt that these people would deal with it properly. There had been one formal complaint received by the Commission for Social Care Inspection that the company was asked to investigate. They did this promptly and dealt with the issue that was proved to be true. Residents were very aware of what abuse might mean for them. One person explained what this was and later the manager used the same example. This showed the inspector that the manager talks to residents about their right to be safe and well treated. Staff had all attended training on protecting adults from abuse. The inspector spoke to one person about this in a lot of depth and she had a very good understanding of what it meant and how she would deal with it. No one had any complaints or concerns on the day. West Winds DS0000038992.V291300.R01.S.doc Version 5.2 Page 14 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): 19,21,26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Residents have a comfortable home that would be improved by new windows and by changes to one bathroom. EVIDENCE: Westwinds is in a residential area of Harrington. It is near to the harbour and the other village amenities. The home was originally two houses that have been made into one home. Keycare have improved the house by completely redecorating and by installing one new bathroom and a new kitchen and by adding on a new conservatory. Residents have the choice of three lounges that have connecting doors that can be opened for parties or entertainments. The residents make good use of these areas. There is one area with a TV; another with a music centre and the conservatory is the quiet area. West Winds DS0000038992.V291300.R01.S.doc Version 5.2 Page 15 Every resident has a single room and some rooms have ensuite toilet and wash hand basin. The residents were very happy with their rooms and said they were nicely decorated and furnished. The inspector looked at all of the rooms and thought that they were comfortable and had the right kind of furniture and fittings to make sure the residents had everything they needed. Bed linens were clean and fresh. Residents said that the home was always clean and they were happy with the way the staff looked after their clothes. The company have put a new laundry into the home with washing machines that can deal with soiled linen. They have very good systems for dealing with infection and this makes the home clean and fresh in all areas. The home is very near to the sea and has double-glazed windows. These are now getting past their best and some of the seals have broken. This means that they are not so efficient at keeping heat in and that there are at least three windows that residents cant see out of. The home has two bathrooms. The downstairs bathroom is comfortable and easy to use. The upstairs bathroom doesn’t get used very much as it is difficult to move around in. The company need to make sure that this bathroom is upgraded so that it becomes easier for all residents to use. West Winds DS0000038992.V291300.R01.S.doc Version 5.2 Page 16 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): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home has enough suitably trained staff to give the residents good levels of care EVIDENCE: The inspector looked at the rosters for staff and spoke to the residents and staff about the ratio of staff to residents. Each shift has two carers; there is also one person who does domestic work, a maintenance person and people who cook the main meals. The staff and residents thought that these levels were good enough to make sure that everyone got the right kind of care and that they were well fed and that the house was clean and well kept. The inspector checked on the most recent recruitment in the home. All of the people who had been taken on had been checked that they did not have a criminal record or that they hadn’t been sacked from another care home. They had taken the right kind of references and had made sure these staff were fit and well. The inspector made a minor suggestion about how this was done and the manager took this on board for future recruitment. The staff said they had completed their National Vocational Qualifications in Care and there was evidence to show that new staff were going to be registered to do this. West Winds DS0000038992.V291300.R01.S.doc Version 5.2 Page 17 The manager had sent copies of staff training records before the inspector visited and these showed that there were plans in place to give the staff the kind of training that would help with their work with the residents. Staff were eager to learn and keen to understand the needs of their residents. West Winds DS0000038992.V291300.R01.S.doc Version 5.2 Page 18 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, 33,34, 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 still need to complete some work on management arrangements that will give the residents good quality services. EVIDENCE: The home has had a manager vacancy for some time. A longstanding member of Keycare has now been appointed as manager. She is applying to the Commission for Social Care inspection to be the registered manager. She is experienced in looking after older people and in supervising staff and has already started to have an influence on how the home is run. Residents and staff find her to be very easy to talk to and they have quickly developed a lot of trust in her ability. West Winds DS0000038992.V291300.R01.S.doc Version 5.2 Page 19 Keycare were asked at the last inspection to provide a report about how they look at what residents see as ‘quality’. The manager and the director of the company who were in Westwinds on the day of the visit said that they were still working on this and the inspector agreed to give them a little more time to do this. As part of this someone from the company must visit the home unannounced every month and prepare a report about how things are in the home. This has not been happening recently and the inspector had made a requirement about this at the last inspection. It is important that the company do this so they have a record of how things are going and so they can send the evidence of their progress to the inspector. The inspector did find evidence that the staff ask residents their opinion and that they check that all the systems that make the home run smoothly are in order. They now need to pull all this information together to make plans for the future of the home. The inspector checked the money that residents ask the manager to look after for them. This was in order. The staff in the home are given the chance to sit down with the manager or one of the directors of the company to talk about how they do their work and the training and development they need to improve the way they do it. The inspector gave the new manger one or two ideas about how this system might be adapted a little to include more specific details about residents. During the visit to the home the inspector read all the residents files and talked to them and to the staff. She found that although most things that happened were in each resident’s file the staff were also keeping a book that had lots of care details about residents recorded alongside messages about the home and the staff. Some of these things weren’t in the care plans. Keycare need to make sure they keep residents information properly in their own files. The inspector also checked on all the safety systems in the home. They are good at making sure that fire safety, food hygiene and routine maintenance are all in order. The home has some very good systems in place and staff are happy to follow these to give residents a safe and comfortable home. West Winds DS0000038992.V291300.R01.S.doc Version 5.2 Page 20 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 X X 3 X 3 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 2 X X X X 4 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 2 2 3 3 2 3 West Winds DS0000038992.V291300.R01.S.doc Version 5.2 Page 21 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 OP7 Regulation 15 Requirement The care plans for all residents must be updated and must show staff how to deal with any problems or any unmet needs. The registered person must replace at least three doubleglazed windows. Keycare must ensure they have a manager who is registered with the Commission for Social Care Inspection. Keycare must complete an audit of the home’s quality systems by the due date. (This is an outstanding requirement from 30/11/05 that has been extended) Keycare must provide an up to date business and financial plan showing future plans for the home that reflect the wishes and needs of the residents. (This is an outstanding requirement from 30/11/05 that has been extended) It is required that Keycare resume their monthly visit reports that show how the home is operating. (This is an DS0000038992.V291300.R01.S.doc Timescale for action 01/09/06 2 3 OP19 OP31 23 (2) (b) 8 01/09/06 01/09/06 4 OP33 24 01/09/06 5 OP34 25 01/09/06 6 OP37 26 01/09/06 West Winds Version 5.2 Page 22 7 OP37 17 (1) outstanding requirement that must be dealt with as soon as possible) The ‘day book’ must no longer be used to write details of residents care and person needs. 01/09/06 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 OP21 Good Practice Recommendations It is recommended that Keycare prepare a plan that shows how they will improve the upstairs bathroom. West Winds DS0000038992.V291300.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: 0845 015 0120 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 West Winds DS0000038992.V291300.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!