Inspection on 30/09/08 for Westwolds Care Centre

This inspection was carried out on 30th September 2008.

CSCI found this care home to be providing an Good service.

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

Westwolds Care Centre 31/10/06

Westwolds Care Centre 07/12/05

Westwolds Care Centre 12/07/05

Westwolds Care Centre 17/03/05

Westwolds Care Centre 23/06/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Westwolds Care Centre 4 Park Avenue Burton Joyce Nottingham NG14 5AF     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Claire Williams     Date: 3 0 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Westwolds Care Centre 4 Park Avenue Burton Joyce Nottingham NG14 5AF 01159313659 01159313769 westwolds@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Elizabeth J. Fletcher Type of registration: Number of places registered: Exceler Healthcare Services Limited care home 34 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: No one falling within category OP may be admitted into Westwolds Care Centre where there are 34 persons of category OP already accommodated within this home. To admit one named individual with dementia. The service user`s needs are to be reviewed six monthly with the social worker to ensure that the care staff are still able to meet the needs and that other service users are not being put at risk. When the service user`s contract is terminated for any reason the registration returns to its preexisting state. To be able to admit the named person under the age of 65 years into Westwolds Care Centre named in variation application number V37017 dated 20 November 2006. Date of last inspection Brief description of the care home Westwolds is a purpose built single storey home set in the quiet village of Burton Joyce. It can offer accommodation for up to 33 older people within the category of old age only. There are two people below 65 who have lived there for a number of years. Care Homes for Older People Page 4 of 27 0 Over 65 34 Brief description of the care home The accommodation is in single rooms with the exception of two doubles. All but six of the rooms have ensuite facilities; fourteen rooms have kitchenettes to enable independent living for those people who are able. The centre of the village is a short walk away and provides access to shops, churches, public houses, a coffee shop and a supermarket. Individuals can access public transport in the village, although there is a mini bus available, which belongs to the home. There is a very pleasant inner courtyard garden and a car park to the front of the building. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The inspection visit was unannounced and took place over a period of 8 hours. In order to prepare for this visit we looked at all of the information that we have received since our last visit which was undertaken on 31/10/06. This includes: Notifications, and information received from the service about events that have occurred. Annual quality assurance assessment (AQAA). This is a self assessment completed by the manager that focuses on how well outcomes are being met for people using the service. During the site visit case tracking was included as part of the methodology. This involved the sampling of a total of four people representing a cross section of the care Care Homes for Older People Page 6 of 27 needs of individuals within the service. Discussion were held with those individuals as able, together with a number of others about the care and services the home provides. Their care planning, and associated care records were also examined and their private and communal facilities inspected. Discussions were also held with staff about the arrangements for their deployment, recruitment, induction, training and supervision, and records examined to support the procedures in place. The current fees to live in this service range from 338 to 490 pounds per week. Information about what these fees cover are included in the statement of purpose and service user guide. What the care home does well: What has improved since the last inspection? What they could do better: We have not made any requirements following this visit. However we have made some good practice recommendations. These are in relation to the following: Ensuring the pre-admission documentation is inclusive to all people. Completing care plans in a person centred way, and to include residents social needs and preferences. Reviewing the hours of the activities staff member with a view of increasing these to enable this staff member to spend sufficient time with residents with high dependency needs. It would be beneficial for this staff member to access training specific to providing activities to residents with dementia and sensory impairment. Ensuring all required information is obtained when recruiting new employees. Care Homes for Older People Page 8 of 27 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assessed and have access to information to enable them to make an informed decision about moving into this service. Evidence: In the self- assessment the manager told us, all of the required documents are available for people to access. The brochure, activities and menus are sent out to all prospective people so they can be informed of the facilities available. They told us they encourage people to undertake trial visits, as this enables them to familarise themselves with the service. They told us they complete a comprehensive assessment before individuals move into this service. Residents told us they have received a copy of the statement of purpose and service user guide, which provides them with information about the service and their rights. Copies of these were available in the reception area. Care Homes for Older People Page 11 of 27 Evidence: Residents confirmed that had been assessed before they moved into this service and was reassured that their needs could be met. This was confirmed when we looked at four files, and all contained the required pre- admission information and assessments. The pre-admission documentation did not include reference to significant other, and only referred to marital status. This means it is not inclusive to all people. Residents told us they had the opportunity to visit the service for a trial visit. Some individuals did visit and stayed for a period of respite. One person told us I came and stayed for a few nights to test the home out . Individuals told us their admission experience was a supportive and positive one, making the decision to move into this service a little easier. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive the care they need and this is provided in a way that upholds their dignity. Evidence: In the self assessment the manager told us they aim to provide a warm, caring environment to meet the individual needs. They strive to ensure that individuals dignity and privacy is promoted at all times. They said that each person has a detailed care plan in place, which they are involved and consulted about. Information in the self assessment told us that each person has a variety of risk assessments completed to ensure any risks are identified and monitored. They said only senior staff administer medication and they have received training. They promote residents to manage their own medication whenever possible. All care files seen contained a care plan which had been completed in sufficient detail to enable the staff to deliver individualised care. Information had been recorded about Care Homes for Older People Page 13 of 27 Evidence: the persons background and about their likes and dislikes. Some information was recorded concerning individuals routines, preferences and hobbies which ensures the plan is holistic. However majority of this information is recorded upon the individuals admission to the service. This document is not then reviewed to ensure it still reflects the persons needs. There was evidence that all four care plans had been reviewed on a monthly basis in consultation with the individual. This ensures the plan reflects individuals current needs. Records are completed on a daily basis of residents well being and a satisfactory standard of recording was maintained. Each file contained risk assessments and risk management plans. This enables and directs staff on how to support residents in a way that will minimise any risks, and to monitor any key health care needs. Residents told us they have access to health care professionals, when they need them, and the records supported this. Discussions with staff members demonstrated they had a good understanding of each persons needs. They told us they regular check the care plan and are informed of any changes to residents needs. We observed staff reading care plans and talking with residents about the contents during our visit. The staff told us a key worker system is in place. Both the staff and residents spoke positively about this as it means they are able to spend quality time together on a one to one, which they enjoy. Residents told us they receive their medication in accordance with their wishes. Records were in place to support that medication was stored and administered as prescribed. Their was evidence in the staff files to support those that administered medication had received training. This ensures residents receive their medication safely. All residents and visitors spoken with told us that support is provided in a respectful and dignified manner. Comments made about the care include: the staff are very good and very caring, I think the care is really good and the staff are very helpful Im cared for very well, nothing is too much trouble for the staff they are a good team. In discussions with a staff member we were told that she was the designated champion for dignity co-ordinator. We were told that this means she monitors staff practices and the care provided to ensure residents dignity is maintained at all times which is good practice. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported to lead a lifestyle of their choosing, which ensures their recreational expectations are met by this service. Evidence: Information provided in the self - assessment identified the range of activities the service provides. The manager told us they consult residents about the provision available to ensure its meet their needs and to seek new ideas for future activities. All care plans that were seen contained some information concerning peoples social needs, likes and dislikes. As mentioned previously this information is obtained when individuals move into the service. There was no evidence in the files to support this information is reviewed and updated. Out of the four files seen only one contained a care plan about their social needs and how these should be met. Many individuals are able to verbalize their choices and preferences about how they wish to spend their day, but some residents are unable to. Therefore if this information is not recorded the staff will not be informed of individuals preferences. Care Homes for Older People Page 15 of 27 Evidence: Residents told us they had enough to do in the day and were satisfied with the provision of activities available. They spoke about many trips out and the variety provided. A colorful display is in the reception area, which contains many notices and information about activities available and informing people about future events. The activities co-ordinator is employed on a part time basis and we spoke with her about the provision of activities. She said she arranges the group activities and tries to spend time with people who have high dependency needs and those individuals who choose to remain in their room. However it was acknowledged that her time is limited as she works four hours each day and majority of this time if facilitating group work and planning events. This then leaves little time for one to one work. Visitors we spoke to and feedback from residents confirmed that they are welcomed into the service. Visitors told us the staff are always welcoming and helpful and very friendly and keep us well informed. Residents told us they enjoyed the food provided and that choices were always available. This was confirmed from our observations when we joined the residents for their lunchtime meal. Information is provided to the catering staff concerning dietary needs and individual preferences. Individuals that required support to eat their meal received this in a dignified manner. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are kept safe through effective complaints and safeguarding policy and procedures. Evidence: In the self assessment the manager told us a robust complaints procedure is displayed in the foyer where complaints forms are also available. The manager said she promotes an open door policy which both residents and relatives are aware of. She deals with any complaints promptly and uses them for continuous improvement. She told us staff are trained in whistle blowing and recognition of abuse. Residents told us they had no complaints and if they did they would raise them with the staff or manager. They said they had confidence that all issues would be addressed. Discussions were held with majority of the staff on duty and they told us they had received training on how to respond to complaints and safeguarding incidents. They demonstrated their knowledge and awareness in these areas, and certificates were available in their training files. The manager told us they had received some information about the Mental Capacity Act, and training for her had been planned. We were told that plans would then be Care Homes for Older People Page 17 of 27 Evidence: made for the staff to receive training so that they are aware of how this legislation impacts on they way they support residents. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The design of the building enables residents to live in a safe well maintained and comfortable environment which encourages their independence. Evidence: The manager told us in the self assessment about the facilities available in this service. She said they have good access to the local community and are well serviced by public transport. All corridors are fitted with handrails, these have small raised buttons on them outside each door so residents who are visually impaired can find their room easily by counting them. Residents we spoke with said they thought the building was homely and they liked the way the communal areas were decorated. They said they had enough space to move around in, and had handrails and equipment to assist them with their mobility. Residents showed us their bedrooms, which they had personalised. Some residents had their own key which we were told was their choice to keep or not. Residents have access to a secure garden area which they said is well used during the summer months. We were told a renewal programme was in place, and this included the toilets which Care Homes for Older People Page 19 of 27 Evidence: were in need of upgrading as they were not homely in design and looking worn. All areas we identified as requiring refurbishment was part of the renewal programme. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are trained and are provided in sufficient numbers to meet residents needs. Evidence: In the self assessment the manager told us has a stable staff group which ensures continuity of care. She said staff are trained to help them have the knowledge and skills to fulfill their roles within the home. Staff receive in house training by the home trainers who have been through a robust training course to ensure they are competent to provide this. This includes Manual Handling, Fire Safety, Food Hygiene, Nutrition, Continence, Customer Care and Abuse and Pova along with many others. Residents made many comments about the staff team and the care they receive, some of these included: the staff are great and always around, I never have to wait very long once I have used the call bell, the staff are very good they look after me very well, I think they work very hard and do a very good job, they are very caring. Residents told us their needs are met by the staff to a good standard, and they said they are well cared for. Staff members spoken to, told us they have enough time to do all of the required tasks expected of them in their respective roles. They said they get to spend quality time with the residents who they are responsible for in their role as a key worker, which Care Homes for Older People Page 21 of 27 Evidence: they enjoyed. The staff told us they have access to regular training which includes all of the mandatory areas, and well as optional courses. This was supported by the training matrix and the certificates in their files. We spoke to a new employee who told us their induction was good and equipped them with the initial skills and knowledge for their role. They said they felt supported during their induction and have been encouraged to apply for courses including a national vocational qualification (NVQ). The evidence provided in the self assessment demonstrated that 10 staff have completed an NVQ to a level 2 standard. We examined four staff files and the required recruitment information was available. This ensures staff are suitable to work with vulnerable people. There was some shortfalls identified in the staff files and these included: one file did not have a complete full employment history; an employment reference was not obtained from a staff members previous caring position; evidence was not available for all references to support they had been validated. During discussions about these shortfalls we were told they would be addressed and their practice improved. We received evidence after the our visit to confirm a full employment history had now been obtained. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is managed to promote and protect the health and safety of the residents and staff. Evidence: The manager told us in their self assessment they ensure the home is providing good value for money by ensuring the companies policy and procedures are followed and through effectively managing of budgets. They said they have an effective quality assurance system which is monitored by the manager, operations manager, operations director, estates manager and facilities manager. The manager told us the residents financial records are monitored by herself and the Home Administrator. These are recorded both electronically and on paper so that residents or their family/appointee have access to them. They said the staff are encouraged to follow safe working practices by ensuring they are aware of the homes policies and procedures, and have attended training in health and safety, COSSH etc. Care Homes for Older People Page 23 of 27 Evidence: Staff are also provided with staff hand books. The manager said she holds regular health and safety meetings and any trends in accidents are analysed. When we spoke with the residents and their families they told us the service was well managed and that the management team were approachable. They had confidence in the manager who they described as friendly. Evidence was available to support that residents are encouraged to voice their opinions about the service, through the provision of meetings, surgeries with the manager, and annual surveys. This ensures that the residents are consulted and involved in the way the service is run. A delegate of the provider undertakes monthly visits in order to monitor the standards in the service. However their was only three of the reports available at the time of our visit, for us to access. We received evidence after our visit confirming reports had been completed each month of this year. The staff team told us they felt supported in their role, and received good guidance and direction from the management team. A new system of supervision has now been implemented, as previously staff have not received this at the required frequency. As stated in the self assessment the staff team have access to training, and procedures to ensure they work in a safe way. Residents told us they have the choice to manage their own finances, but many said they have decided to place their money into safe keeping. We checked the systems in place and these were satisfactory. Evidence provided in the self assessment and from this visit demonstrated that the manager has a clear understanding of the key principles and focus of the service, working to continuously improve the service. The manager told us she aims to provide an increased quality of life for residents with a strong focus on equality and diversity and promotion of human rights. The self assessment was comprehensive and provided us with the information we wanted to support that the service is managed to protect and provide good outcomes for the residents that live here. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 The pre- admission assessment should be updated to include sexual orientation and significant other - to ensure it is accessible to all people. Residents care plans should be person centred and include their preferences and holistic needs and not just areas that individuals require assistance and support with. The contracted hours for the activities co-ordinator should be reviewed and increased to ensure time is available to meet all residents needs who live in the service. Each person should have a care plan about their social needs and preferences and these are to be met. All new employees should provide a full employment history with the day/month and year where possible. Any gaps should be explored and reasons recorded. When recruiting new employees a reference from their previous care related job should be obtained. All references should be validated. the activities co-ordinator should access training about providing activities for individuals with dementia and sensory impairments. 2 7 3 12 4 5 12 29 6 29 7 30 Care Homes for Older People Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - 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. 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