CARE HOME ADULTS 18-65
Westwood 55 St Helen`s Park Road Hastings East Sussex TN34 2JJ Lead Inspector
Jo Mohammed Announced Inspection 13th January 2006 09:00 Westwood DS0000021283.V268450.R01.S.doc Version 5.0 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 Westwood DS0000021283.V268450.R01.S.doc Version 5.0 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. Westwood DS0000021283.V268450.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Westwood Address 55 St Helen`s Park Road Hastings East Sussex TN34 2JJ 01424 428805 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) Hastings & Bexhill Mencap Society Mrs Joanne Wilson Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Westwood DS0000021283.V268450.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. The maximum number of residents to be accommodated is nine (9) The people accommodated will be between the age of eighteen (18) and sixty-five (65) years on admission That the home can continue to provide care and accommodation to a service user who was admitted over the age of sixty-five years on admission. 14th July 2005 Date of last inspection Brief Description of the Service: Westwood is a large two-storey detached property situated in a residential area of Hastings. Shops and transport links are close by. The home is registered to provide care and accommodation to nine people with Learning Disabilities. All service users have single bedrooms. There are currently no vacancies. The registered providers are Hastings & Bexhill Mencap Society. Westwood DS0000021283.V268450.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an announced inspection that took place between 9am until 2.15pm. A total of thirteen key standards were inspected. This report should be read in conjunction with the last unannounced inspection report dated 14th July 2005. Eight out of the nine service users were met during the course of the inspection; one service user was in hospital. A partial tour of the premises took place; discussions were had with the Manager and a staff member on duty. Time was also spent examining a selection of records. Prior to the inspection, The Commission for Social Care Inspection received a high percentage of feedback from service users and relatives via comment cards. What the service does well:
The types of written comments received by the Commission from service users said ‘Yes’ to the following list of questions such as: ‘Do you like living here’, ‘Do you feel well cared for’, ‘Do the staff treat you well’, ‘Is your privacy respected’, ‘Do you wish to be more involved in decision making within the home’ ‘Does the home provide suitable activities’ ‘Do you like the food’, ‘Do you feel safe here’, ‘If you are unhappy with your care, do you know who to speak to’. Comments made by service users who answered ‘No’ and in some instances ‘Yes’ to the same questions were shared with the Manager. Written comments received from relatives responded unanimously in saying ‘Yes’ to being satisfied with the overall standard of care and ‘Yes’ to a range of other questions about the running of the home. Any additional and specific comments made were shared with the Manager. Other general comments of praise made by relatives were that the home was: ‘Caring and well run’ and ‘Extremely happy with the care’. Service users spoken to all said they liked living in the home. They are involved in the general running of the home and assist staff in the preparation of the main meal as well as being provided with a varied menu. They spoke with enthusiasm about the activities they participated in; they’re lifestyles and how they were supported by staff according to individual need. From speaking to the Manager and a staff member on duty it was evident they showed good awareness and understanding of service users preferences, support needs and promoted independence. Opportunities to consult with service users is done as much as possible about a range of matters. The management, running and conduct of the home is good, a range of clear well-kept policies, procedures and records are maintained. The home is proactive in addressing and attending too requirements made as a result of inspections and they can be relied upon to address other matters raised during the course of inspections. The overall impression of this home is that it is well run and managed.
Westwood DS0000021283.V268450.R01.S.doc Version 5.0 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. Westwood DS0000021283.V268450.R01.S.doc Version 5.0 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 Westwood DS0000021283.V268450.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: There have been no new service users admitted to the home since the last inspection so it was not possible to assess admission practices and procedures. Key standard 2 will be inspected at future inspections should a new service user move into the home. Westwood DS0000021283.V268450.R01.S.doc Version 5.0 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: The key standards were not assessed on this occasion. Please refer to the last inspection report dated 14th July 2005 when they were all assessed. Westwood DS0000021283.V268450.R01.S.doc Version 5.0 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 16 & 17 Opportunities to attend educational, training centres are in place as well other meaningful activities. It was evident that service users rights and responsibilities are respected in the course of carrying out their daily routines. A range of varied meals are served that service users said they enjoyed. EVIDENCE: Service users described a range of educational, training and other activities they attended and participated in during the week. It was evident from speaking to service users that they’re rights are respected and responsibilities recognised in their daily lives. Service users spoke about some of the housekeeping tasks they were responsible for. It was evident that service users had freedom of movement around communal areas within the home. It was confirmed that a number of service users have their own bedroom and front door keys and their privacy was respected. Pets are permitted in the home and it was said mail was given to service users and not opened without their agreement. Westwood DS0000021283.V268450.R01.S.doc Version 5.0 Page 11 A daily diary is kept containing three menu choices for the main meal. This showed a good range of meal choices. It was said the menu is drawn up in conjunction with service users preferences and each day service users select which meal they would like to eat. Service users are involved to some extent in the preparation of meals, each person has a set day to assist in the preparation of food and take it in turns to go grocery shopping with staff assistance. There are also two service users who as part of their weekly routine independently go grocery shopping for the home every week. Pack lunches are currently prepared by staff which is a change to previous practices, it was agreed that on-going discussions with service users be had to determine if and when they would prefer to do this. Healthy eating information is displayed and special diets catered for. It was said meal times are fairly flexible including where service users can take meals. The dining room setting was pleasant and homely. Westwood DS0000021283.V268450.R01.S.doc Version 5.0 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 The personal and health care needs of service users are being met with ongoing monitoring in place. Medication practices and procedures that needed improvement have received attention and this is ongoing so as to ensure safe practices prevail. EVIDENCE: Westwood DS0000021283.V268450.R01.S.doc Version 5.0 Page 13 It was reported that service users require varying degrees of assistance and support from staff in carrying out their personal care and this was provided in a way that promoted service users privacy, dignity and independence. Staff hold the responsibility of being key workers to individual service users to ensure consistent and continuous support is provided. A member of staff met at the inspection gave a good account of this role. The health care needs of service users are assessed and recognised and access to healthcare professionals and services is made as and when required. All service users are registered with a General Practitioner and where necessary they are supported by staff to attend appointments. There are sufficient aids and adaptations to meet the current needs of service users residing in the home. One service user self-administers topical medication. A risk assessment for this practice is in place and a record kept of this medication. It was recommended the medication chart for this service user should clearly state which medication is self-administered. From the information supplied, records relating to the administration and dispensing of medication were found to be in order, stored safely and securely. Medication policies and procedures local to the home are in place. Since the last inspection yearly in-house competency training for staff in medication practices and procedures has been introduced. It was suggested the content of this competency training be checked with the Pharmacist from the CSCI to ensure it covered and incorporated all that was needed. All staff have also undertaken formal training in medication. Westwood DS0000021283.V268450.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 The home has satisfactory adult protection policies and procedures in place in order to guide staff. It is important that adult abuse training for staff is pursued so that they are well informed about how to protect and safeguard service users from abuse. EVIDENCE: Adult protection and Whistle-blowing policies and procedures, a copy of the local adult protection multi-agency guidelines and the Prevention of Vulnerable Adults guidance [POVA] was available in the home. At the last inspection a requirement was made for staff who have not had training in adult abuse to receive this training. It was reported this had not been achieved. This requirement will be carried forward. A policy and procedure for the management of service users monies was available. Westwood DS0000021283.V268450.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 The general standard of décor in the home was satisfactory providing service users with a comfortable and homely environment. Further attention must be given to ensuring chemicals are stored securely and safely and heating temperature levels monitored around some areas of the home so that a safe and warm environment is maintained. EVIDENCE: A partial tour of the premises was carried out and on the whole the home was found to be comfortable, clean and satisfactorily maintained. Since the last inspection the Manager reported a builder had looked at areas in the home particularly where the inner walls near a ground floor bathroom have bubbled patches, it was said at the current time no work was needed although this situation would be monitored. A planned maintenance and renewal programme for the fabric and decoration of the premises was available. It was noted there were some rooms around the home that were cold and further attention should be given to ensure heating temperature levels are sufficiently maintained. The steps leading up to the front door were cracked in places and will soon require attention. Westwood DS0000021283.V268450.R01.S.doc Version 5.0 Page 16 The laundry room is located outside in a converted garage. This was found to be satisfactory in appearance with adequate equipment and hand-washing facilities in place. It was noted that yellow stains had begun to penetrate through a side wall; this should be monitored and addressed accordingly. Since the last inspection, infection control policies and procedures have been compiled. It was found that chemicals/cleaning products located in this room were not stored securely and it was said the same applied to chemicals kept in the home. These practices must be addressed as a matter of priority so that they are stored safely and securely. Since the last inspection there has been a change of practices in respect of service users accessing the laundry room and this was mentioned by service users during discussions with them. The Manager agreed to review this matter again and discuss at future house meetings with service users. Westwood DS0000021283.V268450.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 & 35 Good progress has been achieved in setting up a system to determine staffs training needs and monitor when refresher training is needed so that a competent and trained team of staff supports service users. EVIDENCE: Since the last inspection further progress has been achieved in respect of staff training. It was reported that two members of staff have completed their National Vocational Qualification [NVQ] at level 2 in care and are currently working towards their level 3. One person is nearing completion of their NVQ level 2 in care and another person is to commence this training in February. Staff files examined contained yearly appraisals and information showing training completed to date. Since the last inspection, an overall staff training and development plan has been compiled and attention has also been given to providing training for staff in manual handling and first aid. Westwood DS0000021283.V268450.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 & 42 The Manager is experienced, competent and suitably qualified to manage the home. A couple of health and safety matters require attention, otherwise good practices are followed and good progress has been made in determining and monitoring staffs training requisites. EVIDENCE: Westwood DS0000021283.V268450.R01.S.doc Version 5.0 Page 19 Since the last inspection the Manager has confirmed and clarified that their qualification in care and management meets the National Minimum Standards. The Manager demonstrated competence and experience in running the home. Service users spoken to expressed complimentary remarks about the staff team and management of the home. A staff member spoken too confirmed they liked working in the home and said there was good teamwork. The home has a range of generic risk assessments in place as well as individual ones for service users that are regularly reviewed. Fire records, fire drills, training in fire safety and a current fire risk assessment was available and in order. Since the last inspection, staff have attended refresher training in manual handling and First Aid. All staff have previously completed food hygiene training. The accident book and a selection of health and safety records were examined and on the whole this was found to be in order. Details about Controls of Substances Hazardous to Health [COSHH] have been identified under standard 24. Hot water temperature checks are regularly carried out and from the information supplied these are maintained within safe limits. Wiring, gas and portable appliance checks are in order. Legionella checks are not in place and must be introduced. Westwood DS0000021283.V268450.R01.S.doc Version 5.0 Page 20 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score X 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X X X Standard No 24 25 26 27 28 29 30
STAFFING Score 2 X X X X X 2 LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X X 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Westwood Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 X X X X 2 X DS0000021283.V268450.R01.S.doc Version 5.0 Page 21 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA23 Regulation 13 [6] Requirement That all staff must receive training in adult abuse.[Previous timescale of 30th September 2005 not met] That Control of Substances Hazardous to Health must be stored safely and securely. That steps must be taken to monitor and maintain sufficient heating temperature levels in areas around the home that were found to be cold. That Legionella checks must be introduced. Timescale for action 28/02/06 2 3 YA30YA42 YA24 13 [4] 23 [2] [p] 13/01/06 13/01/06 4 YA42 13 [4] 13/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Westwood DS0000021283.V268450.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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