CARE HOMES FOR OLDER PEOPLE
Westwood Talbot Road Worksop Nottinghamshire S80 2PG Lead Inspector
Richard Ramsden Unannounced Inspection 17th November 2005 10:30 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 Westwood DS0000036258.V262062.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 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. Westwood DS0000036258.V262062.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Westwood Address Talbot Road Worksop Nottinghamshire S80 2PG 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) 01909 533690 01909 533691 Nottinghamshire County Council Mrs Melanie Anne Ward Care Home 60 Category(ies) of Dementia (15), Dementia - over 65 years of age registration, with number (15), Old age, not falling within any other of places category (60), Physical disability (15) Westwood DS0000036258.V262062.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. Out of the total number of beds (60), there will be 15 beds for DE 55 and over and/or DE(E) Out of the total number of beds (60), 15 may be used for PD 55 and over A maximum of 5 PD 55 years and over, only to be accomodated outside of the intermediate care unit Service users shall be within category OP Date of last inspection 3rd July 2003 Brief Description of the Service: Westwood is a purpose-built two-storey home which is owned by Nottinghamshire County Council and jointly funded by the local Primary Care Trust (PCT) in respect of the intermediate care unit, health care professionals are employed to work on that unit The home is registered to provide personal care and accommodation for 60 residents. 30 residents receive long-term care, 15 places are allocated for respite care and a further 15 beds for Intermediate care. There is a 20 place day centre attached, for which the manager has overall responsibility. The home is located on the outskirts of the centre of Worksop, where there are many facilities for shopping and socialising. There is a passenger lift providing access to the first floor, and the home is arranged in four separate units each having its own adapted bathroom, dining room, lounge and kitchenette. The grounds are pleasant and securely enclosed with perimeter fencing. Westwood DS0000036258.V262062.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was completed over one day and lasted for approximately 5 hours. It included the inspection of care and other records a discussion four residents, the homes manager and one team leader. A partial tour of the building was also completed. What the service does well:
The home is well managed and run in the best interests of the residents. There were many aspects of good practice highlighted in the main body of this report. The care plans viewed during this inspection were comprehensive and regularly reviewed in consultation with the individual residents. The information contained in the care plans enabled staff to ensure that they are always aware of what assistance and support each resident requires. The residents spoken with during the inspection said that the staff are the best thing about Westwood Care Home. They said that staff are always friendly and respectful and ensure that their privacy and dignity is respected at all times. To residents said that the manager is very approachable and that if they had any problems they are confident that she would deal with them swiftly and appropriately. People said that they enjoy the meals provided at the home, that there is always plenty of choice and that an alternative will always be provided if they do not want the food suggested on the menu. Three residents said that the home provides a good variety of activities and entertainment. One person said that he appreciates the opportunity to make decisions about his day-to-day life. The premises are purpose-built and well maintained. Residents have been encouraged to bring photographs ornaments and small items of furniture to personalise their bedrooms. None of the residents could think of anything that could be changed to improve the services provided by the home.
Westwood DS0000036258.V262062.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 DS0000036258.V262062.R01.S.doc Version 5.0 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 Westwood DS0000036258.V262062.R01.S.doc Version 5.0 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): 1. The information provided to prospective residents does not contain sufficient information to enable them to make an informed choice as to whether the home will meet their individual needs. EVIDENCE: At the time of this inspection the manager was in the process of reviewing the literature provided to prospective residents. The revised literature will contain the majority of required information, but must also include, details of staff qualifications and experience and how people can contact the Commission for Social Care Inspection. Westwood DS0000036258.V262062.R01.S.doc Version 5.0 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): 7,9,10. The care plans produced with individual residents provide sufficient information to ensure that staff are always aware of what support and assistance each resident requires. Some improvements must be made to the way in which medication is managed to ensure that the system is safe for the residents. Residents are treated with respect and their rights to privacy are upheld. EVIDENCE: The individual residents care plans viewed as part of this inspection contained appropriate information and are reviewed frequently enough to ensure that staff are always aware what support and assistance each resident requires. (This is good practice). Residents have signed their care plans to confirm that they have been involved in the planning and review process. One of the residents spoken with during the inspection said that his care plan had just been updated and that his key worker had discussed the changes with him.
Westwood DS0000036258.V262062.R01.S.doc Version 5.0 Page 10 Appropriate risk assessments had also been completed and were being reviewed on a regular basis. The inspector was informed that there is a central medication storeroom and that the temperature in this room is recorded on a daily basis. However medication is also stored in the office of each of the four units at Westwood Care Home. The temperature is not recorded in these rooms. The manager was informed that staff must record the temperature on a daily basis in all the rooms in which medication is stored. The temperature in these rooms must not exceed 25°C. The temperature must also be recorded in any bedroom where medication is stored, if the medication must states that it must be stored below 25°C. The medication Administration on Shrewsbury unit was assessed. The medication Administration records had been well maintained and the medication was stored appropriately. Several people administer their own medication and appropriate risk assessments have been completed. (This is good practice). The inspector spoke with one of the residents who administers his own medication. He stated that he appreciates being able to administer his own medication and showed the inspector where it is stored in a locked cabinet in his bedroom. There were some occasions where the receipt of medication had not been recorded and the staff were only recording the disposal of controlled medication. The manager was informed that staff must record receipt of all medication and that records must be kept showing how all medication has been disposed of when it is no longer required by the resident for whom it is prescribed. All of the residents spoken with during this inspection said that the staff are always friendly and respectful and that they ensure that their privacy and dignity is maintained at all times. The observed interaction between staff and residents was of a very good standard. Westwood DS0000036258.V262062.R01.S.doc Version 5.0 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): 15. The diet provided for residence is wholesome, well balanced and varied. EVIDENCE: The home has a five weekly rotating menu with a vegetarian choice at each mealtime. The manager stated that a new menu would be introduced once it has been discussed at a residents meeting. The residents participated in the development of the new menus. (This is good practice). The meal on the day of inspection appeared wholesome and nutritious. The vegetables were placed in serving dishes so that each resident could serve himself or herself. (This is good practice). One of the residents required in liquefied diet, each element of the meal had been liquidised separately to preserve flavour and appearance. (This is good practice). Two residents informed the inspector that they choose to have all their meals in their bedrooms and one person stated that if they do not want the food suggested on the menu an alternative would always be provided. Westwood DS0000036258.V262062.R01.S.doc Version 5.0 Page 12 One resident said that he appreciates the fact that his daughter has been able to have her Christmas lunch with him at the home for the last two years. Westwood DS0000036258.V262062.R01.S.doc Version 5.0 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): X None of these standards were assessed as part of this inspection. EVIDENCE: Westwood DS0000036258.V262062.R01.S.doc Version 5.0 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): 19,24,26. The purpose-built accommodation is maintained to a very good standard. Residents are very satisfied with their bedrooms, which they have been encouraged to personalise with photographs, ornaments and small items of furniture. At the time of inspection the home was clean and there were no offensive odours. EVIDENCE: A partial tour of the premises was completed as part of this inspection. The purpose-built accommodation is well decorated, comfortably furnished and maintained to a good standard. The gardens are attractive, fully enclosed and accessible to service users. All of the residents spoken with said that they are very satisfied with their bedrooms, they confirmed that they were encouraged to bring photographs, ornaments and small items of furniture to personalise their individual rooms.
Westwood DS0000036258.V262062.R01.S.doc Version 5.0 Page 15 People said that they could use their rooms at any time two people said they choose to have all of their meals in their bedrooms. The laundry was well equipped with suitable floor covering. At the time of inspection there were no staff in the laundry, and yet the door had been left open and cleaning materials had been left on the floor. This presented a health and safety risk to residents. The manager stated that there is another small laundry on the first floor and that the door to that room does not have a lock. The manager was informed that the door to the laundry must be locked when there are no staff in situ and that cleaning products must be stored safely at all times. The cleaning products were removed while the inspector was in the building. The home was appropriately clean and there were no offensive odours at the time of this inspection. The residents spoken with said that the home is always kept spotlessly clean. Westwood DS0000036258.V262062.R01.S.doc Version 5.0 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): 29. All staff files have the necessary documentation to ensure that residents are properly protected from harm and abuse. EVIDENCE: At the last inspection it was noted that staff files did not have all the information and documentation necessary to prove identity and protect vulnerable residents from harm and abuse. The files of the most recently recruited members of staff were checked as part of this inspection. The files each contained two written references, confirmation that satisfactory criminal records bureau checks had been completed and proof of the member of staffs identity. (This is good practice). The home is now in meeting this requirement. Westwood DS0000036258.V262062.R01.S.doc Version 5.0 Page 17 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): 33,35,38. The home is run in the best interests of the residents. Resident’s financial interests are safeguarded and well managed. The aspects of health and safety assessed during this inspection showed that residents and staffs health and safety are promoted and protected. EVIDENCE: The home participates in Nottinghamshire County Councils Quality Assurance System. An annual performance and development plan is produced from the information collated as part of the quality assurance system. The inspector was advised that the manager is in the process of implementing questionnaire to be completed by visiting professionals to ensure that their views are included in the quality assurance process. Westwood DS0000036258.V262062.R01.S.doc Version 5.0 Page 18 The records of resident’s finances were checked at random and had been well maintained. The manager stated that all residents are asked at the time of their admission if they would like to manage their own financial affairs. This is discussed again as part of the formal review process. Two of the residents spoken with during the inspection confirmed that they had been asked if they wish to manage their own finances. The homes Fire records were checked and had generally been very well maintained. However the records showed that the homes emergency lighting systems are not being checked each month. The Environmental Health Officer visited the home in February 2005 and there were no issues outstanding from last inspection. The environmental health officer checked the homes policies on legionella and records show that they were satisfactory. The homes water temperatures are being tested on a regular basis. All staff have received training in basic food hygiene and moving and handling. (This is good practice). 15 members of staff have up to date first aid qualifications and the manager ensures that there is a qualified first aid are on duty at all times. Westwood DS0000036258.V262062.R01.S.doc Version 5.0 Page 19 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 2 X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X 3 X 2 STAFFING Standard No Score 27 X 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X 2 Westwood DS0000036258.V262062.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? No Westwood DS0000036258.V262062.R01.S.doc Version 5.0 Page 21 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 OP1 Regulation 5 Requirement It is required that the literature supplied to prospective residents/their representatives includes:1.Details of staff qualifications and experience. 2.Details of how to contact the local CSCI office. It is required that staff record the temperature in the rooms in which medication is stored each day. The temperature must not exceed 25°C. The temperature must also be recorded in every bedroom where medication is stored, if the guidance states that the medication must be stored below 25°C It is required that the registered person ensures that the receipt and disposal of all medication is adequately recorded. It is required that the door to the laundry is kept locked when there are no staff in situ. Hazardous substances must be kept securely at all times. It is required that the homes emergency lighting is tested at least once each month. The results of the tests must be accurately recorded in the homes Fire records Timescale for action 02/01/06 2 OP9 13 (2) 17/11/05 3 OP9 13 (2) 17/11/05 4 OP26 13 (4) 18/11/05 5 OP38 23 (4) 17/11/05 Westwood DS0000036258.V262062.R01.S.doc Version 5.0 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. X Refer to Standard X Good Practice Recommendations None Westwood DS0000036258.V262062.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Westwood DS0000036258.V262062.R01.S.doc Version 5.0 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!
