Inspection on 20/07/05 for Westwood

This inspection was carried out on 20th July 2005.

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

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

Other inspections for this house

Westwood 06/01/09

Westwood 03/08/06

Westwood 17/11/05

Westwood 21/03/05

Westwood 26/11/04

Westwood 01/03/04

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Westwood Talbot Road Worksop Nottinghamshire S80 2PG Lead Inspector Linda Hirst Unannounced 20 July 2005 10:00 th 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 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 C53 C03 S36258 Westwood V238969 200705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Westwood Address Talbot Road Worksop Nottinghamshire S80 2PG 0190 953 3690 0190 953 3691 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Nottinghamshire County Council Mrs Melanie Ward Care Home - Local Authority 60 Category(ies) of De - Dementia 2 registration, with number OP - Old Age 58 of places Westwood C53 C03 S36258 Westwood V238969 200705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Service Users in the category DE may be under the age of 65. Date of last inspection 21/3/05 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 the 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 oustkirts of the centre of Worksop, where there are many facilities for shopping and socialising. There is passenger lift access to the first floor, and the home is arranged in four separate but linking units each having its own adapted bathrooms, dining room, lounge and kitchenette. All 60 bedrooms have full ensuite facilities. The grounds are being pleasant and are securely enclosed with perimeter fencing. Westwood C53 C03 S36258 Westwood V238969 200705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit involved one inspector who was at the home for half a day (including lunchtime). The main method of inspection used was called ‘case tracking’ which involved selecting three residents and tracking the care they receive through checking their records and discussion with them. The records of medication, complaints, staff files were inspected and three members of staff were interviewed as part of this visit. What the service does well: What has improved since the last inspection? The manager is now reporting all incidents to the Commission for Social Care Inspection as she is required to, this enables checks to be made to make sure residents are safe and well cared for. All staff have had training on the protection of vulnerable adults to make sure they are clear about their responsibilities to report abuse and protect residents. The care plans seen were detailed and thorough giving clear direction to staff about how to help residents. The two matters about Health and Safety and laundry arrangements have been referred to the Environmental Health Officer for them to make a decision about the arrangements at the home, this is more their role than the Commission for Social Care Inspection’s. Westwood C53 C03 S36258 Westwood V238969 200705 Stage 4.doc Version 1.40 Page 6 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 C53 C03 S36258 Westwood V238969 200705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Westwood C53 C03 S36258 Westwood V238969 200705 Stage 4.doc Version 1.40 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 standard(s) 3, 4, 6 The residents are properly assessed before admission to make sure they do not have to move unnecessarily. Intermediate care is well organised and managed and the service provided meets the needs of residents and promotes their independence. EVIDENCE: The person most recently admitted to the intermediate care unit was selected for “case tracking” to check that he had been properly assessed before admission. His care plan was not fully completed but there was enough information to guide the staff about his key needs, his background and his medical history. The document had been signed by the resident himself to indicate his involvement in its development. There was good evidence that the staff had properly assessed his need before agreeing to admission and that he is appropriately placed on the unit. There is an outstanding recommendation for staff to have further training on understanding Dementia and supporting people with challenging behaviour. The manager has been trying to access this but has not yet managed to Westwood C53 C03 S36258 Westwood V238969 200705 Stage 4.doc Version 1.40 Page 9 arrange the training. The evidence from staff interviews and records seen indicates that people with challenging behaviour are not accepted in the home and the staff feel confident supporting people with their current needs. One unit is purpose built for the provision of intermediate care, it has fully equipped kitchens and bathrooms for the purposes of assessment during the residents’ stay and before discharge. Occupational Therapists, Physiotherapists and network health care staff are employed alongside care staff, and they receive training and support to work on the unit in a way which enables residents to retain or regain independence skills. Referrals are made directly from a variety of agencies, and as can be seen above there is evidence of proper assessment before admission. The resident on the unit commented that the presence of Health service staff is reassuring and the mix of health and social care staff on the unit works well. Westwood C53 C03 S36258 Westwood V238969 200705 Stage 4.doc Version 1.40 Page 10 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 standard(s) 7, 8, 9, 10 Care plans are well written and give good detail about how staff should help residents with their needs. The residents’ needs are properly assessed, provided for and met. Medication practice is safe and ensures the residents have their medication as prescribed by their GP. Residents are treated with dignity and respect and their right to privacy is upheld. EVIDENCE: Care plans were inspected and these were well written. Recorded in the first person they contained very good detail about residents’ background, needs, wishes and preferences. The plans are person centred and there is evidence of residents being involved in their development and review. This was confirmed by those interviewed. One of the residents who was “case tracked” is very unwell and is cared for in bed. The person was lying comfortably in bed and confirmed the staff change Westwood C53 C03 S36258 Westwood V238969 200705 Stage 4.doc Version 1.40 Page 11 her position every two hours. There were drinks in adapted crockery by her bed side and the television was on. Care charts are in place and these evidence her fluid intake, comfort levels, positional changes and any oral or eye care given. They were consistently filled in and provide good evidence of the high level of care and support she receives. This resident has an Alpha Xcell mattress assessed for and provided by the District Nurse who visits regularly. There are excellent detailed plans in respect of her health needs and body maps are used to record any marks or sores she sustains. Residents interviewed were very satisfied with the arrangements for their health. The arrangements for medication were inspected. The storage arrangements were safe and secure and the medication records were properly maintained and well organised. Residents said that the staff bring them drinks to take their tablets with and check they have all been taken before leaving. Residents who were interviewed said the staff help them in a positive way that preserves their dignity and sense of self respect. They always knock before entering bedrooms and ask residents their opinions. This is followed through at meal times, vegetables which accompany the meal are placed on the table for residents to help themselves and they are asked if they would like sauces. Westwood C53 C03 S36258 Westwood V238969 200705 Stage 4.doc Version 1.40 Page 12 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 standard(s) 12, 13, 14, 15 Residents lead happy lives at the home, the routines are relaxed, preferences respected and contact with family, friends and the local community are encouraged. The food is varied, tasty and plentiful with a choice available for all meals, this promotes a well balanced diet for the residents. EVIDENCE: The care plans state the activities the residents enjoy and those interviewed said that they like playing BINGO, spending time with family and friends and going on trips out when these are arranged. Every unit organises its own activities and there is an outstanding recommendation to employ an activities organiser who could co-ordinate arrangements. In the absence of this the manager has arranged for the day service staff to offer some training/guidance to residential staff on providing activities to residents. The residents interviewed said that they could get up and retire when they like (one likes to lie in until late morning and goes to bed late). They can spend their day as they choose. Lunch was observed on one of the units, different choices were offered and residents helped themselves to vegetables and sauces. The atmosphere in the Westwood C53 C03 S36258 Westwood V238969 200705 Stage 4.doc Version 1.40 Page 13 dining room was pleasant and relaxed and residents sat chatting in groups. The residents who were interviewed expressed satisfaction with the food which they said is tasty, plentiful with lots of choice available. Westwood C53 C03 S36258 Westwood V238969 200705 Stage 4.doc Version 1.40 Page 14 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 standard(s) 16, 18 Complaints are well organised, investigated and responded to, concerns are taken seriously. The staff have a good knowledge and understanding of issues of abuse and this protects residents from harm or abuse. EVIDENCE: The complaints record was seen and the staff at the home follow two complaints procedures the Social Services Complaints procedure and the home’s own policy which meets the requirements of the Commission for Social Care Inspection. All complaints and concerns are very well recorded with evidence of investigation and action being taken. The records evidence that complaints are taken seriously and responded to properly. The residents interviewed knew they have a right to complain and were clear about the process. They said they would feel able to raise any issue of concern with the staff or manager. The staff confirmed that they have had training on the Protection of Vulnerable Adults (POVA) and those interviewed understood what constitutes abuse and their obligations to report and offer protection to residents. There have been no allegations of abuse in the past year at the home, and none of the staff have been referred to the POVA list to protect other vulnerable people in care. The residents interviewed said they had never experienced anything to worry or concern them in terms of how staff work with residents, but they would feel able to report any incident. They said they feel safe at the home. Westwood C53 C03 S36258 Westwood V238969 200705 Stage 4.doc Version 1.40 Page 15 Westwood C53 C03 S36258 Westwood V238969 200705 Stage 4.doc Version 1.40 Page 16 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 standard(s) 23, 24, 26 Residents live in well equipped, comfortable and personalised bedrooms. The home is clean and fresh smelling and provides a pleasant environment for the people who live there. EVIDENCE: The residents spoken with like their rooms and those seen were highly personalised and comfortable. The home meets the new environmental standards and is purpose built, ensuring the residents have comfortable and practical accommodation. The parts of the home which were seen during this inspection were clean and well maintained and the residents interviewed confirmed that the home is kept clean and tidy at all times and that the support from domestic staff is good. Westwood C53 C03 S36258 Westwood V238969 200705 Stage 4.doc Version 1.40 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29, 30 The staffing levels are appropriate to the needs of the residents and the staff are competent and well trained. Not all staff files have the necessary documentation to ensure that residents are properly protected from harm or abuse. EVIDENCE: There were 10 care staff on duty in the four units during this visit, two of whom were newly employed and shadowing more experienced workers. This is appropriate for the levels of dependency of the residents and the layout of the building. The staff interviewed said that the workload varies, sometimes there are high levels of pressure (E.g. if someone is unwell) and at other times the staffing levels are fine. The residents feel there are enough staff at the home and said they do not have to wait long for staff to help them if they call them. Staff files were inspected as part of this visit. Where one had all of the required information and documentation one had items missing which are necessary to prove identity and protect vulnerable residents from harm or abuse. Staff files must comply with Schedule 4 of the Regulations. The training records of staff members were seen and these indicate that all staff have had or are having the required training to maintain their own and residents’ safety. The staff interviewed confirmed that they have access to lots of training and they feel confident delivering care to residents. The residents interviewed said the staff were very kind and able. Westwood C53 C03 S36258 Westwood V238969 200705 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32 The home is well run and managed. The systems in place are monitored and reviewed to make sure that residents’ needs are properly met. EVIDENCE: Staff and the residents praised the manager and said the home is well run and managed. Staff reported that the manager is very approachable and open to ideas. The record keeping is of a high standard and indicates that the manager has oversight of all key documents. Westwood C53 C03 S36258 Westwood V238969 200705 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 2 x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION x x x x 3 3 x 3 STAFFING Standard No Score 27 3 28 x 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 x x x x x x Westwood C53 C03 S36258 Westwood V238969 200705 Stage 4.doc Version 1.40 Page 20 NO 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 29 Regulation 17(2), Schedule 4(6) Requirement Staff files must comply with Schedule 4 Timescale for action 30/8/05 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. 2. Refer to Standard 4 12 Good Practice Recommendations Staff should have further training on understanding Dementia and how to support people with challenging behaviour (Outstanding) An activities organiser should be employed. (Outstanding) Westwood C53 C03 S36258 Westwood V238969 200705 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 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 C53 C03 S36258 Westwood V238969 200705 Stage 4.doc Version 1.40 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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