Inspection on 25/04/05 for Westwood

This inspection was carried out on 25th April 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Westwood 12/07/07

Westwood 27/07/06

Westwood 13/10/05

Westwood 08/10/04

Westwood 30/06/04

Westwood 23/04/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Westwood 9 Knoyle Road Brighton East Sussex BN1 6RB Lead Inspector Elizabeth Dudley Announced 25 April 2005 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 H59-H10 s14260 Westwood v215715 250405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Westwood Address 9 Knoyle Road, Brighton, East Sussex, BN1 6RB 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) 01273 553077 Mr M Sadek & Mrs S Sadek Mr M Sadek & Mrs Somaya Sadek Care Home 29 Category(ies) of Old age, not falling within any other category, registration, with number 29 of places Westwood H59-H10 s14260 Westwood v215715 250405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. The number of service users accommodated must not exceed twenty-nine (29) 2. The service users will be aged 65 or over on admission. Date of last inspection 8th October 2004 Brief Description of the Service: Westwood is a privately owned residential home,registered to provide personal care for 29 older people. The building consists of two semi-detached properties converted for its current use. Accomodation is presented across three levels,ground, first and second floors, accessed by a shaft lift. This includes seventeen single and three double bedrooms, seventeen of these 20 rooms having en-suite facilities. The home has communal facilities which include a lounge/dining room and an attractive garden which has access for wheelchairs. Situated in a residential area on the outskirts of Brighton, it is close to a main bus route and local parks. Although there are no car parking facilities at the home, all adjoining roads have unrestricted parking Westwood H59-H10 s14260 Westwood v215715 250405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place on the 25th April 2005 and took place over 7 hours forming part of the annual inspection programme for the home. During this time a tour of the home was undertaken, records including ten care plans, medication files, health and safety and personnel files were examined and a total of 23 service users, 5 members of staff and 2 visitors were spoken with. A telephone call was received from an NHS occupational therapist who had recently visited the home, and she was impressed with the care of the residents, the rapport between residents and staff, the catering and the overall atmosphere within the home. What the service does well: What has improved since the last inspection? Westwood H59-H10 s14260 Westwood v215715 250405 Stage 4.doc Version 1.20 Page 6 There has been much improvement in all areas since the last inspection. Efforts have been made to improve the appearance of the home and although a lot is still to be done it is evident that this is becoming a priority. Paperwork and documents necessary to the efficient running of the home are now in place and the manager is ensuring that staff get ample training in order to achieve a good standard of care for the residents. It was also noticed that the manager seemed very enthusiastic on this inspection and is taking a pride in achieving improvement. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Westwood H59-H10 s14260 Westwood v215715 250405 Stage 4.doc Version 1.20 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 H59-H10 s14260 Westwood v215715 250405 Stage 4.doc Version 1.20 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) 1,2,3,4,5. Westwood provides sufficient information to ensure that prospective residents are able to make an informed choice on deciding to make Westwood their home. EVIDENCE: All residents are provided with a service users guide and a copy of the terms and conditions on their moving into the home. Prior to entering the home, prospective residents are assessed by the manager in order to ensure that the home can meet their needs and all residents have the opportunity to visit the home prior to admission. Staff receive training on the needs of the older person and some staff are trained to NVQ level 2 in care. All residents are admitted for a month’s trial period. Westwood H59-H10 s14260 Westwood v215715 250405 Stage 4.doc Version 1.20 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 standard(s) 7,8,9,10,11 Care plans contain sufficient information to enable staff to deliver personal care in relation to the residents needs, and staff can demonstrate that they are able to administer medication to the residents in a safe, knowledgeable manner EVIDENCE: The residents’ plans of care hold sufficient information for staff to deliver the care that is required. The majority of the care plans have been updated monthly and there was evidence that the care had been discussed with residents or their representatives. Whilst staff in the home deliver the personal care that residents require, health care needs are met by district nurses. Wherever possible, residents can retain their own GP and staff will accompany residents to hospital if required. A chiropodist visits the home and the home can arrange visits from opticians and dentists. Six members of the care staff have attended an accredited course on handling medications, and a high standard of knowledge of both storage of medication and the administration of the medication was evident, with staff showing an awareness of the side effects of some of the common prescription medications. Westwood H59-H10 s14260 Westwood v215715 250405 Stage 4.doc Version 1.20 Page 10 All controlled drugs were in order and signed in the controlled drugs register. Residents said that they were able to see doctors and nurses in private if they wished. The home has had three residents die in the past few months and it was evident that both the manager and the staff are going through a grieving process. Although staff are able to care for the dying resident, two of these deaths were unexpected, one of them being a relatively young resident. It has been recommended that the manager arranges bereavement counselling for both himself and the staff Westwood H59-H10 s14260 Westwood v215715 250405 Stage 4.doc Version 1.20 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 standard(s) 12,13,14,15 Residents were satisfied with the quality of life provided by the home. A varied menu is provided and residents stated that they enjoyed the food and that snacks would be provided at any time. EVIDENCE: The majority of residents currently living at the home were spoken with, all identified that they are happy with the lifestyle provided by the home, their visitors are made welcome and that the home provides opportunities for some activities. Two residents stated that they would like more activities provided and would like to be able to get out more. The manager must ensure that a programme of activities, following discussion with residents, is put into place, and it is recommended that staff attend courses on the provision of activities for residents in this age group The manager states that there is difficulty in arranging for church ministers to visit the home although a member of one church comes in to administer communion to two residents. The home arranges for outside entertainers to come in once a month and staff participate in board games and will accompany residents for short walks. One resident spends most of the day out in Brighton and another resident identifies that she enjoys sitting in the garden ‘whenever it’s not raining’. Most choose to Westwood H59-H10 s14260 Westwood v215715 250405 Stage 4.doc Version 1.20 Page 12 spend their time around the lounge talking to each other and the staff. It was evident that staff and residents interact well together. All residents stated that they enjoy the food and one said that staff ‘will make you a cup of tea whenever you want one’, whilst another says that staff provide him with a sandwich at any time of night. All residents were aware that a cooked breakfast could be provided. The lunch provided on this day was: Soup, Braised steak, cauliflower, broccoli, apple strudel and custard. Supper time has now been moved to the slightly later time of 1700 and residents stated they were happy with this. Although choices of food were not apparent on a formal menu, residents identified that they could choose what they wished and that staff were aware of their likes and dislikes. It is recommended that the day’s menu is displayed in the dining room or lounge. The kitchen was very clean and there was a good range of fresh food, fridge temperatures are done daily and COSHH notices were displayed. The majority of staff have the food hygiene course. Westwood H59-H10 s14260 Westwood v215715 250405 Stage 4.doc Version 1.20 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 standard(s) 16,17,18 Residents stated that they were aware of how to make a complaint although all stated that they had not needed to do so. Staff appeared aware of their responsibilities in the protection of the vulnerable adult, but the protection of residents must be consolidated by formal training. EVIDENCE: There have been no complaints made to the CSCI during the past 12 months and the manager has addressed any minor complaints made to him. The complaints procedure is displayed in the hallway and all residents have a copy of this in their service users guide. Residents are able to see solicitors or financial advisors within the home and the manager has contacted the Money Advice Centre on their behalf. Staff have not received any formal training on adult protection although the manager has a training video in place and intends to use this in the near future. This must take place and a requirement has been made around this. Westwood H59-H10 s14260 Westwood v215715 250405 Stage 4.doc Version 1.20 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 standard(s) 19,20,21,22,23,24,25,26. The manager/provider has made efforts to improve the decoration, tidiness and maintenance within the home, and whilst this is still ongoing there is a great improvement in the environment for the residents. EVIDENCE: The manager/ owner has undertaken a large amount of basic maintenance and redecoration within the home during the past year. All recommendations made by the inspector, occupational therapist and fire company have been addressed. The home also appears to be tidier and to provide a pleasanter environment for residents, the majority of whom commented on the redecoration and improvement. There is still some improvements to be made, these include a plan for further redecoration, new curtains to room 8, some beds should be replaced on a gradual basis. New carpets around the home are required, but the manager has ordered these, and there is a need for some new furniture in bedrooms and communal areas. Westwood H59-H10 s14260 Westwood v215715 250405 Stage 4.doc Version 1.20 Page 15 One of the residents who does not use her bed should still have the bed fully made up and sheets changed on a regular basis in order to provide her with this facility should she decide to use it. All radiator guards and window restrictors are in place and all doors have ‘door guards’ for fire prevention. Some rooms still require a lockable drawer and this must be attended to. Water outlet temperatures are tested on a monthly basis and records identified that these were within safe parameters There are infection control policies which have recently been reviewed but in order to minimise the risk of infection it is necessary that the bar soap and communal towels in the w.c and bathroom areas are replaced by liquid soap and paper towel dispensers. Those residents who use a catheter should have single use only night bags provided. The standard of cleanliness throughout the home was good, and although some malodour was apparent in 2 rooms, it is appreciated that attempts have been made to control this and this is unavoidable under the current circumstances. Both the front and back gardens are well maintained and very pleasant. Rubbish from the patio has now been removed and the manager must ensure that this remains a pleasant area for residents. The manager should ensure that risk assessments for all rooms continue to be carried out. Westwood H59-H10 s14260 Westwood v215715 250405 Stage 4.doc Version 1.20 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 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) 27,28,29,30 Evidence is provided to identify that staff are employed in sufficient numbers and with the necessary knowledge to meet the needs of the residents. There are concerns that the documentation obtained prior to employing a member of staff is not sufficient to guarantee the protection of the residents EVIDENCE: There are sufficient staff on duty to meet the needs of the residents, night staff cover consists of one waking and one sleeping carer. Four members of staff (45 )have their NVQ2 qualification with a further 2 members of staff studying for NVQ 3. All new members of staff have undertaken an induction course to the NTO standard and the manager has sent some members of existing staff on an external course to achieve this. Staff attend training relevant to their role and 6 members of staff have undertaken accredited medication training. Staff meetings are taking place as are informal resident meetings. Although there is a great improvement in the documentation kept in Staff personnel files they do not meet the regulations, as there was evidence that staff have been commencing work without a POVA check. A requirement has been made concerning this. Westwood H59-H10 s14260 Westwood v215715 250405 Stage 4.doc Version 1.20 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 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) 31,32,33,34,35,36,37,38The manager has ensured that the health and welfare of service users and staff is safeguarded and that supervision and training of staff is taking place to ensure that residents safety and quality of life. EVIDENCE: The home has been owned and managed by Mr M Sadek, in partnership with his wife, for 16 years. It is evident that there is a very good rapport between the manager, staff and residents. Residents reinforced this with very positive comments about the manager, some stating they found him very helpful and kind. Mr Sadek, attends courses which have included first aid, medication and moving and handling and is now looking at a management course at a local college. A requirement for him to commence some further training relevant to his role, has been made. Westwood H59-H10 s14260 Westwood v215715 250405 Stage 4.doc Version 1.20 Page 18 Some staff had some concerns around their terms of employment and these were relayed to the manager who will be addressing this with staff. A quality assurance system which has addressed residents comments is in place and this needs to further be extended to critically assess the environment , catering and other activities within the home. Residents were made aware of the inspection and very positive comment cards were received by the CSCI from both residents and visitors to the home. During the inspection a telephone call was received from an occupational therapist who had visited the home to assess a resident, she stated that she was impressed with the homely and caring atmosphere and the interaction between residents and staff. All policies and procedures have been reviewed this year. The manager does not act as appointee for any of the residents but does hold some of the personal allowances for safekeeping, all records regarding these were satisfactory and receipts for all transactions were available. The manager has accessed the services of the money advisory centre for some residents. All certificates relating to the servicing of utilities and equipment were seen and there was evidence that staff have attended mandatory fire and moving and handling training. The majority of staff have the food hygiene course and 6 members of staff have a first aid certificate. Westwood H59-H10 s14260 Westwood v215715 250405 Stage 4.doc Version 1.20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 4 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 2 3 3 3 2 3 2 STAFFING Standard No Score 27 3 28 3 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 2 x 3 3 3 3 3 2 3 3 Westwood H59-H10 s14260 Westwood v215715 250405 Stage 4.doc Version 1.20 Page 20 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 29 Regulation Reg19. Schd 2 Requirement That all staff should be in possession of a newly obtained CRB and POVA check prior to commencing employment. This was a previous requirement 30th November 2004 That suitable curtains which fit the windows and are in a good state of repair are fitted to room 8. That all rooms have a lockable drawer. That the radiator guard in room 10 is put in place.The bed in room 9 is kept made up and sheets changed regularly. That all windows are kept clean. That the manager obtains a qualification relevant to his management role That all communal bathrooms and toilets are fitted with soap and towel dispensers. Most ensuite bathrooms should contain these for staff use That carpets are replaced in most areas and that bed bases in most areas are replaced. That service users are consulted about activities and that a programme of activities is drawn up with staff suitably trained in this area Timescale for action June 25th 2005 2. 24 Reg 16(2) May 25th 2005 3. 4. 31 26 Reg9(2)(1 ) Reg 13(3) Sept 2005 June 25th 2005 5. 6. 24 12 Reg 16(2) Reg 16(2)(m)( n) June 2006 August 30th 2005 Westwood H59-H10 s14260 Westwood v215715 250405 Stage 4.doc Version 1.20 Page 21 7. 18 Reg 13(6) 8. 36 Reg 18(2) That staff undertake training in the protection of the vulnerable adult. This was a previous requirement . Nov 2004 That all staff receive formal documented supervision in such frequency as stated in standard 36. This was a previous requirement on 3 inspections May 25th 2005 June 25th 2005 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. 3. 4. Refer to Standard 23 9 26 11 Good Practice Recommendations That the programme of redecoration and refurbishment is continued and kept under review That eye drops have their date of opening identified and are discarded after 28 days. That single use catheter night bags are used. That the manager accesses bereavement counselling for the staff and himself. Westwood H59-H10 s14260 Westwood v215715 250405 Stage 4.doc Version 1.20 Page 22 Commission for Social Care Inspection 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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