Inspection on 21/11/06 for Westwood Care Home

This inspection was carried out on 21st November 2006.

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 Care Home 21/03/06

Westwood Care Home 13/12/05

Westwood Care Home 18/10/04

Westwood Care Home 11/05/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Westwood Care Home 21 Doncaster Road Selby North Yorkshire YO8 9BT Lead Inspector Jo Bell Key Unannounced Inspection 21st November 2006 09:30 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 Care Home DS0000059032.V319437.R01.S.doc Version 5.2 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 Care Home DS0000059032.V319437.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Westwood Care Home Address 21 Doncaster Road Selby North Yorkshire YO8 9BT 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) 01757 709901 F/P01757 709901 Holistic Care Provision Limited Mrs Yvonne Ann Clark Care Home 16 Category(ies) of Dementia - over 65 years of age (16), Old age, registration, with number not falling within any other category (16) of places Westwood Care Home DS0000059032.V319437.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service Users up to 16 DE(E) and up to 16 OP up to a maximum of 16 Service Users 21st March 2006 Date of last inspection Brief Description of the Service: Westwood Care Home provides personal care and accommodation for to up to sixteen older people who may have dementia. It is one of two homes in the area owned and run by Holistic Care Provision Ltd. The charges per week are £395. The home is located on a busy road in the market town of Selby and is close to shops, a post office and other local amenities. The home is an old detached two-storey building with ten single and three double bedrooms, which are on both levels. One single room and one double room have en-suite facilities. The home has a large garden that is well maintained and is easily accessible. Westwood Care Home DS0000059032.V319437.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key inspection of the service took place on Tuesday 21st November 2006. Prior to the site visit a pre-inspection questionnaire was completed and returned to the CSCI, seven relatives comment cards were completed and information was examined relating to service history, notifications and correspondence from other agencies. The site visit lasted six hours and during this time a range of service users, relatives and staff were spoken with, along with a local GP. Observations of care practices, mealtimes, medication system and general interactions with service users and relatives took place. Three service users were case tracked in detail where their needs were discussed and their care plans inspected. Twenty two key standards were examined and outcomes for service users decided. No requirements were made at this visit. The quality of care provided is excellent. Service users live in a pleasant, homely environment and are cared for by professional well trained staff. Every other aspect of the home has good outcomes for service users. What the service does well: What has improved since the last inspection? Some service users’ rooms and communal areas have been redecorated. Westwood Care Home DS0000059032.V319437.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Westwood Care Home DS0000059032.V319437.R01.S.doc Version 5.2 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 Care Home DS0000059032.V319437.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (Standard 6 is not applicable) Quality in this outcome area is good. Service users have detailed assessments carried out prior to admission, to ensure their needs can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three service user assessments were examined. The home manager is responsible for carrying these out along with a care manager if the service user is funded through social services. Detailed information was available though not all the documentation was completed, partly because some is transferred to other parts of the care plan and some is not felt not relevant. A consistent approach to completing this document is needed. Westwood Care Home DS0000059032.V319437.R01.S.doc Version 5.2 Page 9 The manager is very clear about the range of needs a person with dementia has. The initial assessment does not always match with the information obtained once the person has settled into the home and therefore a review of this takes place. Three service users spoken with confirmed someone had completed an assessment with them before they entered the home. Westwood Care Home DS0000059032.V319437.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10 Quality in this outcome area is good. Service users receive an excellent standard of care by staff who are respectful and well trained. However, aspects of the care plans which include nutrition need to be improved to ensure all needs are being met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users were spoken with and observed throughout the site visit. Interactions with care staff were pleasant, friendly and professional. Three service users were case tracked in detail. All three confirmed the excellent standard of care provided. One visitor said ‘the care is second to none’, One lady said ‘all the staff are wonderful and kind, and they work really hard’. A relative said she had no complaints at all. She also commented that there has been a huge improvement in her relative since she has come to Westwood Care Home. No negative comments were made regarding care practices during the six hour visit. Westwood Care Home DS0000059032.V319437.R01.S.doc Version 5.2 Page 11 The care plans were computer generated and contained a range of information regarding social history, personal care, activities of daily living and specific needs of individuals. Plans were reviewed and evaluated though this information was kept separately in a composite file with details of other service users. The home should be aware of Data Protection Act. A signature to confirm that the service user or advocate has agreed to the care plan should be obtained. One service users record said her dislikes were vegetables, though staff had been offering her different vegetables and some she liked and others she disliked, this information was not recorded in the care plan and no nutritional assessments had been completed. Some service users had been weighed recently while others had not been weighed for some months. An overall understanding of nutritional needs is needed, this was discussed with the manager and information from the IT system was to be obtained later that day. In the lounge many service users were spoken with and it was evident that they were well cared for, their clothes were clean, well ironed, their nails were manicured and their hair washed and combed. This was confirmed by relatives through comment cards and healthcare professionals. Service users discussed visits from the chiropodist, GP, District Nurse and visits to the local Hospital in Selby. Records confirmed these take place on a regular basis. Links with healthcare professionals are robust which was also confirmed by the GP who was visiting during the inspection. The manager is aware of how to complete Regulation 37 notifications for the CSCI, these are information relating to any incidents which effect service users in the home. Only a minimum amount of accidents/incidents have occurred since the last inspection. Service users were addressed by staff in an appropriate manner, their rooms were kept shut and staff knocked prior to entering. Service users spoken with all confirmed how well the staff interact with them and what a good rapport they have. Westwood Care Home DS0000059032.V319437.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 Quality in this outcome area is good. Service users enjoy a range of activities, and staff encourage autonomy. Visitors are welcomed into the home and the meals provided are good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users have access to activities which include entertainers, music, plate and candle making, sing-a-longs, dominoes and bingo. In summer service users can enjoy the garden area and trips into Selby. Service users were observed enjoying music being played and care staff asking them questions regarding the name of the singer/song. There is a residents night out planned near Christmas, and a trip to see ‘Aladdin’. The atmosphere was happy and relaxed and relatives spoken with said there are always lots of activities going on. Social and life history is recorded in the care plans and staff have a good understanding of the preferences regarding activities for each service user. Activities which take place are documented in an activity book. Staff are committed to service users being stimulated, motivated and they are Westwood Care Home DS0000059032.V319437.R01.S.doc Version 5.2 Page 13 encouraged to participate and try new activities on a regular basis. Visitors are welcomed into the home, though this is currently not recorded. One relative said staff are always welcoming and offer her refreshment when she arrives. Staff are keen to encourage autonomy and choice, this was evident through observations, independence is maintained where possible and service users were seen using a range of walking aids to assist their mobility. Two service users who share a room were asked if they were happy to do so, this was discussed with the family members and confirmed that this was feasible. The manager is aware of issues regarding mental capacity and the need to have an advocate for some service users, information regarding this is available on the notice board in the home. Religious needs are considered, the home has service users who are Church of England, Roman Catholic, Jehovah’s Witness and Methodist. Mealtimes were discussed and lunchtime was observed. The dining area is part of the lounge and tables and chairs are set within a pleasant environment. Material napkins and table cloths are available with different colours, this helps those service users with poor vision focus on the area where the food is served. The food is home cooked and the menu is displayed in the lounge and staff discuss this with each service user. Fish finger, chips and peas were served with vanilla sponge and custard. The portion sizes were good and service users clearly enjoyed their lunch. Staff offer assistance in a dignified manner, plate guards and specialised cups are available and the atmosphere was calm and relaxed with behaviour being managed effectively by staff. It was noted that the cutlery and plastic glasses had many stains on them, this was due to the poor rinsing system in the dishwasher, and will easily be resolved. The cook was spoken with and it was evident that she knew the service users well and the needs they had. A range of diets could be catered for and care staff liaised closely with the catering staff to communicate relevant information. The kitchen was inspected and this was kept extremely clean and tidy, all produce was stored and dated correctly and the cook had a real sense of pride regarding the food produced and her working environment. Westwood Care Home DS0000059032.V319437.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. Service users have their needs listened to and acted upon in a safe environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints procedure on display. One complaint had been received by the home which was dealt with correctly. No complaints had been received by the CSCI. Service users all confirmed they would speak to the manager or a member of staff if they had any concerns. One service user said a issue had arisen some time ago and this was handled effectively in a prompt manner. Relatives confirmed concerns are dealt with in an open and honest way. Staff had an excellent rapport with service users and this helped them to discuss any issues with them through informal chats. Staff spoken with had received adult protection training and had a good understanding of the different types of abuse. Service users confirmed they felt safe with members of staff and confirmed they treat them in a friendly and professional manner when talking with them or moving and handling them. The manager discussed adult protection and the protection of vulnerable adults list, her knowledge was good and she was aware of who the Lead Agency is if an allegation of abuse is made. Westwood Care Home DS0000059032.V319437.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is excellent. Service users enjoy living in their environment, which is clean and fresh smelling. This judgement has been made using available evidence including a visit to this service. EVIDENCE: For those service users spoken with, many aspects of the environment were excellent. There is a large lounge/dining area with comfortable chairs, good quality carpet and curtains with appropriate placement of furniture to maximise social interaction for service users. There is a good sized garden outside which service users spend time in, chairs and tables and a gazebo are available. The hall, stairs and landing area has recently been refurbished, the wallpaper chosen looks beautiful and many service users commented on it. Consideration Westwood Care Home DS0000059032.V319437.R01.S.doc Version 5.2 Page 16 has been given to use of colours for people with dementia, some of the bathroom areas have red floors with pictures and flowers on display, this gives a less clinical feel to the environment which has a positive outcome for service users. Rooms have a name and number at eye level in different colours so service users can easily identify which is theirs. Staff discuss with service users which furniture and bedding they would prefer. One lady was shown her newly decorated room, and many other rooms were inspected and found to be decorated to a high standard, every room viewed was extremely clean and pleasant smelling. There are some rooms which need to be redecorated and this is ongoing. Service users have call bells and sensor pads next to their bed to alert the staff if they are out of bed either when they are resting or during the night. Currently the lounge and corridor carpet is patterned and very busy, the manager is aware of how this can be perceived by people with dementia. This was discussed with the manager. Staff receive infection control training, this was confirmed by talking with staff and through training records. The home have a laundry and sluice which meets the needs of individuals. Service users were observed wearing extremely clean and well ironed clothes. No concerns were raised regarding hygiene or infection control. Staff were observed washing their hands and wearing appropriate tabards. Westwood Care Home DS0000059032.V319437.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 Quality in this outcome area is good. Service users are cared for by suitably trained staff, who are appropriately recruited in sufficient numbers. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users enjoy being cared for by staff who have received a range of training. Many staff have an NVQ Level 2 or 3 in care, and the needs of the sixteen service users are being met on a daily basis. There are a sufficient number of staff, the manager is supernumerary and there are team leaders, with care and support staff who work well as a team. Many staff have worked in the home for a number of years and staff turnover is low. This is positive for the service users as consistency of staff is extremely important. Induction training takes place, one staff member discussed the training she has received to enable her to carry out her role. Dementia training, challenging behaviour, and abuse awareness is offered on a regular basis. The induction training is equivalent to Skills for Care (formerly TOPSS) which all new staff have to complete to ensure they are competent. Prior to employment the home obtains CRB and protection of vulnerable adults checks, along with two written references. These were checked and found to Westwood Care Home DS0000059032.V319437.R01.S.doc Version 5.2 Page 18 be in place. The manager is aware of the robust recruitment procedures needed to ensure the safety of service users. Westwood Care Home DS0000059032.V319437.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 & 38 Quality in this outcome area is good. The home is run in the best interests of the service users, some quality assurance systems are in place and health and safety is adhered to. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager is experienced in caring for this client group. She has completed an NVQ Level 4 and is professional, friendly and approachable. This was echoed by service users, staff, relatives and the local GP. Resident and staff meetings take place on a regular basis and service users are included in the daily running of the home. The home are keen to obtain views and Westwood Care Home DS0000059032.V319437.R01.S.doc Version 5.2 Page 20 opinions on a range of issues, and a quality assurance system has been developed, though this does need to be fully implemented to ensure the home can evidence the service it is providing, especially around care. Care plan and medication audits should be part of the annual development plan, and surveys should be sent out to all relevant parties (as in 2005). However, it must be noted that as there are only sixteen service users the staff very clearly speak with them on an informal basis throughout the day and are constantly seeking their views and opinions. This was confirmed by service users and staff. Service users have their finances protected through the homes procedures. Pocket money is kept with records and receipts to confirm this. Service users have a choice whether to keep any money themselves or hand this over to the home for safe keeping. This money is usually spent on chiropody, hairdressing or toiletries (though the home will provide toiletries if needed). The preinspection questionnaire stated that all sixteen service users handle their own financial affairs. Health and safety in the home was discussed, the pre-inspection questionnaire gave details of certificates which relate to safety, these included electrical wiring, central heating system, environmental health and equipment checks. The manager is responsible for fire training, a fire alarm test takes place weekly and all staff attend fire training on either a six or three monthly basis. Fire doors and door closures are evident and emergency lighting was observed. The manager confirmed a fire risk assessment has been undertaken in line with new guidance from the fire officers. Staff receive moving and handling, fire safety, infection control and health and safety training as mandatory. These records were up to date. Water temperatures are taken monthly, and the manager confirmed these are within normal ranges. Prior to service users having a bath the care staff check the temperature to ensure the water is at the correct temperature. No concerns were raised regarding health and safety. Westwood Care Home DS0000059032.V319437.R01.S.doc Version 5.2 Page 21 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 x x 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 4 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 x x 3 Westwood Care Home DS0000059032.V319437.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action Westwood Care Home DS0000059032.V319437.R01.S.doc Version 5.2 Page 23 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. Refer to Standard OP3 Good Practice Recommendations The documentation used to carry out the initial assessment should be used consistently, blanks should be accounted for and areas not used should be removed. Once the assessment and care plan is completed it should be agreed and signed by either the service user or an advocate. 2. 3. 4. 5. 6. OP7 OP8 OP13 OP15 OP33 The home should consider Data Protection when storing service users records altogether (care planning info). Service users should have all aspects of nutrition recorded, this information should include an overall assessment. A visitors book should be available for use. The cutlery and plastic cups used at lunchtime need to be thoroughly cleaned. The current quality assurance system needs to be fully implemented, this includes sending out surveys and completing audits for care plans and medication. Westwood Care Home DS0000059032.V319437.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Care Home DS0000059032.V319437.R01.S.doc Version 5.2 Page 25 - 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!