CARE HOME ADULTS 18-65
Westwood Lodge 116 Harlestone Road Dallington Northants NN5 6AB Lead Inspector
Rajshree Mistry Unannounced Inspection 16th February 2006 3:00pm Westwood Lodge DS0000060400.V283107.R01.S.doc Version 5.1 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 Lodge DS0000060400.V283107.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Westwood Lodge DS0000060400.V283107.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Westwood Lodge Address 116 Harlestone Road Dallington Northants NN5 6AB 01604 581181 01604 581181 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) Gold Care Limited Vacant Care Home 15 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (15) of places Westwood Lodge DS0000060400.V283107.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. Service users accommodated must be within the age range of 21 to 65 years. Outside the hours of 9am - 5pm there must be a minimum of one (1) Registered Nurse on duty. The manager of the home must be a Registered Mental Health Nurse. Any changes to the purpose and function of the service as detailed in the statement of purpose (agreed on 02.03.05) and as stipulated in the letter dated 02.03.05, must be notified and agreed with CSCI prior to any changes being implemented. There must be a minimum of two (2) Registered Nurses on duty during the hours of 9am - 5pm. 21st July 2005 5. Date of last inspection Brief Description of the Service: Westwood Lodge is situated in a suburb of Northampton. The house is a large detached property set within extensive grounds. It is close to local amenities and public transport with the town centre approximately one and a half miles form the home. There are 15 single bedrooms, all with the exception of one bedroom have ensuite facilities and furnished to a high standard. The bedrooms are located one the ground and first floor. The upper floor is accessible by the stairs of the passenger lift located at the centre of the property. There are bathrooms with baths and showers on both floors. There is a large communal lounge with a dining area, an activity room and smoking area, along with a laundry and kitchen. In addition the extensive gardens are accessible for the use of the residents. Westwood Lodge DS0000060400.V283107.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection of the service, which took place in the late afternoon of 16th February 2006 and lasted 3½ hours. This is the second regulatory inspection of the service addressing the remaining core standards. The focus of the inspection undertaken by the Commission for Social Care Inspection (CSCI) is upon the outcomes for the resident and their views of the service provided. The primary method of inspection used was ‘case tracking’ three residents. The inspection consisted of discussions with the residents and members of staff, a tour of the home, review of the residents’ records and observation of care practices. The inspection also reviewed of the requirement and the recommendations from the last inspection. What the service does well: What has improved since the last inspection?
The requirements and recommendations made at the last inspection have been completed. At present the Responsible Individual for the home is currently managing the home in the capacity of the Acting Manager with additional support from the
Westwood Lodge DS0000060400.V283107.R01.S.doc Version 5.1 Page 6 Area Manager. An occupational therapist has been appointed on a part-time basis to work with the residents and the staff team. The staff team are now receiving a programme of training on a monthly basis, provided by professionals from the Forensic Team and the Consultant working with clients with mental health issues. Residents’ have weekly meetings with their keyworkers which promotes individual choice of lifestyle and pursue their interests. 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 Lodge DS0000060400.V283107.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Westwood Lodge DS0000060400.V283107.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: The core standards were inspected at the last inspection and were met. Westwood Lodge DS0000060400.V283107.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 8. The residents receive tailored support to meet their individual care needs, whilst being able to pursue their social and leisure interests. EVIDENCE: The residents spoken with confirmed that they are involved setting their goals, level of support and participating in the social and leisure activities in and around the area. Care plans and risk assessments examined for the three residents reflected the restrictions and goals, such as managing their drinking, smoking, finance, current affairs involving the residents and their relatives, where appropriate. Specific contingency plans to be followed such as reporting a missing person, were clearly identified in the care files. Residents confidently identified their key-worker and the satisfactory assistance they provided. The key-worker for one resident spoken with was able to describe how they support the resident to pursue their interest in painting, swimming and bowling. Residents are encouraged to be involved in all aspects of the home and encourage them to take some responsibility. One resident does his own laundry whilst others assist with preparation of meals on occasions. Residents now benefit from having their own meeting on a weekly basis to look at their programme of activities and interests for the week, which is open to change.
Westwood Lodge DS0000060400.V283107.R01.S.doc Version 5.1 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17. The residents feel valued by the respect shown to them by other residents and staff at the home. Residents’ benefit from having varied and balanced meals. EVIDENCE: Residents spoken with indicated that they are encouraged to be involved in the home and can choose to help. For example residents keep their bedrooms tidy, whilst another resident was observed returning used cups to the kitchen. The residents indicated they and their visitors are respected and the mutual respect given between the residents and the staff at all times. The Inspector observed staff and residents speaking with each other in a respectful manner, giving time and space to the person speaking and not interrupting them. The residents indicated that they have a good choice of meals that is varied, appealing and nutritionally balanced. Snacks and drinks are available throughout the day. There is always a bowl of fresh fruit on the table for residents, which is replenished as often as required. The residents’ chose the menus and a record of meals provided is maintained along with the food temperatures when served.
Westwood Lodge DS0000060400.V283107.R01.S.doc Version 5.1 Page 11 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20. Management of medication is good and residents are support and receive their medication promptly. EVIDENCE: Medication is stored in the locked Clinic Room on the upper floor. The senior nurses are responsible for administering the medication. The medication storage viewed was found safe and supported by good management systems for ordering, storing, recording and returning medication. Medication and respective records were examined for two residents were in good order, up to date and auditable. Residents spoken with indicated that they get their medication on time. Westwood Lodge DS0000060400.V283107.R01.S.doc Version 5.1 Page 12 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23. Residents are protected by staff that are aware of how to respond to any suspicion or allegations of abuse. EVIDENCE: Residents spoken with indicated that they felt safe and protected in the presence of the staff both within the home and whilst out in the community. Residents indicated that if they had any concerns they would tell their keyworker whilst identifying their key-worker on duty. The Inspector observed residents freely speaking with other residents and staff. The member of staff that spoke to the Inspector confirmed she had received training in adult protection and demonstrated awareness of the procedures to follow should any allegation or suspicion arise. Training records examined showed staff recently received training in adult protection. Westwood Lodge DS0000060400.V283107.R01.S.doc Version 5.1 Page 13 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24. Residents live in a clean and safe environment that decorated to a high standard. EVIDENCE: The home is in keeping with the local community and style of property in the area, with a short driveway and car parking to the front of the house. There is level entry access to the premises and a passenger lift to the upper floor. The décor, furniture and fixtures are complimentary and create an ambience of warmth and welcoming atmosphere. All areas of the home were clean and safe. The housekeeper is responsible for the cleanliness of the home and supported by the staff on duty. Three residents bedrooms were viewed, which were spacious, comfortable and personalised. Bedrooms have a sofa creating a small lounge area where residents can meet with their visitors in private. Residents spoken with were very complimentary about their accommodation and respected individual residents’ private space. One resident felt “it’s like living at Buckingham Palace but without the waiters”. All the bedrooms have en-suite facilities with the exception of one bedroom that has access to the toilet and shower room opposite.
Westwood Lodge DS0000060400.V283107.R01.S.doc Version 5.1 Page 14 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35. The staff-training programme is in place to ensure staff are well trained and competent to do their jobs safely. EVIDENCE: Since the last inspection there has been a drive towards staff training. There is a programme of training in place provided by a Consultant in mental health, Forensic Team and training colleges. Staff spoken with listed the training they had received which included health and safety, manual handling, first aid, adult protection in addition to specialist training in mental health i.e. personality disorder, challenging behaviour and awareness of mental health conditions and the effects. Training is provided at the home in one of the large unoccupied bedroom. The staff demonstrated good awareness of the residents they key-work and their individual needs. Supervision meetings have re-commenced and occur every six weeks. The topics discussed include the requirements of the job, work issues, training and development. Minutes of the supervision meetings were not viewed on this occasion. Westwood Lodge DS0000060400.V283107.R01.S.doc Version 5.1 Page 15 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39, 42. The residents are involved and consulted about the care provided whilst living at the home. The staff and residents health, safety and welfare is promoted and protected by the systems, management and training. EVIDENCE: Residents meetings take place weekly, supported by the senior nurse. Minutes of the meetings were viewed demonstrated the topics discussed and relevant actions to be addressed by the staff. Residents spoken with said they are consulted in how they are cared for and informed of any changes that are planned for the home. The Area Manager undertakes monthly quality assurance visits and the findings are submitted to the Commission as part of their regulatory duty. The home’s statement of purpose refers the quality assurance undertaken to improve the quality and standard of the service provided. However, there was no evidence to suggest that the home’s quality assurance is taking place. This was discussed with the Acting Manager and the Area Manager who acknowledged the oversight and gave assurance that the quality assurance
Westwood Lodge DS0000060400.V283107.R01.S.doc Version 5.1 Page 16 survey would be undertaken promptly. This will be followed up at the next inspection. Staff handover meetings take place at the end of each shift where key information is passed onto the next team of staff, which is reflected in the residents’ daily records that were examined. During the tour of the home fire exits were clearly marked and were not obstructed. Records of tests to fire safety equipment, electrical tests were in good order and health and safety issues were well documented. The fire risk assessments are in place, along with individual risk assessments for the residents. Staff receive training in fire, health and safety. There is a programme of maintenance and testing of all equipment in the home. The Area Manager is responsible for carrying out monthly visits and includes health and safety checks and records. The home’s policies and procedures are available and accessible to all staff at any time. Westwood Lodge DS0000060400.V283107.R01.S.doc Version 5.1 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 3 X X X 3 X X 3 X Westwood Lodge DS0000060400.V283107.R01.S.doc Version 5.1 Page 18 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 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 YA39 Good Practice Recommendations It is recommended that the home’s management team ensure that quality assurance surveys are formally carried out in accordance to the home’s statement of purpose. Westwood Lodge DS0000060400.V283107.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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