Care Home: 45 Westridge Road

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What the care home does well Residents are offered a `home from home` service and benefit from personal care and support that is provided in a friendly, caring, and family run home. Residents take part in a wide range of activities that they enjoy including holidays and weekly outings. The home is clean and comfortable and well maintained and decorated. One resident told us "I think the home is exceptional and I wish there were a lot more like it". Another resident said "We are taken out for some very good outings, sometimes to the New Forest or local gardens, other useful local visits to shops or library. These are very much appreciated". What has improved since the last inspection? The annual quality assurance assessment from the home said that since the last inspection one of the bedrooms has been re-decorated and there are plans for further decoration in the hallway. What the care home could do better: We found that medication is kept in bathroom cabinets but these are not lockable. The registered manager must ensure that all medication belonging to residents is securely stored. This will ensure that residents` medication is safe at all times. Indiviudal care plans for residents should record visits or contact with health care services such as GP`s, District Nurses, Dentists and Chiropodists. This will demonstrate that residents health care needs are being met and that they have access to other services as required. Health and safety risk assessments for all areas of the home must be regularly reviewed and updated to meet relevant health and safety legislation. The registered manager is not keeping a record of fire practice evacuation drills as required by fire safety regulations. Information in the complaints procedure about how people can contact the Commission must be updated with the current address and contact details. Inspecting for better lives Key inspection report Care homes for older people Name: Address: 45 Westridge Road 45 Westridge Road Portswood Southampton Hampshire SO17 2HP     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Annie Kentfield     Date: 2 3 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 23 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: 45 Westridge Road 45 Westridge Road Portswood Southampton Hampshire SO17 2HP 02380558692 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Evelyn Larmouth Type of registration: Number of places registered: Mrs Evelyn Larmouth care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 45 Westridge Road is registered to provide care for three residents over the age of 65. The home is situated in a residential area of Southampton. There are three single bedrooms; two on the ground floor and one on the first floor, all have en-suite facilities. Residents have access to a lounge/ diner and sunroom, and garden. The home provides transport. The building is accessible and there is a stair lift to the first floor. The home is owned and managed by Mrs Larmouth who has owned the home for many years. The current fees are four hundred and fifty pounds per week with additional charges for chiropody and hairdressing. 0 0 Over 65 3 3 Care Homes for Older People Page 4 of 23 Care Homes for Older People Page 5 of 23 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We visited the home on 23 December 2008. This was an unannounced visit with one inspector (Annie Kentfield) and the visit lasted three hours. We received the Annual Quality Assurance Assessment (AQAA) from the home. This is a self-assessment on what the home does well and where improvements could be made or are planned. We sent surveys to the residents and some health and social care professionals who visit the home. We received surveys from the residents and comments from relatives and friends of the residents. All of the feedback is positive. During the visit we spoke to the residents in the privacy of their own rooms. We looked at other areas of the home such as the lounge and dining room. We looked at some of Care Homes for Older People Page 6 of 23 the records kept by the home including care records, medication records and health and safety records, and also spoke to the registered manager. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 23 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 23 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents who move into the home can be confident that their care and support needs will be met and that they have sufficient information to make an informed choice about moving in. Evidence: Since the last inspection one new resident has moved into the home. The resident told us that they were invited to come and stay for a trial period and they then decided to move into the home on a permanent basis. The manager had already been to meet the resident and assessed their care and support needs to ensure that the home could offer appropriate care. We saw evidence of this in the care records that we looked at. We spoke to all of the residents who told us that they were supported by the manager to bring with them items of personal furniture and possessions to make their rooms homely and personalised. Care Homes for Older People Page 10 of 23 Evidence: We looked at the homes statement of purpose/service user guide - this provides information for prospective residents on what services and facilities the home can provide, and the fees charged. The manager needs to update the service user guide to include the current contact address and telephone number for the Commission. We noted that residents have a contract with the home that is signed and a copy kept in their care records. Care Homes for Older People Page 11 of 23 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have their health care and support needs met by the home. Practice in the home promotes privacy and dignity at all times. The systems for the safe administration and storage of medication must be reviewed to ensure that all medication received into the home is safely and securely stored. Evidence: We spoke to the residents and looked at the individual plans of care. Residents confirmed that the care provided is excellent and their privacy and dignity is always maintained. Residents also told us that they were able to see their GP whenever they needed, or wanted to, and the manager will always make appointments for them, or take them to the surgery. One resident told us we are taken to the dentist every six months and to the optician, we have a chiropodist that comes to the house and we are taken to the doctors when required and have a yearly checkup with them. We are taken by car to our appointments and waited for. Care Homes for Older People Page 12 of 23 Evidence: The care plans are reviewed and updated every two weeks. However, at the moment, the record of contact with GPs and other health professionals is recorded in the managers diary. It would be good practice to record this in the care plan. In the event of other staff or agency staff looking at the care plans, they would need to know when residents last saw their GP or other health specialist and this should be easily accessible. We looked at the arrangements for receiving and dispensing medication in the home. Residents keep their medication in their own bathroom cabinets and the medication is dispensed by the registered manager and recorded on medication administration sheets. Residents have agreed with the manager that they do not want to selfmedicate. It would be good practice for this to be recorded and signed in the care plan. The bathroom cabinets are not lockable. The registered manager confirmed that she would undertake a risk assessment on the safety of medication in the home, or would review the storage arrangements for medication, so that medication is safely and securely stored. The manager is aware that there is new and updated guidance on the safe management of medication in care homes and says she will obtain this from the Commission website. The manager will also consider the risks of storing medicines in bathrooms because medication could be affected by heat and humidity. The home does not have any controlled drugs at present. The registered manager is now aware of the amended regulations for the storage of controlled drugs and the manager is aware that if at any time, the home does have controlled drugs, they must comply with the amended regulations and provide storage that meets the requirements. Care Homes for Older People Page 13 of 23 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported to take part in a wide range of activities, holidays, and social and leisure outings. Meals are freshly prepared and cooked and offer residents a wide choice of nutritious and appetising menus. Evidence: One of the residents told us We lead a very full life, we are taken out by car frequently, to the forest, the quay, Winchester etc. and we have many picnics. We are taken to garden centres. We do exercises. We are encouraged to play games such as scrabble etc, and to play the piano. We are taken to the library and to go shopping, or visit friends - or friends visit us. We go to church regularly and have been on several holidays to Devon, Isle of Wight and New Forest. All of the residents confirmed that meals in the home are very good. One resident told us Mrs Larmouth is an excellent cook. We have a marvelous variety and lots of fruit and vegetables every day, and as much food as we possibly can. We observed that at lunchtime all of the residents were enjoying a freshly cooked lunch of their choice. Visitors are welcome at any time and the manager has a spare room that relatives or Care Homes for Older People Page 14 of 23 Evidence: friends can use if they need to stay or have travelled a long distance. During the visit to the home, we spoke to residents in the privacy of their rooms and in the dining room. The daily routines in the home are flexible to fit in with the wishes and preferences of the residents. Care Homes for Older People Page 15 of 23 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has systems in place to respond to complaints if they arise and protect residents from the risk of harm or abuse. Residents and their representatives are confident that their concerns would be taken seriously and acted upon. Evidence: The home has the complaints procedure on display in the hallway, the manager will ensure that the telephone number and address for the Commission is updated. Residents confirmed that they are aware of the formal complaints procedure. We have not received any complaints about the service and none have been received by the home. There are no safeguarding issues. The home has a policy and procedure for safeguarding people in the home and the manager has a good understanding of her responsibilities to protect the residents from the risk of harm or abuse. Care Homes for Older People Page 16 of 23 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a safe,clean, and well maintained home that meets all of their needs. Evidence: We spoke to all of the residents in the privacy of their own rooms and looked at all of the communal areas of the home. One resident told us all rooms are cleaned every day, my bedroom and bathroom are always beautiful and bedding and towels beautifully clean - the laundry is always done. Residents are able to personalise their rooms with their own furniture and possessions and like to spend time in their rooms, or in the sitting room. The home has a stair lift to the first floor and the manager confirmed that this is regularly serviced. The home is well decorated and furnished to provide a comfortable and attractive home for the residents. The building is well maintained both internally and externally. Care Homes for Older People Page 17 of 23 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The needs of the residents are met by staff with relevant skills, experience and competencies. Evidence: The home employs a cleaner who has started work since the last inspection. We spoke to the member of staff and confirmed that relevant checks had been undertaken and an induction to the home arranged. There are plans for the member of staff to undertake some care training with a view to becoming a care worker in the home in the future. The registered manager occasionally uses temporary staff from a nursing agency. The manager ensures that she has details of the employment checks from the agency and the training that staff have completed. The manager told us that she plans to undertake professional updates of her own training when the new member of staff is doing relevant training in care, hopefully in 2009. Care Homes for Older People Page 18 of 23 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and run in the best interests of the residents. There are systems in place to promote the health, safety and welfare of the residents. Evidence: The registered manager, Mrs Larmouth, has owned and managed the home for many years and it is evident from comments from residents and relatives that residents are very satisfied with the level of care and support that is provided. One resident told us I feel very happy and contented and look forward to another lovely year. Mrs Larmouth lives on the premises and speaks to the residents daily about what they would like to do with regard to care, activities, meals etc. and the routines of the home are flexibly arranged around the choices and preferences of the residents. Residents manage their own financial affairs, or with support from relatives or representatives. Care Homes for Older People Page 19 of 23 Evidence: The health and safety of the residents is promoted and records demonstrate that fire safety equipment is regularly checked and serviced. The manager told us that the home does carry out occasional fire practice evacuation drills, but these are not recorded. The manager told us that she will seek clarification from the fire safety officer if this is a requirement. The manager has reviewed health and safety risk assessments but this has not been recorded. Other records confirm that gas and electrical equipment in the home are checked or serviced to meet relevant health and safety legislation. The manager undertakes informal audits of the quality of care provided, in her daily contact with the residents. The manager told us that a questionnaire has been developed as part of an annual survey that will be given to residents, relatives, and health and social care professionals who visit the home. The manager will summarise the results of the survey. Care Homes for Older People Page 20 of 23 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 21 of 23 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 The registered manager 30/01/2009 must ensure that there are systems in place for the safe storage and administration of medication received into the home. Residents medication must be safely stored at all times. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 22 of 23 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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