Care Home: West View

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What the care home does well What has improved since the last inspection? During a discussion with the manager she explained that in her opinion the various staff members worked well together; they were multi skilled and therefore able to cover other jobs within the home if needed. As a result of this flexibility the number of agency carers needed to cover staff holidays and absence had been reduced which in turn provided a greater continuity of care to the residents. Residents are being encouraged to take risks in order to support a person`s independence. CARE HOMES FOR OLDER PEOPLE West View Underwood Lane Crewe Cheshire CW1 3SA Lead Inspector Paul Ramsden Unannounced Inspection 09:45 9 and 14 November 2007 th th 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 West View DS0000006518.V348028.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. West View DS0000006518.V348028.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service West View Address Underwood Lane Crewe Cheshire CW1 3SA 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) 01270 212080 www.clsgroup.org.uk CLS Care Services Limited Mrs Belinda Jones Care Home 36 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (16), Mental disorder, excluding learning of places disability or dementia (3), Mental Disorder, excluding learning disability or dementia - over 65 years of age (20) West View DS0000006518.V348028.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 36 service users to include:* Up to 20 service users in the category of MD(E) may be accommodated * Up to 3 service users aged over 55 in the category of MD may be accommodated * Up to 16 service users in the category of DE(E) may be accommodated * One service user aged over 55 in the category DE may be accommodated Date of last inspection 23rd June 2006 Brief Description of the Service: West View is a two-storey care home standing in its own grounds. Access between floors is via two shaft lifts or the stairs. The home is owned by CLS care services, a registered charity and is located on the outskirts of Crewe, close to the local shops and other community facilities. There are adequate car parking facilities available. The home provides care for thirty-six older people, and operates in two separate units - one providing care for residents with dementia and the other for residents who have mental health needs. Residents accommodation consists of 36 single bedrooms. Communal accommodation comprises a main ground-floor lounge, and six separate lounge/dining areas dispersed throughout the building. There are an adequate number of toilets and a variety of bathrooms within the home. There are secure and accessible gardens available for residents. The current fee range for the home is £429.84 - £500 per week. information about fees is available from the home manager. Further West View DS0000006518.V348028.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit took place on the 9 and 14 November 2007 and lasted for a total of six hours and twenty minutes. Paul Ramsden, Inspector, undertook the visit on behalf of the Commission for Social Care Inspection. Any references to “we” in the report refer to the Commission. All of the key standards for older people were looked at. Feedback on the findings of the inspection was given to the manager as the inspection progressed. This visit was just one part of the inspection. Prior to the visit the home manager was asked to complete an Annual Quality Assurance Assessment to provide up to date information about the service provided in the home. Questionnaires were made available for residents and families to find out their views and other information received since the last key inspection was reviewed. During the visit various records and the premises were looked at. A number of residents, visitors and staff members were spoken with; they gave their views about the home and the service provided. What the service does well: What has improved since the last inspection? During a discussion with the manager she explained that in her opinion the various staff members worked well together; they were multi skilled and therefore able to cover other jobs within the home if needed. As a result of this flexibility the number of agency carers needed to cover staff holidays and absence had been reduced which in turn provided a greater continuity of care to the residents. Residents are being encouraged to take risks in order to support a person’s independence. West View DS0000006518.V348028.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. West View DS0000006518.V348028.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 West View DS0000006518.V348028.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): 1, 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information and opportunities to visit before choosing to move in are available and residents are assessed prior to admission to ensure that their needs can be met at the home. EVIDENCE: The home provides a range of information to residents; this is contained within a guide called, “Welcome to West View”. A statement within this information says; “Moving to West View is a change of address not a change of lifestyle”. The guide contains all of the information required under the Care Homes Regulations 2001 and Standard 1 of the National Minimum Standards for Older People. During the visit we were able to talk to a person who had visited the home unannounced. She was looking for a residential placement for a close relative who could no longer look after herself safely. She confirmed that she was made to feel very welcome upon arrival at the home. West View DS0000006518.V348028.R01.S.doc Version 5.2 Page 9 As part of the inspection process the care files of three people living at the home were looked at. We found that pre-admission assessments showing that a resident’s individual needs were being assessed in an accurate and consistent way had been carried out. The home manager or senior staff members with input from the resident [where possible] and family members undertake the assessments in order to identify specific individual needs before a service is provided. Where applicable the assessment documentation provided by the placing authority was also seen on the files. Intermediate care is not provided at West View. West View DS0000006518.V348028.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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents care plans seen provided sufficient information for staff members to be able to take appropriate action to meet an individuals needs. EVIDENCE: The care team leaders are responsible for drawing up a resident’s plan of care. The six care plans seen as part of the case tracking process provided staff members with the necessary information for them to look after a person’s needs. The health and well being of residents was being monitored and an appropriate record of development and actions taken was being kept. The care plans seen contained evidence of consultation with residents or their families/advocates. West View DS0000006518.V348028.R01.S.doc Version 5.2 Page 11 Although there was evidence to confirm that the care plans were being reviewed and where necessary re-written on a regular basis some of those seen were overdue for review; we also consider that the care plans in the dementia unit were better organised and had been reviewed more consistently than those in the mental health unit. This was discussed with the home manager who was fully aware of the issues and was working with the senior staff members to address them. Staff members spoken with had a good understanding of the people they were supporting and were able to meet their diverse needs; they continually monitor the residents’ health needs and there was evidence to show that they were receiving appropriate support from health care professionals. This included GPs, community nurses, optician, dentist and chiropodist. The changing needs of individuals are discussed as and when required. We were able to see this in practice during the visit when one of the care team leaders contacted the GP because of concerns about one of the residents. All personal care is carried out in the privacy of a resident’s bedroom or one of the bathrooms. Residents spoken with confirmed that they had been able to express their opinions and wishes about their daily routines. It was seen throughout the visit that residents were being treated with courtesy, respect and good humour by staff. CLS has a written policy on the receipt, administration [including selfadministration] safekeeping, handling, recording and disposal of medication within its homes. The home uses a blister pack system dispensed by a local pharmacist. No obvious issues were seen during the inspection visit. West View DS0000006518.V348028.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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents spoken with were positive about the home and the support they received so they could maintain contact with friends and family and make choices about their daily lives. EVIDENCE: Residents were able to move around freely within their unit and a choice of sitting areas was available. They confirmed that routines within the home were flexible and that they were able to make choices in many areas of daily living; for example times of rising and retiring, participation in planned activities and where to spend time and with whom. Staff members were seen to knock on doors and to await permission before entering residents’ bedrooms. The residents spoken with made a number of wholly positive comments during the visit. Three of the residents spoken with in a lounge all said that the staff members were good and that they enjoyed living at West View. West View DS0000006518.V348028.R01.S.doc Version 5.2 Page 13 The home should have two activities co-ordinators, one for each unit. At the time of this visit however there was only one. The manager explained that she was trying to recruit another person and in the meantime the remaining coordinator was covering the two units. The activity co-ordinators role involves working with residents, both individually and in groups. A variety of social and other activities are organised and information about forthcoming events were displayed on the notice board and throughout the home. A computer is available for residents if they wish to use it. Links with the local community are maintained wherever possible. Visitors are free to visit the home at any reasonable time. Personal mail was delivered unopened, or given to relatives if appropriate. Meals can be eaten in the dining room or in the privacy of residents’ own rooms. There is a menu that has the flexibility to meet individual needs and choices. All of the residents that commented said that the food was good and that choices were available. Special diets are prepared where necessary. West View DS0000006518.V348028.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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives are able to complain and action is taken to respond to their concerns. Adult protection training for staff is available to ensure the continued safety of residents. EVIDENCE: There is a clear complaints procedure for the home; leaflets about complaints and the procedure that will be followed are available in the entrance area. This is also included in the Welcome Guide. The residents spoken with during the visit confirmed that they knew what to do if they were unhappy or wanted to make a complaint. We have not received any substantiated complaints since the previous inspection visit. The home has an Adult Protection procedure (including Whistle Blowing), which complies with the Public Disclosure Act 1998 and the Department of Health Guidance ‘No Secrets’. The manager is aware of the appropriate procedures to follow should an incident arise. Staff members receive training in this area. West View DS0000006518.V348028.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, 23, 24, 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents live in a safe, homely, clean and comfortable home. EVIDENCE: A tour of the premises was undertaken; this included communal areas and a number of bedrooms. Although the home is generally being maintained both externally and internally to a good standard the entrance area and corridors would be improved if they were redecorated. The manager explained that this was in hand and quotes were currently being obtained. During a phone-call to West View on the 28 November 2007 the home manager confirmed that the contractors were now in the home and the entrance area and corridors were being redecorated. West View DS0000006518.V348028.R01.S.doc Version 5.2 Page 16 Furnishings, fittings and lighting of the communal rooms are domestic in character. Bedrooms seen during the inspection were personalised, comfortable, well-furnished and contained items of furniture belonging to residents’. West View has two passenger lifts available to allow access between floors. The home also provides adaptations for use by residents with mobility problems. These include bath and toilet aids, hoists, grab rails and wheelchairs. The home was found to be clean and tidy on the day of inspection. The laundry is appropriately equipped and good systems are in place for the care of peoples’ clothes. West View DS0000006518.V348028.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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff members work positively with residents and families to improve the quality of life of people living in the home. A robust staff recruitment process is in place in order to protect residents from possible harm. EVIDENCE: Staff on duty and rotas seen demonstrated that staffing levels and the skill mix of staff is adequate to meet the needs of the residents within the home. Staff members were cheerful and friendly. Residents were complimentary about staff attitude and competence. The home manager has confirmed that 22 of the 41 staff members employed at the home have either achieved or are currently undertaking an NVQ qualification. The files for two recently appointed members of staff seen contained all of the required information and a robust recruitment procedure was in place for the protection of residents. Prospective staff members are checked against the POVA list before employment commences and CRB disclosures are obtained. West View DS0000006518.V348028.R01.S.doc Version 5.2 Page 18 A thorough induction procedure is in place and all new staff members undertake this in order to ensure that they are suitably trained when starting work. Copies of induction records for the most recently appointed staff members were seen on the day of the visit. A newly appointed person also confirmed that this had happened and that she had worked as a supernumerary staff member when she had commenced employment. There are a variety of training courses available for staff members. West View DS0000006518.V348028.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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is being well run and managed on a day-to-day basis. There are appropriate procedures in place to make sure that residents are safe. EVIDENCE: The home has an experienced and competent manager who is registered with the Commission for Social Care Inspection. She has attended courses/training in order to fulfil her management responsibilities and has demonstrated an awareness of the needs of the client user group and how to manage the staff group. She has completed the registered managers award. A home services manager and senior staff members support the manager. The residents that commented said that the home’s management team were approachable and supportive. West View DS0000006518.V348028.R01.S.doc Version 5.2 Page 20 Attempts are being made to seek the opinions of residents about the quality of service provided by the home; comments cards and a feedback box are located in the entrance area. A quality assurance survey to ascertain whether residents and families are happy with the standards of care being provided has been undertaken. Copies of the previous results are available. This is an on-going process and a new survey is underway. We looked at the records of residents’ personal allowances and valuables held in the safe; those checked had correct balances and were being well managed. The systems for the recording of any monies or valuables held were considered to be good. All staff members are supervised on a continuous basis; regular one to one supervision sessions are also held and notes of these meetings were being kept securely. Staff members receive training in areas such as dementia, moving and handling, fire safety and first aid. CLS have recently introduced a new computerised training database called Resource Link; although we found that this was not up to date the home manager also keeps a record of statutory and other training undertaken by staff. There is a comprehensive health and safety manual as well as policies and procedures in relation to safe working practices in place. The maintenance records demonstrated that the appropriate service contracts were in place. These included the passenger lifts, hoists and fire alarm system. The fire safety record was seen during the visit. This showed that the fire alarm and emergency lighting systems were being tested at the intervals recommended by Cheshire Fire Service. Monthly visits to comply with regulation 26 of the Care Homes Regulations are being carried out. West View DS0000006518.V348028.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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X 3 3 3 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 3 X 3 X X 3 West View DS0000006518.V348028.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 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations West View DS0000006518.V348028.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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. 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