Care Home: Westbourne Lodge

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What the care home does well There are good systems of assessment and care planning that help people be supported to have their needs met. The staff who support people respect their choices and have good relationships with them, helping people to feel valued and to have good engaging conversations. The home is very clean and comfortable throughout, offering people homely accommodation. There are good systems in place to support people would they wish to raise a concern and people were confident that their views would be listened to and acted upon. The manager is experienced in their role and ensures that the health and safety and maintenance checks are kept up to date helping to ensure that people are kept as safe as possible. What the care home could do better: Assessments must be undertaken for aids to daily living that people utilise to ensure that they are correct for the individual and do not pose a risk to safety. The handling of medication and the recording of peoples prescribed medicines must be improved upon to ensure that peoples health is not compromised. The laundry wall must be repaired to ensure that it does not compromise the control of infection within the home. Random inspection report Care homes for older people Name: Address: Westbourne Lodge 126 Cardigan Road Bridlington East Yorkshire YO15 3LR three star excellent service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Sarah Rodmell Date: 1 2 0 4 2 0 1 0 Information about the care home Name of care home: Address: Westbourne Lodge 126 Cardigan Road Bridlington East Yorkshire YO15 3LR 01262676611 01262676611 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Sandra Margaret Turvey Type of registration: Number of places registered: Conditions of registration: Category(ies) : Dr Khalid Hussain Javed,Dr Mussarat Javed care home 20 Number of places (if applicable): Under 65 Over 65 20 20 dementia old age, not falling within any other category Conditions of registration: Date of last inspection Brief description of the care home 0 0 Westbourne Lodge is a large detached building situated in a residential area of the town. A former dwelling house it has been extended and adapted to provide accommodation for 20 residents. Its location makes it convenient for access to local facilities and amenities and to the town centre. Public transport passes the door. There is a car park. The home is on two floors. Level access is available to all external ground floor doors. There is a passenger lift and chair lifts including one with wheelchair access. The ground floor has communal areas together with a number of bedrooms. Care Homes for Older People Page 2 of 10 Brief description of the care home The upper floor houses residents bedrooms, all but one with an en-suite facility. Communal bathrooms and toilets are suitably located throughout the premises. There is a large secure garden to the rear provided with suitable outdoor seating. Ramped access is provided to this area. Westbourne Lodge accommodates people admitted by virtue of old age and infirmity, some of whom may be suffering from dementia. The staff provide personal care, an in-house catering service, laundry service and a domestic and cleaning service. Staffing cover is available in the home throughout the 24-hour period each day. Leisure and recreational facilities are provided. Each resident is registered with a general medical practitioner who addresses their primary health care needs and they can access the more specialised health services as required. Care Homes for Older People Page 3 of 10 What we found: This random visit was completed on 12th April 2010 and lasted 3.5 hrs, with the last Key inspection being undertaken on 25 May 2007. The service was not told in advance when this visit would take place. The manager was available throughout the visit and we spoke to some of the people who live in the home , the manager and some of the staff team. We received surveys back from the home, all of these were positive in their replies and some of these details are included in the report. We looked around the service and inspected peoples records and other documents held in the home. We looked at the following standards: Health and Personal Care We looked at the care files for three of the people who live in the home. The care files included details of an assessment of need for each person. A plan of care then included these details and identified how these needs would be met. The manager has additionally completed a care plan summary that is held at the front of each folder. This summary assists the staff to quickly access information about the service user, and how to meet their needs. When possible the individual service user has signed to say that they are aware of and agree to the content of the care plan. The manager included in the AQAA, The service user care plans provide the staff with good quality, up to date information to ensure that the service users assessed needs are met. The assessment and the care plan both included the details of each persons health needs, medical history and mental health and cognitive needs. The entries reflected that these files are regularly updated, and there were also reviews from the persons key worker. The files included records of visits from the GP and district nurse, with the details of the outcome of these visits.Information regarding specialist hospital support was were also in place. People confirmed both when we spoke to them and in the surveys we received that they are supported to meet their medical needs. The manager recorded in the AQAA, Emphasis has been placed on staff training to ensure that they are competent and confident to provide good standards of care. One person uses an aid to assist them with movement, although there is not an assessment of need or risk assessment in place and the necessity for this was discussed with the manager at the time of the visit. We observed the medication administration in the home. The staff member checked with people if they required any prescribed additional medicines for example, pain killers. This was undertaken in respectful way, maintaining peoples privacy and dignity. Each time the staff member had to leave the medication trolley to assist a service user, she ensured that it was safe to do so and that peoples medication would not be compromised. Although overall practices seen were good the staff member did on occasions dispense tablets into her hand prior to putting them in an appropriate container. This compromises both the safety of the staff member and the integrity of the medication and must cease. We saw that the storage of medication is secure and that records are kept of all medication received, administered and disposed of in the home. There are some records that were hand written and the manager was advised as to the necessity to ensure that these entries are signed by two people to confirm that these details are correct. We saw Care Homes for Older People Page 4 of 10 that the records for the medication described as controlled were up to date and correct. There is a fridge for the safe storage of medication and we saw that daily temperature checks are undertaken to ensure that this is correct and that the medication is not compromised. There has been a recent medication error in the home. This was dealt with appropriately by the manager and staff, ensuring that the person concerned received the correct medical attention and also that this was reported to the CQC. Following this the manager has completed a review and changed some practices in the home whilst also organising additional refresher training on medication for all staff. We observed that peoples appearances reflected their individual personalities and that they were spoken to by their preferred form of address at all times. The manager and staff also ensured that when we spoke to people we were aware of their preferred form of address . We observed the conversations between the people who live in the home and the staff. These conversations were respectful and reflected good relationships. People were chatty and it was clear that this interaction is valued by all involved. Daily Life and Social Activities We spoke to the manager about the previous recommendation for access to transport for activities. She told us that this is no longer an issue as the home now have easy access to a local taxi that also has disabled access and who works well with the home ensuring that people attend any activity they wish to. We did not assess the remaining standards at this inspection. Complaints and Protection We looked at the procedures in place for handling complaints, and the records for any complaints received by the home. No complaints have been received by either the CQC or the service. When we spoke to people who live in the home they told us that they had no concerns about the home, but when asked they said that if they did have they would speak to the manager. They were confident in their answers that the manager would address these concerns. We received surveys back from people who live in the home, all of these were positive and no concerns were raised in any. The manager included in the AQAA, To encourage more visitors to complete questionnaires, therefore more feedback can be reviewed and necessary improvements made prior to any formal complaint being made. The home has a copy of the Local Authority policy The Protection of Vulnerable Adults and a member of staff told us that they had attended training regarding preventing abuse and older people. The manager told us that she has also attended training on protecting vulnerable people. The manager told us about one concern that had been raised as a safeguarding incident by the local health service and had been dealt with by the local authority. The result of this investigation was inconclusive and the manager told us about the actions that she has taken to ensure that this situation does not occur again. Environment A member of staff assisted us to complete a tour of the premises and found that the home was very clean and comfortable throughout; all areas were warm and homely. We Care Homes for Older People Page 5 of 10 asked people what they thought about their rooms and they told us that they were very happy with them. We saw that peoples rooms were nicely furnished and that people were able to personalise them to make them more homely. Toilets are situated throughout the home that offer easy access for people, this helps to maintain peoples dignity. We saw that there was a small damaged area to the laundry wall and the member of staff told us that this had happened recently and that the handy man was aware of this and that it was scheduled to be repaired. We saw the fire records kept within the home. These showed that the fire system, emergency lights and portable fire extinguishers had all been serviced to ensure that they remained in good working order. There had been a recent fire drill and the manager had completed risk assessments regarding this. Staffing We spoke to the manager about the recommendation regarding staffing levels from the last visit to the home. The manager told us that this was regarding additional staff for activities and that this has now been addressed. She told us that she supports the local college and that people who are undertaking care and nursing courses spend time in the home and that these people assist the permanent staff to help people undertake activities. She also told us that the staff are able to undertake additional hours to assist people with activities as necessary.The remaining standards were not assessed at this inspection. Management and Administration The manager has worked in the home for some time and is experienced in their role. They told us about the training that they had completed over the last year and this included training on Moving and Handling, Health and Safety, Nutrition, Deprivation of Liberty and Team Work. This training helps the manager to keep up to date with her knowledge and skills. When we spoke to both people who live in the home and the staff team they all told us that they felt the manager was approachable and would assist them with any concerns. There continues to be a quality assurance system held within the home. We looked at the records for this and saw that questionnaires and reports were completed last year. These included the views of the people who live in the home, relatives and other professionals who are involved in the home. Additionally there are monthly meetings for both the people who live in the home and for the staff who work in the home. These systems help to ensure that the people who live in the home are consulted on and involved in its development. We looked at the maintenance records held in the home. There are records of the monthly checks of all the hot water outlets to ensure that temperatures remain close to 43 degrees and do not pose a risk of scalding to the people who live in the home. There were certificates to show that the gas and electrical systems, including the portable appliances were all checked to ensure their safety. The manager has completed Health and Safety risk assessments in the home, including generic assessments, safe working Care Homes for Older People Page 6 of 10 practice assessments and Control of Substances Hazardous to Health (COSHH) assessments. Records are also kept of all accidents in the home. What the care home does well: 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 2. Care Homes for Older People Page 7 of 10 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 8 of 10 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, 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 Medication must be 04/05/2010 dispensed directly into a medication container and must not be directly handled by staff. This will help to ensure that medication and peoples health is not compromised. 2 9 13 Handwritten entries on 04/05/2010 medication charts must be witnessed by two people and counter signed by both witnesses. This helps to reduce the risk of errors occurring. 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 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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