Care Home: Westbrook House

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What the care home does well People`s assessed needs are being met by a well established and trained staff team who seek the views of residents on a one to one `talk time` session. Care plans are individualised with relevant information on how to support each resident in relation to their assessed and identified needs. Person-centred and individualistic support and care plans with measurable goals. People using the service have an in-house day care package to enable them to access local community facilities. Health care services are provided from the local community and people using the service is registered with the local General Practice (GP) and Dentist. People using the service spoken to said that they received good care from the staff team. What has improved since the last inspection? There is a registered manager now in the care home. The carpet in the lounge has been cleaned and is awaiting replacement. What the care home could do better: The home should obtain the Guidelines set by the Royal Pharmaceutical Society in relation to the Administration and Control of Medicines in Care Homes. Photocopy of prescriptions should be taken and kept. A record of all medicines returned for disposal should also be kept. All staff working in the care home should be facilitated with training in infection control. CARE HOME ADULTS 18-65 Westbrook House Cupid Green Lane Hemel Hempstead Hertfordshire HP2 7GH Lead Inspector Bijayraj Ramkhelawon Unannounced Inspection 29th January 2008 10:00 Westbrook House DS0000019613.V358567.R01.S.doc Version 5.2 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 Westbrook House DS0000019613.V358567.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 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. Westbrook House DS0000019613.V358567.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Westbrook House Address Cupid Green Lane Hemel Hempstead Hertfordshire HP2 7GH 01442 264965 01442 267419 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) www.CareTech-uk.com CareTech Community Services Ltd Mrs Siobhan Vercesi Care Home 8 Category(ies) of Learning disability (8), Physical disability (8) registration, with number of places Westbrook House DS0000019613.V358567.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for 8 people with a learning disability (aged 1865 years and over 65 years) or a physical disability 11th April 2007 Date of last inspection Brief Description of the Service: Westbrook House is situated between the Grovehill and the Woodland Farm areas of Hemel Hempstead and is within five minutes from the local shops, Health Centre and General Practitioners. The property is a conversion of a listed, two-storey farm building. It has been refurbished to a very high standard to provide for the needs of a highly dependent group of service users. The ground floor contains eight single bedrooms; each designed with the potential care needs of the service users in mind, 2 assisted bathrooms, 2 toilets and a laundry room. The lift provides access to the first floor, which consists of a lounge, dining area, kitchen, shower and toilet facilities. The current fees range is from £1,194.03 to £1,457.36 with variance depending on assessed needs. Westbrook House DS0000019613.V358567.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took placed on the 29th January 2008. It was undertaken by one inspector and took one day. The process of the inspection included examining information received prior to visiting the care home, checking the contents of the Annual Quality Assurance Assessment (AQAA) and observing it in practice, looking at policies and procedures, documents, care plans, staff files, records, speaking to residents and staff. Feedback from residents was positive and they said that they were happy with the service provision. The overall quality rating for this service has been judged to be 2*, ‘GOOD’. What the service does well: What has improved since the last inspection? There is a registered manager now in the care home. The carpet in the lounge has been cleaned and is awaiting replacement. Westbrook House DS0000019613.V358567.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. Westbrook House DS0000019613.V358567.R01.S.doc Version 5.2 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 Westbrook House DS0000019613.V358567.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Comprehensive assessments have been carried out for each person living in the care home in respect of their needs and aspirations with regular reviews undertaken. EVIDENCE: Comprehensive assessments of each individual’s needs and aspirations were undertaken and ‘whole life’ reviews were held annually. Each person has a written contract and terms and conditions of stay. Many of the people using the service have social support from family members and all have the dedicated support of staff and other professionals. Westbrook House DS0000019613.V358567.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans were detailed and included information on all assessed health care needs, social needs and risk assessments. People were supported to make decisions about their lives and participated as fully as possible in all aspects of life in the home. EVIDENCE: Care plans examined provided evidence that individual’s assessed needs and aspirations were identified and met. Care plans were reviewed regularly and reflected people’s changing needs. People using the service have their individual activity and leisure programme including access to local amenities. Policies and procedures in relation to confidentiality were in place and these were included in the induction-training programme for staff and in ongoing Westbrook House DS0000019613.V358567.R01.S.doc Version 5.2 Page 10 training. The records relating to the people living in the home were securely stored. Westbrook House DS0000019613.V358567.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13,15, 16 & 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the care home were encouraged and enabled to make choices in relation to their food, clothes and activities to optimise their abilities in developing their skills. They were also encouraged and supported to pursue social and leisure activities as stated in their individual care plan. EVIDENCE: Individual’s personal development was promoted by engaging in planned day care, social and leisure activities. People are encouraged to maintain contact with their relatives and those who are important to them. There are yearly holidays or trips according to people’s preferences. Community activities recorded included trips to places of interests and local amenities. Westbrook House DS0000019613.V358567.R01.S.doc Version 5.2 Page 12 A weekly menu with choices was available for people using the service. The dietician visits the home on a monthly basis to monitor the weight of some of the residents. Policies and procedures are available that reinforce respect for service users rights and responsibilities. The terms and conditions of placement also set out the service user’s rights and responsibilities in a user-friendly format. Westbrook House DS0000019613.V358567.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff constantly review their practice to ensure that service users receive personal and healthcare support in a manner that is both appropriate to individuals and in a style that the individual prefers. EVIDENCE: Care plans demonstrated that personal support is delivered in a way that individual’s prefers. People’s personal and health care was being provided as set out in their care plans. The progress notes indicated that identified needs were being met and kept under review. Changes in any needs were also reflected in individual’s care plan. One service user is fitted with a PEG feed and the District Nurse checks the apparatus weekly. A dietician who calls every six weeks also supports the service user. None of the people living in the home are able to self-medicate due to individual’s complex needs and profound learning disabilities. The administration and management of medicines were kept in good order except it was noted that there was no records of medicines returned for disposal, nor Westbrook House DS0000019613.V358567.R01.S.doc Version 5.2 Page 14 photocopies of prescriptions were kept. It was also noted that the Guidelines set by the Royal Pharmaceutical Society in relation to the Administration and Control of Medicines in Care Homes was not available for staff. Westbrook House DS0000019613.V358567.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the care home and their families can feel confident that their concerns would be listened and people using the service would be safeguarded and protected. EVIDENCE: Staff employ a range of approaches to obtain residents’ views. However, with the exception of the two service users who have verbal communication skills, ‘Talk Time’ has been abandoned in favour of resident’s meetings, (where all service users can be better represented). There is a pictorial and easily understood complaint policy readily available to people using the service. No complaints but two compliments have been received since the last inspection. Staff have received training in Safeguarding Adults. Westbrook House DS0000019613.V358567.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the care home are encouraged to choose individual styles for their bedrooms, which helps to promote their independence and the building generally offers a comfortable, safe and homely environment. EVIDENCE: All rooms are for single accommodation. People’s bedrooms were personalised with individual’s belongings. Staff encouraged people to bring and/or choose their own furniture and can decorate and personalise their rooms, subject to any fire and safety regulations. The premises were safe, accessible, comfortable, reasonably clean and free from offensive odours. Each room has sufficient light and ventilation. The bathroom and toilet provision is sufficient for the number of residents in the home. Westbrook House DS0000019613.V358567.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. An experienced, effective and trained staff team supports the people in the home. The staff recruitment policy and procedure is robust and implemented so as to ensure people are safe. The staff team are well supported by management and formal supervision was provided. EVIDENCE: Staff duty rota showed that there is adequate number of staff rostered on days and nights to meet service users needs. 3 care staff have completed their NVQ Level 2 and another staff is currently working towards this course. One has completed the NVQ Level 3. Staff were aware of and promoted the main aims and values of the home including the key worker system. Staff confirmed that they have received a job description on starting employment and they undergo a period of induction, Westbrook House DS0000019613.V358567.R01.S.doc Version 5.2 Page 18 which included working along side a senior care staff. They also confirmed that they do receive formal supervision on a regular basis. Staff files examined had a proforma for each staff indicating that all checks required by this Standard have been carried out and the required documents are held at the head office. Westbrook House DS0000019613.V358567.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, & 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home can be confident that their views underpin all self monitoring, review and development by the home and that their rights and best interests are safeguarded by the home’s policies and procedures. The health, safety and welfare of people living in and staff are promoted and protected. EVIDENCE: All appropriate written policies and procedures were in place. All records examined were well documented. Staff spoken to confirmed that regular fire drills did take place, which everyone takes part in. A monthly meeting for people living in the care home is held where people have a formal time to air Westbrook House DS0000019613.V358567.R01.S.doc Version 5.2 Page 20 their views. Staff confirmed that they felt supported by the management team and residents gave every indication of being content and secure. The manager is now registered with CSCI and is working towards the Registered Managers Award (RMA). All staff completes the statutory training to maintain safe working practices and the home complies with all relevant legislations to safeguard the health, safety and welfare of service users and staff. Staff who handled food have undertaken food and hygiene training. However, not all staff have been facilitated with the training in infection control. Accidents, injuries, incidents of illness were recorded and reported. The home has a valid insurance cover for legal liabilities to employees, service users and third party persons to a limit commensurate with the level and extent of activities undertaken or to a minimum of £5 million. Westbrook House DS0000019613.V358567.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 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 3 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 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 x 3 x x 2 x Westbrook House DS0000019613.V358567.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. 1. Refer to Standard YA20 Good Practice Recommendations a) Guidelines set by the Royal Pharmaceutical Society in relation to the Administration and Control of Medicines in Care Homes should be obtained. b) Photocopy of prescriptions should be kept. c) A record of all medicines returned for disposal should be kept. All staff working in the care home should be facilitated with training in infection control. 2. YA42 Westbrook House DS0000019613.V358567.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Inspection Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Westbrook House DS0000019613.V358567.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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