Care Home: Westbury House

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Westbury House 2 Blenheim Road Deal Kent CT14 7DB two star good service The quality rating for this care home is: 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: Geoffrey Senior Date: 2 0 1 1 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. They reflect the things that people have said are important to them: 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 Adults (18-65 years) 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. 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. Internet address www.csci.org.uk Information about the care home Name of care home: Address: Westbury House 2 Blenheim Road Deal Kent CT14 7DB 01304360696 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): westbury.house@robinia.co.uk The Robinia Care Group Ltd Name of registered manager (if applicable) Mrs Emma Roberts Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 13 0 care home 13 learning disability Additional conditions: The registered person may provide the following category/ies of service only: Care home only ? (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) The maximum number of service users to be accommodated is 13. Date of last inspection A bit about the care home Westbury House is a large 13 bedded home for people with learning disabilities in the seaside town of Deal. The service is owned by Robinia Care, which is a relatively large organisation with a number of care homes in the South East providing services for people with learning disabilities. The house is set in a residential area close to the town centre and near to the beach. The premises benefit from a garden to the front and large courtyard to the rear. There is adequate communal space and comfortable bedrooms. The resident group has been stable for some time and there is a good blend of youth and experience in the staff team. There is access to a suitable vehicle for trips out. The fees range for the home is #704.30 to #1043.73 per week. For more information about the fee and what it includes please contact the Provider, Westbury.house@robinia.co.uk Previous inspection reports are available from the home. 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home How we did our inspection: This is what the inspector did when they were at the care home This was an unannounced inspection on the 20/11/08 The inspection lasted for around 4 hours. Discussions were held with staff and residents and a tour of the premises was undertaken. A range of documentation was viewed including service user plans and health and safety records amongst others. What the care home does well Westbury House provides a caring, supportive and empowering environment for the service users. There is an excellent range of activities available based on collective and individual needs. These include meaningful and creative activities in the home, trips out to theatres, events and places of interest, visiting entertainers, attendance at local colleges amongst other things. The staff work positively with the residents assisting them to communicate their needs and develop greater levels of independence and confidence. Service user plans are set out in good detail and personal profiles containing photographs of the individuals engaging in activities are being further developed. There is good leadership in the home and throughout the organisation ensuring that staff and service users opinions are heard and that the service continues to develop. Health and safety processes are maintained well and there is a good staff development programme in place. What has got better from the last inspection What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Geoffrey Senior 33 Greycoat Street London SW1P 2QF 02079792000 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 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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 . Prospective service users may visit the home and are provided with comprehensive information to help them make a decision about moving in.Assessments are undertaken to ensure that the Home can support the service users needs and aspirations. Evidence: The service user group is well established and there have been no recent admissions. Staff spoken to described the admission process and emphasised the importance of ensuring that the service users needs are fully assessed and can be appropriately supported by the home. Admissions, even if they are known to the service, are subject to a protracted introduction and assessment period. Prospective service users would be encouraged to visit the home prior to admission and use the opportunity to meet and spend time with the existing service users and staff, view the accommodation and find out about the routine and lifestyle they could expect to experience at Westbury. Assessments, undertaken prior to, and subsequent to admission contribute to the care planning process. Input is welcomed from the service users and families and from relevant agencies and professionals. Aspirations may be expressed and, where possible/ achievable, appropriate support is planned. Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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 . The care planning system is clear, consistent and provides staff with information and guidance when supporting residents.Individual goals are identified and considered within the planning and risk assessment process. Service user plans identify the needs of service users and the home ensures that healthcare needs are met. Residents are enabled to make decisions affecting their daily lives. Risks are assessed positively and comprehensively. Evidence: The home has developed well-structured, informative and person-centred service user files. The needs of each individual are clearly identified as well as the actions required by staff to support residents. There is an effective key worker system in place and they have been working with residents to develop life stories, communication books using photographs to demonstrate choices. Each choice book, with personalised photos of favourite outings, activities and significant people along with makaton symbols has greatly aided communication, to see better what people need and want and proved stimulating to staff as well.All care plans are reviewed on a regular basis and handovers and team meetings are used to pool ideas and develop support plans further. The registered manager provides good support empowering key workers and residents to work positively together.The manager is introducing positive behavioural support plans and encourages staff to be proactive and lateral in their thinking.Long established patterns of behaviour have been looked at with a view to promoting the benefits and intervening only if and when risk arises. Staff have received training at the organisation headquarters. The home has a good system of risk management and Evidence: assessment in place clearly addressing issues and promoting the independence of the service users. Clear guidance is developed to ensure staff minimise any potential risks and the assessments are regularly reviewed. There is clear evidence through documentation and observation that service users are ffacilitated to make daily decisions affecting their lives with regard to routines, trips out, activities and food choices amongst other things. A positive ethos of empowerment has been nurtured in the home. Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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 . The home provides an excellent range of therapeutic and leisure activities based on personal needs, wishes and interests. Family and friends are welcomed into the home and contact with the local community is maintained. Evidence: Staff in the home have worked very positively with residents to establish interests, likes and dislikes. They are supported by the organisation to provide a wide range of formal and informal activities and events for both recreational and therapeutic purposes.Staff often take photographs of residents engaging in activities such as getting on a bus or going out to the theatre and use them to assist future communication. The registered manager with the support by the staff team has fostered a positive and active culture within the home. Family and friends are welcomed into the home to visit service users and assistance is also appropriately provided to enable residents to travel to visit their relatives. The staff keep in good contact with significant others to update them on progress and changes. Residents have regular opportunities to use local community facilities such as the sports centre, library, cinema and local shops. Staff are aware of individual likes and dislikes and cater accordingly whilst maintaing a reasonably varied and balanced diet. Service users are encouraged to spend time in the kitchen participating in the preparation of food and drinks. This is within a risk Evidence: assessed framework. Risk is not considered to be a barrier to activity. Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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 . Service users are treated with respect and their privacy is respected. Healthcare needs are appropriately addressed. Medication systems and procedures are adequate and safe Evidence: Residents are treated with dignity and respect and levels of privacy are maintained. All of the service users require assistance with aspects of personal hygiene and care. The organisation ensures that staff are instructed and supervised to provide this thoughtfully and sensitively. Service users choose and wear their own choice of clothes and are assisted to live their lives as autonomously as possible. The healthcare needs of service users are monitored and addressed. It was reported that the home has developed positive relationships with local GPs and District Nurses who provide good levels of support. There is clear documentation demonstrating that health issues are identified and acted upon with advice from professionals. Additional equipment and facilities are assessed and provided where residents have had changing levels of need. The medication records and storage facilities were viewed, all of which is adequate for the needs of the home. Medication Administration records were clear, accurate and up to date. The home has good policies and procedures in place and staff administering medication are provided with appropriate training. Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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 . Systems are in place to protect and safeguard vulnerable adults from the risk of harm. Evidence: Staff are well aware of their responsibilities regarding the protection of vulnerable adults. There is clear written information and guidance available to all interested parties. Service users are encouraged to communicate any thing that is worrying them to the manager or staff member straight away so it can be dealt with and lessen any anxieties. The organisation has a robust recruitment procedure that undertakes checks and references on prospective staff members prior to commencement of duties. 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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 premises are safe and well maintained and the home is clean and hygienic. Evidence: The premises are suitable for the stated purpose of the home. Service users are enabled access to both floors of the building with the use of a passenger lift. There is an adequate amount of communal space with a large lounge and an activity/dining area. There are attractive gardens, which have been steadily improved and a large courtyard. The organisation has demonstrated a willingness to continually improve the environment and an annual development plan is submitted by the registered manager for consideration by senior managers. Maintenance and improvements are prioritised and costed. There is a works department that is available to address day-to-day maintenance issues as required. The building reportedly complies with environmental and fire department regulations. The premises were clean, odour-free and hygienic at the time of the visit. There are adequate policies and procedures in place for the control of infection and an understanding within the staff team of these issues, which are underpinned by induction and additional training. Laundry facilities are suitable for the needs of the service and hand washing facilities are readily available throughout the home. 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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 . There are sufficient numbers of staff on duty at all times and a good staff development programme Evidence: There are at least 4 members of staff on duty throughout the day. Staff are also on duty throughout the night. The registered manager is also on duty throughout the office hours of 9-5. In addition to this the home has a full-time cook, cleaners and available maintenance staff. There is also an Occupational Therapy assistant who provides support to the service users and staff team through organising individual and group activities both in and out of the home. She assists in the development of support plans and other information such as communication tools, etc. The home benefits from a good blend of youth and experience, with a senior staff member on duty at all times. The home also has a bank of relief workers who are employed to provide additional cover and deputise for annual leave and sickness. Robinia Care offer staff a good development programme. There is a comprehensive induction process that all staff are supported to work through. All mandatory training is provided within the first 6 months of employment and staff receive updates and refresher courses as required. Additional courses are also provided covering a wide range of issues from adult protection to challenging behaviour. Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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 . There are robust quality assurance processes ensuring that the home is run in the best interests of the service users. The health, safety and welfare of all is promoted and protected. Evidence: Monthly monitoring visits are carried out by senior managers to the home ensuring that the standard of care and relevant documentation is maintained and that the premises are in good order. Discussions are held with staff and service users. The registered manager has fostered an open and positive ethos in the home enabling staff, relatives and service users, where possible, to feedback about the service. There is an annual development plan for the upkeep of the premises and the registered manager has elements of control over day-to-day budgets. There is a clear system of accountability within the organisation. The health, safety and welfare of service users, staff and visitors is well-maintained in all areas. Staff receive all necessary training and induction into the service. There are policies and procedures clearly set out to ensure the safety of all individuals, which are regularly reviewed and updated as required. A range of documentation was viewed regarding health and safety including fire and accident records and evidence of routine maintenance and service checks. All information was up to date and complete. Environmental risk assessments have been completed and are reviewed. Are there any outstanding requirements from the last inspection? Yes  No  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 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 Description 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 Description Timescale for action 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 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. - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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