Care Home: Westdale Care Home

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What the care home does well People said they were very happy living at Westdale, remained as independent as possible and made choices in all areas of their lives. The staff provide the support that each person needs in a caring and unobtrusive way. The food was described as `excellent`, `choice available`, `lovely` and the meal seen during the inspection confirmed this. The house itself is homely and well maintained. The communal rooms are pleasantly furnished, bright and airy. People`s views are sought so that the manager and staff can improve the service provided. What has improved since the last inspection? Care plans have improved to be more person centred and they have been signed and dated. Windows and firedoors have been replaced. The medication policy has been revised and staff have had further training. The Nottingham and Nottinghamshire Safeguarding Protocol and Procedure is available in the home and had been referred to when dealing with two incidents. What the care home could do better: Although there are no requirements or recommendations from this inspection staff must not become complacent as there are always areas that can be improved upon. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Westdale Care Home 129 Melton Road West Bridgford Nottingham NG2 6FG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Alison Hilton     Date: 1 0 0 3 2 0 0 9 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. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Westdale Care Home 129 Melton Road West Bridgford Nottingham NG2 6FG 01159233128 01159233128 westdale1@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Westdale Quaker Housing Association Limited care home 19 Number of places (if applicable): Under 65 Over 65 19 old age, not falling within any other category Additional conditions: 0 I bed is to be used for short term respite care only Date of last inspection Brief description of the care home Westdale is registered to provide personal care and accommodation for up to 19 older people. It does not provide nursing. The home is owned by a voluntary organisation and is located on a main road in West Bridgford. There are shops, churches, restaurants, public houses and public transport links in West Bridgford. The home is an adapted period property with an extension over two floors. There is a vertical lift and stair lift providing access to the upper floor. All bedrooms are single and 10 have en suite facilities, one bedroom is below minimum space requirements and is only used for respite care. There is a large, attractive and well-maintained garden to the rear of the property with seating available. There is a small care park to the front. The fees are 1702 pounds per calendar month (from 1/4/09), newspapers, hairdressing, chiropody are not included. This and other information about the service is included in the Statement of Purpose and service user guide, which the manager makes available to prospective service users Care Homes for Older People Page 4 of 25 Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The last key inspection was completed on 9th May 2007. We the Commission for Social Care Inspection (CSCI), carried out a key unannounced inspection of Westdale Care Home on Tuesday 10th March 2009 between 08:30 and 16:15hrs using the Commissions methodology described below. This report makes judgements about the service based on the evidence we have gathered. Staff, people who live in the home, visitors and the manager were spoken to. An Annual Quality Assurance Assessment (AQAA) was completed and returned to the Commission prior to this inspection. Care Homes for Older People Page 6 of 25 A number of records were seen including two staff files and two files of people living in the home. On the day of inspection there were seventeen people in the home, one in hospital and the respite bed was unoccupied. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have information that allows them to make a decision about the suitability of the home. Evidence: People spoken to during the inspection said they had received written information about the home and they or their family had visited before they made a decision about moving in. One person said they had been to see several other homes before deciding on this one. Information in the AQAA showed that there is a comprehensive Statement of Purpose and service user guide as well as other leaflets (some pictorial) available to prospective residents so they know what the home can provide and the type of care they will receive. Care Homes for Older People Page 10 of 25 Evidence: There was evidence on the files seen that staff complete a pre-admission assessment so they can be sure appropriate care can be provided to meet the needs of the person. In discussion with the manager it was evident that ethnic and diverse care needs are considered on an individual basis. Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans have personal information that allows carers to meet the needs of those living in the home. Evidence: There was appropriate care information on the files seen as part of this inspection. One person spoken to said she had talked to a member of staff when she arrived at the home telling her what I liked and she asked lots of other things and wrote them down. Most people living in the home said they managed their own personal care with occasional help at bathtime. They said the care was discreet and done in private. They were aware of care plans and they had been involved in reviewing the information to make sure it was up to date. Care plans and reviews had been signed and dated. Medication Administration Record (MAR) sheets were seen and practice observed. This showed that staff acted appropriately, gave medication as prescribed and completed Care Homes for Older People Page 12 of 25 Evidence: the sheets once medication had been taken to ensure the health of people living there. There was further evidence that the GP and other professionals are called as and when necessary, with details of their visit recorded on the persons file. Some people self medicate and risk assessments are in place to minimise the issues that could arise. These are reviewed regularly. People said they were very happy in the home, the staff were very caring and thoughtful. Staff were heard to speak to people in a pleasant manner which was friendly and supportive so people felt encouraged to undertake as much for themselves as possible. The manager said that in a recent Social Services inspection it was felt the information they held in relation to death and dying was inadequate and she had purchased a training/information pack that she would be looking at with senior staff the following day. The files seen contained the usual information about cremation or burial and the manager intends to include more personal things such as whether there is specific music they would like to be played, subdued lighting and curtains open or closed. The manager will ensure this information is included and we will consider this standard met. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People make choices about their care and the way they lead their lives so they remain as independent as possible. Evidence: People living in the home are very independent and are asked their views on all aspects within the home. Breakfast was being served as we arrived and it was like a hotel with the choices of cereal on a sideboard for people to take what they wanted. The cook came in with a tureen of porridge so people could have a hot breakfast cereal if they wished. Everyone spoken to said the food was very good, cooked fresh and there was plenty of it ensuring a varied diet. One person said staff are very attentive and good. The chef has been away a fortnight and I will tell him we need more toast on the rack. Thats all I have. The chef was spoken to and he was aware of those on diabetic diets and cooks similar looking, but less sugar content desserts so they do not feel deprived. Some of the rooms have facilities for making tea and coffee or cold drinks and people said they did make drinks when they wanted but the staff bring lots of drinks round during the day. Lunch on the day of inspection was Shepherds Pie or Macaroni Cheese with fresh vegetables, followed by home made apple pie and custard or fruit and ice cream. People said they had enjoyed their lunch and staff also Care Homes for Older People Page 14 of 25 Evidence: commented that they sometimes eat meals in the home and enjoyed them. People watch TV in their room, listen to the radio, read books and several were reading their newspapers in the lounge after breakfast. One person said I go to the keep fit class here, although theyre (the people who take the class) a bit young for us. The manager said that staff had brought a Wii into the home and people had enjoyed playing on it but had preferred the brain trainer and she was looking into purchasing one in the future. Another person said there had been karaoke in the lounge the other night but I didnt fancy it, another said Im not sure what it was (karaoke) but we sang some old songs. People make their own arrangements to visit their own hairdresser they do have one here but I have been with my own for many years and she fetches me. Some pay privately for manicures and pedicures. People said their visitors are made welcome and there were details of charges for meals if anyone wants to stay and eat in the home. This means people can maintain their contact with friends and others in the community. There were details on the notice board in the dining room that there is a craft class on the first Monday of each month, movement to music due on 12th March at 11:00 am and the last residents meeting minutes from 27th October 2008. One person said they hadnt bothered to attend that meeting but would tell staff or one of the committee if there was anything they wanted discussed. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know how to make a complaint and could be assured they would be investigated by staff. Evidence: There was a leaflet on Age Concern Advocacy and the Complaints Procedure for the home on the noticeboard in the dining room. The manager said it is quite difficult getting advocacy services as they tend only to deal with specific one off issues and not maintain contact. People spoken to said they would speak to staff, Linda (manager) or a relative if they had any concern about the home or their treatment. There had been one safeguarding incident in July 2008, which had been dealt with according to the policy in the home, and a further incident where one person alleged another slapped her. The issue had been investigated by the manager, but no evidence could be found so details were logged and staff were monitoring the situation. This is in line with the Nottingham Safeguarding Policy 2007. Information from the AQAA shows that there has been a minor incident book introduced and a new safeguarding adults policy to reflect the latest guidelines from Nottinghamshire County Council. There was evidence that staff had received training in Safeguarding Care Homes for Older People Page 16 of 25 Evidence: Adults and when asked were able to answer questions relating to the subject. Care Homes for Older People Page 17 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a homely and comfortable environment, which is well maintained and safe. Evidence: Eight bedrooms have kitchenettes and the other ten have en suite facilities so there is some choice available. The home has lots of small areas for people to sit in. The main lounge has high ceilings and is fresh and bright with well maintained furnishings. Carpets and some furniture have been replaced since the last inspection. Windows and fire doors have been replaced so the safety of those living and working in the home is maintained. The gardens look neat and people said they enjoy getting out when the weather improves. There were no unpleasant odours throughout the home. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff recruitment follows the policies and procedures ensuring people who live in the home are protected. Evidence: Two staff recruitment files were inspected and they both contained the necessary documents. The manager said that staff do not start work until the PoVA First and Criminal Record Bureau (CRB) checks are returned. This was confirmed in the two files seen. This means that people who live in the home are protected by the homes recruitment policy. Staff have undertaken an induction and further training such as dementia awareness, activities, Safeguarding (including workbook), infection control and risk assessment. Some have NVQ Level III in Health and Social Care. This shows that the manager has access to training for staff to ensure they have up to date information on areas of their work. There are three care staff on duty in the morning, plus the manager and deputy (Monday - Friday) two care staff on in the afternoon and one waking night staff. There is also a chef and domestic staff (Monday-Saturday). The staff rota was seen and this showed details of the staff on duty. The rota must not have anything tippexed out, any Care Homes for Older People Page 19 of 25 Evidence: information that is incorrect should have a line put through it so that the information is still legible. Surnames of staff should also be used. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well run and the health and safety of those living and working there is promoted. Evidence: The manager has the necessary qualifications and experience to run the home. Staff said they felt supported by her and they received regular supervision. The home has a relaxed and welcoming feel to it that reflects the care provided and the management ethos. Residents meetings are held (the last being 27th October 2008), and the minutes printed in large print and displayed in the dining room. The people spoken to said the home was delightful and staff caring and pleasant. They were aware of meetings but some chose not to attend but knew who to give their views to if they wanted them raised at a meeting. Care Homes for Older People Page 21 of 25 Evidence: The maintenance checks and servicing of equipment are completed regularly. The fire records showed that tests are completed as required. Fire extinguishers had been checked 21/4/08. The fire doors have been replaced as required at the last inspection. The manager showed us a copy of the quality assurance questionnaire she asks people to complete about the home. She is in the process of improving the anonymous questionnaires for people living in the home, and looking at ways of encouraging relatives and visitors to complete their quality questionnaires. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or 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. 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. Care Homes for Older People Page 25 of 25 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!