Care Home: Westerley

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What the care home does well People who live in the home were pleased with the care they received from staff. Surveys received included these comments. " The staff are attentive to my medical needs." "All the helpers are very caring." "I do not feel the home could look after me better than it has." The word "happy" was used by several people who live in the home. " I am happy and content." "I am happy here. I feel it as much like home as it could be." People felt that they received the care and support they needed and that staff were always or usually available when they needed them. People said that there was always someone they could speak to informally if they were not happy and most knew how to make a formal complaint. When asked what the home does well one person wrote " Treats residents with care and respect." People are encouraged and supported to make choices about daily living and to continue to be active and pursue their own interests. There is a choice of food and efforts are made to ensure special diets are adhered to when required. One person wrote " I am never given any food that can upset me." The home environment is overall very pleasant. There is ample sitting rooms, a light dining room and individual attractive bedrooms. the gardens are a real joy for some people who live in the home being easily accessible, well designed and maintained. Surveys received from people said the home was always fresh and clean. What has improved since the last inspection? The assessments undertaken when people come to the home are more fully recorded and include personal information. A new electronic care planning system has been implemented which gives staff much clearer guidance regarding the care to be provided. The appointment of manager Stevie Shaw has resulted in changes and development in the management and administration systems in the home. The requirements from the last report have beeen addressed. The new care planning system requires people to sign to say they have been involved in the care planning process. Night care records are now kept in the main care plans. People are weighed monthly and the manager was able to talk about the importance of monitoring weight and the actions that would be taken if people lost weight.The dependency and changing needs of people in the home are monitored closely and changes made to care plans when needed. Staff have undertaken an open learning course for caring for people with dementia. Bank staff are available to cover in the event of sickness or holidays. Substantial refurbishment has been undertaken to include a new heating and hot water system. The medication system has been improved to include staff training and regular audits. There is an in-house manual handling trainer who is responsible for staff up-dates. Shift supervisors have been supported and given training to develop their role and a key worker system has been introduced. What the care home could do better: The home is currently without a deputy manager and this has limited some of the work that can be done. The manager said " I have prioritised and begun by implementing the new care plans." There is work to be done on developing the training plans and on implementing a sound appraisal and supervising system for staff. The activities and social programme of the home could be more fully developed although it is improving. An activities co-coordinator for a few hours a week would add a new dimension to the home. The manager is currently the person responsible for health and safety in the home and all servicing seen was current and records were well organised. The manager should conduct a full health and safety audit and put in place staffing arrangements to ensure all functions are undertaken. Key inspection report Care homes for older people Name: Address: Westerley King Edward Road Minehead Somerset TA24 5JB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Shelagh Laver     Date: 3 0 0 7 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 25 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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: Westerley King Edward Road Minehead Somerset TA24 5JB 01643702066 01643708978 minehead@lwpt.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): The Leaders of Worship and Preachers Homes Name of registered manager (if applicable) Type of registration: Number of places registered: care home 21 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated 21. The registered person may provide the following category of service only: Care Home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home Westerley is a large detached property, set in spacious and beautifully maintained gardens. The home is situated close to the centre of Minehead, where there are all local amenities. The home is registered with the Care Quality Commission to provide care and Care Homes for Older People Page 4 of 25 Over 65 21 0 Brief description of the care home accommodation for up to twenty-one people over the age of 65 years, who require assistance with personal care. The home is not registered to provide nursing care. The home also provides day care which is not regulated or inspected by the Commission. The Manager is Stevie Shaw who will be registering later this year. The Registered Provider is Mutual Aid Homes trading as LPMA Homes. The home cares for people within a Christian community and accepts requests for assessment from all Christian denominations. A short Christian service takes place in the home each morning. Accommodation is provided over two floors. There is a passenger lift, two assisted bathrooms and a call system available. All areas of the home have been well maintained and furnished to a high standard. We were provided with information which identified the current fees levels as between #441 and #518 per week. All rooms have en-suite toilet facilities and an additional supplement of #7 per week is incurred for the provision of an en-suite with bath/shower. A rebate of #30 per person is given for married couples sharing a double bedroom. People meet the costs of personal items/toiletries, private chiropody, newspapers and hairdressing. People are encouraged to maintain their independence and to follow their own interests in the home. 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: To carry out this unannounced Key Inspection we (Care Quality Commission ) visited the home over one day to meet with people who lived there. We reviewed care and staff files and spoke to the manager and staff on duty. Before the inspection took place we requested and received an Annual Quality Assurance document which gives us information about the home in the previous year. The AQAA also gives us factual information about the home and outlines their plans for the coming year. We sent surveys to people who live in the home and received 9 replies. We reviewed information that we had received from the home since the last inspection. Care Homes for Older People Page 6 of 25 What the care home does well: What has improved since the last inspection? The assessments undertaken when people come to the home are more fully recorded and include personal information. A new electronic care planning system has been implemented which gives staff much clearer guidance regarding the care to be provided. The appointment of manager Stevie Shaw has resulted in changes and development in the management and administration systems in the home. The requirements from the last report have beeen addressed. The new care planning system requires people to sign to say they have been involved in the care planning process. Night care records are now kept in the main care plans. People are weighed monthly and the manager was able to talk about the importance of monitoring weight and the actions that would be taken if people lost weight. Care Homes for Older People Page 7 of 25 The dependency and changing needs of people in the home are monitored closely and changes made to care plans when needed. Staff have undertaken an open learning course for caring for people with dementia. Bank staff are available to cover in the event of sickness or holidays. Substantial refurbishment has been undertaken to include a new heating and hot water system. The medication system has been improved to include staff training and regular audits. There is an in-house manual handling trainer who is responsible for staff up-dates. Shift supervisors have been supported and given training to develop their role and a key worker system has been introduced. 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 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. The home provides information to assist people to make a decision about coming to live in the home. There is a structured assessment procedure in place to ensure the home can meet peoples needs. Evidence: The home produces an information pack and has up-dated the statement of purpose. The home provides for people who have a Christian ethos. There are morning devotions that are enjoyed and valued by people in the home. There is a home policy on referrals and assessment. Whenever possible the manager will undertake a full standard assessment before someone comes to the home. All admissions are offered a one month trial. We looked in detail at three files. We saw assessment documents that included a health and social care questionnaire, a health statement and a financial assessment. Some files contained assessments and reviews from social workers and hospital Care Homes for Older People Page 10 of 25 Evidence: discharge information. People come to the home for respite care and decide to come back many times. Some will decide eventually to stay permanently. The manager of the home has a clear view of the people whose needs could be met in the home and will advise and support people and their families in the event of changing needs. People can come to the home from any area of the country however the manager is also raising the profile of the home in the local area to ensure peope know the services that they can offer. 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. There are care plans in place that state peoples needs and give direction to staff regarding actions to be taken. There is a medication system in place that indicates safe storage and administration. People feel they are treated with respect and their privacy is upheld. Evidence: Since the last key inspection the care planning system has been reviewed and improved. Computer generated plans have been used as the starting point of the system with each plan being adapted and made relevant for each person. Care plans are comprehensive and included clear guidance regarding personal care to be delivered. There is evidence that people at the home receive a good standard of health and personal care. The manager told us there was no one in the home with pressure damage. We saw that people are registered with General Practitioners and received regular visits to attend to routine and emergency health matters. Records indicate that people can access dentists,chiropodists and can attend hospital appointments. There was evidence that peoples health improves in the home. A review of a recently Care Homes for Older People Page 12 of 25 Evidence: admitted person said that wounds had healed and falls had diminished. The person said he felt content and settled. The staff at the home have maintained the health of one person for some time by working closely with the local surgery and promoting independence. When testing the blood sugar of a person with diabetes the actual number should be written and not qualitative comments such as low or high. There was guidance in the care plan regarding action to be taken in the event of a significant change however it is required that a training up-date is provided to all staff to ensure a standard response. Weights are monitored in the home and the records of one person recently admitted indicated a weight gain. There was evidence that medication is stored and administered safely.Medication is supplied by Boots and medication administration charts were seen to be completed accurately. Staff had received training and up-dates are planned. There is an audit system in place from the chemists. All people who returned a comment card or who were spoken to during the inspection said they were treated with respect and kindness. One person said they look after me well. I am quite happy. 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 are able to make choices about how they spend their days. Family and friends are welcome in the home at any time. People are offered a choice of wholesome food with attention paid to special dietary needs. Evidence: People spoke positively about the food. The menus are displayed and indicate a choice of main meals. Menus have been reveiwed and up-dated and include additional supper choices such as cheeseboard and soup of the day. Two people spoke about the ways in which the home ensured that they were able to follow special diets. Entries in the diary showed that people invited guests for lunch and also went out to eat with families and friends. Meals can be flexible if people have appointments. The dining room is being redecorated however people were seen eating lunch in a pleasant adapted room. Tables are set attractively, people are given plenty of time to enjoy their meal and assistance when needed was polite and appropriate. People in the home have formed a social committee and people said that they enjoyed the quizzes and occasional outings. People talked about pursuing their own interests in the home. One person talked about painting and reading the papers, another knitting and Care Homes for Older People Page 14 of 25 Evidence: listening to the radio. The garden surrounding the home is a source of enjoyment to many. One person had just picked sweetpeas from the garden. There was an opportunity to go for walks or enjoy sitting in one of the attractive seating areas. Some people said they would like more activities and the manager is planning to develop the social and activities programme further. It is hoped that an activities coordinator can be apoointed for a few hours a week in the near future. People confirmed that visitors are welcome in the home a any time and those spoken to during the inspection said they were welcomed into the home and were kept informed about the welfare of family members. 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. There is a complaints procedure in place that is clearly displayed. There are policies and procedures in place to protect people who live in the home. Evidence: A large print complaints procedure is displayed on the community notice board. This had been up-dated to include contact details of CQC and the Somerset Safeguarding Adults team. A complaints file is kept however there have been no complaints since the last inspection. Support for people is available from keyworkers, the home chaplin and shift leaders if help is required to access this procedure. The home tries to ensure that concerns are dealt with promptly and do not become complaints. There is a clear whistle blowing policy in place. Staff are trained to and there are plans to keep them regularly up-dated using the Safeguarding adults in Somerset guidance. Recruitment and staff management procedures are designed to keep people safe. Care Homes for Older People Page 16 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 an attractive and comfortable home that is adapted to meet their needs. There are policies and procedures in place to minimise the spread of infection. Evidence: On the day of the inspection the home appeared overall well maintained and comfortable. All bedrooms seen were en-suite, comfortable and reflecting peoples taste and interests. There is plenty of communal space with two lounges and a sun room overlooking the garden. There is a loop system fitted in the main TV room. There is a separate laundry room. All bedroom doors are lockable. At the time of the inspection the home is having a new heating system installed and this has involved some disruption in the home. The building works had been well managed. One person said they were not disturbed at night or at the weekend. People had been offered alternative rooms when appropriate. The home has some very pleasant unregistered rooms that will be considered for registration in the coming year once all building work is complete. The gardens are a real feature of the home being accessible and very well maintained. Housekeeping staff work to a very good standard and despite the current building work the home was very clean. There is equipment in place to minimise the spread of infection. Care Homes for Older People Page 17 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. The home has in place recruitment policies and procedures that protect people who live in the home. There is a developing training programme offered to staff. Evidence: People who use the service have confidence in the staff who care for them. This was confirmed both in the surveys that were returned to us and by the comment made by people during the inspetion visit. There is an established staff group where 61 of people have a National Vocational Qualification at level 2 or above. There are plans to increase the number of staff who have this qualification in the coming year. We looked at two recruitment files. These were organised and showed that before employment commenced people had had references taken up and Criminal Record checks undertaken. There were records of interviews and completed health questionnaires. There were records of the induction progress. Staff have received updates in manual handling, food hygiene and fire drills. A training up-date should be provided in the management of one person with diabetes. The role of the Senior carers who run the shift has been reviewed and developed. staff Care Homes for Older People Page 18 of 25 Evidence: have received coaching and supoort and are undergoing first line management awards. There were records of staff meetings. Whilst some supervisions have occurred the manager is committed to completing all appraisals and setting up a robust of supervision in the next twelve months. Care Homes for Older People Page 19 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 in the interests of peole who live in the home. The manager of the home is competent and experienced and committed to the continued improvement of the home. There is an organised approach to health and safety. Evidence: Stevie Shaw is the home manager recently appointed after a period as acting manager. She will registering with CQC later this year. She has experience in management and care and is currently completing her care management qualifications. She has implemented changes required at the last inspection and is committed to the continuous improvement of the home. The manager was able to talk about the plans for the home in the coming year and understood key principles and main focus of the home. People in the home knew the manager and many said that they would speak to her if they were concerned about anything. Care Homes for Older People Page 20 of 25 Evidence: Records are kept of service users money and the two examples inspected were accurate although one record could have been made clearer. Spot checks on records are undertaken monthly. The manager is currently the health and safety monitor and records were clear. Records were seen of the home contracts arranged for key areas and equipment that requires maintenance. Well organised records were seen for hoists, fire extinguishers, lifts and wheelchairs. The home is currently without a deputy manager and the manager is fulfilling all management duties. The manager should undertake a health and safety audit in the home and construct a plan that allocates some duties to other key members of staff. There has been an initial quality assurance questionnaire showing people are satisfied with the service. A more formal approach should be developed based on an annual development plan of the home and the results of surveys of peoples views. Care Homes for Older People Page 21 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 22 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 1 33 24 The manager must establish 01/01/2010 and maintain a system for reviewing and improving the quality of care provided in the home. Feedback from people who live in the home should be used to continuosly improve the home. 2 36 18 The manager must fully implement the plans for the supervision and appraisal of staff. Effective appraisal and supervision of ensure that care standards are maintained and staff are supported to improve skills and knowledge. 01/01/2010 Care Homes for Older People Page 23 of 25 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 1 12 It is recommended that there is further development in the leisure and recreational activities in the home based on peoples interests and capacities. Each member of staff should have an individual training and development assessment and plan based on their own skills and interests and the requirements of the service. A training up-date shuld be provided to all staff on the management of diabetes. The manager should complete the health and safety audit and ensure that all monitoring is allocated to appropriately trained staff. 2 30 3 38 Care Homes for Older People Page 24 of 25 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. Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. 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