Care Home: Westerley

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What the care home does well There is detailed information about the home provided to people who are looking for a place to move into. Staff obtain information about each persons needs and how they would like to be supported before a person is offered a place in the home. When a person chooses to move into the home staff develop a plan of care with information so that the individual can be cared for and supported in a way of their choosing. There are opportunities for residents to participate in activities and social events so as to keep people occupied and stimulated. Residents can make comments and suggestions about what they would like to do and staff act upon these wishes. There is a planned menu which is reviewed and changed regularly based upon the comments and suggestions made by residents. Complaints and concerns are dealt with promptly and people feel that any concerns will be taken seriously. Staff are trained to recognise and deal with abuse or ill treatment of people living in the home.and residents live in a clean, comfortable and safe environment. The home is well managed and the views of the people who live there underpin practices and daily routines. What has improved since the last inspection? Since the last inspection a new deputy manager has been employed so as to support the manager in the day to day running of the home. All of the issues as identified at the last inspection have been addressed. Residents receive the care and support they need. Information about residents needs is recorded clearly and regularly reviewed and updated so that staff can easily identify any changes to the care a person needs. Staff are supported and supervised so as to monitor practices and ensure that care and support is delivered in a consistent way. What the care home could do better: The supper time menu should be reviewed so that residents are offered a choice of a more substantial meal at this time. Some improvements to the homes environment such as new seating and a review of the layout of furniture in the lounge area would benefit residents who feel that chairs are too low and that the layout of seating makes it difficult to interact and communicate for some people. The manager needs to ensure that all checks are carried out before a person is employed at the home and that all staff undertake training to ensure that residents are supported safely. Routine checks on equipment and systems in the home could be carried out more rigorously so as to identify any problems and potential risks to people living in the home. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Westerley 1 Winton Avenue Westcliff On Sea Essex SS0 7QU     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: Carolyn Delaney     Date: 1 7 0 9 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. the things that people have said are important to them: They reflect 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 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Westerley 1 Winton Avenue Westcliff On Sea Essex SS0 7QU 01702349209 01702213192 westcliff@lwpt.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Simon Andrew Lee Type of registration: Number of places registered: The Leaders of Worship and Preachers Homes 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: Date of last inspection Brief description of the care home Westerley is registered to provide care and accommodation for 21 older people. The home is managed and run on Christian faith, belief and values. The premises was converted from 2 hotels and extended in 2001. All rooms have ensuite facilities. There are 5 double rooms, which may be used as large singles. Some bedrooms have views of the Thames Estuary. There is a choice of 2 lounges and a separate dining area. There is a small patio area at the rear of the home. A prayer service with hymns takes place in the lounge each weekday morning. There is no off street parking and the driveway provides very limited spaces. The home is situated close to the main shopping areas of South end, Westcliffe and Leigh on Sea. There are good bus and train links to the area. The range of fees provided by the manager was #406 #500.00 per week. There are additional charges depending on the type of bedroom available/requested and items of a personal nature. A copy of the home?s Statement Care Homes for Older People Page 4 of 27 0 Over 65 21 Brief description of the care home of Purpose is displayed in the foyer. The Service User?s Guide and brochure is currently not available and the manager should be contacted for the updated version when available. Care Homes for Older People Page 5 of 27 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: This was a routine annual inspection of the service. An unannounced visit was made to the home on 17th September between the hours of 11.00 and 20.30. As part of the inspection process we reviewed information we have received about the service over the last twelve months including notifications sent to us by the manager of any event in the home, which affects residents such as injuries, deaths and any outbreak of infectious diseases. At the time of the inspection we had not received an Annual Quality Assurance Assessment, as it had not been requested by us in time. This document is a self-assessment which the registered provider / owner tell us what they do well, how they evidence this and the improvements made within the previous twelve months. Care Homes for Older People Page 6 of 27 We spoke with four residents, two visitors and five members of staff including the manager and deputy manager. Three members of staff and one relative completed surveys. The information provided was Incorporated into the report and used to make judgments about outcomes for people living in the home. During the inspection visit a number of records and documents including care plans, staff records and maintenance records were sampled. Mealtimes were observed and we were invited to have lunch with three of the residents. A brief tour of the premises was carried out and communal areas including lounge and dining room as well as some residents bedrooms were viewed. Information obtained was triangulated and reviewed against the Commissions Key Lines for Regulatory Activity. This helps us to use the information to make judgments about outcomes for people who use social care services in a consistent and fair way. 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.csci.org.uk. You can get Care Homes for Older People Page 8 of 27 printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 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 10 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know that the home will meet their assessed needs in a way which meets their expectations. Evidence: There is detailed information about the home made available to people when they are first considering whether it is a suitable place for them to move into. Each new resident is provided with a copy of the homes service users guide which tells the person about staffing levels, how care will be planned and delivered, daily routines and events in the home and how to make comments or complain about the service. Two people who had recently moved into the home were spoken with. Both said that they had received information and were offered the opportunity to visit the home before they made a decision about moving in. Residents who were spoken with during the inspection spoke very highly about the home. One person said the home exceeds Care Homes for Older People Page 11 of 27 Evidence: all my expectations. Another person said in their opinion you could find no better home. As part of the process for assessing a persons needs each individual is invited to complete an assessment and provide details about their abilities and the care and support that they need. People are asked how they wish to be addressed, how they wish to spend their free time and any special requirements for diet, maintaining personal care and their level of mobility etc. This helps to ensure that care can be planned in a way which reflects the wishes and capabilities of each person who moves into the home. The homes manager or a senior member of staff will visit the individual to carry out a full assessment of their personal and health care needs. Staff are provided with this information so as to plan for the persons admission to the home and copies of this information was available in residents care plan. The cost of a place in the home at the time of this inspection was 458.00 to 536.00 per week. This includes all services with the exception of hairdressing. Care Homes for Older People Page 12 of 27 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. People living in the home are well cared for and supported to remain active and as independent as possible. Evidence: Each person living in the home has a plan of care and support developed to identify the support that each individual needs. The care plans for three people were examined during the inspection. Information was recorded clearly and reflected each persons capabilities and how they would like staff to help and support them. Staff review care plans with residents every month or more often if there are any changes to the persons needs or treatment. Residents were supported to remain as independent as possible and offered assistance where needed. There were records in respect of health and medical tests and treatments which residents undergo such as eye tests, routine medication reviews and visits by general practitioners. Residents and their relatives who were spoken with or who completed surveys said that they were pleased with the care provided by the home. One person said the Care Homes for Older People Page 13 of 27 Evidence: home is wonderful and their relative loves it there. Another person said that the care of their relative is perfect. Residents said that staff look after them well. Staff assess risks to each persons health and safety and develop plans to support residents and minimise risks. There were plans in place to reduce the risks to residents including risks of injuries due to falls, pressure sores due to immobility or weight loss due to reduced appetite. These plans are reviewed each month or more often if there is a change to the level of risks to a person. A review of records indicated that the risks to residents are well managed as there have been very few incidents of falls or injuries to residents. Residents are asked when they move into the home if they would wish to manage their own medicines. If they choose and are capable of safely doing so this is recorded within the individuals plan of care. A number of people in the home were managing their medicines at the time of this inspection. Residents have lockable storage in their bedrooms to keep medicines. Where people are incapable or do not wish to do this staff are trained to safely administer medicines. Staff follow the homes policy and procedure for storing and keeping accurate records in respect of medicines. Staff were observed during the inspection to give residents their medication at the appropriate times and records were completed appropriately. Care Homes for Older People Page 14 of 27 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 living in the home enjoy a lifestyle which suits their social and cultural preferences. Evidence: The home is managed and run on Christian beliefs and values and this underpins much of what happens in the home on a day-to-day basis and therefore, attracts residents of like mind and a mutual interest. Daily prayers are an important part of the activities in the home. There are church services held in the home every week and a communion service every two weeks. At the request of residents activities such as games and music are held in the afternoons. There is a plan of activities displayed on the notice board and these include ten pin bowling, quizzes, days out bingo and watching DVDs and videos. One member of staff is responsible for obtaining residents comments and suggestions about what things they would like to do in their free time and to plan and coordinate activities which reflect residents choices. Residents also have the opportunity to attend regular meetings with the manager where they can make suggestions about social and recreational activities. Residents are reminded each day of planned activities which they have expressed and interest in. Care Homes for Older People Page 15 of 27 Evidence: Most of the residents and relatives who were spoken with said they are happy with the activities provided in the home. One person said I am not into activities much but I do enjoy watching television and sitting in the garden when the weather is good. Another resident said I enjoy most activities and sometimes going out. One relative commented that while there always appear to be things to do in the home that sometimes residents are not encouraged enough to participate, particularly the less mobile residents. Residents have choice of meals each day from a planned menu, including a cooked breakfast. Residents said that the breakfast and lunch meals are very good or very nice and that the new cook is very good One resident said the food is great I have never eaten so good. Another resident said the food is very nice and there is plenty of it. Visitors to the home may have a meal with their relatives for a nominal charge and some relatives who have done said that they meals are very good. The inspector was invited to have lunch with three residents. The meal consisted of roast chicken and a selection of vegetables and it was well presented and appetising. Three residents and two relatives commented that the evening meal was not always so good. One relative said that on occasions residents have fruit cocktail or bread and butter for supper meal which is not really substantial. Residents said that for the evening meal sometimes they have bread and jam or toast and mushrooms, and this is ok. On the evening of the inspection residents were offered a choice of omlette or sandwiches. Some residents refused the meal saying that they did not like the omlette and were offered sandwiches or bread and jam. Care staff prepare the evening meal and this may be the reason why residents are not satisfied with the meals provided. Care Homes for Older People Page 16 of 27 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 living in the home are treated well and are assured that concerns and comments are taken seriously. Evidence: The manager said that the homes complaints policy and procedure had been recently updated and was available to residents and visitors to the home. The policy was seen to be displayed on the notice board next to the dining room where both residents and visitors to the home can access it easily. Residents who were spoken with during the inspection said that they had not had any cause to complain. Complaint records were examined and indicated that there have been no complaints made since 2005. Relatives who were spoken with also confirmed that they have not had cause to make complaints about the home. Residents said that staff treat them well. One person said everyone gets on together. Another resident said staff are kind and there is always a lot of laughter in the home. Staff who were spoken with or who completed surveys said that they have received training in respect of safeguarding people from harm. Each of the three members of staff who were spoken with could demonstrate that they were aware of the homes policy and knew who to report to if they witnessed or suspected any ill treatment of people living in the home. Care Homes for Older People Page 17 of 27 Evidence: There have been no allegations or concerns made to us about the home since the last inspection. Care Homes for Older People Page 18 of 27 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 adequate 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 clean, comfortable and safe environment which suits their needs. Evidence: The majority of people who were spoken with said that they were happy with the environment. Some residents said that the chairs in the communal areas were not comfortable, too low and not arranged so as to encourage people to communicate. These issues had been raised in residents meetings and the manager said that the purchase of new seating would be factored into the next years budget for the home. Residents have access to a large communal lounge area, library area and a large dining area. All communal areas were clean and free from any unpleasant odours. Residents bedrooms which were viewed were clean, bright and personalised. Care Homes for Older People Page 19 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are well cared for by competent and skilled staff however the quality of care may be reduced due to shortfalls in recruitment and staff shortages. Evidence: Staff are employed in the home based upon the assessed needs and dependencies of the people who live there. These are reviewed each month. A sample of staff duty rotas were examined and indicated that minimum staffing levels were usually but not always maintained. Some residents, staff and visitors commented that shortages of staff can sometimes be a problem but that staff work very hard to minimise the impact on the care received by people living in the home. Staff who completed surveys said that there were usually enough staff on duty. One relative said staff shortages can be a problem but staff always do their utmost to maintain the high standards in the home. The manager said that there have been some shortages due to staff sickness and planned staff holiday. Some residents said that there had been a bad period with staff shortages but that things were better now. There is programme for staff training so as to ensure that staff have the skills and knowledge to properly care for people living in the home. Training programmes cover Care Homes for Older People Page 20 of 27 Evidence: dementia and diabetes awareness, safeguarding, pressure area care as well as Deprivation of Liberty and Mental Capacity Act. There was evidence that most but not all staff have had recent training. A number of people had not undertaken training in respect of the safe moving and handling of people and one member of staff was observed to assist a resident to stand up from their chair, in an inappropriate and potentially unsafe manner. Residents and their relatives feel that staff have the skills required to care for people living in the home. Generally people who work in the home are recruited robustly and thoroughly so as to ensure that they are appropriately skilled and suitable to work with older people. However references from a persons previous employer had not been obtained for two people before they were employed in the home. Staff complete a period of induction which includes shadowing so that they can see how residents like to be cared for and supported. Staff who were spoken with during the inspection and those who completed surveys said that they are supported and provided with training and information to enable them to be able to care for residents. Care Homes for Older People Page 21 of 27 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. Residents live in a home that is well managed and run in their best interests. Evidence: Since the last inspection a deputy manager has been employed so as to support the manager and improve the day to day running of the home. Residents and relatives said that things have improved since this person commenced work in the home. People who live in the home and their families are invited to complete surveys at least once a year as part of the process for monitoring and improving the quality of services provided. A recent survey had been carried out and the manager was in the process of analyzing these at the time of the inspection. Generally people were satisfied with the home and the care and support provided to residents. Some people commented that improvements in communication and access to information as an area where improvements could be made. This was echoed in comments made by residents and relatives who we spoke with. Residents and relatives who were spoken with said that both the manager and deputy manager are very approachable and available to discuss Care Homes for Older People Page 22 of 27 Evidence: any issues that may arise. A review of records and certificates indicate that equipment necessary for the safe operation of the home are well maintained. Regular checks are carried out to test fire safety and detecting equipment. Gas, electrical and mechanical equipment in the home such as lifting equipment and domestic appliances are in good working order. Staff undertake regular fire safety drills and any issues are recorded so as to help prepare staff to deal with any outbreak of fire in the home safely. Staff have not regularly checked the temperatures for hot water in the home. On the day of the inspection hot water in one of the bathrooms exceeded fifty degrees and could potentially cause burns to residents. The manager said that he would deal with this issue promptly. Regular unannounced visits are carried out by the organisations operations manager and they identified that staff had not been regularly testing fire alarms and emergency lighting. However this had been addressed at the time of the inspection. Care Homes for Older People Page 23 of 27 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 24 of 27 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 29 19 All of the checks required by 31/10/2008 regulation including references must be carried out before a person is employed to work in the home. These check must be carried out so a to determine that each person is suited to work caring for older people and that residents are safeguarded by the homes recruitment practices. 2 30 18 People working in the home must receive training which reflects the work they are to perform. Staff must be trained to be able to safely care and support people living in the home. 31/10/2008 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. Care Homes for Older People Page 25 of 27 No. Refer to Standard Good Practice Recommendations 1 2 15 16 The menu for the evening meal should be reviewed so that it reflects residents choices. A system for recording informal complaints or suggestions should be implemented as evidence to how minor issues are dealt with. The layout of furniture in communal areas should be reviewed so that it suits the needs and wishes of residents. 3 19 Care Homes for Older People Page 26 of 27 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 © (2008) 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 27 of 27 - 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!