Care Home: Westfield

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What the care home does well Westfield provides a friendly, caring, clean and safe environment for service users. The service users spoken with said that their care needs were met and that staff were caring and helpful. Comments from service users included: "Well, they are caring, anything you need they help you with, and they can be a good laugh too". "I can`t fault the girls, they`re very good, they know what you need or you just ask". "Apart from the lights in the lounge not working properly I like it here". What has improved since the last inspection? A registered manager is now in post and general improvements are being made with the homes administrative systems. Foods are now stored safely following this matter being identified previously. Also, a temperature controlled medication storage facility is in place. The homes statement of purpose has recently been updated and is made available to service users. What the care home could do better: CARE HOMES FOR OLDER PEOPLE Westfield 34 Sleaford Road Boston Lincs PE21 8EU Lead Inspector David Bacon Unannounced Inspection 28th November 2007 08:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Westfield DS0000002474.V353491.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Westfield DS0000002474.V353491.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Westfield Address 34 Sleaford Road Boston Lincs PE21 8EU Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01205 365835 johnericvalmoria@yahoo.com www.countrycourtcarehomes.com Mr Abdulaziz Alykhan Kachra Mr John Valmoria Care Home 32 Category(ies) of Learning disability (15), Learning disability over registration, with number 65 years of age (1), Old age, not falling within of places any other category (17), Physical disability (1) Westfield DS0000002474.V353491.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Mr Abdulaziz Kachra is registered to provide personal care to service users of both sexes in Westfield Care Home, whose primary needs fall within the following categories : Old Age, not falling within any other category (OP) 17 Physical Disability (PD) 1 Learning Disability - over the age of 45 years LD(DE) 15 Learning Disability - over 65 years of age LD (E) 1 No persons should reside at Westfield care Home under the PD category unless they are 44 years of age or over. The maximum number of persons to be accommodated at Westfield Care Home is 32 The category of LD (DE) is to accommodate persons with both learning disability and dementia. 11th July 2006 2. 3. 4. Date of last inspection Brief Description of the Service: Westfield Residential Home is a two storey detached building with a purpose built extension to the rear. It is situated in the market town of Boston and is a short walk from the shops and local facilities. The accommodation in the older part of the building is in 10 single and three double rooms and in the extension there are 15 single rooms with en-suite facilities. There is car parking to the front of the home and a courtyard garden to the rear. The home is registered to provide care for up to 32 Service Users, 15 of those having a learning disability and one being under the age of 65 years with a learning disability. The care fees range from £348 to £850 per week. Copies of inspection reports are maintained in the office and reception area of the home for service users and members of the public. Westfield DS0000002474.V353491.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place during November 2007 and the visit to the home was undertaken over approximately 4.5 hours. The care received by three service users was looked at in detail. This process is called “case tracking” and individual service users care records and general home records were looked at as part of this along with discussions with service users about their experience of life within the home. The inspector spoke with five service users, three staff members, the recently registered manager and area representative. Prior to the visit, the inspector reviewed the previous inspection report and any information relating to the service since that inspection was assessed as part of the overall review of the service. Ten quality satisfaction questionnaires completed by service users were also viewed prior to the visit. A partial tour of the premises was conducted including areas relating to the service users who were case tracked. Staff records were also inspected along with policies/procedures and administrative systems. What the service does well: What has improved since the last inspection? A registered manager is now in post and general improvements are being made with the homes administrative systems. Foods are now stored safely following this matter being identified previously. Also, a temperature controlled medication storage facility is in place. The homes statement of purpose has recently been updated and is made available to service users. Westfield DS0000002474.V353491.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Westfield DS0000002474.V353491.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Westfield DS0000002474.V353491.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are satisfied with the admission process and are involved overall in planning the care they receive. EVIDENCE: The homes statement of purpose has recently been updated, which documents the services provided by the home and includes information about service users rights, terms and conditions of residence and also the homes philosophies of care. Copies of this are maintained in communal and bedroom areas. The care records seen identified where an assessment of each service users care needs had been undertaken. Records provided staff with clear details of service users care needs and how these were to be met. Information regarding service users personal daily living preferences were noted and documented where service users had been involved in the assessment process Westfield DS0000002474.V353491.R01.S.doc Version 5.2 Page 9 of which they were fully satisfied. Service users comments included: “The staff will come to you and say about your care and talk about what you need”. “If you needed things done differently then you’d just say but it’s pretty good”. “They did ask me what help I would need and I did sign something but I’m not sure”. “Yes, they ask you if the care is right and you sign, you could tell them if you didn’t agree”. “I would tell the staff if I needed something, it wouldn’t be a problem”. The home does not provide intermediate care. Westfield DS0000002474.V353491.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are satisfied with how they are treated and they can be assured that their care needs will be met by a caring staff team. Procedures for the administration of medication are appropriate and support service users to maintain their independence where possible. EVIDENCE: The service users spoken with were satisfied with the care provided and said: “They are good, angels really, you do get good help when you need it”. “I get on well with them, they do help”. “I do what I can to stay independent but they know where I need help and it works that way”. “I get the help I need, it’s easier to talk with some staff because of the language differences but they all are helpful”. Information gathered from the initial assessment is used to complete a care plan of which service users are involved. However, care plans were not in an appropriate format for service users having a learning disability, to more fully Westfield DS0000002474.V353491.R01.S.doc Version 5.2 Page 11 support them to be part of the care planning process. The manager said that this would be addressed. The records seen documented each individual’s care needs and instructed staff as to how these were to be met. Care records were regularly reviewed and updated as necessary. A risk assessment is undertaken of each service user and the records seen clearly showed how any risks were to be minimised. The staff members spoken with confirmed that they received awareness training appropriate for their roles and policies and procedures promoting service users rights, privacy and dignity are in place. Systems are also in place to support service users to administer their own medicines where this is risk assessed as appropriate. Staff whom administer medication receive accredited awareness training regarding this. Medicines were properly stored and records clearly documented medicines as receipted into the building, as administered and where disposed. A new refrigerated facility is now in place for medicines requiring storing at controlled temperatures. Westfield DS0000002474.V353491.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users can choose how they spend their time and to maintain any community links as they prefer although they are not fully consulted with about life within the home. Service users enjoy the meals provided although the homes meal provisions are not fully adequate. EVIDENCE: Service users are initially asked to express their likes, dislikes and any preferred routines as part of the admission process, which is recorded in their individual care plan. Service users confirmed that there were no restrictions as to how they could spend their time and that their visitors were made welcome. Comments included: “I don’t know of any limits, I do what I want really and I’ve not been told different”. “I think that it’s a friendly place, the staff are good and make everyone welcome”. “The door has to be locked on the other side because the residents need it to be safe but we do as we please”. Service users said they enjoyed the activities available and comments included: “It’s good to get involved in things, it passes the time, we do a Westfield DS0000002474.V353491.R01.S.doc Version 5.2 Page 13 variety of things, not that we have to”. “Well, there’s enough for me to do”. “I go out to church, which I enjoy and we have a girl that does activities, it’s nice to have things going on”. “I like to get involved in the crafts and its good fun, we have a laugh”. An activity co-ordinator works part time during the week and regular activities include: board games, coffee afternoons, one to one, art classes and shopping trips. Formal residents meetings are not held although the service users spoken with said they would like to be included more in making decisions about life in the home. The visiting area representative said that this matter would be addressed, which is discussed further within the management and administration section of this report. Service users dietary needs and preferences are assessed upon arrival of which the homes kitchen staff are made aware. A four-week rolling menu is in place although a menu was not displayed during the visit and it is recommended that appropriate versions are in place for all service users residing in the home. For example, those having a learning disability. Also, service users were not aware of a choice of food being made available at each mealtime and said that their views regarding meals were not regularly sought. The cook said that an alternative would be provided where kitchen staff were aware of any service users specific food dislikes or requirements. Records of meal and equipment temperature checks are maintained. Comments regarding meals included: “Its alright, some of the meat is tough, I’ve told the cook and it’s good because they came back to me”. “The food is good, it suits me but you have to have what there is, you could have something different I suppose but there’s just one thing on the menu”. “Yes, it would be nice to meet with the kitchen staff and to talk through the meals more, I’d be interested in that”. Westfield DS0000002474.V353491.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems are in place to enable service users to complain about the care they receive. Staff are made aware of how to protect service users from abuse. EVIDENCE: The service users spoken with said they felt able to express any views about the care they received, even if these were negative. Comments included: “I’ve not needed to tell them anything but they do seem to listen”. “I would say what I needed to and yes, I think they would be alright”. Policies and procedures are in place to protect service users from abuse and to enable them to express any views regarding the services provided. There has been one safeguarding adult’s referral since the last inspection visit, which is now closed and there have been no complaints. The complaints procedure is displayed in the home and information regarding this is located within the service users guide and provided to service users. The staff members spoken with were aware of the need to safeguard service users from abuse and the correct action to be taken in the event of a concern being identified and confirmed they had received awareness training regarding this. Westfield DS0000002474.V353491.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a clean, comfortable and generally well-maintained environment with the organisation ensuring the safety of the home. EVIDENCE: The service users spoken with were satisfied with the cleanliness of the home and comments seen in the homes completed satisfaction questionnaires further confirmed this. Comments included: “It is kept very clean and I like it because you can talk to them”. “My room is cleaned regularly, all of it is”. “Well, I find it’s kept very well”. Service users are supported to personalise their own rooms. The areas seen were clean, tidy and well maintained overall. The manager said that a rolling programme of maintenance and decoration was in place, which was evidenced throughout most areas. However, the corridor walls in the original part of the home were in need of some refurbishment although the Westfield DS0000002474.V353491.R01.S.doc Version 5.2 Page 16 manager said that this was due to be addressed. Also, some of the ceiling lighting in the new lounge area was in need of repair. An environmental risk assessment has been undertaken and an individual risk assessment is undertaken for each service user, which takes into account the physical environment. Substances identified as being potentially hazardous to health are stored appropriately and information sheets are in the place, which provide guidance for staff who confirmed they received health and safety awareness training of which records are maintained. Westfield DS0000002474.V353491.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users care needs are met by a well trained staff team. Recruitment procedures and staff training is in place to safeguard service users. EVIDENCE: The service users spoken with confirmed that their care needs were met, which was further evidenced during the visit. Comments included: “Well, I’m happy with it, they are there when you need them and they encourage you, to keep up and about”. “I couldn’t ask for better I am treated very well”. “I have to say I like it here and it’s how they look after you”. “There is some occasional difficulty in communicating with some of the staff from other countries but they do try, everyone is very helpful”. The records viewed evidenced that recruitment checks had been undertaken prior to staff commencing work at the home. The checks included criminal record bureau checks, obtaining professional references and staff completing application forms. Equal opportunities policies and procedures are also in place. The manager said that newly appointed staff receive a formal induction, which was further confirmed by the staff members spoken with although the induction records for one staff member could not be located during the visit. This was later addressed by the manager. Westfield DS0000002474.V353491.R01.S.doc Version 5.2 Page 18 At least 50 of staff have undertaken nationally recognised awareness training and the staff members spoken with that they received training specific to the needs of service users of which records are maintained. Westfield DS0000002474.V353491.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and safety systems are in place to safeguard service users. Service users are not fully supported to express their views regarding the care they receive. EVIDENCE: The service users spoken with confirmed that they were satisfied with the management of the home and the care provided. Comments included: “They are all polite, they talk to you how you would talk to people yourself”. “Very good, it is friendly and you can have a laugh with some of them, they are all here to help”. Service users and staff said they found the manager to be approachable. Westfield DS0000002474.V353491.R01.S.doc Version 5.2 Page 20 An annual quality review survey has not recently been undertaken, which would further support service users to express their views regarding the services provided and enable home staff to adjust the service accordingly. One service user said: “Occasionally, they ask you what you think of the food and they do listen but there’s no meetings to talk about things that I’m aware of but that would be good”. However, a representative from the organisation is now visiting the home each month to undertake a quality audit and the representative spoken with said that quality satisfaction audits would be included as part of this. The staff members spoken with said they received good management support and that their views were respected. Policies and procedures are in place to protect service users where the home has any involvement in their finances and records of any relevant expenditure are maintained. Fire safety policies and procedures are in place, including regular safety tests. Policies are also in place for issues such as accidents, emergencies, equal opportunities, general health and safety, and also record/information management of which are made available to service users. Safety tests had been undertaken regarding legionellosis and a risk assessment has been undertaken regarding this. Water temperature safety valves are fitted to water outlets and water temperatures were regularly checked. Substances identified as being potentially hazardous to health are securely stored and information sheets and risk assessments are in place for staff. A formal risk assessment of the premises to identify and minimise risks to service users has been undertaken. Westfield DS0000002474.V353491.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Westfield DS0000002474.V353491.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP19 Regulation 23 (2) (d) Requirement The walls in the original part of the home, including hallway and corridor areas must be reasonably decorated. The lighting in the new lounge area must be adequate. Timescale for action 31/03/08 2 OP19 23 (2) (p) 31/01/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP7 OP15 Good Practice Recommendations It is recommended that care plans are in a format, which is appropriate for each service user. For example, service users having a learning disability. It is recommended that menus are clearly displayed to provide service users with clear information about the meal provision and that a choice of foods is more fully promoted at each mealtime. Westfield DS0000002474.V353491.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Westfield DS0000002474.V353491.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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