Latest Inspection
This is the latest available inspection report for this service, carried out on 30th June 2008. CSCI found this care home to be providing an Good service.
The inspector made no statutory requirements on the home as a result of this inspection
and there were no outstanding actions from the previous inspection report.
For extracts, read the latest CQC inspection for Westfields.
What the care home does well The process of admission to the home is generally sound and helps to ensure that when people are admitted they can be confident their needs and wishes can be met. The restaurant style approach to meals helps ensure people get plenty of choice, are able to eat their meals in pleasant surroundings and have easy access to facilities such as a water cooler and cappuccino machine. The provider has established and enacted a process of improvement to ensure the home is updated. All areas of the home are kept clean and hygienic. Residents benefit from a staff and management team who work well together and are committed to their jobs.Staff receive the training needed to equip them to do their jobs and the provider has a robust recruitment system which helps ensure that those working with residents are subject to all necessary checks before commencing work. The home benefits from a consistent and experienced management team. The provider has a sound approach to health and safety. What has improved since the last inspection? Since last inspected much work has been carried out to identify areas of the environment, which are in need of updating and improvement. Work is underway to improve the heating system giving residents control of the temperatures in their rooms. Replacement of draughty old windows is soon to commence with modern sealed unit windows replacing them. The home`s lift is to be replaced with a new larger lift which will allow staff to accompany a resident in a wheelchair when using it. A walk in shower has been created on the ground floor of the home. CARE HOMES FOR OLDER PEOPLE
Westfields Westfield Road Swaffham Norfolk PE37 7HE Lead Inspector
Mr Pearson Clarke Unannounced Inspection 30th June 2008 10:00 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 Westfields DS0000034875.V367606.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. Westfields DS0000034875.V367606.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Westfields Address Westfield Road Swaffham Norfolk PE37 7HE 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) 01760 721539 glenistudor@norfolk.gov.uk www.norfolk.gov.uk Norfolk County Council-Community Care Mrs Glenis Tudor Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Westfields DS0000034875.V367606.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The home to accommodate 40 Service Users who are older people not falling within any other category. 4th July 2006 Date of last inspection Brief Description of the Service: Westfields is a purpose built Local Authority Home providing accommodation for 40 elderly residents. The accommodation is on the ground and first floors. There are 40 single rooms. The home is set in its own grounds, with a car park at the front and side of the home. The home has a small rehabilitation unit on the first floor and receives nursing care from the District Nurse and medical services from GP practices. The home is situated adjacent to the town centre of Swaffham. The fees for the home are £368.72 a week. Westfields DS0000034875.V367606.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means that people who use the service experience good quality outcomes. Care services are judged against outcome groups, which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out by using information from previous inspections, information from the providers, the residents and their relatives, as well as others who work in or visit the home. This has included a recent unannounced visit to the home and this report gives a brief overview of the service and current judgements for each outcome. During the site visit the inspector spent time with service users and views expressed have helped shape the judgements made. In addition time was spent observing life in the home and staff on duty were spoken to, as was the service manager. A tour of the premises was undertaken and relevant records were inspected. What the service does well:
The process of admission to the home is generally sound and helps to ensure that when people are admitted they can be confident their needs and wishes can be met. The restaurant style approach to meals helps ensure people get plenty of choice, are able to eat their meals in pleasant surroundings and have easy access to facilities such as a water cooler and cappuccino machine. The provider has established and enacted a process of improvement to ensure the home is updated. All areas of the home are kept clean and hygienic. Residents benefit from a staff and management team who work well together and are committed to their jobs. Westfields DS0000034875.V367606.R01.S.doc Version 5.2 Page 6 Staff receive the training needed to equip them to do their jobs and the provider has a robust recruitment system which helps ensure that those working with residents are subject to all necessary checks before commencing work. The home benefits from a consistent and experienced management team. The provider has a sound approach to health and safety. What has improved since the last inspection? What they could do better:
Where residents are admitted for short term care, their care plans should be kept under review and in circumstances where their stay becomes extended, then the plan should contain more detail so as their needs and wishes are properly addressed. The provider should continue to improve the environment where necessary. Staffing levels on both day and night shifts should be monitored and, where necessary, adjusted as needs dictate, to ensure that people continue to get the care they need. The management of the home should make every effort to cover all vacant shifts in order to ensure that good quality care is consistently maintained. Westfields DS0000034875.V367606.R01.S.doc Version 5.2 Page 7 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. Westfields DS0000034875.V367606.R01.S.doc Version 5.2 Page 8 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 Westfields DS0000034875.V367606.R01.S.doc Version 5.2 Page 9 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): 3 and 6 Quality in this outcome area is good. The home admits people whose needs it can meet, helping ensure that residents feel well cared for and that their support needs can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the site visit admission records for the last three people to move to the home were tracked. In all cases the service had received pre admission documentation from social workers which described peoples care needs and other significant information. The home’s manager confirmed that all three people had been admitted for short term care in emergency situations and as such it had not been possible for the home’s management to carry out their own assessment process, which would be their normal practice. The manager said that they received good professional assessments. Westfields DS0000034875.V367606.R01.S.doc Version 5.2 Page 10 The service has three beds which are used for rehabilitation and to increase the confidence of people who have been in hospital, but need further input to go home. Two people were accommodated at the time of the site visit and both said what an excellent service they were receiving, stating “ I could not recommend this place more” and “the carers think ahead, they are a shining example to some of the hospitals I have been in “. Westfields DS0000034875.V367606.R01.S.doc Version 5.2 Page 11 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): Quality in this outcome area is good. That people get care which is based on their wishes and needs and which is delivered in a way which helps protect their dignity and privacy. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the site visit the views of residents were sought about the care that they receive. All of those spoken to were extremely positive about the care received and the approach of staff making comments such as “They are kindness itself”, “ the staff respect you” and “if your door is shut they always knock before entering”. Six care plans were looked at and were found to give clear guidance as to how to care for the individual concerned, to have been regularly reviewed and to show evidence of the residents involvement/acceptance of the plan. Risk assessments were in place relating to falls and moving and handling. Where necessary nutritional screening had been instigated to help ensure that people
Westfields DS0000034875.V367606.R01.S.doc Version 5.2 Page 12 were protected from the risk of malnutrition. A number of the plans seen related to short term care and as such were less extensive. Although this is understandable in some cases the period of short term care was quite lengthy and ongoing. In these cases a more detailed plan including social history would be beneficial. From information supplied by the provider the service has “dignity champions” in line with government initiatives and residents said that they felt their dignity and privacy was respected by the approach of staff. The arrangements for the management of medication were inspected. Storage was secure and appropriate, although records showed that the temperature in the medication storage area could be too high. From discussion with the management and records seen it was clear this has been accepted and arrangements are in hand to install air conditioning in this room. The provider undertakes regular medication audits and records of these indicated that they are working to pick up errors and poor practice with measures taken to try and prevent repeat. Sample recording was checked, including that relating to controlled drugs. Whilst the records seen were generally accurately completed, it was noted that a signature had been made for medication administered to a resident who was in hospital at the time. It was not possible to clearly establish how the error occurred and there was no immediate evidence of this being a widespread practice. Westfields DS0000034875.V367606.R01.S.doc Version 5.2 Page 13 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): Quality in this outcome area is good. Residents enjoy a relaxed lifestyle where they are able to exercise choice and control, have good quality food and are able to take part in activity and stimulation. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the site visit it was apparent from observation that there is a relaxed atmosphere within the home and residents confirmed that they felt in control of their lifestyles and able to exercise choice about what they do, One person’s visitors talked of their happiness with all aspects of the home and the care that their relative receives. The relatives of a recently deceased resident were also present stating their relative “could not have been in a better place”. Inspection of the minutes of residents’ meetings showed that residents are fully involved in choosing activities for the home. The homes record of activities showed a range of individual and group activity within the last two months. These included a sports day, visiting entertainers, gardening, making
Westfields DS0000034875.V367606.R01.S.doc Version 5.2 Page 14 scones and cakes, a fathers day lunch and going out to shops, garden centres and cafes. People expressed positive views about the catering in the home. Lunch was observed and looked appetising. Staff were available to give help to those who need it and were seen to do so in a patient and helpful way. The home has a restaurant style of dining, with an attractive dining room with fresh flowers and menus on the tables. Water coolers and a cappuccino machine are available for residents and guests to help themselves to drinks. Westfields DS0000034875.V367606.R01.S.doc Version 5.2 Page 15 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): Quality in this outcome area is good. Residents are confident that the homes approach to complaints and safeguarding will help ensure that any concerns they have will be appropriately addressed and will contribute to their safety. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the site visit the home’s record of complaints was inspected and the approach to complaints was discussed with the manager. The records seen showed that complaints are taken seriously and if upheld, action is taken by the service. Residents said that they would be confident that any complaints they made would be addressed although they could not imagine the need to complain. The manager is a trainer for safeguarding and told of plans to carryout refresher training for the staff team in the near future. The provider is known to have a robust approach to safeguarding and staff spoken to were aware of their responsibilities in this respect. Westfields DS0000034875.V367606.R01.S.doc Version 5.2 Page 16 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): Quality in this outcome area is good. Once completed, improvements to the building and facilities will enhance residents quality of life. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the site visit a tour of the building was undertaken with the homes manager. All areas seen were clean and fresh with no unwanted odour. Residents spoken to said that this was how the home normally was, for instance “ the home is spotless, cleaner than a hospital”. Since last inspected a new walk in shower has been created offering residents a choice of whether to bath or shower and some redecoration has been undertaken. At the time of the visit work was being done to install a new radiator system giving residents the opportunity to control the level of heat in
Westfields DS0000034875.V367606.R01.S.doc Version 5.2 Page 17 their rooms. From discussion with the manager and records seen it was clear that a programme of window replacement will soon commence and the homes lift will be replaced within this financial year. Westfields DS0000034875.V367606.R01.S.doc Version 5.2 Page 18 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): Quality in this outcome area is good. That residents benefit from a staff team which is well trained, properly recruited and normally available in sufficient numbers to meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents spoken to during the site visit were very positive about the care that they receive from the staff team. Comments such as “ the staff are wonderful, nothing is too much trouble” and “I could not recommend this place more “ were typical of people’s views. Three members of care staff and one of the management team were talked to and all felt that they gave a good service and that a strength of the home was the general sense of teamwork. Those spoken to felt that when fully staffed they could deliver the care needed, but when shifts could not be covered the job became much harder. All of those spoken to would recommend the home. The manager confirmed that they always tried to cover shifts, using agency staff where necessary but on occasions it was simply not possible. Discussion also took place regarding the adequacy of night cover and the manager stated that this had not changed since last inspected, however there was now better support for staff with a senior person on call.
Westfields DS0000034875.V367606.R01.S.doc Version 5.2 Page 19 Sample employment records were seen for the last two people employed and these showed that the provider continues to operate a robust and safe employment process, Staff training records seen, evidenced a thorough approach to training and staff spoken to confirmed that they had the necessary training to equip them to do their jobs. Westfields DS0000034875.V367606.R01.S.doc Version 5.2 Page 20 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): Quality in this outcome area is good. That residents benefit from a home which is well managed and run in their best interests, where the approach helps to ensure that people feel safe. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The views of staff and residents expressed during the site visit show that people feel they work and live in a good home which is well run. The manager confirmed that since last inspected she has completed her NVQ level 4 in care and this added to her other qualifications and experience are indicative of someone who is well placed to discharge her duties in an effective manner. Westfields DS0000034875.V367606.R01.S.doc Version 5.2 Page 21 Inspection of records relating to fire and health and safety show that due weight is given to these areas, helping to ensure peoples safety. The provider has robust systems for holding and managing peoples monies which are subject to external audit. Sample records of monies held for residents were inspected and were found to be in good order. The provider has an established quality system based on an annual survey of residents, families and staff. At the time of this inspection the survey was due and the manager confirmed that it would be completed soon. The results of the last survey were used to underpin a development plan for the service and this was seen. Westfields DS0000034875.V367606.R01.S.doc Version 5.2 Page 22 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 x x 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 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 3 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 Westfields DS0000034875.V367606.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 Refer to Standard OP7 Good Practice Recommendations That the homes management review care planning practice in relation to residents admitted for short term care, whose stay becomes extended. Westfields DS0000034875.V367606.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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
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