Care Home: Westhaven

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What the care home does well Peoples` needs are assessed before they are offered a place in the home to ensure that their needs and expectations can be met there. Staff in the home and other health professionals regularly monitor the mental health of the people living in the home so that they stay as well as possible. Prompt action is taken by all concerned to obtain appropriate support when necessary so that people avoid unnecessary admission to hospital. People living in the home are encouraged to be as independent as possible and make decisions about what they do so they maintain control of their lives. There are procedures for complaints and protection in place and staff have received appropriate training to ensure that residents` welfare is safeguarded. The home is well maintained so people living there live in comfortable, safe and homely surroundings. Thorough staff recruitment processes and training are in place to ensure that the people who live at the home are safeguarded from possible harm and poor practice. What has improved since the last inspection? Processes are now in place to regularly review the care plans and risk assessments of people living in the home to ensure they are receiving appropriate support. Storage facilities have improved so that confidential information is stored suitably. Improvements have been made in recording accidents/incidents that occur in the home so that the person in charge can monitor and respond to any issues What the care home could do better: People who live in the home who look after their own medicines should only carry enough medication to meet their needs whilst away from the home so that they are safeguarded and protected from loss or theft. A record must be maintained of all complaints made and the action taken in response so that the home can demonstrate that the people living there are listened to. The interconnecting doors must not be wedged open so that fire safety in the home is properly maintained. Stay open devices should be fitted if the door needs to be kept open for staff to monitor the wellbeing of people living in the home. CARE HOME ADULTS 18-65 Westhaven 38b/38c Sandbach Road Congleton Cheshire CW12 4LJ Lead Inspector Ms Julie Porter Unannounced Inspection 18 February 2008 11:30 Westhaven DS0000006685.V350584.R01.S.doc Version 5.2 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 Westhaven DS0000006685.V350584.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 Adults 18-65. 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. Westhaven DS0000006685.V350584.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Westhaven Address 38b/38c Sandbach Road Congleton Cheshire CW12 4LJ 01260 298157 01260 291068 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) East Cheshire Housing Consortium Care Home 8 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (8), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (8) Westhaven DS0000006685.V350584.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 8 residents aged 18 years and over as follows: * * Up to 8 service users in the category of MD (mental disorder, excluding learning disability or dementia) aged 18 to 64 years Up to 8 service users in the category of MD(E) (mental disorder, excluding learning disability or dementia) aged 0ver 65 years. 27th July 2006 Date of last inspection Brief Description of the Service: Westhaven is a care home for adults/older people with mental health needs. It opened in 1990, and is run by East Cheshire Housing Consortium. This organisation also provides a range of other residential and sheltered accommodation within the Macclesfield and Congleton areas. Westhaven is located within a small sheltered housing complex, in a residential area off Sandbach Road. It is within walking distance of a local supermarket, post office and public house; it is also on a public bus route into Congleton town centre. The home is situated in pleasant and well-maintained open-plan grounds, and has a small private garden at the rear. Bedroom accommodation for service users is on the first floor of both houses, and access to these areas is via staircases. Ground-floor accommodation comprises two lounges, two dining rooms, two kitchens and two utility rooms. The two properties are linked by an office for staff. There are four separate toilets between the two floors, and two bathrooms. Information is available for the home regarding the cost of staying there. This fee covers rent and support. Westhaven DS0000006685.V350584.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The overall quality rating for this service is 2 stars. This means that the people who use the service experience good quality outcomes. An unannounced visit took place on the 18 February 2008 and lasted four and a half hours. This visit was just one part of the inspection. Before the visit the manager was asked to complete a questionnaire to provide up to date information about services in the home. Questionnaires from CSCI were also made available for residents to find out their views; none were returned. Other information received since the last key inspection was also reviewed. During the visit various records and the premises were looked at. All of people living in the home and available on the day of the visit were spoken with and they gave their views about the service What the service does well: What has improved since the last inspection? Westhaven DS0000006685.V350584.R01.S.doc Version 5.2 Page 6 Processes are now in place to regularly review the care plans and risk assessments of people living in the home to ensure they are receiving appropriate support. Storage facilities have improved so that confidential information is stored suitably. Improvements have been made in recording accidents/incidents that occur in the home so that the person in charge can monitor and respond to any issues 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. Westhaven DS0000006685.V350584.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Westhaven DS0000006685.V350584.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 4 and 5 People who use services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service. People moving to the home have their needs assessed before they move so that they can be assured that their needs and expectations can be met there and staff know what support they need. EVIDENCE: One person has moved into the home since the last inspection. Information was available on her care file regarding her needs and how those needs should be met. The person had moved from another part of East Cheshire Housing Consortium operation and so staff already knew her. She had visited the house before she moved there. People who live at Westhaven are tenants and have contracts with the landlord, Contour Housing. A change in this person’s contract had been recorded and it included information about rent, care, housekeeping and personal allowance. Westhaven DS0000006685.V350584.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 People who use services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service The health needs and support needs of people living in the home are continually monitored so that they receive the best possible care. EVIDENCE: During the visit one care plan was inspected and improvements have been made to make sure these are monitored more often. As a result the information on the plan was current and provided staff with accurate written information on how to provide support for that person. Information was available regarding the other health care professionals involved with the person’s care. Staff and health professionals work closely with the people living in the home so that their mental health is maintained. The person was asked to comment on the care/support they received at the home and their care plan but they declined to comment. Westhaven DS0000006685.V350584.R01.S.doc Version 5.2 Page 10 Risk assessment associated with daily living and the routines of the home were seen on the person’s care plan. Nightly checks of people living in the home have now stopped unless their care individual plans indicate that monitoring through the night is necessary. Since the last inspection the home has been refurbished, including the staff office. As a result the storage arrangements for files and confidential information have been improved. Westhaven DS0000006685.V350584.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 People who use services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service. People living in the home are encouraged to maintain a degree of independence and make decisions about what they do so they stay in control of their lives. EVIDENCE: People living in the home attend various activities suitable to their age and their interests. Each person has a timetable of activities, either supported by staff from the home or other organisations. People living in the home attend luncheon clubs and activities at Rosemount centre. One person was collected from the day centre during the visit and then went out to the shops. We spoke with one person in the home who told us that she has regular visits from her family and these meetings happen in private. She said that she still enjoyed life in the home and was fine. Westhaven DS0000006685.V350584.R01.S.doc Version 5.2 Page 12 People were seen preparing and having their lunch and rotas for household task were seen around the house. The degree of independence provided for each person living at the home has to be assessed daily in relation to their mental health. Staff are very experienced in supporting people discreetly when they need more help than usual. The evening meal is prepared and cooked by the staff with help from the residents when they are well. Westhaven DS0000006685.V350584.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 People who use services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service. The health of the people who live at the home is monitored to ensure they stay well and receive the care/support they need. EVIDENCE: The routines at the home are flexible and the people who live there are able to decide how they spend their time. They can choose who they want to help them, what they want to wear, and when they get up and when they go to bed. None of the people who live at the home has a problem with mobility and at the time of the visit specialist equipment was not needed. All the residents are registered with a doctor (GP) and the care plans that were checked during the inspection visit showed that other health care professionals are involved with the care of the people who live at the home. There is a medicines policy and procedures for the home to make sure that the people who live at the home get their medicines as prescribed. Staff have received training in medicine administration. The medication administration record (MAR) sheets had been filled in correctly. Westhaven DS0000006685.V350584.R01.S.doc Version 5.2 Page 14 People living in the home can manage their own medication subject to a risk assessment. We discussed one person’s usual routine of taking a large quantity of medicine out with her when she attends lunch club and the danger of losing a week’s medication. The senior member of staff will address this as a matter of urgency. Westhaven DS0000006685.V350584.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 People who use services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service. There are procedures for complaints and protection in place and staff have received appropriate training to ensure that residents’ welfare is safeguarded. EVIDENCE: There is a written complaints procedure for the home and a copy of this was seen in the home. Staff said there had been no complaints since the last inspection. Two of the people who live at the home who were spoken with said they knew who to complain to if they thought anything was wrong. The person in charge of the home said that verbal complaints made by residents are dealt with as they arise. However, these have not been recorded since April 2007. All staff working in the home have received training on adult protection and the Department of Health’s document “No Secrets” is available in the home. There have not been any referrals made under adult protection. There are robust processes and monitoring processes in place to ensure that money held in the office on behalf of people living in the home is managed appropriately. Westhaven DS0000006685.V350584.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 People who use services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service. The home is well maintained so people living there live in comfortable, safe and homely surroundings. EVIDENCE: Since the last inspection the ground floors of both properties have been decorated and new carpet and furnishing has been bought. The impression on entering the home was that it was warm and fresh and bright. People living there told us they were happy with the way their home looked. The person in charge of the home confirmed that the landlord responds promptly to any requests for maintenance. Westhaven DS0000006685.V350584.R01.S.doc Version 5.2 Page 17 The office is situated in the middle of the two houses and during the visit the inter-connecting doors were wedged open so that the staff could monitor the wellbeing of the people in the houses. This is also common practise for the night staff. However, this presents a risk to fire safety and the door should be kept closed unless other steps are taken to make sure it closes automatically in case of fire. Westhaven DS0000006685.V350584.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 People who use services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service. Thorough staff recruitment processes and training are in place to ensure that the residents are safeguarded from possible harm and poor practice. EVIDENCE: The person in charge of the home confirmed that no new staff have been employed since the last visit. East Cheshire Housing Consortium have recruitment processes in place which include obtaining references and criminal record bureau checks before anyone starts work. Job descriptions are available for staff at all levels within the organisation. East Cheshire Housing Consortium has a rolling programme of training available to staff and the acting manager confirmed that training includes NVQ. Staff spoken with told us the training offered to them was always relevant to the work they do. Westhaven DS0000006685.V350584.R01.S.doc Version 5.2 Page 19 There was no overview or chart on the day of the visit and a inspected. This showed that training, emergency aid, adult Qualification (NVQ) at level 3. of the training undertaken by all staff available sample of one member of staff records was she had completed training as follows; fire protection, medicines and National Vocational Westhaven DS0000006685.V350584.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 People who use services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service. The temporary management arrangements in the home ensure that the welfare of the residents and staff is promoted. EVIDENCE: The home still does not currently have a manager registered with the Commission for Social Care Inspection (CSCI). Interim management arrangements are in place and were found to be sufficient. The fire records show that the alarm systems and emergency equipment are serviced appropriately and staff receive regular instruction and drills. Westhaven DS0000006685.V350584.R01.S.doc Version 5.2 Page 21 The accident record was inspected and all accidents/incidents had been recorded appropriately and were being monitored monthly by the manager and/or the responsible individual. Westhaven DS0000006685.V350584.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 Adults 18-65 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 X 2 3 3 X 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Westhaven DS0000006685.V350584.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. 1 Standard YA24 Regulation 23(4) Timescale for action Advice regarding stay open 30/04/08 devices for the interconnecting doors should be obtained from the fire officer so that people living in the home and the staff stay safe. Requirement 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 YA20 YA22 Good Practice Recommendations Suitable safe storage containers are to be made available to residents taking medication away from the home, and only the required quantity should be removed. A log should be maintained of all verbal complaints made/concerns raised by residents including the outcome, to show that residents are listened to and their concerns are acted upon. A matrix of all staff training should be kept so that the manager can ensure staff are receiving regular up dates in the mandatory training. 3 YA32 Westhaven DS0000006685.V350584.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Northwest Regional Contact Team Unit 1, 3RD Floor Tuskin Court Port Way Preston PR2 2YQ 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. 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