Care Home: Westhaven

Similar services:

• Thorndene
• Insight - Eastchurch
• Southfields
• Magenta
• Seabourne House
• 33 St John`s Church Road
• Dovedale Court
• Lyncol House

What the care home does well Westhaven provides sensitive and dignified support in a relaxed and gentle environment to suite the needs and older age range of the residents being accommodated. All persons consulted with regarding the home spoke positively about their experiences with the home. A sample of residents comments included: "love living here"; "Like it here" and "Quite alright". A sample of comments made by relatives included: "I cant speak highly enough about the place it gives me real peace of mind to know that he is so well cared for" and "I have observed the place for over ten years and I have the very highest regard for the home, fantastically well run and really care for the people". Resident`s lives are enriched by the promotion of independence, choice and being enabled to live their chosen lifestyle. A relative said: "he is treated as a person and his opinions are listened to". The meals are good offering both choice and variety and catering for special dietary needs. Resident`s said: "Nice I get to eat what I like"; "choose what you want to eat" and "alright not bad". The home fosters a family environment with a relative saying: "She feels that the home is her family and all the people who live there benefit from the family atmosphere that the staff generate" Two relatives commended the home on the sensitive and dedicated support provided to their relatives during recent serious illnesses. Residents continue to live in a clean homely environment with relatives commenting: "Immaculately kept its so welcoming such a good feel good factor when you walk in" and "fantastic gardens". Staff make a positive contribution to residents lives as they benefit from a trained and enthusiastic staff team that know them and who are safely recruited and employed in sufficient numbers as is necessary to meet their needs. Resident`s comments about staff included: "nice"; "I like"; "great help"; and "I get upset sometimes and I can talk to staff and they help me to feel better". A relative commented: "Staff show real love and patience for him"; What has improved since the last inspection? All of the areas of shortfall noted at the previous inspection have now been addressed this has improved the guidance available for staff on how to meet residents needs to help ensure that residents receive consistent support. Staff have undergone training in mental health to improve their knowledge and skills further. Clearer guidance and training has been provided for staff to follow on what to do if they suspect abuse. The home has sought feedback from residents and relatives on the quality of its services and have acted upon this feedback to improve practices at the home. What the care home could do better: In order to ensure residents, staff and visitors safety the home has been required to consult with the fire authority to ensure that there are adequate fire safety precautions on the first floor of the premises. In order to further improve practices at the home good practices recommendations were made regarding medication practices, staff training and how resident`s aims and objectives are reviewed.Subsequent to the inspection the manager confirmed that they have contacted the fire authority to seek advise on the homes fire safety practices and have arranged for a fire safety visit to the premises. CARE HOME ADULTS 18-65 Westhaven Westhaven 68 Blackborough Road Reigate Surrey RH2 7BX Lead Inspector Jane Jewell Unannounced Inspection 29th April 2008 12:00 Westhaven DS0000013822.V361048.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 DS0000013822.V361048.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 DS0000013822.V361048.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Westhaven Address Westhaven 68 Blackborough Road Reigate Surrey RH2 7BX 01737 221503 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) westhaven@millsted.co.uk Millsted Care Limited Amanda Vivienne Finch Care Home 6 Category(ies) of Learning disability (3), Learning disability over registration, with number 65 years of age (3) of places Westhaven DS0000013822.V361048.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The age/age range of the persons to be accommodated will be: 41-65 YEARS & THREE OVER 65 YEARS 10th April 2007 Date of last inspection Brief Description of the Service: Westhaven care home is owned and managed by Millstead Care Limited and is registered for six (6) people with a learning disability. The organisation also owns a further registered care home in the surrey area. The property is a large detached converted domestic dwelling converted for its current use. It is located in a pleasant residential area in close proximity to two local towns, Reigate and Redhill. Local amenities such as shops and pubs are within walking distance. The accommodation is presented across two floors with access to the first floor via stairs. Communal space consists of a combined lounge dinning room, small conservatory and large kitchen area. There is a large attractive garden area. Resident’s accommodation consists of six single bedrooms with one room providing en-suite facilities. The home has its own transport, which is accessible for all current residents. The homes literature states that its philosophy is based on ordinary life principals firmly grounded in the belief that people with a learning disability have the same value as everyone else. The fees for residential care are currently £1,000 to £1,300 per week, depending on the services and facilities provided. Extra such as: newspapers, hairdressing, chiropody, transport, holidays, toiletries are additional costs. Westhaven DS0000013822.V361048.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 Two star. This means the people who use the service experience Good quality outcomes. The information contained in this report has been comprised from an unannounced inspection undertaken over five and half hours and information gathered about the home. This includes discussions with relatives and stakeholders involved in resident’s care. The inspection was facilitated by the Deputy Manager. There were six residents living at the home at the home at the time of the inspection. The focus of this inspection was to identify the progress made towards addressing the areas of shortfall noted at the last inspection and to look at the current experiences of life at the home for people living there. This involved observing residents and their interactions with staff and examination of the homes facilities and documentation and discussions with residents and staff. Signs of residents well-being/ill-being (terminology used for observing behaviour for people who do not verbally communicate) were observed and are also included in this report. In order that a balanced and thorough view of the home is obtained, this inspection report should be read in conjunction with the previous inspection reports. The Inspector would like to thank the residents, staff and management for their assistance and hospitality during the visit. What the service does well: Westhaven provides sensitive and dignified support in a relaxed and gentle environment to suite the needs and older age range of the residents being accommodated. All persons consulted with regarding the home spoke positively about their experiences with the home. A sample of residents comments included: “love living here”; “Like it here” and “Quite alright”. A sample of comments made by relatives included: “I cant speak highly enough about the place it gives me real peace of mind to know that he is so well cared for” and “I have observed the place for over ten years and I have the very highest regard for the home, fantastically well run and really care for the people”. Resident’s lives are enriched by the promotion of independence, choice and being enabled to live their chosen lifestyle. A relative said: “he is treated as a person and his opinions are listened to”. The meals are good offering both choice and variety and catering for special dietary needs. Resident’s said: “Nice I get to eat what I like”; “choose what you want to eat” and “alright not bad”. Westhaven DS0000013822.V361048.R01.S.doc Version 5.2 Page 6 The home fosters a family environment with a relative saying: “She feels that the home is her family and all the people who live there benefit from the family atmosphere that the staff generate” Two relatives commended the home on the sensitive and dedicated support provided to their relatives during recent serious illnesses. Residents continue to live in a clean homely environment with relatives commenting: “Immaculately kept its so welcoming such a good feel good factor when you walk in” and “fantastic gardens”. Staff make a positive contribution to residents lives as they benefit from a trained and enthusiastic staff team that know them and who are safely recruited and employed in sufficient numbers as is necessary to meet their needs. Resident’s comments about staff included: “nice”; “I like”; “great help”; and “I get upset sometimes and I can talk to staff and they help me to feel better”. A relative commented: “Staff show real love and patience for him”; What has improved since the last inspection? What they could do better: In order to ensure residents, staff and visitors safety the home has been required to consult with the fire authority to ensure that there are adequate fire safety precautions on the first floor of the premises. In order to further improve practices at the home good practices recommendations were made regarding medication practices, staff training and how resident’s aims and objectives are reviewed. Westhaven DS0000013822.V361048.R01.S.doc Version 5.2 Page 7 Subsequent to the inspection the manager confirmed that they have contacted the fire authority to seek advise on the homes fire safety practices and have arranged for a fire safety visit to the premises. 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 DS0000013822.V361048.R01.S.doc Version 5.2 Page 8 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 DS0000013822.V361048.R01.S.doc Version 5.2 Page 9 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): 1 2 3 4 5 and 6 People who use the service experience good, quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home provides both prospective and existing residents with information about what services are provided and what to expect when living at the home. The home provides relaxed and gently lifestyles in keeping with the needs of the residents living at the home. Prospective residents are only accommodated if the home is satisfied that their needs can be met. EVIDENCE: There is some literature about the home and the services and facilities it provides. This includes a statement of purpose and service user guide. These are given to prospective residents and interested parties. Some of the information is in a pictorial format for ease of understanding. Discussion occurred on the areas for potential improvements in the homes literature, which would more accurately reflect the good range of services provided by the home. Documents seen for a recent admission to the home showed that the management team assessed the prospective resident’s needs before they moved into the home. Information about their needs was gathered from a variety of sources including the resident, their representative and health care Westhaven DS0000013822.V361048.R01.S.doc Version 5.2 Page 10 professionals. The needs assessment then formed the basis of their initial care plan. This helped to ensure that staff were aware of their basic needs before they moved into the home. Residents at the home are assessed as having low to medium needs including some who have additional low-level mental health needs. The age of residents ranges from 47 to 72 years. Through observation, looking at records and speaking to relatives, evidence was gathered that the home is meeting the needs of residents and provides relaxed and gentle lifestyles. All persons consulted regarding the home spoke positively about their experiences with the home, residents commented: “love living here”; “Like it here” and “Quite alright”. A sample of comments made by relatives included: “I cant speak highly enough about the place it gives me real peace of mind to know that he is so well cared for”; “We are very lucky to have found a home like Westhaven”; “I have observed the place for over ten years and I have the very highest regard for the home, fantastically well run and really care for the people”. Residents are provided with a written contract of terms and conditions of residency with the home. This can be used with residents and their families to make explicit the placement arrangements and clarify mutual expectations around rights and responsibilities. The deputy manager reported that a signed copy of the contract is retained in resident’s files. Westhaven DS0000013822.V361048.R01.S.doc Version 5.2 Page 11 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 8 9 and 10 People who use the service experience good, quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Care plans provided the appropriate guidance for staff on how to meet the assessed needs of residents. The homes practices actively promote choice for residents. The home balances well the rights to residents to take reasonable risks as part of an independent lifestyle. EVIDENCE: Five individual plans of care were examined and these showed that staff had a range of guidance on the needs and preferences of residents. The information included in the care plans would enable staff to deliver consistent support to residents based on their individual’s needs and preferences. Good care practices were noted in identifying the dreams and aspirations of residents. In line with the previous requirement the deputy manager spoke of the changes to the care planning documentation that has occurred to improve the range of information recorded about residents. Staff consulted with showed a good understanding of the personal preferences and routines of residents. Westhaven DS0000013822.V361048.R01.S.doc Version 5.2 Page 12 Changes in resident’s needs and preferences were identified through the review of care plans. To promote good practices it is recommended that these reviews should also be linked to establishing the progress made towards achieving the individual’s goals and aspirations identify in their care plans. This then promotes the continuous personal development of residents. Annual placement reviews are also held with the placement authorities and residents families to assess whether the home is still able to meet an individuals needs. Daily notes are recorded on each resident, which recorded the actions and events that have occurred. These were written in a respectful and none judgmental style. To promote good practices further it was discussed that daily records should also be based on resident’s individual aims and objectives in order to be able to easily assess when gaols are being worked towards and achieved. The home has a developed system for enabling residents to take responsible risks as part of an independent lifestyle. For example the main risks faced and posed by residents are assessed and any measures to reduce or manage the risk is recorded in order to guide staff in their work with residents. It was evident that integral to the ethos of the home is ensuring and respecting residents rights to make decisions about their daily lives. The deputy manager was familiar with the principals of the mental capacity act, which helped to ensure that resident’s rights to make decisions about their lives was promoted. Staff were observed using a variety of communication tools to provide appropriate choices regarding food, drink, activities and personal care. A staff member said that they often have to make choices on behalf of residents based on their knowledge of residents’ likes and dislikes. One resident has an advocate who supports them to be able to make decisions and choices about their lives. Residents participate in the day to day running of the home in accordance with the range of their individual preferences and strengths. The home is proactive in involving residents in as much of planning their day as possible. One resident was observed helping to make their lunch. Other residents are involved in light domestic duties ie making light snacks and cleaning their bedrooms. Staff demonstrated an awareness of good practices about confidentiality, ensuring that sensitive information is kept secure and knowledgeable about the circumstances under which information must be shared with management and others. Staff are also aware that residents have the right to ask that some information not be shared with family or others. Westhaven DS0000013822.V361048.R01.S.doc Version 5.2 Page 13 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): 11 12 13 14 15 16 and 17 People who use the service experience good, quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are encouraged to remain as independent as possible and maintain control over all aspects of their daily lives. Resident’s lives are enriched by the home providing various opportunities for occupation and leisure. Resident’s benefit by being supported to maintain relationships with their families and friends. The meals are good offering both choice and variety and catering for special dietary needs. EVIDENCE: The homes practices promoted and encouraged residents to remain as independent as possible. Without exception all relatives consulted with spoke of the progress made in their relative’s personal development since they have Westhaven DS0000013822.V361048.R01.S.doc Version 5.2 Page 14 lived at the home, with a relative saying: “Such a vast improvement since he was at the previous home he was quite institutionalised when he arrived, but the home have achieved wonders through individual loving care and they still encourage his potential its marvellous”. Records and discussions highlighted that residents attend local day centres collages, evening social clubs and swimming. Residents spoke of their favourite activities, which included going out for meals and drinks in local pubs and restaurants. Several residents spoke about going away on holiday and how much fun this was. A resident spoke of their part time work and how much they enjoyed this. A resident’s bedroom had many photographs of all the different activities that are important to them. Staff spoke of the considerations they need to observe when undertaking activities for older residents. Relatives commented upon how welcomed they are made to feel when they visit, this included being offered beverages or meals and staff being friendly and approachable. Relatives spoke of how the staff support their relatives to remain in contact with them either through visiting or telephone calls. A relative commented “the home are very good at keeping me in touch”. A resident spoke of their friends visiting them at the home. The deputy manager was sensitive to the potential vulnerability of residents, and mindful of issues around informed consent and adult protection, when residents become involved in intimate relationships. On the day of the inspection, it was observed that the routines of the home were reflective of individual needs and their lifestyle. Residents were able to move around the communal space freely, choosing which rooms to be in and what level of company they wanted to enjoy. Staff spoke of the flexibility in daily routines regarding meal times, going to bed, rising and bathing. A resident said “I have a bath every morning get up and go to bed when I like” Residents are able to help plan menus, shop for food and in some cases help prepare meals and snacks. Staff were observed eating along with residents promoting a social atmosphere. Menus showed that a varied and balanced diet is provided which includes fresh produce. Mealtimes and arrangements for eating are tailored to meet individual residents needs and what events and activities are occurring that day. Specialist diets are catered for, including weight reduction. A sample of comments made by residents regarding meals included: “Nice I get to eat what I like”; “choose what you want to eat” and “alright not bad”. Westhaven DS0000013822.V361048.R01.S.doc Version 5.2 Page 15 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 and 21 People who use the service experience good, quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from the provision of flexible and respectful personal and healthcare support that is individual, respects their privacy and dignity and encourages residents to remain as independent as possible. Residents are protected by the systems in place to manage medication, with further good practices recommendations made in order to further benefit residents. EVIDENCE: Staff were observed providing dignified and sensitive care to residents which helped to maximise their choices and independence. Staff were knowledgeable about the support needs of residents and were sensitive to how this should be provided to respect residents rights and dignity. A relative said: “he is treated as a person and his opinions are listened to”. Another relative spoke of the support provided by the home to change some negative behavioural displayed there their relative. Residents spoke of how their key worker supported them with one residents saying: “I get upset sometimes and Westhaven DS0000013822.V361048.R01.S.doc Version 5.2 Page 16 I can talk to staff and they help me to feel better”, another resident showed signs that they had chosen what to wear that day. Much feedback was received regarding the family orientation of the home with relatives commenting: “She feels that the home is her family and all the people who live there benefit from the family atmosphere that the staff generate” and “residents seem to get on well it’s a real family”. Staff support residents to ensure their health needs are met, with care plans containing a record of any visits or contact with professionals external to the home. There was evidence of involvement from General Practitioners, dieticians, and behavioural management teams. It was clear that where there are concerns regarding the health or welfare of resident’s medical advice and intervention is sough promptly a resident said “if I feel unwell all I have to do is tell staff and they get the Dr for me”. Two relatives commended the staff on how well they supported their relatives through recent serious illnesses, this includes visiting them in hospital most days and the sensitivity shown during their recovery. The system for the administration of medications were good with arrangements in place to ensure residents medication needs are met. However, in order to fully eliminate the associated risk when copying by hand the prescribed instructions onto Medication Administration Records (MAR) a good practice recommendation is that MAR charts are checked and countersigned for accuracy by a second member of staff. A further good practice recommendation is that additional instructions are provided on the use of “As directed” or “PRN” medication. This is to ensure that staff are fully aware of the individual requirements for when these medications should be administered. Staff spoke knowledgeable and sensitively about the needs of older people and how they take this into consideration in their daily practices from activities, food and occupations. Westhaven DS0000013822.V361048.R01.S.doc Version 5.2 Page 17 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 and 23 People who use the service experience good, quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. An effective complaints procedure and staffs sound understanding of their roles and responsible under safeguarding adults protects the rights and interests of residents. EVIDENCE: There is a complaints procedure in place for residents, their representative and staff to follow should they be unhappy with any aspects of the service. The deputy manager reported that no complaints have been received or recorded by the home since the last inspection. All residents and relatives consulted with said that they were aware of how to raise any concerns and felt comfortable to do so and that where they have raised minor concerns in the past these have been addressed promptly. It was previously required that the homes adult protection procedure be reviewed to provide distinct and clear guidance for staff. The deputy manager reported that a copy of the Surrey Multi agency Guidelines on safeguarding adults had been obtained and the homes procedure updated accordingly, however this could not be located at inspection. Staff have received formal training in safeguarding adults and prevention of abuse and the staff consulted with showed a good understanding of their roles and responsibilities under safeguarding adults guidelines. Resident’s financial interests are safeguarded through accurate and robust recording of their expenditure and personal allowances given to them. Westhaven DS0000013822.V361048.R01.S.doc Version 5.2 Page 18 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 26 27 28 29 and 30 People who use the service experience good, quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents live in a clean, homely environment, which has been decorated and furnished to a good standard with their bedrooms furnished and decorated according to their individual lifestyles. EVIDENCE: Westhaven is located in a residential area on the outskirts of Reigate and within walking distance of local shops. The home is decorated and maintained to a good standard, with reasonable steps taken to maintain a safe home. Communal space consists of a large kitchen, combined lounge and dining room which can be partitioned off and a small “lean to”. Much effort is made to create a homely feel to the home whilst ensuring that furnishing and fittings are appropriate for the needs of the group of residents currently living at the home. A sample of comments made about the environment included: “Immaculately kept its so welcoming such a good feel good factor when you walk in”; “comfortable it’s a home”; “lovely house and gardens” and “home Westhaven DS0000013822.V361048.R01.S.doc Version 5.2 Page 19 lovely well kept clean and on the whole run very well”. The home is set in its own grounds with a well maintained garden which has various points of interest and a seating area, a relative commented: “fantastic gardens”. A resident clearly enjoyed using this space and staff were observed enabling them to do so as independently as possible. Resident’s bedrooms are highly individualised reflecting their tastes and lifestyles. The deputy manager stated that all residents have been provided with the opportunity to have locks fitted to their bedroom doors with one resident requesting a lock. There are sufficient number of toilets and bathrooms located around the home including one bedroom which has an en-suite facilities. The home is not designed to offer a service to people with physical disabilities and the stairs and other access arrangements would make it unsuitable for residents with significantly restricted mobility. Generally residents do not currently need any specialist equipment to help with mobility or independence around the home, however staff were mindful of the aging process and felt confident that they would be able to access occupational therapy support should the need arise for any specialist equipment adaptations in the future. All areas inspected were observed to be cleaned to a high standards. Westhaven DS0000013822.V361048.R01.S.doc Version 5.2 Page 20 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): 31 32 33 34 35 and 36 People who use the service experience good, quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staff make a positive contribution in residents lives as they benefit from a trained and enthusiastic staff team that know them and who are safely recruited and employed in sufficient numbers as is necessary to meet their needs. EVIDENCE: Staff and relatives felt that there was always sufficient numbers of staff on duty for staff to undertake their roles in a timely manner and for residents to receive the support they needed, when they wanted it. It was observed through the inspection that staff understood their roles and had a good rapport with residents and planning skills. The tasks of the day appeared wellorganised and individual staff appeared confident in carrying them out. This helped ensure that residents knew who would be supporting them. Staff consulted with had a clear understanding of the aims of the home and how their individual role contributed towards achieving this. Westhaven DS0000013822.V361048.R01.S.doc Version 5.2 Page 21 The deputy manager reported that there has been little staff turnover helping to promote continuity in the support that residents receive. Staff on duty at the time of the inspection had known the residents for some years and demonstrated a good understanding of their needs and preferences. A sample of comments made by residents about staff included: “nice”; “I like”; “great help”; “I like them all” and “alright”. A sample of comments made by relatives included: “Staff show real love and patience for him”; “lovely”; “She feels that the home is her family and all the people who live there benefit from the family atmosphere that the staff generate”. A male resident spoke of the importance of having male staff that he could talk to and undertake male orientated activities with. The home has been proactive in ensuring that the majority of staff receive a National Vocational Qualification (NVQ ) in Care or are in the process of working towards it. The personal files of newly appointed staff were inspected and these showed that a good recruitment process is followed which includes the use of an application form, interviews, Criminal Records Bureau (CRB) checks and written references prior to employment commencing. Staff on duty said that they had undergone all of the mandatory training in Fire, Food safety, safeguarding adults and manual handling needed to help them work safely with residents. In line with the previous requirement staff reported that they have undertaken training in mental health and safeguarding adults. There was no record of staff having recently undertaken any specialist training in learning disabilities. To further improve practices this has been recommended in order that staff are updated in changes in good practices guidance in working with people who have a learning disability. Staff spoke of also undertaking specialist training in areas such as learning disabilities and intervention techniques. A training and development plan has been developed which identifies the training undertaken and planned for in order for the home to meets its aims and objectives and residents needs. The deputy manager reported that all new staff complete a local induction into the home, this includes the industry recommended minimum induction standards. This helps to ensure that all new staff entering into the care industry have at least a minimum level of initial training. Staff are supported to only work within the range of their expertise and training and to seek advice from senior staff if they are unsure of situations. Staff said they felt well supported to undertake their roles and were receiving some formal supervision from their line manager. Westhaven DS0000013822.V361048.R01.S.doc Version 5.2 Page 22 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 and 43 People who use the service experience good, quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Resident’s and staff benefit from a management team that is experienced and who provide a sense of direction and who run the home in the best interest of residents. The systems for resident and relative consultation are good with evidence that indicates that their views are both sought and acted upon. A range of regular health and safety checks helps to promote the health and safety of residents and staff, however advice must be sought regarding some aspects of the homes fire safety practices in order to ensure residents, staff and visitors are safe. EVIDENCE: Westhaven DS0000013822.V361048.R01.S.doc Version 5.2 Page 23 It was reported that the manager has worked at the home for ten years. The manager has previously informed the commission that they have the recommended management qualifications. The manager is supported by a deputy manager who has also worked at the home for a number of years. It was clear that the management team provides a clear sense of direction and leadership. The relationships between residents, staff and the deputy manager on duty at the time of the inspection was observed to be friendly and informal and the general atmosphere of the home was relaxed and open. A sample of comments made about the manager from residents and relatives included: “lovely lady”; “alright” and “fantastic”. In line with the previous requirement there are now several mechanisms in place for the manager to obtain feedback on the services of the home and whether it is achieving its aims and objectives. These include: annual placement reviews, residents and staff meetings. Feedback questions have also been sent to relatives regarding their views on the services and facilities at the home. Examples were noted whereby improvements to working practices have been made based on this feedback. A staff member said about the management team: “they do actually care and listen to staff”. No recent records could be located of the required monthly visit by the provider or their representative to monitor the services at the home. The Deputy manager stated that these visits did occur but the records had been temporarily misplaced. Written guidance is available on issues related to health and safety, which includes the regular servicing and testing of health and safety equipment. Some systems were in place to support fire safety, which include: regular fire alarms and emergency lighting checks, staff training and maintenance of fire equipment and fire drills were reported to have been undertaken. A fire risk assessment had been undertaken by the manager, however this did not identify that there were no fire safety signage or alarm call points on the first floor. No explanation could be provided at inspection as to why this was the case. In order to ensure residents, staff and visitors are safe in the event of a fire the home has been required to contact the fire authority for advice and consultation regarding the appropriate level of fire safety procedures on the first floor of the home. Westhaven DS0000013822.V361048.R01.S.doc Version 5.2 Page 24 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 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 x 3 x x 2 3 Westhaven DS0000013822.V361048.R01.S.doc Version 5.2 Page 25 No 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 YA42 Regulation Requirement Timescale for action 30/05/08 23(4)(a-c) That the provider contacts the fire authority for advice and consultation regarding the appropriate fire safety procedures on the first floor of the home to ensure residents staff and visitors safety in the event of a fire or alarm sounding. 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 YA6 Good Practice Recommendations That residents aims and goals identified in care plans are linked to what is being daily recorded about residents and are also included in the reviews of care plans, in order to promote further residents personal development. That hand written MAR charts/entries are checked and countersigned for accuracy by a second member of staff in order to fully eliminate the associated risk when copying by hand the prescribed instructions onto Medication Administration Records. That additional instructions are provided on the use of “As DS0000013822.V361048.R01.S.doc Version 5.2 Page 26 2 YA20 3 YA20 Westhaven 4 YA32 directed” or “PRN” medication. This is to ensure that staff are fully aware of the individual requirements for when these medications are prescribed. That staff receive specialist training in accordance with the needs of the service users accommodated, namely in working with people who have a learning disability, in order that they keep updated in good practices in the care of people who have a learning disability. Westhaven DS0000013822.V361048.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Westhaven DS0000013822.V361048.R01.S.doc Version 5.2 Page 28 - 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!