Care Home: Westlea

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What the care home does well The home provides a high level of care. There are comprehensive assessments and care plans. Care plans contained detailed information that has been written in an empathetic and person centred way. They clearly demonstrate how people`s needs are monitored, managed and met. The staff team ensure that the home has a friendly and caring environment. People appreciate the cleanliness and the upkeep of the home. An activities co-ordinator ensures a varied programme of activities and events is tailored to the needs of people who use the service. Surveys reflected very positive views from service users and relatives. In response to the question What does the home do well people told us the following: `Provide meals`, `The home looks after me well and puts on activities that I like. I like the quizzes` , `The carers give me a shower when I need one. The carers here are very good and I find no fault with the place. I like it here and I am very satisfied`, `The home does everything well`, `The television is on when I want to watch a programme. I enjoy watching the television and the activities`, `I am very happy with my care most of the time`, `Looks after me very well`, `I cannot think of what the home could do better`, `Keeps my mother safe`. What has improved since the last inspection? The requirements made at the previous inspection have been met. Medication is stored in their original containers and labelled with the prescriber`s instructions. As required (PRN) medication is reviewed if prescribed for a prolonged basis. Staff have received specialist training to enable them to meet specific needs e.g. stroke aftercare, Safeguarding. All parts of the home are free from hazards to service users` safety. Fire doors shut correctly to protect people using the service. A summerhouse has been purchased and the paths have been widened to provide better access to wheelchair users. What the care home could do better: The manager has plans to further and improve the service. There are plans to develop the option for large print documentation in the home. A request has been submitted to purchase a computer and web camera to facilitate service users` contact with family and friends. Surveys highlighted some ares that people who use the service would like to see improvement in and these were fedback to the manager during the inspection: Many surveys said nothing could be done better, one person requested a bigger room if one became available, `make the coffee stronger`, `I would like my clothing returned from the laundry quicker`, `The carers could come a bit quicker when the buzzer is pressed`, `Meals could come quicker as we sometimes are sat down for a long time before they arrive.` Key inspection report Care homes for older people Name: Address: Westlea 121 High Street Leagrave Luton Bedfordshire LU4 9JZ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Angela Dalton     Date: 1 8 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Westlea 121 High Street Leagrave Luton Bedfordshire LU4 9JZ 01582574587 01582847232 p.pugh@Luton.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Luton Borough Council care home 34 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Westlea is a large Luton Borough Council residential care home that provides permanent and respite care to people. The homes location is on the main street in Leagrave providing easy access to local amenities. Service users have access to local GPs and District Nurses. Westlea provides a comfortable and homely atmosphere in a safe and domestic style environment. The accommodation includes single occupancy bedrooms, several lounges/ dining areas, bathrooms and toilets that are strategically placed within the home. The home has a separate smoking room and visiting areas, a hairdressing room and two shaft lifts providing access to both floors. Parking facilities for several cars are available. Care Homes for Older People Page 4 of 26 Over 65 34 0 2 0 1 0 2 0 0 8 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: One inspector conducted this unannounced site visit on 18th September 2009 between 10am and 4.30pm. Three people were case tracked who had lived at the home for various periods of time between 2 weeks and 2 years. We followed the care of people who use the service to ensure the care they receive is reflected in the care plan and meets their individual requirements. The case tracking process cross references all the information gathered. This is to confirm that what we are told is happening is actually occurring. This should reflect the Statement of Purpose, which contains the aims and objectives for the service. We spoke to the people who use the service, their relatives, members of the staff team and the manager. Weekly fees range from 75 pounds to 560 pounds but personal costs such as toiletries, chiropody and hairdressing are not included. We received lots of surveys from people who use the service, some from relatives and Care Homes for Older People Page 5 of 26 professionals who visit the home and their comments have been included in the report. We were present for lunch and observed several aspects of care delivery. Care Homes for Older People Page 6 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 7 of 26 following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to make an informed choice about the home from the information available. Evidence: The home provided up to date information about its facilities and services in a user friendly format. Visitors to the home could access the Statement of Purpose and previous inspection report as they are on display in the entrance to the home. This enables prospective residents to access information and make an informed choice about moving into Westlea. The Service User Guide is very user friendly and reflects comments about the home from people who currently live there. We were told by residents and their relatives that the service users guide had provided useful information prior to moving into Westlea. A large noticeboard provides people who use the service with a wealth of information to the home. It is also useful for visitors and prospective residents as it reflects activities available, staff Care Homes for Older People Page 10 of 26 Evidence: qualifications and advice about local support groups and useful information. Assessments had been completed prior to moving into the home. The manager told us that they or a member of the management team completed assessments with a member of the care staff. This introduced the service user to their keyworker and enabled them to allay any concerns at an initial stage. It also ensured that all needs were identified and staff were able to meet them. The assessment provides a foundation for the care plan and also provides an overview of needs. We saw a comprehensive assessment for a person who had been admitted as an emergency the day before the inspection. It was detailed and informative and provided information to enable person centred care to be delivered. Assessments are signed by service users or their relative to reflect their involvement in gathering information. We saw evidence of written contracts and people were provided with a statement of terms and conditions which they or relatives signed: this included fees charged and the facilities available. The service offered opportunities for people to visit the home prior to moving in. Some people who use the service had stayed for periods of respite care before choosing to move in on a permanent basis. The home did not admit people who needed intermediate care. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service meets individual neds and treats people with dignity and respect. Evidence: We followed the care of three people who had lived at Westlea for varying lengths of time - from 2 weeks to over 2 years. Each had a comprehensive and informative care plan written in a person centred way. Care plans contained a great deal of thoughtfulness and personal detail. Every aspect of care had been covered and information was detailed and reflected that staff had placed themselves in specific situations to ensure that people received care in a dignified and empathetic way. We observed staff working with people at their pace and treat people with dignity and respect. Staff knocked upon doors before entering bedrooms and spoke to people in a polite and friendly manner. Funeral wishes had been recorded to ensure that people received the end of life care that they desired. Each aspect of care had a relevant care plan e.g.skincare, tissue viability, social Care Homes for Older People Page 12 of 26 Evidence: history, religious needs and individual diagnosis. Personal histories had been recorded as had likes and dislikes. There was evidence that care plans were reviewed to ensure that they contained up to date information. Service users or their relative or representative signed care plans to reflect their involvement. Risk assessments had been completed to ensure that risks could still be safely taken and were monitored, managed and met. Staff are swift to involve health professionals when required and their advice is incorporated into care plans. Some people receive support from a district nurse and health records are held in separate folders completed by nursing staff. Care plans refer to care being delivered to the nurse and this ensures seamless care delivery. We checked regular and controlled medication for five people who use the service and found records to be kept in good order. Copies of prescriptions are kept which act as a receipt and a copy of GP instructions. Medication is stored securely and at a safe temperature. Requirements made at the previous inspection had been met. Medication is stored in labelled original containers reflecting prescribers instructions. PRN (as required) medication is regularly reviewed by a GP to ensure that if it is required over a prolonged period it can be prescribed appropriately. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The social expectations of people who use the service are met. Evidence: People who use the service told us they enjoyed the activities provided and that there was choice and variety. Surveys commented that people especially liked the quizzes and films. A visiting professional told us in their survey response that there was a good range of activities. The activities co-ordinator works 20 hours each week between 10am and 2pm on weekdays. The manager has made a request for this to be increased to 30 hours each week. A request for a computer and webcam has been submitted by the manager to assist people who use the service to stay in touch with their families and friends. On the day of the inspection a small group were going out for a pub lunch. The home contracts in transport as it does not have its own provision. The activities programme is displayed in prominent places throughout the home. Residents meet regularly at meetings and discuss outings and trips they would like to make and review activities currently offered. People told us that they felt involved in the running of the home. The home has a dedicated hairdressing room for the visiting Care Homes for Older People Page 14 of 26 Evidence: hairdresser to use. Menu options are also discussed. We sampled lunch which was tasty and several options were available: Fish and chips, shepherds pie and seasonal vegetables and Caribbean chicken with trifle or alternative for dessert. Service users told us that food was of a high standard and choices were always available. There are dining areas on the ground and first floor. One service user stated in their survey that the cooking was done well but sometimes people were sat for a long time before meals arrived. The manager will investigate this further but it was not supported by other service users. We noted that care plans were descriptive in detailing the level of support people required if they were assisted at mealtimes. Food preferences were also recorded and records kept if people required support and encouragement with their diet. Relatives are welcome to visit throughout the day and we were told that the home made them feel very welcome. Members of local churches visit regularly to hold services within the home. The manager told us if a request was made to attend church then staff would try to facilitate it. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service were protected from harm, and as a result their best interests were assured. Evidence: The service has not received any complaints since the previous inspection. There is a designated folder to record complaints and residents minutes and care plans record any concerns and how they are dealt with. The home also keeps a compliments folder which holds cards and letters thanking the staff for their care and consideration. The manager plans to record when they are received to incorporate compliments into the annual quality review. People who use the service told us that they knew who to raise any concerns to and felt that they were listened to and taken seriously. A copy of the complaints procedure is displayed in the foyer and summarised in the service users guide. As stated earlier risk assessments are in place to ensure that service users are protected from harm. Staff said they would know what to do, if confronted with situations relating to the possible abuse of those people using the service and confirmed that they had received training relating to the protection of vulnerable adults. The home has made one safeguarding referral since the last inspection, which was undertaken using Luton Borough Council safeguarding procedures. The outcome of this is awaited and the Care Homes for Older People Page 16 of 26 Evidence: safeguarding team have been satisfied with the measures taken. The service ensured satisfactory financial procedures were in place for staff handling peoples finances. Finances are regularly checked and records kept accordingly. We checked 3 peoples finances and found this to be the case. Financial records are also checked as part of senior managers regular visits to the home. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a comfortable and homely environment to people who use the service. Evidence: Westlea provides a well maintained and homely place to live. It employs a member of staff to maintain the home and any faults are swiftly dealt with. We observed people were enjoying the well kept garden with plenty of garden furniture available and a newly purchased summer house. Paths have been widened to ensure that they are suitable for wheelchair users. A family was using the conservatory to meet with their relative who had moved into Westlea the day before the inspection. Domestic staff ensure that the environment is well maintained and offers people a homely and comfortable place in which to live. There is plenty of communal space available within the home to ensure people are able to meet visitors in private. A dedicated smoking room for residents was also available. The home was clean, tidy and odour free. One service user told us The home looks after me and does the cleaning well. People told us that the home provided a clean bed and that bedding is changed frequently so that the bed is always nice and clean. There are aids and adaptations to ensure that the home can meet the needs of people who live there: these included various types of hoists, grab Care Homes for Older People Page 18 of 26 Evidence: rails and assisted toilets and baths. Bedrooms suit the needs of the people using the service and they are encouraged to personalise their room. People who stay for respite care are also encouraged to bring personal belongings. Respite stay rooms are integrated with permanent residents to ensure that people who receive respite care are not isolated and had people around them to help them settle in and approach for advice. The home achieved a five-star rating from the environmental health inspectors in November 2007 for exceptional hygiene standards and this has been achieved again in June 2009. Staff have access to protective clothing and all have completed infection control training. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Competent and skilled staff support people who use the service. Evidence: We saw evidence of a comprehensive training programme. Staff we spoke to reported that they were well supported in receiving training and if they requested training in a particular subject it was forthcoming. We saw evidence that the previous requirement regarding specific training to meet the identified needs (specifically health) of service users has been met. A high level of staff have achieved an NVQ - over 80 of 50 members of care and auxiliary staff hold a qualification. There is currently a recruitment freeze and the service is covering vacancies (approximately 85 hours per week) with agency staff. The home ensures that a pro forma detailing the checks the agency has carried out is received prior to employing agency staff which we examined. We inspected recruitment records of 2 staff who had been employed since the previous inspection and the appropriate checks had been carried out to ensure the safety of people who use the service. Service users and their relatives spoke highly of staff. Staff told us that they enjoyed being part of a happy and friendly team. One staff stated that Westlea was like a family home from home to work in. We received positive comments from relatives surveys. I would like to thank all the great staff at Westlea for all the hard work they are doing for my mother. They are Care Homes for Older People Page 20 of 26 Evidence: friendly and kind people. They keep me informed with anything I want to know about. There is nothing more they could do as they do all they can to look after my mother,We are happy with the way J is looked after, They keep my mother safe. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run by a competent manager who strives to deliver quality care for people who use the service. Evidence: The manager has many years experience in care and has managed Westlea for over 2 years following the closure of their previous care home. They are supported by an experienced team of Care Team Leaders and care staff. Staff, service users and relatives spoke highly of the manager and felt supported. One staff member said they are one of the best managers Ive worked for and the way they train people is second to none. Service users meet regularly and any issues raised are addressed. Views of service users, relatives and stakeholders are sought annually via questionnaire. Results are published in a report which is distributed to all who were asked to complete a questionnaire. Monthly visits are conducted by a senior manager to ensure that a quality service is being delivered and to review practices within the home. The Care Homes for Older People Page 22 of 26 Evidence: manager completed the Annual Quality Assurance Assessment and sent a copy to the Commission to evidence the improvements since the previous inspection and goals for the future. The requirements made at the previous inspection have been met. There were no identified hazards to service users safety and fire doors were not impeded from closing. Robust Health and Safety Records are in place to ensure service users, staff and visitors to the home are not exposed to unnecessary risk. Each service user has a fire risk assessment using a red, orange or green sticker to illustrate the level of risk identified if the home required evacuation. This is completed as part of the assessment process on admission to the home. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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