Care Home: Westminster House Care Ltd

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What the care home does well The service has a well trained work force that have been in post many years. The manager is experienced, dedicated and professional and she has a positive impact on staff motivation and the care given to people who live at Westminster house. The team are providing a warm, relaxed, welcoming environment, and give consistency of care. Staff listen to individuals and support them in a positive and caring manner. People looked well cared for and staff interaction was good. All professionals, relatives and residents spoke highly of the manager, staff and the overall service provided. What has improved since the last inspection? All staff have had dementia training. Any recommendations and requirements from the last inspection have been achieved. The manager has completed a medication audit alongside the local Pharmacist. What the care home could do better: Risk assessments could include the positive aspects of individuals being able to take risks rather than just why a persons rights have to be restricted at times. Additionally an, `Infringements of rights` documentation should be put into place to explain why restrictions are needed, what other professionals are involved in this decision and how much consultation and information has been given to the person in question. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Westminster House Care Ltd 41 Westminster Drive Westcliff On Sea Essex SS0 9SJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sarah Hannington     Date: 0 4 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. the things that people have said are important to them: They reflect 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 23 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: Westminster House Care Ltd 41 Westminster Drive Westcliff On Sea Essex SS0 9SJ 01702333034 01702333034 linda.reilly@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Westminster House Care Ltd Type of registration: Number of places registered: care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home Westminster House is a care home offering care and accommodation for up to twelve older people who have dementia or a mental health disorder. Westminster House is situated in a residential area of Westcliff-on-Sea and the premises are in keeping with the houses in the locality. Accommodation comprises of a large lounge with dining area. There are twelve single bedrooms situated on the ground and first floor. There is a five person passenger lift. The home has a non-smoking policy and staff and residents who wish to smoke make use of a cabin in the garden. 0 0 Over 65 12 12 Care Homes for Older People Page 4 of 23 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: The quality rating for this service is *2 star. This means that the people who use this service experience Good quality outcomes. The unannounced site visit took six hours to complete and was carried out as part of the annual inspection programme for this home. This visit was conducted with assistance from the registered care manager and provider. As part of the process a number of records relating to residents, care staff and the general running of the home were examined. The site visit also focused on any requirements and recommendations from the last key inspection. We looked at all of the information that we have received, or asked for since the last Care Homes for Older People Page 5 of 23 key inspection. Prior to the site visit the manager completed an Annual Quality Assurance Assessment (AQAA) form and forwarded it to the commission. This is a self-assessment form that registered services are required by law to complete. This form provided us with information of how well the provider feels that the service meets the needs of the people who live at Westminster House and how the service are performing against the National Minimum Standards. On this site inspection five staff and five residents were spoken with as part of this process. Prior to this visit we sent out surveys to the home for residents and staff to express their views about the service provided and the staff team. Comments from these surveys will be included as part of this report. 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 following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 23 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 8 of 23 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A clear and comprehensive assessment process assures people that their needs could be met prior to moving into their home. Evidence: The current statement of purpose and service users guide is up-to-date and available for any prospective residents and their families. The two most recent care files of people that moved into Westminster house showed us that, assessments were in depth and each stage of visits taken, were well recorded and informative. We spoke to the two residents who had recently been admitted and one family member. They said that they felt the manager and staff had made them feel welcome, gave lots of useful information and consulted with them about their views. They also told us that they had plenty of visits beforehand to meet the staff and other residents. Speaking with the manager and staff they told us that if a person could not visit the home for any reason then a photographic brochure would be given to them and that if appropriate, a Care Homes for Older People Page 9 of 23 Evidence: resident would come and meet them. The managers admission process means that any prospective residents could be assured that the service understood peoples needs and would know that they will be able to meet them before agreeing to admit them. Care Homes for Older People Page 10 of 23 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. People using the service can be confident that their personal care and health needs will be met in the way that they would wish. Evidence: Four residents spoken with during the inspection said that they were being well looked after and cared for. Members of staff were acknowledgeable of peoples conditions their likes and dislikes and delivered the care and support accordingly. Individuals received personal care and health care support based upon identified needs in their care plans, including the rights of dignity, privacy, respect and choice. Risk assessments were reflective of care plans and reviewed regularly. People informed us that they had plenty of contact with health care professionals and care records reflected this. The manager has recently carried out a medication audit alongside the pharmacist they use. The records of ordering, administration, storage and disposal of medicines is kept in good order. All staff who administer medications have undergone the safe administration and Care Homes for Older People Page 11 of 23 Evidence: management of medicines training and those spoken with, said they have robust systems in place to ensure that medicines are managed safely. Care Homes for Older People Page 12 of 23 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. People can be confident that they enjoy a lifestyle that meets their expectations. Evidence: People spoken with informed us that staff supported them in making choices about how they wanted to spend their day. A weekly activity program is devised for each person as part of their care plan and on a daily basis people are also given a choice. Activities and leisure interests include indoor and outdoor activities of their choice. People told us that they visit friends, carry out shopping for their own personal needs, go to clubs and visit places that interested them. Some people informed us that they had agreements with staff about times for coming home which suited them and protected them.Care practice observed appeared to empower people using the service and their rights to decision-making were also being proactively encouraged, as appropriate. People using the service are encouraged to develop and maintain social, emotional, communication and independent living skills. Observation and discussion with people showed us that they carried out daily tasks such as, shopping, care of rooms and laundry. Information gained from staff, residents and documentation around menus indicates Care Homes for Older People Page 13 of 23 Evidence: that people living in the home are consulted with regarding culinary likes and dislikes. People expressed satisfaction with the food provided and observation during the lunch time period revealed that food looked appetising, nutritious, fresh and smelt good. Care Homes for Older People Page 14 of 23 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 can be assured that their concerns and complaints will be listened to and acted upon and that they will be safeguarded from abuse, neglect and harm. Evidence: Residents and relatives confirmed that they feel able to raise any concerns, complaints and issues that they may have, that staff listen and take the appropriate action. The manager receives very low number of complaints, this is partly due to the good contact that the manager, proprietors and staff have with outside agencies, relatives and the way in which they work with people who live in the home. People told us that staff, listened to them and worked through any issues they had and that they felt confident they could raise anything that was bothering them. A review of the complaints systems in place showed us that if a complaint is received it was dealt with in a timely and satisfactory manner. Safe guarding vulnerable adults training is provided for the care staff team and is included within induction processes. Discussion with individual staff showed us that they knew what constituted abuse and where to report this if need be. This ensures that the staff training and their knowledge around these issues protect people who live at Westminster House. Care Homes for Older People Page 15 of 23 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. People live in an environment that is homely, comfortable and safe. Evidence: A good standard of cleanliness was evident through the home and no odours were apparent. The home has an infection control system in place and staff spoken with showed us that they knew procedures well and are all trained to a good standard around this. Staff training records also backed this up. One member of staff has had the in-depth health and safety training and takes a lead in undertaking checks that are needed to maintain a safe environment. There is an annual maintenance plan which includes regular weekly, monthly and yearly checks. Staff members told us that people are spoken with about decor and general updating of their home. People spoken with confirmed this and one person informed me that she had requested her room be redecorated in the colours she wanted and this had been arranged for her. Care Homes for Older People Page 16 of 23 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. People using the service are cared for by a competent and qualified staff team and are protected by the homes recruitment policy and practices. Evidence: Since the last inspection all staff have received training in dementia Care. Staff have the necessary skills and they receive appropriate training to meet the variying needs of the people who live at Westminster House. Staff files were reviewed and recruitment records showed us that application forms were completed, interviews were held, two references obtained, criminal records bureau checks undertaken and proof of ID and a photograph kept. Contracts of conditions of service and job descriptions were issued to new staff. Staff rotas confirmed that the staffing numbers and skills mix are appropriate to meet the assessed needs of the people living at the home. The manager reported that the home does not use agency staff and looking through staff recruitment documentation showed us that the staff team have been in post for a number of years and provide stability, and consistency of care for the people living there. Speaking with staff they confirmed that supervision, staff meeting and yearly Care Homes for Older People Page 17 of 23 Evidence: appraisals went ahead and documentation backed this up. Care Homes for Older People Page 18 of 23 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. People live in a well run home and are suppoerted by a dedicated staff team. Evidence: The care manager is presently working towards the NVQ 4 qualification and has put in an application to CSCI to be the registered manager of Westminster House. The manager has already achieved the level NVQ 2 and has had seven years experience within the home in a senior role. Discussion with the manager showed us that she is knowledgeable and is highly organised and efficient in her role. There are clear accountability of roles amongst the team. Policy, procedures and documentation evidence that resident finances are protected. All health and safety checks that were inspected are up to date. The fire records looked at were found to be to a good standard, risk assessments are in place for all residents and staff carried out annual fire training and regular fire drills. Fire safety officers visit every year and checks made by the team are regular and promotes the Care Homes for Older People Page 19 of 23 Evidence: safety of all residents. Quality assurance is due to be carried out and will include views from all residents, relatives and other professionals and persons that may come in contact with the home on a regular basis by means of surveys being sent out. This will finally be made into a report with the outcomes, achievements and actions that will be taken as a result of the Quality monitoring Survey carried out. This documentation needs to be made available to all interested parties and displayed within the home and a copy sent to us. These results could also prove useful to the manager when completing any future AQAA. People and staff that live and work in Westminster house commented that they were happy with the manager and the support she provides. Additionally a professional who works on a regualr basis with the team, stated that the manager and staff are consistent, provide good care and puts the people that live there, first. Care Homes for Older People Page 20 of 23 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 21 of 23 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 1 8 To ensure that risk assessments include the positive aspects of individuals being able to take risks. Additionally that if a persons rights have to be restricted, then an, Infringements of rights documentation is put into place. Overall this would show us how risks are managed and explain decisions and how much consultation has been given to the individual in question. Ensure that as well as the homes complaints systems also record all concerns and issues raised by staff, visitors and residents. This will show us how concerns are dealt with and may aid to mould the service by lsitening to peoples views. 2 16 Care Homes for Older People Page 22 of 23 Helpline: 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 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 © (2008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. 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