Care Home: Westoe Grange

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What the care home does well The staff collects information together about the person before anyone moves into the home to make sure they can meet their needs. Staff are friendly and have a good relationship with people who use the service, families and other professionals. The service is busy and there are activities everyday if people want to join in.The menus offer a variety of well-cooked nutritious meals. People can enjoy a healthy, well-balanced and interesting diet. The home has a good standard of decoration and furnishings. All bedrooms are a good size and all have their own private en-suite toilet. Lounges are comfortable, warm, bright and cheerful. Bathrooms are also well decorated and warm. Clear information is available should anyone have a concern or complaint about the care or service they are receiving. The registered manager makes sure that all checks and clearances are received before staff are employed. Staff training is good with over 70% of staff having achieved NVQ level 2 or 3 so they are trained to support people in the right way. People who use the service and their relatives are able to say what they think about how the home is run which helps them to have control over their lives. There are good arrangements for supporting people to keep their personal monies in a safe place if they want. The registered persons make sure that the home is a safe place for visitors and those who live there. Comments from relative surveys sent out by the Commission included: "Excellent care. I have no complaints what so ever." " Care is excellent, they do very well." "Keep up the excellent standards" "I am very happy with the care and loving attention X is given." Comments from health professions included: "Problems arising for any of our clients in the care home are reported promptly and our advice and care put in place as appropriate" ". Any health care need which is not able to be met by the staff contracting district nurse service promptly, to involve them to ensure clients health care needs are met". "During visits by district nursing service. Staff always escort clients to their own bedroom for the appropriate care to be given or they assist them into a wheelchair if necessary and take them to their bedroom."Westoe GrangeDS0000064791.V354969.R02.S.docVersion 5.2Page 8"Staff do appear to have a good insight into what their clients require." " Staff always appear skilful and experienced during visits to clients in the care home." "If they are unsure they will always seek out the senior carer, manager or assistant manager as necessary." "I have never had to raise concerns about any of our clients care whilst visiting them at this care establishment." People spoken to during the site visit said" "It`s 100%, I get good food and the staff are good" "They are kind and helpful and the food is fine" "I am very happy living here" "I go to the club across the road, the staff are friendly and always act quickly should I need any help". What has improved since the last inspection? Care plans now show how the care is being provided. They were clear and up to date regarding peoples health and personal care needs. All staff working at the home have appropriate pre employment checks carried out beforehand so that people are safeguarded from harm. Staff now have proper training at the beginning of their employment at the home so that they can look after people`s assessed needs. The manager has now been assessed by the Commission to make sure she is fit to be in charge and is able to manage the service. Information about the money people have are now individually recorded and routinely given to them. Fire training is now up to date with records kept. What the care home could do better: The handwritten directions on Medication Records need to have two signatures to make sure information is written correctly. Condiment bottles, for example, tomato sauce, must be kept free from spills and be stored as directed by the manufacturer.Bread needs to be stored properly to keep it fresh and contain crumbs spreading in cupboards. A dishwasher is needed to make sure all food utensils can be washed properly. Some minor maintenance is needed to the dining room furniture and repairs are needed in the small downstairs kitchenette. A dress code should be put in place, which prevents staff wearing excessive jewellery. The training programme must include specialist training in such areas as dementia, nutrition and wound care Comments from relative surveys included: "I feel a telephone call would be better than waiting till I go in. Recently the first I knew of an outbreak of sickness and the home being closed to visitors was when I turned up at the door. " "Name badges would help. Why they are not worn is a mystery to me as most of the people there have bad memories and Mam still only knows one name. A the new Manager". "More seating areas away from main area. Seats in these places often taken up by residents." CARE HOMES FOR OLDER PEOPLE Westoe Grange 4 Horsley Hill Road South Shields Tyne and Wear NE33 3DY Lead Inspector Mrs Irene Bowater Key Unannounced Inspection 7th January 2008 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Westoe Grange DS0000064791.V354969.R02.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Westoe Grange DS0000064791.V354969.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Westoe Grange Address 4 Horsley Hill Road South Shields Tyne and Wear NE33 3DY 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) 0191 4552221 0191 4558691 Mr Trevor Nesbit Carole Blackett Care Home 40 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (40), of places Physical disability (1), Physical disability over 65 years of age (5), Sensory Impairment over 65 years of age (3) Westoe Grange DS0000064791.V354969.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places: 40 Physical disability, over 65 years of age - Code PD(E), maximum number of places: 5 Dementia, over 65 years of age - Code DE(E), maximum number of places: 3 Sensory impairment, over 65 years of age - Code SI (E), maximum number of places: 3 2. Physical disability - Code PD, maximum number of places: 1 The maximum number of service users who can be accommodated is: 40 27th February 2007 Date of last inspection Brief Description of the Service: Westoe Grange is a purpose-built care home that is close to the centre of South Shields and a number of local amenities. The home is a 3-storey building with service areas on the lower ground floor. The building provides 40 single bedrooms for people, which are on the ground and first floors with all bedrooms having a toilet and sink en-suite. There are two main lounges, a dining room and a conservatory. The home has a small garden area, which provides a pleasant area for people to use in better weather. There is a car park spaces at the front of the building including disabled parking near the entrance. There is easy access into building through the main doors into the reception area. Westoe Grange is a short walking distance from town centre shops and amenities. There is access to local transport directly outside the building. Westoe Grange DS0000064791.V354969.R02.S.doc Version 5.2 Page 5 The home is registered to provide personal care for up to 40 older people. The home is not registered to provide nursing care. A place at this home costs £385 per week. Additional charges are made for toiletries, newspapers / magazines, and hairdressing. Items, which are included in the cost, are listed in the homes terms and conditions. Westoe Grange DS0000064791.V354969.R02.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good, quality outcomes. Before the visit: We looked at: • Information we have received since the last visit on 20 February 2007. • How the service dealt with any complaints and concerns since the last visit • Any changes to how the home is run • The provider’s view of how well they care for people • The views of people who use the service and their relatives, staff and other professionals The Visit: An unannounced visit was made on 7 January 2008 During the visit we: • Talked with people who use the service, relatives, staff, the manager and visitors • Looked at information about the people who use the service and how well their needs are met • Looked at other records which must be kept • Checked that staff had the knowledge, skills and training to meet the needs of the people they care for • Looked around the building to make sure it was clean, safe and comfortable • Checked what improvements had been made since the last inspection. • We told the manager what we found. What the service does well: The staff collects information together about the person before anyone moves into the home to make sure they can meet their needs. Staff are friendly and have a good relationship with people who use the service, families and other professionals. The service is busy and there are activities everyday if people want to join in. Westoe Grange DS0000064791.V354969.R02.S.doc Version 5.2 Page 7 The menus offer a variety of well-cooked nutritious meals. People can enjoy a healthy, well-balanced and interesting diet. The home has a good standard of decoration and furnishings. All bedrooms are a good size and all have their own private en-suite toilet. Lounges are comfortable, warm, bright and cheerful. Bathrooms are also well decorated and warm. Clear information is available should anyone have a concern or complaint about the care or service they are receiving. The registered manager makes sure that all checks and clearances are received before staff are employed. Staff training is good with over 70 of staff having achieved NVQ level 2 or 3 so they are trained to support people in the right way. People who use the service and their relatives are able to say what they think about how the home is run which helps them to have control over their lives. There are good arrangements for supporting people to keep their personal monies in a safe place if they want. The registered persons make sure that the home is a safe place for visitors and those who live there. Comments from relative surveys sent out by the Commission included: “Excellent care. I have no complaints what so ever.” “ Care is excellent, they do very well.” “Keep up the excellent standards” “I am very happy with the care and loving attention X is given.” Comments from health professions included: “Problems arising for any of our clients in the care home are reported promptly and our advice and care put in place as appropriate” “. Any health care need which is not able to be met by the staff contracting district nurse service promptly, to involve them to ensure clients health care needs are met”. “During visits by district nursing service. Staff always escort clients to their own bedroom for the appropriate care to be given or they assist them into a wheelchair if necessary and take them to their bedroom.” Westoe Grange DS0000064791.V354969.R02.S.doc Version 5.2 Page 8 “Staff do appear to have a good insight into what their clients require.” “ Staff always appear skilful and experienced during visits to clients in the care home.” “If they are unsure they will always seek out the senior carer, manager or assistant manager as necessary.” “I have never had to raise concerns about any of our clients care whilst visiting them at this care establishment.” People spoken to during the site visit said” “It’s 100 , I get good food and the staff are good” “They are kind and helpful and the food is fine” “I am very happy living here” “I go to the club across the road, the staff are friendly and always act quickly should I need any help”. What has improved since the last inspection? What they could do better: The handwritten directions on Medication Records need to have two signatures to make sure information is written correctly. Condiment bottles, for example, tomato sauce, must be kept free from spills and be stored as directed by the manufacturer. Westoe Grange DS0000064791.V354969.R02.S.doc Version 5.2 Page 9 Bread needs to be stored properly to keep it fresh and contain crumbs spreading in cupboards. A dishwasher is needed to make sure all food utensils can be washed properly. Some minor maintenance is needed to the dining room furniture and repairs are needed in the small downstairs kitchenette. A dress code should be put in place, which prevents staff wearing excessive jewellery. The training programme must include specialist training in such areas as dementia, nutrition and wound care Comments from relative surveys included: “I feel a telephone call would be better than waiting till I go in. Recently the first I knew of an outbreak of sickness and the home being closed to visitors was when I turned up at the door. “ “Name badges would help. Why they are not worn is a mystery to me as most of the people there have bad memories and Mam still only knows one name. A the new Manager”. “More seating areas away from main area. Seats in these places often taken up by residents.” 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. Westoe Grange DS0000064791.V354969.R02.S.doc Version 5.2 Page 10 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Westoe Grange DS0000064791.V354969.R02.S.doc Version 5.2 Page 11 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3. Standard 6 is not applicable to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are given detailed information about the home and receive full and comprehensive assessments of need to help them make the right decision about using the service. EVIDENCE: The home sets out the aims and objectives of the service in a Statement of Purpose, which is readily available. There is also a Service Users Guide that sets out the values of the home. This makes references to supporting the diversity of needs, cultures, and beliefs of all those involved in the home. Westoe Grange DS0000064791.V354969.R02.S.doc Version 5.2 Page 12 Before anyone is admitted to the home a full needs assessment is undertaken by a Care Manager and the Home Manager. The pre-admission assessments were detailed providing information about peoples personal care, life history’s preferred routines, social activities and cultural needs. This information is then used to complete a plan of care for the individual living in the home. Westoe Grange DS0000064791.V354969.R02.S.doc Version 5.2 Page 13 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care planning, and access to health care services are good, demonstrating that peoples’ needs are being fully met. EVIDENCE: Since the last visit to the home a lot of work has been done to improve the care plans. The plans are now person centred and look at all areas of a person’s life. The information includes risk assessments for prevention of falls, nutrition, pressure sore prevention, moving and handling and continence care. These assessments identify what action should be taken to support the individual. Care plans are in place covering such issues as personal care, mobility, daily living and communication. Westoe Grange DS0000064791.V354969.R02.S.doc Version 5.2 Page 14 For example staff have taken time to find out about previous life histories including “likes crosswords and opera and watching tennis”. One person likes “cats and gardening” and another “likes going to the shops for a paper and likes to sit in the sunshine.” Care plans also set out how staff are to support individual preferences about personal care, daily routines and food preferences. For example one person likes” whisky and lemonade before going to bed”, another likes to be “up at 6:30 am every day”. The care plans are working documents, which are reviewed and updated with the individual and other professionals involved in their care. People living in the home have full access to all health services including, GP’s dental, ophthalmic and chiropody services. The home has good contact with district nursing services and asks the advice of specialist health care professionals such as dieticians when required. Medication is managed on behalf of residents. Senior staff are responsible for the administration of medication, and they are provided with training in the safe handling of medicines. There is secure suitable storage for medication, and administration of medication was carried out correctly. Some people manage their own medication and appropriate locked facilities are provided in their rooms. Self-medication policies and individual risk assessments are in place. An audit of Controlled Drugs found no errors. The Medicine Administration Records showed no gaps in recording but hand written directions did not have two signatures to show that staff had copied the directions accurately. People living in the home are treated with respect by staff that know them well. The atmosphere was relaxed and friendly and staff supported those who needed help in a sensitive respectful manner. Westoe Grange DS0000064791.V354969.R02.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12.13.14.15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Opportunities to take part in meaningful activities and keep control of everyday decisions are good. And people are given the opportunity to lead full and active lives. EVIDENCE: There is an activities programme available and this is displayed within the home. Events include coffee mornings, board games, cake making, in house entertainment and events held out of the home. There are photographs of past events displayed in the home. As the facilities of the town are very close some people spend time in the town or visiting friends and families. Relatives are able to visit at anytime convenient to them The home holds regular meetings for relatives so that they can make comments and suggestions about the care provided in the home.. Information about advocacy is displayed in the reception area of the home. Westoe Grange DS0000064791.V354969.R02.S.doc Version 5.2 Page 16 The location of the dining room has been changed with the lounge areas. This means that the kitchenette is next to the lounge and staff have to walk across the corridor to access the kitchen during mealtimes. Observations of the lunchtime meal showed that staff spent the majority of their time walking backwards and forwards to the kitchen leaving the dining room unattended. This meant that some people had to wait for help or wait for the next course to be served. Another reason is that the home does not have a dishwasher and all the dishes are washed and dried in the small kitchenette by a member of staff. There is nowhere that any dishes can be washed, cleaned and dried at high temperatures. A member of the care staff had to complete this task as the kitchen assistant was off sick. Condiments such as tomato sauce bottles are stored in cupboards. The tops dirty with dried debris and staff did not know that once opened they had to be stored in a fridge. Bread was also stored in the cupboards, which meant crumbs were not contained in one place. The dining tables were nicely set for the lunchtime meal with cloths, condiments and appropriate crockery. There were choices for lunch and dessert. Alternatives included sandwiches or omelettes. Hot and cold drinks and snacks are readily available throughout the day and night. Everyone spoken to said the food “was good”. “I enjoy my meals” and “the food is fine”. Westoe Grange DS0000064791.V354969.R02.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good complaints and protection systems are in place. This makes sure that people are able to express any concern and they are protected from harm. EVIDENCE: There is a detailed complaints procedure, which clearly sets out how and to whom to make a complaint. The procedure is available in the Statement of Purpose, Service User Guide and is displayed in the home. The philosophy in the home is to address any concerns straight away and make sure that they are sorted out quickly and to everyone’s satisfaction. There have been three complaints recorded at the home since the last visit. These have been accurately recorded and resolved by the home. Staff are trained in Safeguarding Adults procedures so can recognise abusive situations and would know what to do if they suspected abuse. There is also written information and guidance, as well as policies and procedures available in the home for staff to look at if they need further guidance. There have been no Safeguarding Alerts made to Local Authority or to the Commission. Westoe Grange DS0000064791.V354969.R02.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,24,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained and a pleasant, clean and comfortable place for people to live. EVIDENCE: The home has two lounges, a dining room, and a conservatory on the ground floor and forty single bedrooms with en-suite facilities on the ground and second floor. The laundry, some offices, kitchen and staff areas are on the lower ground floor. Living areas of the home have a good standard of decoration and furnishings. Lounges are comfortable, warm, bright and cheerful. Bedrooms were also Westoe Grange DS0000064791.V354969.R02.S.doc Version 5.2 Page 19 comfortable, warm and well furnished. Some people have brought some personal possessions with them making their rooms highly personalised. There is a small kitchenette off the lounge. There is some damage to the work surface and the grouting around the sink. The dining tables and chairs are showing some signs of wear mainly from damage from wheelchairs. All bedrooms have an en-suite facility and there are bathrooms and toilets close to all areas. Bathrooms and shower rooms have plenty of aids and adaptations so the people can use these facilities easily and safely. The laundry area is well–equipped, organised and clean. Staff were able to discuss infection control procedures. Some care staff were wearing rings with stones in them and other jewellery. This could create infection and injury risks. Westoe Grange DS0000064791.V354969.R02.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels and systems around recruitment, selection and training of staff are good and meet the range of needs of the people using the service and protect them from harm. EVIDENCE: The registered manager makes sure that there are enough staff on duty to support the people who live in the home. There are sufficient ancillary staff including domestic, administration, cook and kitchen assistants. There has been some staff turnover during the last year although there is a core staff team who have worked at the home for some time. They now are forming a stable team who work well together. Four staff files showed that a suitable application form had been used. Two references are obtained and Criminal Records checks are always carried out before anyone is employed. Westoe Grange DS0000064791.V354969.R02.S.doc Version 5.2 Page 21 The staff files have been changed since the last visit and are now easy to follow and contain detailed information including supervision and training records for that person. Over 70 of staff have attained the National Vocational Qualification (N.V.Q) level 2 in care. Mandatory training for moving and handling, fire prevention, first aid, and infection control and food hygiene is up to date. People who live in the home have different health care needs, for example, they have had a stroke, have poor nutrition or have dementia care needs. All staff have not had specialist training in these areas. New staff have a specific induction programme to complete .The programme includes the “skills for care”, health and safety and Safeguarding Adults information. Westoe Grange DS0000064791.V354969.R02.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run by a competent manager who makes sure that good quality assurance and safety systems are in place. This makes sure that people receive a good, safe quality of care. EVIDENCE: The manager has now been registered with the Commission for Social Care Inspection. She is experienced and has made changes, which has improved the quality of the service. Westoe Grange DS0000064791.V354969.R02.S.doc Version 5.2 Page 23 Regular meetings are arranged to gain the views of people using the service. Questionnaires are sent out six monthly and the results used to continually improve the service. Quality assurance systems are in place and there is a development plan for the next two years. Regular staff meeting are held and staff are asked how senior management can help them develop their roles. Since the last visit the manager has put systems in place to make sure individual records of finances are put in the care plans so that people can keep control over expenditures. There are good arrangements for supporting people to manage their personal allowances if this is requested. The home will support them to keep their personal monies in a safe place. Monies are securely stored in individual, named wallets. A sample of monies and records showed that these were upto-date and in good order. All mandatory training was up to date. Health and safety risk assessments are clear and kept up to date. Accidents are recorded and best practice guidance is used to track trends, which prevents as far as possible the same accidents occurring. Internal maintenance checks are up to date and external service certificates are available and up to date. Westoe Grange DS0000064791.V354969.R02.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 Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 2 3 X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Westoe Grange DS0000064791.V354969.R02.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13 Requirement The registered persons must ensure that handwritten entries on medication charts are always signed, dated and witnessed to reduce the risk of mistakes when copying complex information. The registered persons must ensure that, once opened all condiments are kept refrigerated as directed by the manufacturers. Any spillages on the jars and bottles must appropriately cleaned after use. Bread must be stored in suitable containers. The registered persons must ensure that the back splash on the sink unit in the downstairs kitchenette is repaired. Repairs are required to the damaged worktop. The registered persons must repair the damage to dining tables and chairs. A dishwasher must be provided to make sure all utensils are washed properly after each meal. The registered persons must DS0000064791.V354969.R02.S.doc Timescale for action 03/02/08 2 OP15 16 03/03/08 3 OP20 16,23 03/03/08 4 OP20 16,23 03/03/08 5 OP26 13,16 03/03/08 6 OP30 18 01/06/08 Page 26 Westoe Grange Version 5.2 ensure that staff receive appropriate specialist training to ensure that staff are equipped to provide the right type of care for the people who live here. 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 OP26 Good Practice Recommendations The registered persons should make sure that staff do not wear excessive jewellery and introduce a dress code. Westoe Grange DS0000064791.V354969.R02.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Westoe Grange DS0000064791.V354969.R02.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. 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