Care Home: Westside Home 2

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What the care home does well `I visited for an afternoon before I moved in. I was glad to come here`. Comment from a resident. `I had ten weeks of visits before I moved in`. Comment from a resident. `The staff here know what help I need and they always help me`. Comment from a resident. `I only eat halal meat and the manager always gets this for me`. Comment from a resident. `This is a good place to live, it`s safe here`. Comment from a resident. We saw that the home provided excellent standards of private and communal accommodation. Residents told us that they had been supported to make an informed choice to move into the home. The manager arranged individual transition programmes for each person to make sure that their care needs were known and could be met in the home. The home had a qualified and experienced manager who was committed to providing the best outcomes for people living in the home. What has improved since the last inspection? This was our first inspection of the home, following its registration in May 2009. What the care home could do better: Following this inspection we have made one requirement to improve the recording of the care and support given to residents. We have also made one recommendation to improve the management of residents` prescribed medication. Key inspection report Care homes for adults (18-65 years) Name: Address: Westside Home 2 26 Kenton Gardens Harrow Middx HA3 8DE     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: Tony Lawrence     Date: 1 1 0 8 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 Adults (18-65 years) Page 2 of 27 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 Adults (18-65 years) 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 Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Westside Home 2 26 Kenton Gardens Harrow Middx HA3 8DE 02089077979 02089077979 west_sidehomes@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr John Femi Beckley, Mrs Kemi A Beckley Name of registered manager (if applicable) Type of registration: Number of places registered: care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 30 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 needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia - Code MD Date of last inspection Brief description of the care home Westside 2 was registered in May 2009 as a care home providing support and accommodation for up to six people with a mental illness. The home is an extended three-storey property in a residential area of Kenton, close to local shops and public transport. The home provides excellent standards of accommodation. There are six single bedrooms, one with an ensuite shower and toilet. The home is well furnished Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 6 6 Brief description of the care home and decorated throughout and residents bedrooms are very individual. Details of the weekly fees can be obtained from the homes owners or manager. Care Homes for Adults (18-65 years) Page 5 of 27 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced inspection took place on Tuesday 11th August 2009 from 09:45 13:45. During this visit we reviewed outcomes for residents against the key National Minimum Standards for care homes for adults. We did this by talking to residents, staff and the homes owners and manager. We also checked care records and saw all communal areas and bedrooms in the home. Care Homes for Adults (18-65 years) Page 6 of 27 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 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 Adults (18-65 years) Page 7 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 27 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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. The owners understand the importance of having sufficient information when choosing a care home. Admissions are not made to the home until a full care needs assessment has been completed. Evidence: I visited for an afternoon before I moved in. I was glad to come here. Comment from a resident. I had ten weeks of visits before I moved in. Comment from a resident. We saw that the homes owners had produced a Statement of Purpose and Service User Guide that gave prospective residents good information about the home and the care and support provided there. We spoke to both people living in the home and they told us that they had enough information about the home before they moved in. During this visit we reviewed the way that the two current residents were referred and admitted to the home. We did this by talking to the residents and checking care Care Homes for Adults (18-65 years) Page 9 of 27 Evidence: records kept in the home. We saw evidence that both admissions had been well planned and both residents told us they were involved fully at each stage. The homes manager had obtained detailed assessments and reports from health and social care professionals responsible for each persons care. These included psychiatric and medical reports that were completed shortly before each person moved into the home. Care Homes for Adults (18-65 years) Page 10 of 27 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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. Staff involve people in the planning of care which affects their lifestyle and quality of life. Staff understand the importance of of people being supported to take control of their own lives and individuals are encouraged to make their own decisions and choices. Evidence: I talk to the staff and other people about the support I need. Comment from a resident. The staff here know what help I need and they always help me. Comment from a resident. During this visit we looked at the care plan files for both people living in the home. We saw that both people had a current Care Programme Approach (CPA) care plan that had been agreed by all the agencies providing each person with support. The plans included specific tasks and goals that staff from the care home and other health and Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: social care agencies would support residents to achieve. We saw that the homes manager and each persons key worker in the home had used the information included in the CPA care plan to develop a support plan that showed how people would be supported in the home. We saw that the homes support plans needed to be more detailed, including goals from the CPA plan and details about how residents would be helped to achieve these. the homes support plans also needed to be reviewed regularly to show the progress made by each resident. Both residents who spoke to us during this visit told us that they were supported to make choices about their daily lives in the home. One person also told us that staff always respected his choices. We also saw that the homes manager and staff had completed a risk screening form for each resident. This was evidence that potential risks had been identified and actions agreed to minimise the risk to residents and other people. Care Homes for Adults (18-65 years) Page 12 of 27 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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 has a strong commitment to enabling residents to develop or maintain their skills, including social and independent living skills. The home respects the human rights of residents with fairness, equality, dignity, respect and autonomy underpinning the support provided. Evidence: We do all our own cooking, but staff will help if we need it. Comment from a resident. Ill be going back to college after the summer break. Comment from a resident. I only eat halal meat and the manager always gets this for me. Comment from a resident. I see my family every weekend. Comment from a resident. Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: Its my job to help people be as independent as possible. Comment from a member of staff. During this visit we checked the daily care notes kept by staff to make sure that residents had access to appropriate activities. We saw that staff kept a good record of each persons daily routines, both in the home and the local community. One person told us that he usually went out every day, either on public transport or on his bike. The daily records kept by staff showed us that this person went out locally or more widely, most days. The second person told us that he had been going to literacy and numeracy classes three times a week at the local adult college and he planned to return after the summer holiday. We saw that the contact details for both residents family, friends and other significant people were well recorded as part of their care plan. Both people told us that staff helped them to keep in touch with other people and both said they saw their relatives regularly. Both residents told us that they enjoyed cooking and usually did this independently. They told us that they were supported to cook culturally appropriate meals, with support from staff if needed. Care Homes for Adults (18-65 years) Page 14 of 27 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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 receive personal and health care support using a person centred approach. Residents have access to the healthcare services they need. Staff respect and understand the rights of residents in the area of health care and medication. Evidence: I decide when I want to get up and when I have a bath, but the staff do remind me as well. Comment from a resident. The staff help me with my medication. Comment from a resident. During this visit we spoke to the two people living in the home and they told us that staff encouraged them to be independent. They said that they could go to bed and get up when they chose, but staff always reminded them if they had appointments to keep. They also said that they could go out, have a bath and eat meals when they chose. We saw evidence from the daily care notes completed by care staff that staff knew each persons preferred daily routines and residents were supported to be as independent as possible with their personal care. Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: We saw good evidence from one persons care plan file that staff had supported him to register with local health services soon after he moved into the home. We also saw good evidence that current medical and psychiatric reports and assessments were available for each resident and these had been used by staff to establish each persons health care needs and how these would be met in the home. we also saw good evidence of effective joint work with other agencies, including social services and health professionals. Both of the care plans files we checked included a good record of medical appointments, including GP appointments and visits to local hospitals and clinics. During this visit we also checked the homes management of residents prescribed medication. The homes manager told us that medication was provided by a local pharmacist but the home planned to move to a monitored dosage system provided by Boots. We saw that all medication was securely stored in a lockable metal cabinet. We checked the Medication Administration Record (MAR) sheets for both people living in the home. We saw that the records were well completed by staff but there was a need to record reasons for the small number of times when people did not have their medication. Care Homes for Adults (18-65 years) Page 16 of 27 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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. Residents say they are happy with the service provided, feel safe and well supported. The home has a complaints procedure that is clearly written and easy to understand. The policies and procedures for safeguarding are available and give specific guidance to people using them. Evidence: This is a good place to live, its safe here. Comment from a resident. Ive never complained, but if I did, I think the manager would take it seriously. Comment from a resident. If we disagree, we sort it out with staff when we have a meeting. Comment from a resident. During this visit we saw that the home had a clear complaints procedure that was included in the Service User Guide. Both of the people we spoke to told us that they knew how to make a complaint, but both said this had never happened. The manager and staff told us that issues were dealt with at the time they arose and there had been no formal complaints since the home opened in May 2009. Staff told us that they knew about the local safeguarding adults policy and procedures and said they would use these if they had any concerns about a residents welfare. Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: The manager confiremd that the home had a copy of the local authoritys safeguarding adults policy and procedures. She also tld us that there had been no safeguarding referals or investigations since the home opened. Care Homes for Adults (18-65 years) Page 18 of 27 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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. The providers have ensured that the physical environment provides for the individual requirements of the people who live there. The environment is appropriate to the lifestyles and needs of the residents and is homely, safe, clean, comfortable, well maintained and reflects the individuality of the people who live there. Evidence: Im very happy with my room. Ive got everything I need here. Comment from a resident. My rooms good. Comment from a resident. Westside 2 is a large house in a residential area of Kenton, close to local shops and public transport. The house is indistinguishable from neighbouring properties and is suitable for use as a registered care home. During this visit we saw all communal parts of the home, the vacant bedrooms and the two occupied rooms, with the residents permission. The accommodation is provided on the ground, first and second floors. On the ground floor there are 2 bedrooms, a lounge, kitchen / dining room, toilet, shower room with toilet and laundry room. On the first floor there are 3 bedrooms, one with ensuite shower and toilet, and Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: bathroom with toilet and an office. On the second floor there is one bedroom, the staff sleep-in room and meeting room and shower room with toilet. the home has a large, attractive garden that has ramped access and a covered area for people who smoke. During this visit we saw that the two occupied bedrooms were bright, spacious, well decorated and well furnished. Both residents told us that they had everything they needed in their rooms and staff had helped them to personalise their rooms. The vacant bedrooms we saw were also spacious, well decorated and furnished. Communal areas were also spacious and gave residents a choice of areas to spend time with other people or on their own. All parts of the home we saw during this unannounced visit were extremely clean and hygienic. Care Homes for Adults (18-65 years) Page 20 of 27 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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 have confidence in the staff who support them. Residents tell us that staff working with them are skilled in their role and are consistently able to meet their needs. Evidence: The staff are all good and I get all the help I need. Comment from a resident. The manager and staff are very good. Ive got no complaints. Comment from a resident. When we arrived for this unannounced visit, one member of staff was on duty supporting the two people living in the home. The joint owners, one of whom is the registered manager, arrived later to help with this inspection. During our visit, the member of staff on duty worked well to make sure that residents were supported appropriately. We checked the homes rota and this showed us that there was a minimum of one member of staff on duty in the home at all times. The owners told us that this would increase to a minimum of two staff at all times when more people moved into the home. The rota also showed that there was one person duty in the home at night, to Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: support residents if necessary. The residents we spoke to were very positive about the staff who worked in the home. They told us that staff were always available to advise and support them and that they had a good knowledge of local services and facilities. The homes manager confirmed that all staff working in the home had completed their National Vocational Qualification (NVQ) Level 2 training. Staff also told us that they had good access to training. The manager also told us that people living in the home were involved in interviewing potential new staff. All staff appointed to work in the home had a Criminal Records Bureau (CRB) check and two written references. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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 manager has the required qualifications and experience and is competent to run the home. The manager has a clear understanding of the key principles and focus of the service and they work to continuously improve the service and outcomes for residents. Evidence: We meet every month to talk about things. Comment from a resident. The manager knows what shes doing. Comment from a resident. Westside 2 was registered by us as a care home in May 2009. As part of the homes registration, we also registered one of the homes joint owners as the manager of the home. The manager told us that she qualified as a social worker in 1996. She had experience of working in home care, with young people and with people with a mental illness. She also told us that she qualified as an Approved Social Worker to work with people with a mental illness. During this visit the manager demonstrated a good awareness and knowledge of best practice in mental health and residential care. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: Residents we spoke with during our visit were positive about the manager and the way the home was run. They told us that a monthly house meeting was held to discuss issues affecting the home and the people living there. They also told us that residents and staff took turns to chair these meetings. During this visit we reviewed a selection of records kept in the home, including residents admission records, care plans, risk assessments, daily care notes and medication records. We saw that standards of record keeping in the home were good and staff kept a good record of the care and support offered to each resident. We saw no health and safety issues during this visit. Care Homes for Adults (18-65 years) Page 24 of 27 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 Adults (18-65 years) Page 25 of 27 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 1 6 15 The homes support plans for each resident must be more detailed. This will help to show how each persons identified care needs will be met in the home. 30/11/2009 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 1 The owners should update the homes Statement of Purpose and Service User Guide to include the new contact details for the Care Quality Commission. When a resident does not take their prescribed medication, the reason for this should be recorded. This will make sure that an accurate record is kept of each persons medication. 2 20 Care Homes for Adults (18-65 years) Page 26 of 27 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. 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