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Inspection on 20/03/06 for The Whispers Care Home

Also see our care home review for The Whispers Care Home for more information

This inspection was carried out on 20th March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Provides a small homely environment for semi- active service users who wish to live in a quiet care home.

What has improved since the last inspection?

The home has improved how they identify service users needs and the tools to support staff to provide the individuals care needs.

What the care home could do better:

The manager should ensure that the homes legal requirements are met to protect service users and staff. These are in regard to safe recruitment practices, management of concerns or complaints, care planning and ensuring that service users are provided with meals of their choice and of a suitable nutritional standard.

CARE HOMES FOR OLDER PEOPLE The Whispers Care Home 30 Rambler Lane Langley Slough Berks SL3 7RR Lead Inspector Ruth Lough Unannounced Inspection 20th March 2006 10:00 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 The Whispers Care Home DS0000047604.V286536.R02.S.doc Version 5.1 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. The Whispers Care Home DS0000047604.V286536.R02.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Whispers Care Home Address 30 Rambler Lane Langley Slough Berks SL3 7RR 01753 527300 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) Mrs Mohanjit K Hyare Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (19) of places The Whispers Care Home DS0000047604.V286536.R02.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th January 2006 Brief Description of the Service: The Whispers is a small independently owned residential home for 19 service users situated in a quiet cul-de-sac off the A4 Bath Road linking Slough and Langley. This home is a converted domestic house, which still retains some of the original structural and décor embellishments when built and is set in a moderate sized garden encompassed by large residential properties. The Whispers Care Home DS0000047604.V286536.R02.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection visit to review the concerns raised during the last inspection visit 5th January 2005, the quality of the service and outcomes for service users. The inspectors visited the home during the midday period specifically to consult with service users, observe a mealtime and how the staff team provide care and support during a busy period of the day. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The Whispers Care Home DS0000047604.V286536.R02.S.doc Version 5.1 Page 6 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Whispers Care Home DS0000047604.V286536.R02.S.doc Version 5.1 Page 7 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 The Whispers Care Home DS0000047604.V286536.R02.S.doc Version 5.1 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Service users have a detailed assessment of need carried out prior to admission to the home. EVIDENCE: The inspectors reviewed the care plans of seven service users resident in the home that included two of the most recent admissions. The assessment tools include physical and mental heath needs, mobility, sensory loss, skin integrity, nutrition and weight. Risk assessments for falls, moving and handling are carried out routinely. The Whispers Care Home DS0000047604.V286536.R02.S.doc Version 5.1 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 and 8 The care plans do not fully support the staff to provide the appropriate care to meet the service users identified needs. The service users physical and mental health needs are not always met. EVIDENCE: The care plans did not provide fully, specific guidance for staff to carry out the care in accordance with the service users choices and their physical and mental health needs. The assessment documents identified the service users specific physical and health needs but does not provide evidence that the home has sought further assistance when needed for those with diabetes and long term mental health problems. Service users are supported to receive regular visits/appointments from chiropodists, GP’s and opticians Service users and relatives expressed that they felt that their health and the majority of their social needs were being provided by the home. Staff are not recording sufficiently the daily outcomes for the service users in the individual care plans. Some staff are using inappropriate language to record information. The Whispers Care Home DS0000047604.V286536.R02.S.doc Version 5.1 Page 10 The Whispers Care Home DS0000047604.V286536.R02.S.doc Version 5.1 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 The quality of the menu planning and diet for service users has improved. EVIDENCE: The home has implemented a rotational menu plan that is displayed on a daily basis in the home. Service users are able to choose alternatives to the planned menu if they wish. A nutritional assessment of each individual is carried out on admission and is reviewed periodically. Service users preferences are also recorded. Where specific nutritional needs eg. Diabetes or cultural, have been identified these are not always reflected in the meal planning/ provision. The manager has implemented changes to ensure that the meal times are sociable events and has encouraged service users to come to the dining room for these. During the visit 14 of the 16 service users resident in the home enjoyed the main meal together. None of the current residents require assistance with eating. Service users confirmed that they enjoyed the majority of the meals provided especially the midday meal. The Whispers Care Home DS0000047604.V286536.R02.S.doc Version 5.1 Page 12 The staff are not ensuring that chilled food is stored or disposed of appropriately. Green salad had been kept beyond its recommended expiry date, dates of opening had not been recorded on some opened foods stored in the fridges/ freezers. The Whispers Care Home DS0000047604.V286536.R02.S.doc Version 5.1 Page 13 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 The service users and relatives confirmed that they have greater confidence that the home will listen to their concerns and act upon them. EVIDENCE: The policy, procedure and monitoring of complaints or concerns has not been fully reviewed or developed as required at the last inspection visit in January 2006. The complaints policy has had the required information included but the manage has not put a suitably effective recording tools and monitoring in place for all staff to use. However, service users and relatives confirmed that this had improved recently they felt listened to and that the home took suitable actions to rectify their concerns. The Whispers Care Home DS0000047604.V286536.R02.S.doc Version 5.1 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 26 These standards were not fully assessed on this inspection visit. The service users protection from infection is compromised. EVIDENCE: The home had not provided liquid soap in a shared bathroom/ toilet on the 1st floor of the home. The Whispers Care Home DS0000047604.V286536.R02.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 29 The service users could be at risk from some of the staffing levels and recruitment practices. EVIDENCE: There were 16 service users resident on the day of inspection and 3 vacancies. The staffing rota reviewed did not reflect the care and ancillary staff actually on duty that day. The rota indicates that there is usually 2-3 care staff in the home during the day including the manager and one staff member overnight. The inspectors were informed of the on call system that is managed between the manager and the proprietor but this is still not formalised or documented fully. There is no domestic support on Sundays. The manager has undertaken a needs assessment of the service users and has identified that there are deficits in the staffing skills, experiences and levels at times in the home. One full time staff member recently recruited to the home had left suddenly. The recruitment processes for the 3 most recently employed staff were reviewed. Two files evidenced that all information had been obtained prior to the staff commencing employment. One staff members work history, references and training had not been explored fully. The Whispers Care Home DS0000047604.V286536.R02.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards not assessed on this inspection visit. EVIDENCE: As above. The Whispers Care Home DS0000047604.V286536.R02.S.doc Version 5.1 Page 17 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 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 x X X X X X X X 2 STAFFING Standard No Score 27 2 28 X 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X 2 The Whispers Care Home DS0000047604.V286536.R02.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? Yes 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 OP19 Regulation 23 Requirement That the home is adequately maintained including windows and bathing equipment made safe. Previous requirement made 30/07/05. Ensure that rosters are an accurate reflection of staff on duty. That a review of the staffing levels on duty to effectively meet the needs of the Service Users is carried out. This is an outstanding requirement from 17/02/05 Timescale for action 31/03/06 2. OP27 18(1)a 31/03/06 3. OP30 18 Ensure that a comprehensive 31/03/06 training programme is put in place for all staff and evidence kept. Previous requirement made in an additional visit 4/9/05. That effective quality assurance and monitoring is put in place. This is an outstanding requirement from 31/08/05 That the care plans provide information of how the care is to be delivered and that the DS0000047604.V286536.R02.S.doc 4. OP33 24 31/03/06 5. OP7 15 20/04/06 The Whispers Care Home Version 5.1 Page 19 assessed specific care needs of service users are met. 6. OP15 16 That service users are provided with a varied and nutritional diet that meets their needs and choices. Previous requirement made in an additional visit 4/9/05. Food is stored in accordance to food safety regulations. Previous requirement made in an additional visit 4/9/05. That complaints are managed in accordance to regulations and evidence is kept. That liquid soap and paper towels are provided in all communal bathing and toilet areas. Previous requirement made in an additional visit 4/9/05. That staff are recruited appropriately and robustly and that information is kept of the process carried out. 20/04/06 7. OP15 13.4.c 21/03/06 8. OP16 22 25/03/06 9. OP26 23 21/03/06 10. OP29 19 25/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Whispers Care Home DS0000047604.V286536.R02.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA National Enquiry Line: 0845 015 0120 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 The Whispers Care Home DS0000047604.V286536.R02.S.doc Version 5.1 Page 21 - 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. 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