Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 05/01/06 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 5th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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

The newly appointed manager is looking to improve the service provision for service users. The staff provide a homely friendly environment for people living in the home.

What has improved since the last inspection?

The employment of an experience person to the role of manager, who has in the short time in the home, developed the activities available for service users. The assessment and admission process for service users has improved. The proprietor has continued to redecorate service users rooms.

CARE HOMES FOR OLDER PEOPLE The Whispers Care Home 30 Rambler Lane Langley Slough Berks SL3 7RR Lead Inspector Ruth Lough Unannounced Inspection 5th January 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.V275024.R01.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.V275024.R01.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.V275024.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th June 2005 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.V275024.R01.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 services provided and the outcomes for service users living in the home. There were also a number of outstanding requirements made during the previous inspection visit on the 9th June 2005 and an additional visit in September 2005 following complaints received by the CSCI. This inspection was conducted over one day by two inspectors. During the visit the inspectors spoke with service users, observed staff, and reviewed the environment of the home and records kept. The proprietor has recently employed a new manager who has been in post since 12th December 2005. What the service does well: What has improved since the last inspection? What they could do better: To ensure that the care plans should reflect how the care is provided to service users. The building and the fittings should be maintained to a better standard. Make sure staff are recruited with all checks being undertaken. Staff need training in medication, moving and handling, food hygiene and protection of service users. Please contact the provider for advice of actions taken in response to this The Whispers Care Home DS0000047604.V275024.R01.S.doc Version 5.1 Page 6 inspection. 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.V275024.R01.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.V275024.R01.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): 1 and 3 The Statement of Purpose and Service User Guide that is given to service users prior to admission to the home, however it is not compliant to the regulations. A comprehensive assessment of service users needs is carried out before being admitted to the home. EVIDENCE: The Statement of Purpose and Service User Guide do not reflect the recent changes in manager and the telephone number for the CSCI in the complaints section. This was a requirement from the previous inspection. Service users are provided with copies of the Service User Guide in their rooms. Three service users files were reviewed. Of these all had had an assessment of need although not all appear to be prior to arrival in the home. A new comprehensive assessment process that has recently been introduced, by the new manager, has been carried out for one service user recently admitted. This process included incorporating information from the Social Worker referring the service user. The Whispers Care Home DS0000047604.V275024.R01.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): 7,8,9 and 10 The care plans do not explain fully how service users personal care and health care needs are to be met. The policies, procedures and practices for the safe handling of medicines could put service users at risk. Service users privacy and dignity is not fully respected by staff at times. EVIDENCE: The care plans currently in use do not reflect how the identified needs of service users are to be met. The manager has identified that the documents do not support staff of how to carry out the care support to meet the individual’s needs. One service user has very specific health needs that are not addressed in their care plan. The service users care files reviewed did support that some service users weight is recorded on a regular basis. Methods of assessing service users risks in developing pressure sores are used. There is a very good manual handling risk assessment document tool for the individual service user although those seen had not been reviewed regularly. The Whispers Care Home DS0000047604.V275024.R01.S.doc Version 5.1 Page 10 The home has policies and procedures in place for the management of medications in the home that require minor amendments to ensure a robust system. These deficits include the method of receiving medication in to the home and returning medications to the pharmacy, service users consent to self medicate and the training of staff. Staff informed the inspector that they had received no formal training for medication administration apart from observing the previous manager. Service users are not provided with sufficient privacy as curtains and blinds have not been provided in some of the bathrooms. Room 19 had poorly fitted curtains that do not give full privacy. The Whispers Care Home DS0000047604.V275024.R01.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): 12 and 15 Service users are able to take part in activities should they wish. The meals and menu plans do not fully support that a nutritional varied diet is provided and that service users choices and wishes are taken into consideration. EVIDENCE: The manager has ensured that a programme of planned activities is now displayed in the home and some service users have been supported to attend a pantomime recently. The home has Slough Mobile Library who calls regularly and staff provide bingo and cards games should the service users wish. The lunch-time meal was observed by the inspector and service users were provided with a meal that was not reflected in the menu plan or service users expectations. An alternative to the meal was not available. One service users who said she was vegetarian was given the vegetables only. No alternative vegetarian dish was provided. There was no evidence that specialist diets are provided for service user diagnosed with diabetes or other medical conditions. The service users informed the inspector that they were not consulted in menu planning and are not provided with alternatives at the midday meal but are provided with a choice for the tea-time meal. The Whispers Care Home DS0000047604.V275024.R01.S.doc Version 5.1 Page 12 The manager has recently commenced displaying the daily menu in the dining area. Staff seen serving mid-morning drinks and biscuits did not consult service users if they wanted a drink or what type and whether they wanted biscuits. Biscuits were placed in the service users hands not on a plate. Cooked meat products had not been stored or dated appropriately in the fridge. The Whispers Care Home DS0000047604.V275024.R01.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 and 18 The homes management of complaints is not compliant to the regulations and National Minimum Standards. EVIDENCE: The complaints policy and procedure are incomplete as they do not inform service users of the full contact details of the CSCI, the manager and the proprietor. One record of a complaint from a relative was seen as received by the home, but no action had been taken. The staff spoken to informed the inspector that they had not received training regarding the protection of service users from abuse. There was no evidence that had been given any supporting information during induction or in a staff handbook. The Whispers Care Home DS0000047604.V275024.R01.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): 19,20,22 and 26 The home is not maintained satisfactorily. The lighting internally is poor in parts and some soft furnishings need renewal. The control of infection is at risk in some parts of the home. Service users are not protected from the cold in some parts of the home because of missing and broken window frames. EVIDENCE: The home is not purpose built and has been adapted over previous ownership to provide its current layout and environment. Some redecoration of service users rooms has occurred since the last inspection. There is not a planned programme of routine maintenance checks. The service users are not protected from the winter weather as a top window in the upstairs bathroom by room 19, has been lost. The window frame in the The Whispers Care Home DS0000047604.V275024.R01.S.doc Version 5.1 Page 15 corridor link, by the lift on the first floor, is rotten in parts and could put service users safety at risk. There is sufficient communal space for the number of service users currently in the home. Some rearrangement of the communal dining area has improved the access for service users and staff. There is not sufficient seating for all service users to sit in the dining area at one time should they wish to. Some of the furniture in the communal areas is worn with chair pads split and could compromise the prevention of cross infection. Service users expressed to inspectors that they were feeling the cold in the lounge area. The inspector informed the proprietor and an additional heater was placed in the room. The lighting in the communal space is poor in parts and does not give sufficient light for reading. This is also reflected at some of the meal tables. The lighting in parts of the communal corridors is quite low. The bathrooms in the home are fitted with bath aids and specialist bathing equipment. The ground floor Parker bath had general debris of personal toiletries, unused rubbish bags inside and was encrusted with lime-scale at the bottom. The bath seat in the first floor bathroom by room 19 was broken and could cause injury to service users. This had been identified as a concern by the manager and action commenced to rectify this. Carpeting and flooring in the bathroom and toilet on the ground floor as tiles are loose and soiled in parts and could be a risk to service users or the control of infection. The carpet at the lower part of the staircase is worn, has holes and loose threads and is a risk to both service users and staff. Not all bathrooms and toilets had liquid soap and paper towels available to reduce the risk of cross infection. A new wash hand basin has been fitted to the laundry room for staff to use. The Whispers Care Home DS0000047604.V275024.R01.S.doc Version 5.1 Page 16 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): 27,28,29 and 30 The service users could be at risk from some of the staffing levels, recruitment practices and lack of appropriate training. 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 are usually 2-3 care staff in the home, which can be inclusive of the manager when on duty plus a cook, during the day. There is one member of staff between 8pm and 8am. The inspectors were informed of the on call system that is managed between the new manager and the proprietor but this is not formalised or documented. There is no domestic support on Sundays. The manager is in the process of assessing the staffing levels with reference to the needs of the service users. The inspector was informed that one member of staff has achieved NVQ 2 that was obtained at a previous employment. Some recruitment practices seen indicated that insufficient checks had been carried out to ensure suitable staff had been employed. The inspectors reviewed 4 personnel files of staff, whom were employed prior to the new manager commencing at the home. These were incomplete and did not support a robust process had occurred. Three staff files showed that references from previous employers had not been obtained. One member staff had been The Whispers Care Home DS0000047604.V275024.R01.S.doc Version 5.1 Page 17 employed without any references, CRB and only a POVA check and minimal work history. The evidence of the employees full work history or interview meeting was incomplete. Not all the files examined supported that staff had received terms and conditions of employment or job descriptions. Not all files had current photographs of the staff member. The date of commencement of employment was not recorded in some files and it was difficult to confirm that the required checks had been carried out prior to this. There was no evidence of the induction process in the staff files reviewed and very little supporting documentation for training obtained by staff. The manager has identified that staff need health and safety training and has recently developed a planned programme of in-house training to update staff with the mandatory training necessary. However, this has not been fully implemented as some of the training has to be arranged with a suitably qualified trainer. The inspector observed poor practice of safe moving and handling. A member of staff transferred a service user in a wheelchair with no foot rests and failed to put the brakes on when assisting them to a chair at the dining table. The Whispers Care Home DS0000047604.V275024.R01.S.doc Version 5.1 Page 18 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): 33,35 and 38 The recently employed manager has commenced implementing changes to improve the services provided. Service users are not formally consulted regarding their opinion of the services provided. The home does not handle service users monies. Safe working practices are not fully compliant to the regulations. EVIDENCE: The manager has been working in the home for 3 weeks and has recognised and implemented changes needed to improve and develop services provided in the home. These have included a review of the dependency needs of service users, the assessment of need document tools, activities provided and The Whispers Care Home DS0000047604.V275024.R01.S.doc Version 5.1 Page 19 methods of seeking service users input to how the home is run. The manager informed the inspector of her previous experience as a registered manager and qualifications. A formal application for the registered manager has yet to be submitted to the CSCI. The homes quality assurance has not been developed fully. Very little formal methods of seeking service users opinions of the services provided or audit by management have occurred. Service users were unable to confirm that feel listened to or consulted. The home has a system of invoicing service users or their representatives for any personal purchases that occur such as hairdressing, newspapers and chiropody. Records of these purchases are not routinely kept in the home and were not open to the inspection process. The home does not hold monies on service users behalf. There was not a full inventory kept of service users personal possessions brought into the home. Some members of the staff team have not had the required mandatory health and safety training in order to protect the service users and themselves. This was evident in moving and handling techniques, food handling and infection control practices in the home. Service users are put at considerable risk by the poor hot water checks currently carried out by staff. The water outlet in the upstairs bathroom by room 19 was found to be very hot. The manager has implemented strategies for the safe handling of soiled clothing and incontinence pads, fire drills and fire safety audit checks. The home did not have COSHH for all the cleaning products used in the home. There is a regular servicing programme for the lift, fire and nurse call systems and PAT testing. The lifting equipment is serviced on a regular basis and an engineer called regarding the damaged bath seat during the inspection visit. The Whispers Care Home DS0000047604.V275024.R01.S.doc Version 5.1 Page 20 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 2 X 2 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 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 1 2 2 2 2 X X 2 2 STAFFING Standard No Score 27 2 28 1 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 1 X 2 X X 2 The Whispers Care Home DS0000047604.V275024.R01.S.doc Version 5.1 Page 21 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 OP1 Regulation 4,5 Requirement That the Service User Guide is fully developed with the required information. Previous requirement to be met 17/06/05. That the care plans provide information of how the care is to be delivered and that the assessed specific care needs of service users are met. That staff receive the appropriate training for medication administration. Previous requirement to be met 17/02/05 That curtains or blinds are provided in bathrooms to afford privacy for service users. 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 DS0000047604.V275024.R01.S.doc Timescale for action 10/02/06 2 OP7 15 20/02/06 3 OP9 13(2) 05/03/06 4 5 OP10 OP15 12.4 16 20/02/06 20/02/06 6 OP15 13.4.c 06/01/06 7 OP16 22 05/01/06 Page 22 The Whispers Care Home Version 5.1 8 OP19 23 9 OP26 23 10 OP27 18(1)a 11 OP30 18 12 OP29 19 13 OP33 24 14 OP38 13 15 OP38 13 accordance to regulations and evidence is kept. That the home is adequately maintained including windows and bathing equipment made safe. Previous requirement made 30/07/05. 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. 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 Ensure that a comprehensive training programme is put in place for all staff and evidence kept. 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. That effective quality assurance and monitoring is put in place. This is an outstanding requirement from 31/08/05 That suitable precautions are put in place for the protection of service users regarding water temperatures. That the COSHH information reflects the products used in the home. 31/03/06 31/01/06 31/01/06 31/03/06 06/01/06 31/03/06 07/01/06 31/01/06 The Whispers Care Home DS0000047604.V275024.R01.S.doc Version 5.1 Page 23 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.V275024.R01.S.doc Version 5.1 Page 24 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.V275024.R01.S.doc Version 5.1 Page 25 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!