Inspection on 20/06/06 for The White House

This inspection was carried out on 20th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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.

Other inspections for this house

The White House 14/11/05

The White House 03/06/05

The White House 24/11/04

The White House 24/05/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE The White House High Street Brotton Saltburn-by-Sea TS12 2PJ Lead Inspector Ray Burton Key Unannounced Inspection 20th June 2006 02:00 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 White House DS0000000094.V301207.R01.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. The White House DS0000000094.V301207.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The White House Address High Street Brotton Saltburn-by-Sea TS12 2PJ 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) 01287 677106 Mrs A Jackson Mr R Jackson Mr R Jackson Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places The White House DS0000000094.V301207.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th November 2005 Brief Description of the Service: The White House is a two storey detached Victorian house converted for use as a care home in 1985. The building stands in extensive private gardens and occupies an elevated site set well back from the road. The home is within easy reach of local community facilities and is accessible to public transport. Accommodation is provided in twelve single and two double bedrooms, none of which have en-suite facilities. The main lounge, affording a pleasant view of the gardens, is appropriately furnished and contains television, music, books etc. A second lounge is a designated smoking room. The dining room also overlooks the garden. The home is registered to provide residential care for 16 persons over the age of 65 years. The White House DS0000000094.V301207.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection covering all of the key standards. It commenced on 20th June 2006 and was completed on 30th June 2006. During the inspection a tour of the building was conducted, records were examined and the inspectors spoke to service users, staff, the registered manager and proprietor. An important part of the inspection process was the case tracking of randomly selected residents to see whether they had been given sufficient information before making a decision to enter the home and whether the care they had received since admission had met their individual needs and wishes. This process involved examining personal care plans, talking to the resident and relatives (if available) also members of staff. What the service does well: This was a positive inspection of a small care home providing care in a comfortable and homely environment. The building was well maintained, décor was attractive, and furniture was domestic in style and appropriate for the needs of the residents. Bedrooms were well decorated and appointed and had been individualised by personal items and small pieces of furniture brought from the occupants own home. Externally the garden provided an attractive and peaceful place for residents to sit. Residents said they were happy with the care they received and praised the staff for the way in which they looked after them. Records and systems were in place to ensure the smooth running of the home and to ensure the safety and well being of residents. Care plans were well maintained and there was evidence of regular reviews taking place. There was a stable staff team and a robust management structure in place. Examination of personnel files revealed the home operated a thorough recruitment procedure and an excellent training programme that ensured all staff received appropriate training to enable them to meet service users needs. The home is to be commended on the high number of staff with a minimum of NVQ level 2 in Care. The White House DS0000000094.V301207.R01.S.doc Version 5.2 Page 6 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 report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The White House DS0000000094.V301207.R01.S.doc Version 5.2 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 White House DS0000000094.V301207.R01.S.doc Version 5.2 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): 1,2,3,4,5 The quality of this outcome area was good. Prospective residents and their family were able to visit the home and were given sufficient information to enable them to make an informed decision about the suitability of the home. The homes assessment procedure ensured resident’s needs could be met. Each resident had received a contract of residence. EVIDENCE: Residents were given a Service Users Guide and Statement of Purpose setting out the aims, objectives, philosophy of care and details of facilities offered. Each resident was also given a Contract of Residence showing the fees charged (currently £345 per week). The White House DS0000000094.V301207.R01.S.doc Version 5.2 Page 9 Examination of care plans and conversation with the proprietor, manager and members of staff revealed that prior to admission a needs assessment was received from a care manager of the placing authority. Following receipt of the referral an invitation was extended to the prospective resident and his/her family to visit the White House to meet residents and staff and to look round the home. Overnight stays could be arranged if desired. If prospective residents were unable to visit, the manager or proprietor would visit them in their own home or in hospital to carry out an assessment to determine if the person’s needs could be met at the White House. All admissions were subject to a trial period followed by a review before a decision was made to make the stay permanent. The home does not offer intermediate care therefore standard six does not apply. The White House DS0000000094.V301207.R01.S.doc Version 5.2 Page 10 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): 7,8,9,10,11 The quality of this outcome area was good. Personal and healthcare needs of residents were met. Systems for the safe and efficient administration of medication were in place. Personal care was conducted in a sensitive manner that upheld the dignity and privacy of residents. An appropriate policy was in place to deal with the dying and death of a resident. EVIDENCE: Monitoring of health was undertaken and healthcare needs addressed by community based healthcare professionals e.g. G.P’s, District Nurses and Chiropodists etc. Medical appointments were made as necessary and any changes in medication or treatment were recorded and implemented. Each resident had a care plan that contained information about the general health of the individual and details of any specific ailment or medical condition. Risk assessments were conducted and risk management strategies developed in areas such as mobility, risk of falls etc; any specialist equipment e.g. airflow mattresses, bed-sides were obtained after appropriate professional advice and assessment. The plans contained evidence that residents, and their families, The White House DS0000000094.V301207.R01.S.doc Version 5.2 Page 11 had been consulted about their care and had given their agreement. Reviews and re-assessments regularly took place to ensure changing needs were recognised and appropriate action taken Only one of the current residents had been assessed as able, and had expressed a wish, to control his medication. A lockable facility for medicines had been provided in his room. Members of staff who had undergone appropriate training in the safe administration of medicines administered all other medicines, according to the homes policy and procedures. The home had suitable facilities for the safe storage of medication. Examination of accident records revealed, where an accident had occurred, appropriate action had been taken and where necessary medical assistant had been sought and risk assessments reviewed. It was observed during the inspection that there was a good rapport between residents and staff and that members of staff treated residents with respect and addressed them courteously and appropriately by their preferred name. Staff understood the importance of being sensitive to resident’s feelings and of assisting them, particularly when delivering personal care, in such a way that they were able to maintain their privacy and dignity. Residents spoke very highly about all members of staff and told the inspector they were happy with the way in which their care was delivered. A suitable policy was in place to deal with dying and death and The White House was looked on as a “home for life” with residents, unless medical needs dictated otherwise, being able to remain in the home during their last days. The White House DS0000000094.V301207.R01.S.doc Version 5.2 Page 12 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): 12,13,14,15 The quality of this outcome area was good. Residents were able to exercise control over their lives. Staff encouraged residents to maintain links with their family, friends and the local community. A healthy and balanced diet was provided. EVIDENCE: The general atmosphere in the White House was relaxed and informal. Routines were flexible and able to accommodate individual wishes and needs. Residents were able to choose what time they went to bed and what time they rose in the morning. Meals were generally served in the dining room, a pleasant room overlooking the garden, although there was a great deal of flexibility to allow for individual wishes and circumstances; sometimes residents would choose to have their meals served in their own rooms. Examination of the menus showed a healthy, balanced and varied diet was provided. Observation and conversation with the cook revealed all meals were made from fresh ingredients and that cakes, biscuits and scones etc were freshly baked on a daily basis. On the day of the inspection the inspector shared a meal with the residents – it was nicely cooked and well presented. All of the residents appeared to enjoy the meal and The White House DS0000000094.V301207.R01.S.doc Version 5.2 Page 13 it was observed that some residents had chosen to have an alternative to the main dish of the day. Televisions, videos and DVD’s, books and various board games such as cards and dominoes were provided in communal areas; and morning and evening newspapers were delivered to the home. The library bus visited the home on a regular basis. The manager said they employed the services of an outside company to provide monthly motivation sessions and they were trying to recruit an activities co-ordinator to assist with resident’s activities for a few hours each week. Special activities were organised for occasions such as birthdays, Christmas and Easter; in addition the home had an annual Garden Party or Autumn Fair. The Vicar from the local church visited the home for a monthly communion service, and residents were encouraged to participate by choosing hymns to be included on the hymn sheet. Residents were encouraged, in so far as was possible, to continue with activities and interests they had pursued before coming to live at the home. One resident had an electronic keyboard in his bedroom; another was able to access the community unaccompanied and regularly went for long walks or trips by bus to Middlesbrough. The importance of residents maintaining contact with family and friends was recognised by the manager and staff who helped them to keep in touch by the sending of Christmas and birthday cards etc and assisting with the making and receiving of telephone calls. A cordless ‘phone was available to enable calls to be made in private, and many bedrooms had been fitted with telephone points should the occupant wish to have a private ‘phone. The manager said there was a lot of family involvement and visitors were always welcome; the family of one resident regularly brought their dogs into the home. The White House DS0000000094.V301207.R01.S.doc Version 5.2 Page 14 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): 16,17,18 The quality in this outcome area was good. The home had a satisfactory complaints system and policies and procedures to protect residents from abuse and to safeguard their legal rights. EVIDENCE: The home had an appropriate policy and procedure for the handling of complaints that stated how complaints could be made, who would deal with them and what to do if not satisfied with the way in which the matter was handled. In conversation residents said they would speak to the manager or proprietor if they were concerned about anything and said they were confident that matters would be quickly and appropriately dealt with. The complaints record showed that no complaints had been received since the last inspection. Policies and procedures were in place to ensure the safety and protection of residents and to respond to any suspicion or allegation of abuse. A copy of the “No Secrets” adult protection procedure was available to staff, who were able to demonstrate a suitable understanding of what constituted abuse and what to do in the event of such an incident occurring. Details of a local independent advocacy service was displayed on the notice board The White House DS0000000094.V301207.R01.S.doc Version 5.2 Page 15 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): 19,20,21,22,23,24,25,26 The quality of this outcome area was good. The environmental standard was good, providing residents with an attractive and homely place in which to live. EVIDENCE: A tour of the building revealed décor and fabric to be maintained in good condition and the home clean, hygienic and free from offensive odours. All areas of the home were centrally heated and radiators had been covered with suitable guards to ensure a low surface temperature. Hot water outlets accessible to residents had been fitted with pre-set valves to safeguard against scalding. First floor windows had been fitted with restrictors. Lighting was domestic in nature and emergency lighting had been provided throughout the home. The numbers and suitability of lavatories and bathing facilities met the National Minimum Standard and the assessed needs of the current residents. Toilet facilities were accessible from communal areas and bedrooms. Residents The White House DS0000000094.V301207.R01.S.doc Version 5.2 Page 16 were able to access all necessary parts of the building and gardens via ramps and a stair lift. Specialist bathing equipment was available for those residents requiring assistance to access bathing facilities. Since the last inspection a new hoist had been fitted in one of the bathrooms. The home provided comfortable and homely accommodation with furniture that was domestic in style, suitable for purpose and in keeping with the character of the house. Most of the bedrooms had views across the garden or countryside; all were pleasantly decorated and comfortably furnished. Personal effects e.g. furniture and other items such as pictures, photographs and ornaments brought from the occupants own home had helped individualise the rooms. The large and well-kept garden provided a pleasant and peaceful outside area. During the inspection residents were observed walking with staff or sitting chatting and enjoying the sunshine. Since the last inspection furniture had been replaced in the smokers lounge and communal areas had been fitted with new carpets. The White House DS0000000094.V301207.R01.S.doc Version 5.2 Page 17 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): 27,28,29,30 The quality in this outcome area was good. The home had a suitable recruitment policy and procedures and employed staff in sufficient numbers to meet residents needs. The home had an excellent training programme and exceeded the National Minimum Standard for staff being qualified to a minimum of NVQ level2 in Care. EVIDENCE: Observation during the inspection and examination of staffing rosters indicated adequate numbers of staff were on duty at all times to meet residents needs. The homes recruitment procedure ensured all necessary checks, including Criminal Records Bureau, were conducted and two suitable references received prior to commencement of employment. Three randomly selected personnel files were examined, each contained evidence that all necessary procedures had been carried out. Staff records and conversation with the manager revealed an appropriate induction programme was in place for new employees and that all members of staff were encouraged to take part in on-going training. The training programme showed that between February and November this year all members of staff were required to undertake the following training: - The White House DS0000000094.V301207.R01.S.doc Version 5.2 Page 18 Food Hygiene, Manual Handling, Oral Hygiene, Record Keeping/Care Planning, Risk Assessments, First Aid, Safe Handling of Medicines, Fire awareness, Health & Safety, Infection Control, Pressure area Control Ten off the fifteen members of care staff were qualified to a minimum of NVQ level 2. The White House DS0000000094.V301207.R01.S.doc Version 5.2 Page 19 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): 31,32,33,35,36,37,38 The quality of this outcome area was good. The home was well managed and had policies, procedures and records in place to ensure the health, safety and welfare of residents. EVIDENCE: The White House has an active proprietor who works closely with the registered manager to form an effective management team. All necessary records (including individual service user records and care plans), policies, procedures and records to cover all aspects of the health, safety and welfare of service users were in place, up to date and stored appropriately. Management and staff were aware of their responsibilities under health and safety legislation. There was a good training programme for all members of staff that included areas such as First Aid, Health & Safety etc. The White House DS0000000094.V301207.R01.S.doc Version 5.2 Page 20 Examination of the supervision records revealed good constructive supervision to be in place, with all members of staff receiving six formal supervisions and an appraisal per year. Two members of staff were interviewed during the course of the inspection each said the home had a good staff team who worked well together. They confirmed they received regular training and supervision. Both were enthusiastic about their work and said they enjoyed working at the home. They said they received good management support and felt the manager and proprietor were approachable. This is a small family run home and quality assurance and quality monitoring systems, whilst being largely informal, were appropriate for the size of the home. Residents said they were happy living at the White House and had no complaints at all. They said the manager and all members of staff were very kind and helpful and were always asking them if they were satisfied with their care or if there was anything that could be improved or they wished changing. Regular discussions with relatives either at review meetings or on an informal basis when they visited helped the manager measure success in meeting the aims, objectives and statement of purpose of the home. Six resident/relative comment cards were returned to the inspector, all expressed satisfaction with the home and the care given by staff. A designated representative, usually a family member, dealt with resident’s financial affairs; the home did not hold money on behalf of residents. The manager is close to completing the NVQ level 4 in Care and intends enrolling onto The Registered Managers Award in the autumn. To meet the National Standard he must achieve a qualification at level 4 in both management and care. The White House DS0000000094.V301207.R01.S.doc Version 5.2 Page 21 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 x 3 3 3 3 The White House DS0000000094.V301207.R01.S.doc Version 5.2 Page 22 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 OP31 Regulation 9(2)(b)(i) Requirement The registered manager must hold an appropriate care and management qualification at NVQ level 4 or equivalent. Timescale for action 01/09/06 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 White House DS0000000094.V301207.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX 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 White House DS0000000094.V301207.R01.S.doc Version 5.2 Page 24 - 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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