Inspection on 22/02/06 for The White House

This inspection was carried out on 22nd February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The White House 06/03/07

The White House 26/11/05

The White House 26/10/04

The White House 29/04/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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 Eggington Leighton Buzzard Bedfordshire LU7 9PQ Lead Inspector Leonorah Milton Unannounced Inspection 22nd February 2006 10.35 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 DS0000054000.V264304.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 White House DS0000054000.V264304.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The White House Address High Street Eggington Leighton Buzzard Bedfordshire LU7 9PQ 01525 210322 01525 211925 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) Janes Care Homes Ltd Miss Tracey O`Hara Care Home 23 Category(ies) of Dementia (23), Old age, not falling within any registration, with number other category (23) of places The White House DS0000054000.V264304.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Service users over the age of 65 years not falling within any other category (OP) 23 Service users over the age of 65 years with dementia DE(E)) 23 The maximum number of service users that the home can accommodate at any time must not exceed 23 The home can accommodate service users of either sex Date of last inspection Brief Description of the Service: The White House was registered to provide for 23 older people who may also have dementia. The Home was located in an attractive semi-rural setting in Eggington Village, a short distance by road from the town centre of Leighton Buzzard. The premises were set back from the road and approached via a driveway and large front garden given over mainly to parking but affording a seating area for service users with views over pleasant shrubbery borders. Further parking spaces were situated to one side of the home. The accommodation was distributed over three floors that were accessed via staircases and a shaft lift. Seventeen single bedrooms and three double bedrooms were provided. One single room had an ensuite toilet facility. Other rooms had washbasin fixtures. All rooms were connected to the call bell system. Toilet and bathing facilities were located for convenient access throughout the building. Communal accommodation was located on the ground floor and comprised two lounges and a dining room. Kitchen, laundry and office facilities were also situated on the ground floor. The White House DS0000054000.V264304.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second of the statutory two inspections that the Commission for Social Care Inspection (CSCI) is required to carry out each year. This inspection was carried out in accordance with the CSCI’s procedures to assess core care standards within the two inspections as detailed on this report. This inspection therefore focussed the core standards not assessed at the first visit and reviewed the progress on requirements from that inspection. During this inspection the arrangements for the care of two service users were assessed. Their case files were reviewed, as were their private bedrooms. Conversations took place with one of these service users, five other service users and two visitors. Discussions also took place with three members of staff and the manager. A partial tour of the building took place and sundry other records were assessed. The majority of the inspection took place with the service users in the two lounges, where the arrangements for recreation and relaxation were also assessed. It is recommended that this report be read in conjunction with the report of the inspection carried out in November 2005 for a complete overview of the standard of the operation between these dates. What the service does well: The home had friendly and competent staff, a welcoming atmosphere and a comfortable environment. Suitable arrangements had been made to enable service users to consult with healthcare professionals as need be. The majority of staff had worked in the home for a significant time and were well acquainted with service users and the routines of the home. Those members spoken had an evident loyalty to the home and were knowledgeable about service users’ needs. There were sufficient numbers of care and ancillary personnel on duty to ensure that service users were well cared for and that the catering, cleaning and laundry tasks were carried to satisfactory standards. Sufficient time had been built into the staffing rosta to provide recreational and stimulating activities for service users and to brief and support personnel with their jobs. All but one of the service users expressed satisfaction with the service in the home, as did the visitors. One service user was a little disgruntled with some routines that did not suit her but never the less praised the team at the home. The White House DS0000054000.V264304.R01.S.doc Version 5.1 Page 6 Records indicated that the home had consulted with the service user about her preferences and was still striving to meet these. Other service users, some of whom had lived in the home for many years, were enthusiastic about the service. One stated, “this is a great place to live” and, “ I wouldn’t want to live anywhere else”. She was complimentary about the home’s personnel and when asked whether they treated her with respect, replied, “ Definitely”. The service user confirmed that recreational activities were arranged on a daily basis and that she frequently joined in but could also just read her book, as she sometimes preferred. She and other service users confirmed that they were satisfied with the routines for getting up and going to bed and stated that they could do as they pleased. Compliments were also passed about meals, one of the choices on offer this day being described as “my favourite”. Service users also confirmed that they had been able to see their doctor promptly when they were unwell, that the chiropodist visited regularly and that they had been seen by an optician and a dentist. What has improved since the last inspection? What they could do better: Major works to increase the size of the premises and refurbish other areas were planned. However, the upkeep of décor in the existing building where building and refurbishment works were not scheduled must not be neglected. The entrance hall to the home, corridors and several bedrooms were in need of repainting, the walls and doorways to the same being marked and in places chipped. The arrangement of furniture in a bedroom where a service user was confined to bed meant that the bed had to be pulled out each time the service user needed assistance to move up the bed. This could result in a back injury. A risk assessment on these arrangements must be carried out. The flooring of the doorway leading through to the corridor to the dining room was uneven and might cause a trip. A repair must be actioned without delay. Records of fluid and food intake must accurately show the amounts taken. Signed consent from service users or where applicable their representatives must be introduced to agree the use of bed rails. The White House DS0000054000.V264304.R01.S.doc Version 5.1 Page 7 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 DS0000054000.V264304.R01.S.doc Version 5.1 Page 8 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 DS0000054000.V264304.R01.S.doc Version 5.1 Page 9 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): 3,5,6 The home had taken steps to ensure that it had the capability to meet service users’ needs before the decision to admit had been taken. Service users had, where practical to do so, visited the home before deciding to move in. EVIDENCE: A case file of a service user who had been admitted to the home the week before this inspection showed that the home had carried out a comprehensive assessment of need that took account of the details outlined in Standard 3 before the service user was admitted. In practice most service users had not visited the home before admission. They had relied on their representatives to assess the home on their behalf. On the day of the inspection a prospective service user was making her second visit to the home and was contributing to the pre-admission assessment process. At the first visit she had chosen the bedroom she would be occupying from the two rooms available. The White House DS0000054000.V264304.R01.S.doc Version 5.1 Page 10 The home provided a respite service that included those discharged from hospital who needed a little more care and before they returned to their own home. This did not constitute a rehabilitation service. The White House DS0000054000.V264304.R01.S.doc Version 5.1 Page 11 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): 7,8,10,11 Sufficient written guidance was available to staff to ensure that they were aware of service users’ day-to-day needs and how these were to be met. Appropriate referrals had been made to health care services to ensure the health of service users. There had been some progress to record service users’ wishes at their death but those outstanding meant that there was risk that a wish/wishes would not be met. EVIDENCE: The case files assessed contained a comprehensive assessment of need and resulting plan of care that showed how needs were to be met. Personal preferences had been noted but would benefit from a little more detail in relation to preferences for bedtimes, getting up times and food preferences. Risk assessments had taken account of moving and handling, skin care and the safety of bed rails. Consent for the use of these rails must be obtained to demonstrate that they are not a form of restraint. The White House DS0000054000.V264304.R01.S.doc Version 5.1 Page 12 Sequential records of individual daily progress had been maintained. Similarly there were records for each service user of regular consultations with healthcare professionals for routine treatments and as need be. Members of staff were observed to speak to service users with respect. Service users and visitors confirmed that the staff had treated them well. It was noted that one service was addressed by her preferred name rather than her given name. The two case files assessed at this inspection did not contain information about the service users’ wishes in the event of terminal illness or at their death. The inspector was informed that such information was gradually being compiled. The White House DS0000054000.V264304.R01.S.doc Version 5.1 Page 13 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 Service users had been supported to experience a lifestyle in keeping with their needs and wishes. EVIDENCE: Conversations with four service users confirmed that they were content with the daily routines of the home and the opportunities for recreational activities. A notice was advertised for service users’ information about the range of planned activities. These included arts and crafts, bingo, hoopla, colouring, and reminiscence sessions. A record was maintained of those provided on a day-to-day basis. Service users commented on the handicrafts they had made that had been sold at the home’s annual fete. Visitors to the home stated that they had been made welcome in the home. One service user had continued to attend a social club since admission to the home. Three service users had been supported to manage some aspect of their personal monies so that they could pay for services such as chiropody and hairdressing themselves. The White House DS0000054000.V264304.R01.S.doc Version 5.1 Page 14 A notice was displayed for service users’ information informing of their rights to access their records. Such records were kept securely in the staff office. The manager was advised to inform service users about advocacy services. The White House DS0000054000.V264304.R01.S.doc Version 5.1 Page 15 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): EVIDENCE: Standards 16 and 18 were not reviewed as they had been assessed as met at the previous inspection. The White House DS0000054000.V264304.R01.S.doc Version 5.1 Page 16 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): 19,24 The home provided and clean and comfortable environment that was mostly suitable. It was a pity that the deterioration of the décor was beginning to detract from the homely appearance that had been noted at previous inspections. There were risks to safety from a trip hazard and back injury. EVIDENCE: Areas of the building seen at this inspection were clean and orderly. The two lounges on the ground floor were comfortably furnished. The décor in both was of a satisfactory standard. The entrance hall and doorways to both rooms were chipped and marked by the constant passage of people and wheel chairs. Similarly, some bedrooms and other corridors also required redecoration. The White House DS0000054000.V264304.R01.S.doc Version 5.1 Page 17 Six bedrooms were seen. In the main they too were comfortably furnished although it was noted that the wooden frames of the armchairs in two rooms were beginning to show wear and tear. One service user described her room as “home” and stated that she wouldn’t want to exchange it for a larger room. The arrangement of the furniture in one bedroom did not allow for safe moving and handling of the service user without pulling the bed out from the wall, which in itself was a hazard. The White House DS0000054000.V264304.R01.S.doc Version 5.1 Page 18 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 There were sufficient numbers of care and ancillary personnel on duty to ensure that service users were well cared for and that the catering, cleaning and laundry tasks were carried out to satisfactory standards. EVIDENCE: The home had a recognisable senior team that had ensured that the home had been properly managed: The rota indicated that the deputy worked mostly supernumerary hours to assist the manager with the management of the home and the support and direction of the team; a head of care assisted with the organisation of staff and the day-to-day care of service users. She also oversaw the provision of activities and worked one day each week in a supernumerary capacity to plan and arrange activities. The rota also identified that four care staff were on duty throughout each day and two were scheduled to carry out waking night duties. A cook was rostered every day and a domestic assistant on six of the seven days each week. Most of the laundry was taken to another care home. Additional hours had been allowed on the rota to deal with the laundry that remained on site. The care staff spoken to at this inspection had worked in the home for a significant time and were aware of their responsibilities. The previous inspection had shown that the standard for training had been met. This inspection showed that further training was scheduled for the near future: A notice detailed training scheduled between February and March in moving and handling, dementia awareness, infection control, COSHH, food hygiene, The White House DS0000054000.V264304.R01.S.doc Version 5.1 Page 19 medication, death and bereavement, staff motivation. The rota showed when staff were scheduled to attend training events and that their shifts had been covered by other personnel. Progress had been made towards NVQ care qualifications. The home was on target to achieve a fifty percent of its workforce with qualifications in care. The manager reported that of the twenty members of the care staff team five held an NVQ 2 award and two were working towards the award. One carer had achieved NVQ at level 3 and four others were working towards the award. The White House DS0000054000.V264304.R01.S.doc Version 5.1 Page 20 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): 31,33,35,38 The home had been well run to the benefit of the service users. EVIDENCE: The manager was experienced and knowledgeable about the responsibilities of her role: she had worked in the home for a number of years and had been promoted to manage the home after holding the deputy’s role for sometime. She reported at this inspection that she had completed the Registered Manager’s award and had almost completed the NVQ 3 in care and was also working towards an NVQ in care management at level four. Members of staff and service users spoke highly of her influence in the home. The manager reported that another quality audit involving service users’ opinions was underway. Questionnaires had been circulated and had begun to be returned. The need to compile a report on the outcomes of the survey to include an action plan on any arising issues was discussed with the manager. The White House DS0000054000.V264304.R01.S.doc Version 5.1 Page 21 Records for the use of service users’ personal monies were assessed. They had been properly maintained. They showed that mostly small amounts were held on behalf of service users. Expenditures were mainly for chiropody and hairdressing services and were substantiated by receipt. Health and safety matters in the home were well managed. The omissions noted elsewhere in this report could be readily solved. These must include the following: The doors to the lounges were marked as “fire doors, keep shut”. They were propped open on the day of the inspection to enable service users to move around the home without hindrance. This arrangement must be agreed with the fire officer. The White House DS0000054000.V264304.R01.S.doc Version 5.1 Page 22 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 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 x 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 2 x x x x 1 x x STAFFING Standard No Score 27 3 28 2 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 x x 2 The White House DS0000054000.V264304.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP8 Regulation 13(7)(8), 15(1) 17(1)(a) (m) 13(4)(a) (c) 13(4)(c) Requirement Signed consent for the use of bed rails must be obtained from the service or their representative. Records that record fluid and food intake must accurately record the amounts taken by service users. The flooring of the doorway leading through to the corridor to the dining room must be made even. A risk assessment must be carried out on the positioning of beds against walls in bedrooms where service users are confined to bed. A report that includes an action plan must be prepared on an annual quality review process, which has involved consultation with the service users. The fire officer’s consent must be obtained in relation to fire doors to lounges remaining open during the day. Timescale for action 31/03/06 2 OP8 28/02/06 3 OP19 31/03/06 4 OP24 31/03/06 5 OP33 24 31/03/06 6 OP38 23(4) (c )(i) 31/03/06 The White House DS0000054000.V264304.R01.S.doc Version 5.1 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP11 OP14 Good Practice Recommendations The registered persons must ensure that all records are maintained of the wishes and decisions of all service users in the event of their death. Service users should be provided with information to enable them to contact advocacy services. The White House DS0000054000.V264304.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF 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 DS0000054000.V264304.R01.S.doc Version 5.1 Page 26 - 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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