Inspection on 26/11/05 for The White House

This inspection was carried out on 26th November 2005.

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 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 22/02/06

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 Georgia Chimbani Unannounced Inspection 26 November 2005 16:00 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 DS0000054000.V266780.R01.S.doc Version 5.0 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.V266780.R01.S.doc Version 5.0 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.V266780.R01.S.doc Version 5.0 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 26 October 2004 Brief Description of the Service: The White House is a home registered for 23 older people who may have physical disabilities and/or dementia. The home is located in Eggington, a picturesque village a short distance from Leighton Buzzard town centre. The home is set back from the road and approached via a driveway and large front garden that gives service users views of pleasant shrubbery. The house comprises three floors accessed via staircases and a shaft lift. The home has seventeen single bedrooms and three double bedrooms. Communal facilities such two lounges, a dinning room and kitchen and laundry facilities are situated on the ground floor. The White House DS0000054000.V266780.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on a Saturday evening and lasted 2 ½ hours. Present at the inspection were four members of staff. A senior carer Mr Robert Milemore assisted with the inspection process. The home is registered for 23 service users although at the time of the inspection there were 5 vacancies. Individual interviews were held with 4 service users. Group discussions were attempted with other service users however this was not successful due in part to their reluctance to participate and as result of memory impairment. Feedback on the quality of care offered by the home was very positive. Following the last inspection 4 requirements were made relating to medication, infection control, staff recruitment and fire safety. A number of standards could not be assessed at this inspection as the absence of the manager meant that documentary evidence was not available. Standards not assessed at this inspection will be inspected at the next inspection. In the absence of documentary evidence 3 requirements are restated. A further 3 requirements are made following this inspection bringing the total number of requirements to 6. The inspector is confident that the registered persons will achieve compliance within the timescales set by the CSCI. What the service does well: What has improved since the last inspection? Medication records are completed when medication is administered. Arrangements have been made to ensure that only staff not service users have access to disposable gloves. Skin preparations are not shared and are used for the person whom they were prescribed. The White House DS0000054000.V266780.R01.S.doc Version 5.0 Page 6 Doors leading to the laundry area are now free of obstructions. 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 DS0000054000.V266780.R01.S.doc Version 5.0 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 DS0000054000.V266780.R01.S.doc Version 5.0 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): EVIDENCE: The inspector attempted to inspect standards 1 and 3 however in the absence of the manager, access to the statement of purpose and service user preadmission assessments could not be achieved. Staff on duty advised that these documents are kept in the manager’s office, which was locked. These standards will be assessed at the next inspection. The White House DS0000054000.V266780.R01.S.doc Version 5.0 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, 9, 10 and 11 Care planning documentation is sufficiently detailed however the lack of consistency in recording in some sections can result in the needs of individual service users being overlooked. Medication administration and storage systems are satisfactory and ensure the safety of service users. The home must seek the views of service users on a regular basis covering all aspects of their life at the home. This will give service users confidence that their wishes and decisions are valued and will be carried out. EVIDENCE: A sample of three service user files was examined. All files contained comprehensive care plans and risk assessments that included moving and handling as well as waterlow risk assessments. It was evident that care plans had been reviewed monthly and risk assessments on average every 3 months. A care plan and risk assessment of a bed bound service user included a comprehensive assessment of the risk of falls, pressure ulcers and injury that could result in the use of cot sides. Discussions with staff revealed that this service user was turned in bed every two hours, completed turning charts The White House DS0000054000.V266780.R01.S.doc Version 5.0 Page 10 dating back to October were seen as confirmation of this. Of the 3 files examined only 1 contained evidence of consultation by the home and this was not directly with the service user but their daughter. This consultation was in the form of a signature indicating agreement with the service user’s care plan. The inspector noted that another service user had participated in a review of their care with their placing authority in August. At this meeting the service user was able to articulate their wishes such as more cups of teas and the fact that they got bored during the day. There was no documentary evidence to indicate that this feedback from the service user had been incorporated into their care plan. In fact the monthly review of their care plan at the end of August [after the local authority review] stated “no changes” to the current care plan. Although the service user had been consulted at this annual review meeting, there was no evidence that they were consulted by the home on a regular basis. The inspector was keen to speak to this service user however staff advised that they were in bed, as they were feeling unwell. The registered persons must ensure that there is evidence of consultation with service users each time their care is reviewed. The wishes and decisions of service users must be recorded and implemented. At the previous inspection a requirement was made for the registered persons to ensure that medication administration record [MAR] sheets are signed when medication is administered and that there is a sample of signatures of staff who have been authorised to give out medication. The inspector was able to observe medication being dispensed by the senior member of staff on duty. Discussions with 2 other staff on duty revealed that they did not give out medication and they had not received medication training. A random inspection of MAR sheets indicated that they were completed appropriately. Medication is stored in a trolley that is secured to the wall in the office. There is also a separate fridge for the storage medication that requires refrigeration. The controlled drugs were stored securely in a separate cupboard and records were accurate. The sample of staff signatures was not available for inspection as staff informed the inspector that these were in the manager’s office that they had no access to. In the absence of documentary evidence this requirement is restated. 1 out of 3 care plans contained information on service users’ wishes in the event of their death. 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. Interviews with some service user revealed a high level of satisfaction with the care provided by the home and the members of staff that work there. Service users interviewed by the inspector all agreed that staff at the home treated them with respect. The inspector observed this during the course of the inspection. The White House DS0000054000.V266780.R01.S.doc Version 5.0 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 variety and quality of food offered by the home is impressive and there is no doubt that the home has achieved a high level of service user satisfaction in this area. EVIDENCE: The inspector was present as staff served supper in the evening and was able to observe staff and service user interaction. Staff addressed service users politely and asking them what they would like to eat. Where service users for whatever reason had difficulty understanding the choices available to them, staff were patient and did not rush them. 1 service user described the staff as accommodating regarding food and remarked to the inspector, “they are very good like that. They remember what people want to eat and how many sugars they like in their tea.” The supper served to service users was varied and designed to meet the needs of all service users. There was a selection of sandwiches on different types of bread and a selection of desserts and cakes including a diabetic cake. Quantities of food were generous; staff were very attentive and constantly asked service users if they wanted more food. A tour of the kitchen revealed sufficient quantities of fresh and frozen food. A list of names of service user’s with special dietary needs was displayed in the kitchen. The White House DS0000054000.V266780.R01.S.doc Version 5.0 Page 12 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 Feedback from service users indicates that they feel safe in the home and they have confidence in the home’s ability to deal with their concerns. EVIDENCE: The inspector was unable to view the home’s record of complaints as staff informed that these were kept in the manager’s office. The adult protection policy was also not available for inspection. Discussions with service users revealed that they had no complaints and if they did they would be comfortable addressing these to staff on duty. 2 staff on duty confirmed that they had received adult protection training. The White House DS0000054000.V266780.R01.S.doc Version 5.0 Page 13 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 and 26 The home provides a comfortable and pleasant environment however some areas need attention to ensure that the health and safety of both service users and staff is not compromised. EVIDENCE: A tour of the home revealed that the home is comfortably furnished, brightly decorated and has a “homely” atmosphere. There are two lounges, the larger lounge seats a larger number of service users and is livelier. The second lounge is smaller and appeared to suit service user who prefer a quieter environment. There are however areas that need to be addressed. A drawer was missing from a cabinet in the kitchen and the faulty light that kept flickering in the pantry/storage area must be replaced. No offensive smells were detected however a requirement made at the last inspection relating to infection control was still not met. Gloves are now stored in the office and staff were observed entering the office when they required more gloves but bins in toilet facilities still do not have lids. This requirement is restated. The White House DS0000054000.V266780.R01.S.doc Version 5.0 Page 14 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): 29 and 30 Recruitment practices at the home must be improved to ensure the safety of service users. The investment in staff training ensures that staff have the knowledge and skills to adequately meet the needs of service users. EVIDENCE: At the previous inspection a requirement was made for the registered persons to ensure that staff are legally employed and relevant identity checks are carried out. Compliance with this requirement could not be confirmed at this inspection as staff on duty did not have access to staff records. In the absence of documentary evidence this requirement is restated and will be inspected at the next inspection. Staff training records were also not available however discussions with two staff on duty revealed that they had received recent training in first aid, food hygiene, moving and handling, adult protection and fire safety. The White House DS0000054000.V266780.R01.S.doc Version 5.0 Page 15 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): 38 The health and safety of service users is promoted through regular health and safety checks. EVIDENCE: At the previous inspection a requirement was made relating to consultation with the fire authority relating to the safety arrangements in the area adjacent to the laundry. The home’s laundry is situated in a separate area of the home with access via two separate doors from different areas of the home. The senior carer on duty informed the inspector that the bulk of laundry was still being taken to the proprietor’s other home with only small amounts being handled on site. An inspection of this area revealed no obstructions to both doors leading to this area. While documentation from the fire authority regarding the safety of this area was not available, the inspector was satisfied that adequate safety precautions were in place. Other health and safety checks carried out were records of the home’s fire risk assessment. Records of regular fire drills and weekly fire alarm tests were also viewed. Health and safety The White House DS0000054000.V266780.R01.S.doc Version 5.0 Page 16 certificates relating to gas and electrical installations are kept in the manager’s office and were therefore not available. The White House DS0000054000.V266780.R01.S.doc Version 5.0 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 2 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 X 28 X 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X 3 The White House DS0000054000.V266780.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? 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 OP7 Regulation 15 Requirement The registered persons must ensure that there is evidence of consultation with service users each time their care is reviewed. The wishes and decisions of service users must be recorded and implemented. The registered persons must ensure that a record is maintained of sample signatures of staff that have been authorised to administer medication. [Previous timescale of 30/11/04 not met]. 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. The registered persons must ensure that the faulty light in the kitchen and the missing drawer are replaced. The registered persons must ensure that lidded bins are provided in all toilet facilities in the home. [Previous timescale of 30/11/04 DS0000054000.V266780.R01.S.doc Timescale for action 26/02/06 2 OP9 13(2) 26/01/06 3 OP11 12(2) 26/02/06 4 OP19 23(2)(b) 26/02/06 5 OP26 13(3)(4) 26/01/06 The White House Version 5.0 Page 19 6 OP29 18 Schedule 2 and 4 not met]. The registered person must 26/01/06 follow recruitment procedures for the protection of service users and to ensure that personnel are legally employed to include identity checks via photograph and permits to work. [Previous timescale of 30/11/04 not met]. 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 DS0000054000.V266780.R01.S.doc Version 5.0 Page 20 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.V266780.R01.S.doc Version 5.0 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. 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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