Inspection on 29/06/06 for The White House

This inspection was carried out on 29th June 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 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 28/08/08

The White House 30/10/07

The White House 27/01/06

The White House 21/06/05

The White House 01/02/05

The White House 25/06/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings 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 1 Chichester Drive West Saltdean Brighton East Sussex BN2 8SH Lead Inspector Andy Denness Key Unannounced Inspection 29th June 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 White House DS0000014255.V298328.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 DS0000014255.V298328.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The White House Address 1 Chichester Drive West Saltdean Brighton East Sussex BN2 8SH 01273 302465 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) Mr J Hall Mrs C Hall Mrs Carolyn Hall Care Home 14 Category(ies) of Old age, not falling within any other category registration, with number (14) of places The White House DS0000014255.V298328.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is fourteen (14). Service users must be older people aged sixty-five (65) years or over on admission. 21st June 2005 Date of last inspection Brief Description of the Service: The White House is a residential care home for up to fourteen older people. The current providers have owned and managed the home since 2000 as a family business. Weekly fees range from £360 - £600. The home is located on the main coast road close to the village of Rottingdean and to bus routes into Brighton and Eastbourne. The home is in an elevated position overlooking Saltdean Bay with many of the bedrooms providing sea views. The home is presented on four floors with resident’s accommodation in the basement, ground and first floor. Access to the first floor is provided by stairs or a chair lift. There are ten single and two double rooms all have toilet ensuite facilities. Currently all shared bedrooms are used as single occupancy giving a currently capacity of twelve. Some rooms have their own balconies overlooking the bay and one room has a small garden area. There is a combined lounge dining room and curved sun lounge. The garden is terraced and has various patio and decking areas. The homes mission statement is to provide a haven for older people combining a carefree and comfortable retirement with maximum independence without fuss or intrusion into privacy. The White House DS0000014255.V298328.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over a morning and afternoon in June and lasted 5 ½ hours. Nine service users were in residence at the time of the inspection. To help gather evidence on how the home is performing the Inspector met with staff and the home’s manager, examined a range of records and written information and undertook a tour of all communal areas and some bedrooms. In depth discussions took place with five service users and two relatives who were visiting at the time of the inspection. Written feedback regarding the home was received from several service users, two health professionals who provide medical support for service users and four members of staff. The help judge the quality of meals the Inspector sat and ate lunch with service users. What the service does well: What has improved since the last inspection? What they could do better: To make sure that service users are aware of their rights of residency it has been required that the home’s owners issue them with the contracts of residency that they have recently produced; also staff should be issued with contracts of employment to ensure that their employment rights are protected. So that service user’s care needs are not overlooked or forgotten is has been required that the manager develops further the plans which describe the help The White House DS0000014255.V298328.R01.S.doc Version 5.2 Page 6 and support that service users need from staff. To ensure that staff are suitably supported by the manager the introduction of individual supervision meetings have been required. The owners have been required to refurbish a ground floor bathroom and make sure that in one bathroom hot water is delivered at a safe temperature. 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 DS0000014255.V298328.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 DS0000014255.V298328.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Pre-admission procedures and information available to potential service users are good and help ensure that they move into a home, which is suitable to meet their needs. EVIDENCE: A statement of purpose is in place for the home, this document provides guidance for prospective service users and their relatives about the home and the service provided, this document was examined; it has been amended since the last inspection and now contains all required information. Written feedback from one service user indicated that they had not received information regarding the home prior to moving in. Discussions with the home’s manager confirmed that a copy of the home’s statement of purpose and service user’s guide are given to service users once they have moved in, copies of these were actually seen in service user’s rooms; it has been recommended that copies of these documents are sent to prospective service users prior to them moving in, when the Manager sends them a brochure. Prior to a service user moving in the manager carries out an assessment of their needs to make sure The White House DS0000014255.V298328.R01.S.doc Version 5.2 Page 9 that the home would be suitable for them; assessments of need for three service users were examined, they contained all required information and were of a satisfactory quality. The home does not provide a rehabilitation service. The White House DS0000014255.V298328.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Current arrangements ensure that service users receive the help and support from staff to meet their health and personal care needs. EVIDENCE: Using the initial assessment of need undertaken by the manager as a starting point individual plans of care are compiled for each service user; these should identify amongst other things what support service users require from staff to meet their day to day needs in relation to health, personal and social care needs. Three plans were examined; they did not contain all of the required information necessary to ensure that care needs are not overlooked. Staff spoken to, said that they did not use the care plans as they knew service users well and were aware of the help and support they needed. Service users said that they received the help and support that they required from staff, their comments included “ they help me with everything” and “ they are really good if you are ill”. The manager said that she was aware that work was required in this area and showed the Inspector a detailed care plan format that she is in the process of adapting for use in the home; the format covered all required The White House DS0000014255.V298328.R01.S.doc Version 5.2 Page 11 areas. Records examined confirmed that some work has been done regarding the introduction of individual risk assessments; these help ensure that dangers to service users are identified and risks reduced. Areas covered included the use of kettles in bedrooms, risks of falling from windows, service users looking and managing their own medication and issues related to assisting service users who may have mobility problems. The manager has been told to further develop risk assessments including assessing if service users are at risk of developing pressure sores. Information gained from an examination of records, discussions with service users and comment cards returned by health professional confirmed that service users’ health care needs are appropriately met by staff. Service users said that staff would arrange for Chiropodists, Doctors, Opticians and other health care professionals to visit them if required; comment cards received from service users confirmed that they “always” get the medical support they need. The home looks after and gives out medication on behalf of most service users one service user said, “ We have our pills regularly when we should”. Some service users confirmed that they look after their own medication, an examination of records confirmed that an assessment of risk is undertaken by the manager in these instances to ensure that it is safe for them to do this. Medication records and storage were in order and indicated that prescribed medication is given out at the right times. Observations made during the inspection confirmed that staff ensured service user’s privacy and dignity; this included how they spoke to service users and knocking on bedroom doors and awaiting a reply before entering. The White House DS0000014255.V298328.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements in the home regarding activities, entertainment, visitors and food were good ensuring service users opportunities for choices in all of these areas of daily living. EVIDENCE: Service users confirmed that they have choices in all areas of their daily living, including what time to get up and how to spend their time. Two service users did say that they would like the visits by local clergy that used to happen, to be reinstated; this was discussed with the manager who said that she would arrange this. The manager said that service users may receive visitors at any time; this was confirmed in discussions with two relatives who were visiting at the time of the inspection, they said that “ the home is a lovely place and we are always made welcome”. The manager said that no regular activities were arranged, but that from time to time music sessions and singsongs take place. Service users confirmed in discussions and in written comments that this arrangement suited them; one service user said, “ We often have sing songs of all the old songs”. The home has digital television and service users said that last Christmas they had each been bought a DVD player for their rooms by the owners. Records examined confirmed that a varied menu is provided; service users said that they are given a copy of the menu at the beginning of each The White House DS0000014255.V298328.R01.S.doc Version 5.2 Page 13 week so that they can order alternatives if they so wish. The Inspector sat and ate lunch with service users, the meal was well prepared and service users confirmed that they liked the meals and had choices and alternatives; their comments included “the food is good” and “this is my favourite”. The White House DS0000014255.V298328.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users feel safe and listened to and are protected from abuse by the home’s procedures and staff. EVIDENCE: The home has a written complaints procedure in place, this in included in the home’s service users guide, copies of which are in service users’ rooms. Written feedback from service users said that they knew how to complain and discussions with them confirmed that they were happy that any concerns they raised would be acted on. Records examined confirmed that no complaints have been made since the last inspection. No complaints have been made to the Commission for Social Care Inspection. Records examined confirmed that all staff are trained in Adult Protection matters, this was confirmed in discussions with them. The White House DS0000014255.V298328.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Physical standards in the home were generally good and ensure that service users live in a safe, comfortable and well-maintained environment. EVIDENCE: An inspection of all communal areas and some bedrooms confirmed that the premises were generally safe well maintained and clean. At the last inspection of the home several requirements were made regarding the physical environment, these included the completion of the landscaping of the garden, the making safe of hot pipes and radiators, that evidence be provided re an up to date electrical certificate and that rubble was removed from a fire exit route; all of this work has been completed. Still outstanding is the refurbishment of a ground floor bathroom. Individual mixer valves are fitted to all hot water outlets to ensure that hot water does not present a danger of scalding to service users; records examined confirmed that these are tested regularly. The hot water delivered to one bath was too hot and posed a The White House DS0000014255.V298328.R01.S.doc Version 5.2 Page 16 possible danger to service users; action was required to address this and since the inspection the owners have confirmed that this has been done. The laundry was suitably equipped and hand-washing facilities were available for staff. All areas of the home seen were clean and hygienic. The White House DS0000014255.V298328.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Current arrangements ensure that service user’s needs are met by sufficient numbers of competent staff. EVIDENCE: From records examined and discussions with staff and service users it was evident that sufficient numbers of staff are always on duty to help and support service users; one service user said, “ There are always enough staff to look after us”. Service users and relatives said that without exception staff were good; their comments included, “ excellent, couldn’t wish for better” and “very good staff”. The manager said that currently 2 care staff hold NVQ qualifications and two other staff have completed units of the training; this was confirmed in discussions with staff. No new staff have been employed since the last inspection, because of this recruitment records were not re-examined, however at the last inspection it was required that Criminal Record Bureau checks were carried out on all staff, records examined confirmed that this has now happened. Staff said that they have not yet been issued with a contract of employment, the manager confirmed this, it has recommended that these are now introduced. Staff spoken to confirmed that they have undertaken a range of training courses this was confirmed by staff training records that have been introduced since the last inspection. The White House DS0000014255.V298328.R01.S.doc Version 5.2 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Management arrangements are generally good ensuring that the service is well managed. EVIDENCE: The manager has been registered with the Commission for Social Care Inspection for a number of years; she told the Inspector that she has completed a diploma in health and social care, which is apparently equivalent to the required NVQ level 4 qualification. Service users spoke very positively of her one said “ she is a diamond”. Throughout the inspection she demonstrated a clear understanding of the needs of older people. The home has recently purchased a new quality assurance package; this should help them recognise how well the home is being run and identify areas for improvement; this is not being used yet, it has been required that this now happens. The manager holds some money on behalf of service users; balances and records were examined, The White House DS0000014255.V298328.R01.S.doc Version 5.2 Page 19 these were in order although it has been recommended that receipts for expenditure such as hairdressing fees are obtained and kept. In discussions with the manager and staff it was evident that informal supervision does take place however in line with national minimum standards it has been required that formal 1:1 meetings are now introduced to give staff the time to discuss work issues, training and other matters in a confidential setting. A selection of records required by regulation was examined, these were in order. At the last inspection some requirements were made regarding health and safety matters; evidence seen during the inspection confirmed that these matters have now all been addressed. A selection of health and safety records was examined these were in order. From discussions with the manager and staff and an examination of records it was evident that staff have been trained in required health and safety matters. The White House DS0000014255.V298328.R01.S.doc Version 5.2 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 3 2 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x 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 x 18 3 3 3 2 x 3 3 2 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 2 3 3 The White House DS0000014255.V298328.R01.S.doc Version 5.2 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 OP2 Regulation 5 (1)(b) Requirement Timescale for action 29/09/06 2 OP7 15(1) 3 OP21 23(2)(a) (b) That the terms and conditions of residency that have been produced are issued to all service users. That care plans are expanded to 29/09/06 include clear information regarding service users needs and how guidance for staff on how they should meet these needs. Care plans should include an assessment of risk of service users developing pressure sores. That the ground floor bathroom 29/12/06 be refurbished. (Made at inspection of 1/2/05 and 27/01/06 and not yet completed. And that a suitable lock is fitted to the 1st floor bathroom door. That adjustments are made to the hot water delivered to the 1st floor bathroom to ensure that it is delivered at a safe temperature. That the new quality assurance system is implemented. That formal supervision is provided for staff. 07/07/06 4 OP25 12(1)(a) 5 6 OP33 OP36 24 18(2) 29/09/06 29/09/06 The White House DS0000014255.V298328.R01.S.doc Version 5.2 Page 22 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 3 4 Refer to Standard OP1 OP12 OP29 OP35 Good Practice Recommendations That the homes statement of purpose and service user guide is distributed to potential new service users. That arrangements are made to meet service users spiritual needs. That terms and conditions of employment are issued to all staff. That receipts are kept of expenditure of service user’s money. The White House DS0000014255.V298328.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 DS0000014255.V298328.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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