Inspection on 30/10/07 for The White House

This inspection was carried out on 30th October 2007.

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 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 29/06/06

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 Judy Gossedge Key Unannounced Inspection 30th October 2007 11:00 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.V348611.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.V348611.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) Info@thewhitehouseuk.co.uk 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.V348611.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. 29th June 2006 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. 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 service users’ accommodation in the basement, ground and first floor. Stairs or a chair lift provides access to the first floor. Two bedrooms in the basement are only accessible by a flight of stairs. There are ten single and two double bedrooms, all have a toilet and wash-hand-basin en-suite facilities. Currently all shared bedrooms are used as single occupancy, giving a capacity of twelve. Some bedrooms have their own balconies overlooking the bay and one bedroom 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 home’s 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. A copy of the Statement of Purpose and Service Users Guide is available to view in the home. At the time of the Inspection fees were documented to be between £390.00 and £600.00 per week. Additional charges are made for hairdressing, chiropody, toiletries and magazines and newspapers. The White House DS0000014255.V348611.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 five and quarter hours on 30 October 2007. Prior to the inspection an Annual Quality Assurance Assessment (AQAA) was sent to the home, which has been completed and returned and information detailed within is quoted in this report. A tour of the premises took place to look at communal areas and a selection of service user’s bedrooms and care records were inspected. Ten service users were resident and four service users were spoken with individually in their bedroom and a number were spoken with as part of the Inspection process in the communal areas. The care that four of the service users received was reviewed. The opportunity was also taken to observe the interaction between staff and service users in the communal area. Two care workers, one of whom also works at night; one domestic who also works as a care worker in the home, the cook, and the owner/Registered Manager were all spoken with. One visiting social worker was spoken with during the Inspection. Seven service users and four relatives/visitors surveys were sent out, and six completed service user and four relative/visitors surveys were received. What the service does well: The home has many attractive features including its position overlooking Saltdean Bay and personalised bedrooms decorated to a good standard. The home provides service users with a homely, relaxed and caring environment. Service users are enabled where possible to exercise choice and control over their lives whilst resident in the home. Staff was observed to deliver care with dignity and respect. The four service users spoken with felt the care provided respected their privacy and dignity. All of the six service users surveys stated they received the care and support they needed, and comments included, ‘the home is very comfortable and the staff are always very friendly. It provides a lovely environment for the service users. It provides a wide choice of nutritional well-cooked meals,’ I believe I have found the perfect home for my relative. The staff is extremely kind and very helpful and I have every confidence that they look after my relative wonderfully. I cannot praise them highly enough,’ ‘very helpful,’ they are very kind. The place is spotless and my friend says they could not be better looked after,’ ‘ I cannot think of anywhere else that could make my relatives stay any better, they are very happy here,’ ‘ the home is very comfortable and the staff are always very friendly. It provides a lovely environment for the service users. It gives a wide choice of nutritional well cooked meals,’ ‘I love it here,’ The White House DS0000014255.V348611.R01.S.doc Version 5.2 Page 6 ‘these are the happiest days of my life,’ ‘ I could not speak too highly of the staff.’ ‘ exactly what it says care,’ ‘ every single member of staff treats my relative with dignity and respect. Nothing is too much trouble for them and they constantly monitor my relative when they are no feeling too good.’ What has improved since the last inspection? What they could do better: The written records, which the home is required to maintain, should be fully accessible for any Inspection. That advice is sought from the Environmental Health Department as to the regularity checks are made of hot water being delivered to outlets assessable to them. That evidence is in place to fully demonstrate recruitment procedures followed and that staff do not commence working in the home until two satisfactory written references have been received. Where possible a reference is sought from the last employer. That evidence is available of the training undertaken by individual staff. That formal 1:1 supervision is provided for staff and maintained. There must be an up-to-date gas certificate for the home. A regular recorded health and safety/fire check should be undertaken in the home and recorded. The White House DS0000014255.V348611.R01.S.doc Version 5.2 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 summary of this inspection report can be made available in other formats on request. The White House DS0000014255.V348611.R01.S.doc Version 5.2 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 DS0000014255.V348611.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 6. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There is detailed information available for prospective service users. The admissions process ensures staff are provided with adequate information in advance of admission to ensure each service users care needs can be met in the home, but it should be ensured that the assessment documentation is fully completed. EVIDENCE: There is a detailed Statement of Purpose and Service Users Guide, which were both viewed during the Inspection. The AQAA details these documents have been improved over the last twelve months and are regularly reviewed. It should be ensured that this information details that respite care is also a service provided by the home. The AQAA details that a copy of the last Inspection report is also available to read in the home. One service user spoken with had a copy of the Service Users Guide in their bedroom. Five of the six service users surveys stated they had received enough information The White House DS0000014255.V348611.R01.S.doc Version 5.2 Page 10 prior to moving into the home and one did not. One commented, ‘I came to visit and liked what I saw.’ All of the four relatives confirmed they had received enough information. The AQAA detailed there is a contract/terms and conditions, to be used between the home and the service user. These were not available to view during the Inspection, but the Manager stated these had been distributed. Four service user surveys stated that they had received a contract/terms and conditions; one stated they had not and one could not remember. New service users are visited prior to any admission. This is to ensure individual service users care needs can be met in the home and to provide staff with information on the care to be provided. The documentation for three of the new service users resident since the last Inspection was viewed and confirmed they had been visited prior to admission and their pre-admission information was recorded. For the fourth the documentation had not been fully completed. Intermediate care is not provided in the home. The White House DS0000014255.V348611.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users are protected by an individual detailed plan of care being in place, where their care needs are identified at the start of their stay and which informs staff of the care which needs to be provided. It must be ensured these are always completed and regularly reviewed Medication policies and procedures are in place. EVIDENCE: Using the initial assessment of need undertaken as a starting point, individual plans of care are compiled for each service user. The AQAA detailed that a new format to record the care plans was being introduced and it is planned to continue to develop these over the next twelve months. Four of the service users individual care plans were viewed. Three were detailed and gave guidance to staff of the care to be provided, service users health care requirements and dietary needs etc. One service user who was staying for a The White House DS0000014255.V348611.R01.S.doc Version 5.2 Page 12 period of respite care in the home did not have a care plan in place. The Manager stated this would be addressed the next day. So a Requirement was not made on this occasion. There was a format for risk assessment, and it should be ensured these have all been fully completed. The AQAA detailed that any service user who is at risk of pressure sores will be refered to the District Nurses who will provide monitoring and appropriate intervention and equipment to alliviate the condition. A copy of a photograph of each service user were not seen during the Inspection and should also be part of the records kept for each service user. Care plans had been reviewed, but not at least at monthly intervals as required. This was discussed with the Manager who stated that it would be ensured that the all the reviews were up-to-date. Detailed daily records were viewed. All service users are registered with a local General Practitioner (GP) and have access to other health care professionals, including district nurses, via the surgeries. It was noted, in care plans that were examined, that appointments with or visits by health care professionals are recorded. Service users spoken with were asked about access to a GP, chiropodist optician or a dentist. Not all had required these services, some they stated they had accessed these services as required. The AQAA detailed that medication policies and procedures are in place. Medication is stored in a locked cupboard in a locked room and sample of the recording of medication administered was viewed. The recording of medication to be administered to one service user was not clear and was shared with staff on duty to ensure it was checked and rectified if necessary. Staff confirmed that where new/repeat medication is ordered this is directly though the service user’s GP’s, and a record are kept of when the medication is received in the home and regular checks are undertaken. One service user was self-administering at the time of the Inspection and there was a supporting risk assessment recorded. Staff spoken with confirmed they had received medication training; one from a pharmacist and the other had had inhouse training. It was not possible to evidence training provided to all staff as there were no records to view in the home. The service users spoken with stated they always received the medical support that they needed and were happy with the arrangements for the administration of their medication and always received this at the agreed time. The staff team were observed during the Inspection to ensure that the privacy and dignity of service users is respected at all times. The four service users spoken with felt the care provided respected their privacy and dignity. The care and support provided was observed to enable service users where possible to exercise choice whilst at The White House. The service users and relatives surveys stated that service users always received the care and support they needed. All the service users surveys further stated that the staff listened and acted on what they say. Comments received were, ‘I could not The White House DS0000014255.V348611.R01.S.doc Version 5.2 Page 13 wish for better care since I have been here,’ and ‘ the staff are always cheerful and understanding.’ The feedback from all the service users spoken with was that they were happy with the overall care provided in the home. Comments included, ‘the home is very comfortable and the staff are always very friendly. It provides a lovely environment for the service users. It provides a wide choice of nutritional well-cooked meals,’ I believe I have found the perfect home for my relative. The staff is extremely kind and very helpful and I have every confidence that they look after my relative wonderfully. I cannot praise them highly enough,’ ‘very helpful,’ they are very kind. The place is spotless and my friend says they could not be better looked after,’ ‘ I cannot think of anywhere else that could make my relatives stay any better, they are very happy her,’ ‘ the home is very comfortable and the staff are always very friendly. It provides a lovely environment for the service users. It gives a wide choice of nutritional well cooked meals,’ ‘I love it here,’ ‘these are the happiest days of my life,’ ‘ I could not speak too highly of the staff.’ ‘ exactly what it says care,’ ‘ every single member of staff treats my relative with dignity and respect. Nothing is too much trouble for them and they constantly monitor my relative when they are no feeling too good The White House DS0000014255.V348611.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Where possible service users are enabled to exercise choice in their lives whist resident in the home, there are opportunities to participate in social and recreational activities provided, service users maintain contact with family and friends as they wish and a varied diet is provided. EVIDENCE: The AQAA details that there are opportunities for service users to participate in activities in the home. A structured programme of activities is not in place, but on hand is a supply of on site leisure activities which the service user can access at any time, this ranges from the homes library (some in large print) of books, CD and DVD’s, jigsaws and craft items. A selection of daily papers are available in the main lounge. Music sessions and sing-a-longs are arranged throughout the year. The Manager stated that the range of activities provided depends on the social care needs of the service users resident at the time and The White House DS0000014255.V348611.R01.S.doc Version 5.2 Page 15 this should be kept under review to ensure all service users social care needs continues to be met. Five service users surveys stated there were always activities provided and one did not answer the question. There were no activities organised during the Inspection, but staff were busy getting ready for Halloween, when they were dressing up and ‘scary music’ was planned for the evening. Service users have been bought DVD players to have in their bedrooms and several service users showed us a range of DVD’s they had received as presents from the home depending on their interests. The Manager stated service users birthdays are always celebrated with a gift and a party, and one service user commented on the lovely birthday party they had recently had. Feedback from the service users spoken with identified that there is flexible visiting, that staff are always very welcoming and it is possible to go to a service user’s bedroom if a private meeting is required. The care and support provided was observed to enable service users where possible to exercise choice whilst at The White House. The three service user files viewed and the service users and relatives feedback with confirmed this. The home has a cordless telephone so that service users can make and receive telephone calls in private. Service users spoken with said that they have choices in all areas of their daily living including how to spend their time and what time to get up and go to bed. Relatives also confirmed that service users were supported to live the life they choose. There is a dining room/lounge where meals are served and staff were observed to be available to offer service users assistance with their meals if required. A number of service users also chose to eat their meals in their bedrooms. The cook working on the day stated they held a basic food hygiene certificate. The AQAA detailed that the food provided is all fresh and home cooked. There is an eight-week rotating menu is in place. Alternatives to the dinner and tea menu are not detailed on the menu, but staff and service users stated that alternatives are provided and that service users are provided with the menu each week to request an alternative if they wish. Special diets are catered for. Lunch on the day was beef bourguignon, mashed potatoes and vegetables, followed by spotted dick and custard. Service users were asked during the afternoon what they wished to select for tea. Fresh fruit was also available to meet individual service users requests. Two of the service users surveys stated that they always liked the meals and four stated usually. Comments received were varied, ‘the meals could be better,’ and ‘the quality of the meals varies.’ The White House DS0000014255.V348611.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Procedures are in place to enable service users or their representatives to raise any concerns about the care being provided and to ensure that service users are protected from abuse. EVIDENCE: The home has a complaints policy and procedure in place and this was available to view in the home. The AQAA detailed that no complaints had been received since the last Inspection and the CSCI has not received any concerns in relation to The White House. All of the service users and all relatives knew who to speak to if they had any concerns and had been happy with the way any concerns had been dealt with and all but one service user knew how to make a complaint. The service users spoken with during the Inspection confirmed that they would feel comfortable raising any concerns with staff. Comments received were, ‘someone will always listen,’ and ‘every effort is made to help service users overcome any problems they might have.’ The AQAA detailed that there is a policy and procedure in place in relation to safeguarding vulnerable adults. Staff spoken with had an awareness of the policies and procedures. There were no training records to view to confirm The White House DS0000014255.V348611.R01.S.doc Version 5.2 Page 17 that all staff is trained in Adult Protection matters. For two staff spoken with one confirmed they had received this training and for another new member of staff stated they had not. The White House DS0000014255.V348611.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is decorated and furnished in a homely style, and there is ongoing work to refurbish and improve the facilities in the home to ensure that the standard of the environment continues to be maintained and improved. EVIDENCE: A tour of the building was made. The home is decorated and furnished in a homely style. There is evidence of wear and tear in the corridor areas and the Manager confirmed this is to be redecorated. The AQAA detailed that in the last twelve months the garden area has been completed with decking areas and all slopes no steps. It is planned during the next twelve months to replace the The White House DS0000014255.V348611.R01.S.doc Version 5.2 Page 19 easy chairs in the service users bedrooms, renew the dining furniture, redecorate the sun lounge and plant shrubs in the new landscaped garden. Heating is provided by a central heating system with radiators guarded in the home. There were no records to view of regular checks of the hot water temperature, but were provided subsequently. These recorded three monthly checks that hot water is delivered to outlets accessed by service users close to the recommended safe temperature of 43° C. Advice should be sought as to the frequently these checks should be undertaken. Four service users spoken with confirmed that there was adequate hot water and heating in the home. All twelve bedrooms were being used for single occupancy at the time of the Inspection, and the bedrooms are situated on all the floors in the home. Bedrooms have been decorated and furnished to a good standard. Some bedrooms have their own balcony or veranda and one has their own small garden area with a pond. All service users spoken with said how much they liked their bedrooms. Comments received were, ‘my bedroom is lovely,’ and ‘I have views from my window and I love them.’ Bedrooms are provided with tea and coffee making facilities as well as a fridge. All bedrooms have an emergency call system fitted and the Manager has previously reported that extension cords are available to call points so they can be reached from the bed if a service user became bed bound. A number of bedrooms viewed displayed service users individual styles and interests. All of the bedrooms have en-suite facilities, with a wash-hand-basin and toilet. There is one communal assisted bath in the home. The Manager stated a suitable lock has not been fitted to the bathroom door following the Requirement made at the last Inspection, as currently all service users are assisted with bathing. Should this change, following a risk assessment being completed a suitable lock will be fitted. So a further Requirement has not been made on this occasion. The Manager also stated the second bathroom had been refurbished to meet the Requirement made following the last two Inspections, but following consultation with service users is being subject to further refurbishment and will provide walk-in shower facilities. A suitable lock will be fitted to this bathroom door. There is currently only the one bathroom facility for all the service users resident to access, and the Manager stated the second bathroom would be finished within the next four weeks. So a further Requirement has not been made on this occasion. There is a garden at the front of the home, which is sloping, further works have been undertaken to complete its landscaping. This has included additional decking areas and pathways and these provide for an attractive view over Saltdean Bay. There is not a passenger lift and a stair lift enables service users to move between the ground and first floor. Two bedrooms to the basement are only accessible by a flight of stairs. The White House DS0000014255.V348611.R01.S.doc Version 5.2 Page 20 There is a large lounge with a separate dining area and a large sun lounge for service users to use on the ground floor. The home was clean and odour free and feedback from service users and relatives was that the home is always ‘fresh and clean’. The AQAA details that the Department of health guidance has been used to assess infection control management in the home. A domestic/care worker was spoken with who stated she had received training/guidance in infection control, which had included guidance on control of substances hazardous to health regulations (COSHH) and there was good access of protective clothing. Recording of routine fire checks carried out in the home were viewed. The book to record the checks need to be renewed and should also evidence the checks undertaken on the emergency lighting and regular checks of the automatic doorstops. The Manager stated this would be addressed so a Requirement has not been made on this occasion. The White House DS0000014255.V348611.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use this service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staffing levels are satisfactory. A robust recruitment procedure needs to be in demonstrated to be in place to ensure service users are in safe hands at all times. Evidence should be in place to confirm that care workers are being provided with training to ensure they can meet the care needs of the service users. EVIDENCE: Staff spoken with and rotas viewed confirmed that two members of staff are deployed to work in the home during the day, one of who was the Manager at the time of the Inspection. A further domestic assistant who also covers some care duties was also working in the home during the day and a cook. At night the home deploys one ‘sleeping in’ member of care staff, which should be kept under review to ensure the care needs of the service users continue to be met. All of the service users surveys stated ‘yes’ when asked if staff always listen and act on what service users said. The AQAA details that of the nine care workers in the home, four care workers hold NVQ level 2 in care and further two care workers are working towards this The White House DS0000014255.V348611.R01.S.doc Version 5.2 Page 22 qualification. On completion the home will then have over fifty percent of the care staff qualified. A thorough recruitment process was not demonstrated to be in place. There were three new members of care or ancillary staff who have been recruited to work in the home since the last Inspection, and the documentation for only one of these new staff was available to view during the Inspection. Records viewed showed this member of staff had commenced working in the home prior to two satisfactory written references having been received. Also where possible reference should include a reference from the last employer, which was discussed with the Manager during the Inspection. The Manager has previously confirmed that the staff working in the home have had a Criminal Records Bureau (CRB) check and was able to evidence all the three new staff had had the required checks. Both staff spoken with confirmed they had received terms and conditions of employment. The Manager stated that the induction meets the requirements of General Skills for Care induction standards. One member of staff was able to confirm they had received an induction. The White House DS0000014255.V348611.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38. People who use this service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home benefits from a Manager who ensures an open, supportive, homely and caring environment. Quality assurance systems have been developed to enable ongoing feedback about the care provided in the home, but it should be ensured that the outcome from the quality assurance process is available to view. Individual staff supervision should be provided and maintained. EVIDENCE: The White House DS0000014255.V348611.R01.S.doc Version 5.2 Page 24 Responsibility for the home rests with the joint owners one of whom is also the Registered Manager. The other is currently undertaking the building works at the home and training with the staff. The Manager has many years experience in working with older people and is undertaking a diploma in social care having taken some time out from completing this qualification. The AQAA details that a quality assurance system has been developed and being implemented and that views have been sought from staff, service users, and visiting professionals. The Manager stated there are service users forums in the home. The minutes of the last meeting were viewed, but the last meeting was in February 2007. There have been a number of new admissions to the home and it is recommended that the frequency of the service user groups are reviewed to ensure all service users have had the opportunity to participate in this forum. There were no records to view of the outcome from the quality assurance process already undertaken and this information should be available in the home for the CSCI, service users and their representatives to read. The AQAA detailed that policies and procedures are in place in the home and these have been reviewed and updated. Where a small ‘float’ of money is held for one service user, this was securely stored and there were financial records to support this activity and checks on the balances of money held. Again receipts were not available to view to support all the financial transactions, but the Manager stated that these could be made available if required. In discussions with the Manager and staff it was evident that informal supervision does take place, however in line with national minimum standards a further Requirement has been made that formal 1:1 meetings are introduced and maintained to give staff the time to discuss work issues, training and other matters in a confidential setting. Staff did speak of attending staff meetings. The Manager stated that the other owner undertakes the training of staff. That he has undertaken a ‘Train the Trainer’ qualification to do this. It was not possible to evidence this during the Inspection. Two care staff spoken with confirmed good access to training and of attendance on moving and handling, health and safety training and one had attended basic food hygiene training. The Manager stated that updates for staff are due to be arranged shortly and that options to provide first aid training were being looked in to. It was not possible to fully evidence what training had been provided and undertaken for all staff, as training documentation was not held at the home and only limited recorded information was provided during the Inspection. The AQAA detailed that a fire risk assessment is in place and it was discussed with the Manager during the Inspection that it should be ensured that this is regularly reviewed. There was no recording to evidence that a regular health and safety/fire check of the building had been undertaken. Staff stated they had undertaken fire training. The White House DS0000014255.V348611.R01.S.doc Version 5.2 Page 25 The AQAA detailed that the maintenance of equipment and services has been carried out, but that the last certificate for gas appliances was dated 2004 are checked yearly, but the last certificate was dated 2004. The Manager stated that that gas appliances are checked yearly and were due to be tested again shortly and that she would ensure a new certificate was in place. Recording was viewed of incidents and accidents. The White House DS0000014255.V348611.R01.S.doc Version 5.2 Page 26 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 2 X X 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 2 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 2 X 2 The White House DS0000014255.V348611.R01.S.doc Version 5.2 Page 27 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 OP25 Regulation 13(4)(c) Requirement Timescale for action 31/12/07 2. OP29 3. OP30 4. OP36 That advice is sought from the Environmental health Department as to the regularity checks are made from hot water being delivered to outlets assessable to them. To protect service users. 19 (1) (b) That evidence is in place to (i) demonstrate recruitment procedures and that staff do not 38 (1) (a) commence working in the home (b) (2) (a) until two satisfactory written (b) (c) (d) references have been received. (e) Where possible a reference is sought from the last employer. This is to protect service users. 18(1)(c) That evidence is available of the (i) training undertaken by individual staff. To protect staff and service users. 18(2) That formal supervision is provided for staff. This issue is outstanding since 29/09/06. 12(1)(a) That evidence is available of an up-to-date electrical fixed wiring installation certificate. To protect service users. That a regular health and DS0000014255.V348611.R01.S.doc 31/12/07 31/12/07 31/12/07 5. OP38 31/12/07 6. OP38OP38 Reg 23 31/12/07 Page 28 The White House Version 5.2 (4) (a) safety/fire check is undertaken in the home and recorded. 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 DS0000014255.V348611.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V348611.R01.S.doc Version 5.2 Page 30 - 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. 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