Inspection on 16/03/06 for The White House, Bodmin

This inspection was carried out on 16th March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The White House, Bodmin 17/11/09

The White House, Bodmin 02/12/08

The White House, Bodmin 04/01/07

The White House, Bodmin 28/09/05

The White House, Bodmin 20/10/04

The White House, Bodmin 27/04/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE The White House 40 Castle Street Bodmin Cornwall PL31 2DU Lead Inspector Elaine Bruce Announced Inspection 16th March 2006 08:15 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 DS0000009143.V271517.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The White House DS0000009143.V271517.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The White House Address 40 Castle Street Bodmin Cornwall PL31 2DU 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) 01208 72310 01208 79381 thewhitehouse@surfsnet Platinum Care Limited Mrs Eves Carkeek Care Home 34 Category(ies) of Dementia - over 65 years of age (11), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (11), Old age, not falling within any other category (34), Physical disability over 65 years of age (5) The White House DS0000009143.V271517.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Service users to include up to 11 adults aged over 65 with a mental illness (MD[E]) Service users to include up to 11 adults aged over 65 with dementia (DE[E]) Service users to include up to 5 adults aged over 65 with a physical disability (PD[E]) Service users to include up to 34 adults of old age (OP) Total number of service users not to exceed a maximum of 34 Date of last inspection 28th September 2005 Brief Description of the Service: The White House is a care home providing personal care and accommodation for thirty four older people. Eleven of the thirty four beds are available to service users with a dementia or a mental disorder. The home provides a respite care service in a dedicated bedroom through a booking service which is well used. The home is a large premises situated on a hill overlooking Bodmin town to the Gilbert Memorial and the surrounding countryside. The premises has a garden on the West and North side of the home. Car parking is available in the grounds of the home. The building is a two-storey Victorian house, which has been extensively modernised including a three storey extension. Internally, the house has been adapted whilst retaining the characteristics and age of the building. Accommodation includes two separate dining rooms and two lounges, which are available on the ground floor as are some bedrooms. All bedrooms are for single occupancy use. A total of nineteen bedrooms on all floors of the home have en-suite facilities. Access between floors is aided by a passenger lift and a stairlift. The White House DS0000009143.V271517.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection at The White House took place on the 16th March 2006 between the hours of 0815 and 1600. A director from the Company that owns the home: Platinum Care Limited was present during the course of the inspection as were the registered and deputy managers. The outcome of the inspection is that the standard of care being delivered to the service users is of a very good standard. All the service users spoken to during the course of the day expressed only positive comments on all aspects of life at the home. This included comments on the good food, the kindness of the staff, with specific references to the registered manager. The pleasant environment is also very much appreciated by the service users. What the service does well: What has improved since the last inspection? The good practice recommendations of the inspection report of the 28th September 2005 have been addressed except one. This is included again in this inspection report. The White House DS0000009143.V271517.R01.S.doc Version 5.1 Page 6 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 DS0000009143.V271517.R01.S.doc Version 5.1 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 DS0000009143.V271517.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,4 and 5 The home’s statement of purpose and service user guide documentation as well as a brochure provide prospective service users with details of what the home provides helping an informed decision about admission to the home. The care needs of prospective service users are assessed by one of the management team prior to admission to the home to ensure that the home will be able to meet the care needs of every individual. Prospective service users are welcome to visit the home prior to admission. EVIDENCE: The statement of purpose document is available to all visitors in the entrance of the home. It is presented as a very professional document with a large amount of detailed information given. The principles of care are discussed with an explanation of how the home will deliver a standard of care that respects a service users right to privacy, dignity and respect for example. It includes information as required by the care homes regulations and information that The White House DS0000009143.V271517.R01.S.doc Version 5.1 Page 9 potential service users may require in the form of an A to Z directory of services. A service user guide has also been produced which is professional in presentation and is handed out to each potential service user with other information to include a brochure. All this documentation has recently been reviewed (and amended if appropriate) by management on the 29th December 2005. The pre admission assessment document is completed during the assessment process by the registered manager or the deputy manager. This document includes information on the specialist care needs of the service users being admitted to the home. Staff records indicate that regular training is provided to the staff to enable them to meet all the specialist care needs of the service users being admitted to the home. The statement of purpose document advises prospective service users that they are welcome to visit the home prior to admission. The White House has a respite bed available all year. The majority of admissions to the home have stayed in the respite bed and therefore had an excellent opportunity to have a trial stay at the home prior to a long stay admission. The home has an admission policy and procedure in place to guide staff. The documentation clearly states that as much information as possible must be gathered on potential service users prior to admission. The manager ensures that she receives all pre admission documentation from social services when they have a funding responsiblitiy. The White House DS0000009143.V271517.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8 and 9 The service user’s health and personal care needs are being met by the staff and multidisciplinary staff as required. Medication is being administered correctly to the service users but two good practice recommendations are made as a result of this inspection. EVIDENCE: Each service user has a detailed care plan in place which evidences the involvement of the service user in care planning. Regular monthly reviews of care needs are taking place. Daily records support the care plans. Additional information to include risk assessments and moving and handling assessments are available in care planning. All care staff have a responsibility for recording in care planning. Service users are registered with a general practitioner on admission to the home. Evidence is in place in the care plan of health care needs being met on a multidisciplinary sheet. Service users are weighed regularly and this is also documented in the care plan. Additional health care services to include for The White House DS0000009143.V271517.R01.S.doc Version 5.1 Page 11 example chiropody are also documented as taking place. It is noted that dietary needs are identified in care planning but it is recommended that a formal nutritional screening tool is used to identify those service users who are at increased risk to guide staff specifically to their nutritional needs. The home has in place a medication policy and procedure. The local Boots pharmacy provides medication to the home in the monitored dosage system. The system is regularly inspected by the pharmacy. All staff who administer medication to include the manager have received accredited training from a local college. Medication administration records were found to be completed appropriately on the day of the inspection. It is recommended that when the medication is logged as being received into the home a date of receipt is consistently used. It is also recommended that the index of the controlled drug register is used. The White House DS0000009143.V271517.R01.S.doc Version 5.1 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): 14 and 15 Service users were complimentary about the choice they are able to express about their daily routines at the home. Service users were complimentary about the standard of the meals being provided at the home. EVIDENCE: Service users advised the inspector that the have their breakfast in their bedrooms and they are then free to chose how they spend their day at the home. Information is given in the service user guide and statement of purpose documentation that the home respects the rights of the service users. The documentation also states that advocacy services can be accessed if required. All the service users spoken to during the course of the inspection expressed very positive comments on the standard of the meals at the home. Staff members who are employed to cook the meals in the home are qualified to the basic and intermediate food hygiene level. The cooks have the support of a kitchen assistant. All records of meals are in place as required and there is a The White House DS0000009143.V271517.R01.S.doc Version 5.1 Page 13 very good choice of meals and drinks available at all times. The cook is given good information on the likes and dislikes of the new service users being admitted to the home as well as those already in the home. The menu is displayed in central areas for the service users and visitors to the home to see. The cook serves the meals in the dining room which is a very pleasant room. An inspection of the kitchen by the District Environmental Health Officer took place on the 7th April 2005 the recommendations from that inspection have been addressed. All documentation to include cleaning rotas are in place. The White House DS0000009143.V271517.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 The home has in place a satisfactory complaints policy and procedure issued to each service user and their relatives. Staff have received adult protection training to protect the service users from the risk of abuse. EVIDENCE: The home has in place a simple, clear and accessible complaints procedure. It is named “we welcome your views” and states that suggestions and compliments are also most welcome. There have been no complaints received but should there be the home are fully aware they must keep a record of the complaint. The home has in place a policy and procedure on adult protection which includes information on whistle blowing. This policy and procedure has recently been updated in line with the good practice recommendation in the inspection report of the 28th September 2005. A large number of care staff have attended the local county council social services department (including the manager) for adult protection training and there are plans for more staff to receive this training. Supervision documentation evidences that adult protection is discussed with staff and evidence is in place that the staff have read this important policy and procedure. The White House DS0000009143.V271517.R01.S.doc Version 5.1 Page 15 The White House DS0000009143.V271517.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 21,23,24 and 25 Service users live in a safe, comfortable, and well maintained environment that is suitable for it’s stated purpose. EVIDENCE: The home is very well maintained externally and internally with a maintenance person being employed. Nineteen bedrooms in the home have en-suite facilities to include a wash hand basin and toilet. Two bedrooms have in addition to a toilet and a wash hand basin a bath and two bedrooms have a shower. The home has a good range of assisted bathing facilities (six) to meet the needs of the more dependent service users. The home is well provided with handrails and grab-rails in toilets and bathrooms. Bedrooms in the home are available on the ground or first or second floor of the home. The bedrooms on the first and second floor can be accessed by a passenger lift or a stair lift if required. There is one bedroom that cannot be accessed with the lift, this is identified in the statement of purpose document. Bedrooms can be personalised to include the use of a telephone line into the The White House DS0000009143.V271517.R01.S.doc Version 5.1 Page 17 room if required. Furniture and soft furnishings in the home are noted to be of a good standard. All central heating radiators in the bedrooms and communal areas of the home have been guarded for safety. Water temperatures are set for safe bathing and notices are available in bathrooms for service user safety. Baths in the home have been fitted with pre-set valves for safe bathing and the pre set valves are being fitted to the hand basins on a risk assessment priority basis. The service users commented very favourably on their pleasant environment during the course of the inspection. The White House DS0000009143.V271517.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28, 29 and 30 The management team are committed to having a trained workforce and training is regularly provided and accessed to the benefit of the service users. Recruitment procedures for employing staff are satisfactory. EVIDENCE: Just under half of the staff have a qualification in NVQ 2 or 3 with six more staff undertaking these studies at this time. When these staff members have obtained their qualifications 72 of the staff will have an NVQ in care. Statutory training is all up to date. This includes fire drill training, moving and handling and first aid. Good practice training includes a wide variety of subjects to include for example dementia training and asthma. This good practice training is regularly provided and staff files evidence that a large amount of training is regularly taking place in the home. It is a credit to the manager that she spends a considerable amount of time organising and accessing training for the staff. Staff files evidence that references and criminal records bureau checks are in place for the employment of staff. Staff application forms are completed appropriately. All staff members have been issued with terms and conditions of employment documentation. The White House DS0000009143.V271517.R01.S.doc Version 5.1 Page 19 It is recommended that staff files are re-organised to access easily the information on the training evidence and recruitment documentation as required. The White House DS0000009143.V271517.R01.S.doc Version 5.1 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,37 and 38 The management team are committed to delivering a good standard of care at The White House. This inspection has confirmed that they are achieving their aim. All the service users spoken to during the course of the day expressed very positive comments on the standard of care that they are receiving. EVIDENCE: The registered manager is very experienced to include having been at the home for nineteen years as a manager. She has obtained the registered managers award qualification along with her deputy manager. The manager is a D32 and D33 assessor. She regularly undertakes training. The manager has been provided with a job description as has her deputy manager. During the course of the inspection the service users expressed very positive comments about the manager. The White House DS0000009143.V271517.R01.S.doc Version 5.1 Page 21 A director from the Company visits the home regularly and will be providing to the CSCI evidence from their accountants of the continued financial viability of the Company. The staff are very involved in the running of the home which includes being involved in regular staff meetings. The minutes of the meetings are then available for all the staff to read in their staff room. All the staff are involved in staff meetings and the timings of the meetings are varied to allow the staff the opportunity of attending in their shift time. The directors of the Company that own the home are involved in regular monitoring and quality assurance of the home. Feedback from the CSCI relatives’ questionnaire sheets prior to the inspection were very positive about The White House. The home has also recently also obtained their own views of the relatives with their comments noted as very positive. The service users are involved in regular meetings to discuss the running of the home and these meetings are minuted and available. Insurance cover is displayed and up to date as required by legislation. Service users are encouraged to take responsibility for their own financial affairs as long as they feel able. Where any finances need to be held and money paid for services these records are all in place as required. Staff receive a yearly appraisal and regular supervision. This task is undertaken by the manager and all documentation is in place as required by the standards. All records as required by legislation are in place. All maintenance records for equipment in the home is up to date. Policies and procedures are regularly reviewed and updated. The home has a large amount of safety information and policies and procedures in place. There is recorded evidence that staff are reading this documentation. The manager has a health and safety qualification. Infection control policies and procedures are all in place and equipment is provided in bedrooms for safe practices. The White House DS0000009143.V271517.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 4 x x 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 x x 3 x 3 3 3 x STAFFING Standard No Score 27 x 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 3 3 3 3 3 3 3 The White House DS0000009143.V271517.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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. 5. Refer to Standard OP11 OP8 OP9 OP9 OP30 Good Practice Recommendations The Registered Manager should ensure that information pertaining to service user wishes in respect of terminal illness, dying and death is ascertained and recorded. To give consideration to using a formal nutritional screening tool in care planning documentation. To consistently date on the medication administration records when the medication is received into the home. To use the index in the controlled drug register. To re-organise the staff files so training evidence and recruitment information can be accessed easily. The White House DS0000009143.V271517.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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 DS0000009143.V271517.R01.S.doc Version 5.1 Page 25 - 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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