Inspection on 02/12/08 for The White House, Bodmin

This inspection was carried out on 2nd December 2008.

CSCI found this care home to be providing an Excellent service.

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 04/01/07

The White House, Bodmin 16/03/06

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 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The White House, Bodmin 40 Castle Street Bodmin Cornwall PL31 2DU     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Kim Fowler     Date: 0 2 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: The White House, Bodmin 40 Castle Street Bodmin Cornwall PL31 2DU 0120872310 0120879381 whitehousecarehome@googlemail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Platinum Care Limited Name of registered manager (if applicable) Mrs Eves Carkeek Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: Service users to include up to 11 adults aged over 65 years with a mental illness (MD[E]) Service users to include up to 11 adults aged over 65 years with dementia (DE[E]) Service users to include up to 2 adults between the ages of 60-65 years. Service users to include up to 34 adults of old age (OP) Service users to include up to 5 adults aged over 65 years with a physical disability (PD[E]) Date of last inspection Care Homes for Older People Page 4 of 28 care home 34 Over 65 11 11 34 5 0 0 0 0 Brief description of the care home 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 ensuite facilities. Access between floors is aided by a passenger lift and a stairlift. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 star. This means the people who use this service experience excellent outcomes. The unannounced inspection took place over 1 day and started at 10:10am and finished at 3:15pm. The homes Registered Manager, Mrs Eves Carkeek was available throughout the inspection. We made a tour of the building and spoke to most the people living at the home, and the staff on duty. Documentation relating to the care planning process and the management of the home were examined. Surveys were sent out before the inspection. Four surveys were returned from people living in the home as well as one Care Homes for Older People Page 6 of 28 relative survey. Any comments people made are in the relevant section of the report. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are considering admission to the home can be confident that a full assessment will be completed before admission, to ensure the home can meet their individual needs. Evidence: The Registered Manager stated that each new prospective admission has an initial point of contact sheet completed, the home then arrange a visit and completed the pre-admission assessment and only the manager or deputy undertake this task. The files examined for people living at home show that the last new admissions had a completed pre-admission assessment carried out and that people admitted to the home have been assessed. Another file examined showed the placing authorities care plan supports these assessments and no one is admitted without a full assessment undertaken. This ensured that the care staff are aware of peoples needs. Everyone is Care Homes for Older People Page 10 of 28 Evidence: invited to visit the home before admission, however The White House have admitted people direct from hospital and a visit is not always possible. The White House has one respite bed available all year and the majority of referred admissions to the home have stayed in the respite bed. This enabled people to test the home before a full admission was undertaken. This resource is also accessed via professionals providing intermediate care with a view to maximising independence for people before they can return to their own home. These admissions come under the RATS (Rapid Assessment Team) or the CATS (Community Assessment team). Any people admitted via these teams come with the teams completed assessment and the home will also complete their own pre-admission assessment on the day of admission. One person living in the home said that they had a visited to the home before they moved in. The homes AQAA returned states, Pre-admission assessments are recorded and filed in the Care Plans. Care Homes for Older People Page 11 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff and manager provide good personal and health care support to people who live at the home. They also ensure the promotion of privacy and dignity at all times. Evidence: All files examined held a detailed and comprehensive care plan. Evidence was recorded which showed that regular reviews were undertaken and recorded into individual care plans were the dates and times of these reviews. These care plans give detailed instructions to all staff to ensure intimate personal care is being provided in a manner that meets with peoples approval. This is particularly important, as some people living at the home have limited communication skills. All peoples assessment and daily care plans are easy assessable for staff on duty and risk assessments are held on individual files for the protection of all people living at the home. The manager stated that the risk assessments are reviewed regularly and updated as and when needed. These risk assessments are provided to meet the needs Care Homes for Older People Page 12 of 28 Evidence: of people living in the home and include information on nutritional screening and Manual Handling. All people living at the home have access to all health care services and information was recorded onto a medical visit record sheet in each persons file that there was input from other professionals including GPs, chiropodist and consultants based at the local hospital. One person was attending a hospital appointment during the inspection and the home provided a care staff to support this person. This person said, The staff always come with me when I go to the hospital. Another person said, I see the GP when I want. A person living in the home is currently requiring a higher level of care and had information on their file which showed that this information is updated regularly, and from discussion with the staff they are aware of this persons high care needs and have sought advice when needed. Information was recorded of the extra care support required and who provides this. The homes AQAA states, Pressure sores- staff are trained to identify signs of the on set of pressure sores and report them to the Manager. The Manager will refer directly to the District Nurses for a pressure risk assessment. Most people living in the home were spoken with and some were able to confirm that their health care needs were met and one person said, I have seen the District Nurse recently. The medication round was observed and one of the senior staff talked through the medication procedure for the home. The home uses the blister pack system for administration. This staff member confirmed that the staff had attended medication training. It was evident from these discussions that this staff member and other staff spoken with that they understood the medication procedure that included administration, storage and disposal of medication. The controlled drugs were checked and showed a clear audit trail of medication received and date and time of administration. Any changes in medication were recorded, signed and dated onto the medication recording sheets. One staff file examined held a medication training course certificate. Most people living at the home were spoken with during this inspection and all confirmed that the staff respects their privacy and dignity at all times. Observed during the inspection were staff knocking on peoples doors to promote privacy and Care Homes for Older People Page 13 of 28 Evidence: shutting the bedroom door when attending to a person personal care needs. One person living in the home said, the staff always shut my door and another stated, They help me in private. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at The White House can be confident that the home offers good wholesome meals. The home welcomes and encourages families and friends to visit. Evidence: People were observed moving freely around the home. Some people remained in their individual bedrooms and one person said,I like to stay here most of the time. Staff were seen interacting with people and discussing everyday topics and included assisting individuals when needed showing staff were aware of the needs of people living in the home. The home has a comprehensive list of activities arranged during the rest of the month leading up to Christmas. And the activities programme was displayed in the home and this included a Carol service, bingo and a manicurist/hairdresser visit. The home produces a regular Newsletter to update people on what is going on in the home. Care Homes for Older People Page 15 of 28 Evidence: The singing Postman visiting during the inspection was spoken with and confirmed that he attended regularly and there was always a good response to his act. This session was observed and showed the lounge area full and people enjoying them selves and participating in the singing and dancing. The homes quality assurance surveys returned to the home ticked excellent or good when asked about the activities provided. Recorded in individual files was information that some people went to Age Concern and a Luncheon club regularly. All family visits and contact is recorded into individual files, and daily records examined showed recent family visits for several people living in the home. A family and friends party is arranged for later this month. All bedrooms visited contained personal possessions and items, one person living at the home said that the home encouraged them to bring in items from home. All people, who were able to, made positive comments about the food provided. Two of the cooks on duty were spoken with during the inspection about the menus and food on offer. The homes 4 weekly menus were displayed for all to see and showed a varied and nutritional diet. It was evident from the food seen served at lunch time: turkey casserole, potatoes and vegetables followed by home made lemon cheesecake, that the food was home cooked using fresh products. The meal was well presented and freshly prepared. Everyone is asked for his or her choice at teatime. The homes AQAA states, We have applied for the North Cornwall District Chefs Award and we received their Gold Award in July 2008. The comments received from people living at the home about the food provided included, good food. One person said of the lunch observed being served, The casserole was lovely. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Most of the people living at the home were spoken with and some were aware of the homes complaints procedure and a few stated that they had never had any need to use it. Evidence: The homes complaints procedure was displayed for all to access and the complaints file was available in the main office. The home complaint file showed one complaint received by the home. Also recorded were the date, time and outcome of this complaint. The Commission has not received any complaints. Most of the people living at the home were spoken with and some were aware of the homes complaints procedure and a few stated that they had never had any need to use it. Some of the staff members on duty were interviewed during this inspection. The discussion with these staff members confirmed that many had completed the Adult Safeguarding training. This training was carried out by the local authority and it was clear from the information given to the inspector from some staff they had a clear knowledge and understanding of the Adult Safeguarding process. Some staff are also booked onto a Deprivation of Liberty course for the New Year. Care Homes for Older People Page 17 of 28 Evidence: The published newsletter showed the results of surveys sent to people and when asked, do you feel you can raise concerns easily all ticked yes and one person living in the home wrote, staff listen to concerns that crop up and a relative wrote, All concerns are dealt with very professionally and most helpful and caring. The homes AQAA records that, We will trial a suggestions box again. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The White House continues to maintain a clean and suitable environment for its stated purpose and the people who live at the home can be assured that they will live in an attractive and comfortable home that is regularly maintained. Evidence: The home is safe and well maintained and suitable for its stated purpose. It is a very comfortable, warm and light home. Several people living at the home confirmed this is usual. The gardens and patio area are to the front of the house are well maintained and assessable for all. The home employs a maintenance person to carry out repairs. The home was very clean, hygienic and free from offensive odours. The process for the removal of clinical waste was discussed and was satisfactorily dealt with. Several of the staff confirmed they had completed an infection control course and that the home provided disposable aprons and gloves for their use. Most bedrooms reflect individuals choice and many held personal items brought in by individuals. Since the last inspection the homes has purchased new curtain and some carpets were Care Homes for Older People Page 19 of 28 Evidence: due to be replaced. The entrance hall, communal areas and the kitchen had all been repainted since the last inspection. The home has also open a Secret Garden area for all to access. One survey returned to the Commission commented that the lift seems to fail at regular intervals. The manager confirmed that the fault has now been repaired and it has been working well. The homes Aqaa report that the plans for the next 12 months are, ongoing maintenance. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff training is encouraged and this enables people who live at the home to receive the best possible service. Not all staff files contain all required pieces of information to help protect the people living at the home. Evidence: The staff interviewed felt that the home had sufficient staff on duty and observation of staff throughout the inspection showed them to be relaxed, patient and helpful when assisting the people. There was 31 people living in the home and 6 Care staff, 2 cleaner, 2 kitchen staff, 1 laundry staff as well as the Registered Manager and deputy manager supported them. Thus providing evidence that the home had sufficient staff to support people currently living in the home. Many of the care staff employed at the home are long serving staff members having worked at the home for a number of years therefore have a great deal of experience working with older people. Some of the people living at the home were able to state that the care received is very good. The homes rotas and the staff confirmed that there is sufficient staff employed to care for the number of people currently living at the home. Care Homes for Older People Page 21 of 28 Evidence: Most of the staff on duty during the inspection was spoken with and some confirming they hold an NVQ qualification and two staff working toward it. This is a nationally recognised care qualification for which staff have had their work performance and knowledge evaluated by an external training organisation. The Manager provided a list of staff holding an NVQ qualification and this showed that 14 staff hold an NVQ certificate at level 2 or 3 and 10 staff working toward this qualification. One staff member spoken with said they already held an NVQ level 2 and the home is supporting them to complete a NVQ level 3. The homes AQAA states, Percentage of staff with NVQ s - 60 NVQ 2 and 14 NVQ3. Examination of staff files showed that most staff had the required pre-employment checks, including CRB (Criminal Record Bureau Disclosure) in place ensuring as far as possible unsuitable staff are not employed. However one staff file only held one reference though this staff did have a CRB and POVA (Protection of Vulnerable Adults) check in place. However shortly after the inspection was carried out the manager called the Commission to say that the 2nd reference had been obtained. The staff-training files provided further evidence that regular training was carried out. All staff interview confirmed that they receive regular and updated training. This included First Aid, Manual Handling, Food Hygiene and Equality and Diversity training. The training booked for further dates include, Mental Capacity Act, Deprivation of Liberty and Person Centered Approach courses. One staff member said good staff team. Another said, I am very happy here! The people living at the home said of the staff, Staff look after me well and another said, The staff are wonderful, I have everything I want. One survey returned to the Commission said of the staff, All staff are very kind. Care Homes for Older People Page 22 of 28 Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager and the staff team strive to provide a homely, stimulating environment that respects and protects people who live at the home. Evidence: The Registered Manager, Mrs Eves Carkeek has worked at the home for many years and is supported by a deputy manager. Both were available to assist throughout the inspection. Both the manager and deputy manager hold a Registered Managers award certificate and have recently completed the Person Centered Approach training and have each attended the Skills for Care conference. Both the manager and deputy sit on a local Managers support group with providers in the local area. One staff member interviewed said, Excellent manager, and is supportive. Care Homes for Older People Page 24 of 28 Evidence: A quality assurance survey was completed in September 2008 and the results were published in the homes regular newsletter. The survey seen showed mainly positive results and a relative writing, The short time my mum has been in the White House she has received excellent care. Any issues of concern raised recorded that they were dealt with and included the outcome, date and signed by the person dealing with the issue. One person living at the home thought they had completed a form recently and said any issues they raised were acted upon. Staff spoken with confirmed that the home holds staff meetings and supervision sessions. The staff interviewed felt that they were able to express their view at these meetings. Regular consultation with staff ensures staff can contribute to the running of the home and are aware of the homes aims and objectives, philosophies of care and promotes consistency and improvement. Either family members or the people living in the home hold their own money. The home will purchase items required and then bill who ever is holding the money for individuals. Sampling of records indicated equipment is serviced regularly and maintained in good order. Health and Safety is a priority in the home and records examined showed fire safety training and fire protection is in place and up to date. The accident records were accurate and files examined showed that information is recorded onto accident forms and also written into peoples daily records with appropriate action taken when needed. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - 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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