Inspection on 05/01/09 for The White House Care Home

This inspection was carried out on 5th January 2009.

CSCI found this care home to be providing an Good 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 Care Home 04/03/08

The White House Care Home 13/09/07

The White House Care Home 11/09/06

The White House Care Home 12/12/05

The White House Care Home 28/06/05

The White House Care Home 14/12/04

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Snydale Care Home

Hawkhills

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Ravensworth Lodge

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 Care Home Rivelin Dams Manchester Road Sheffield South Yorkshire S6 6GH     The quality rating for this care home is:   two star good 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: Shirley Samuels     Date: 0 5 0 1 2 0 0 9 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 26 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 26 Information about the care home Name of care home: Address: The White House Care Home Manchester Road Rivelin Dams Sheffield South Yorkshire S6 6GH 01142301780 01142306638 none Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Simon Cobb,Mrs Julia Pauline Cobb Name of registered manager (if applicable) Ms Julie Dawn Frith Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 32 The registered person may provide the following cateory of service only: Care hone only - Code PC To service users of the following gender: Either Whose primary care needs on admisison to the home are within the following categories; Old age, not falling within any other category - Code OP, maximum number of places: 16 Dementia - Code DE, maximum number of places: 16 Date of last inspection Brief description of the care home The White House is a converted property providing personal care and accommodation for thirty-two older people, some who have dementia. Care Homes for Older People Page 4 of 26 care home 32 Over 65 0 16 16 0 Brief description of the care home The accommodation is on two floors with lift access, and the majority of rooms are single. All areas of the home are accessible to wheelchairs. There is a parking area to the rear of the home The homes registered providers are Mrs Julia Pauline Cobb and Mr Simon Cobb. The home has beautiful views overlooking Rivelin Dams. There are large landscaped gardens and views of the Dams can be seen from the majority of the rooms. The home is located some distance away from shops and other amenities. The manager told us, the weekly fees range from 375 pounds- 425 pounds This does not include costs for items such as hairdressing or chiropody. Information about the home is available in the entrance halls to both units of the home. The latest CSCI inspection report and the complaints procedure are also available in the entrance halls. Care Homes for Older People Page 5 of 26 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: two star good 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 previous inspection of this service was carried out on 4/3/08. On this visit We sought the view of fifteen people using the service, seven relatives and seven members of staff. Some people spoke to us on the day of the visit others completed questionnaires. The manager was present and assisted with the inspection. At the end of the visit feedback was given to the manager. During the visit we looked at the environment and made observations of staff interaction and approach to people using the service and visitors. We checked samples of documents regarding peoples care support and safety. Care Homes for Older People Page 6 of 26 These included assessments, care plans, medication records, staff recruitment files, records of health and safety checks and staff training. We have reviewed our practice when making requirements,to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into the report as recommendations- but only when it is considered that people who use the service are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken We would like to thank everyone for their help and welcome. What the care home does well: What has improved since the last inspection? What they could do better: The process for reviewing care plans needs to be developed further. To reduce the risk of accidents the floor covering in the lift on the Unit for people living with dementia needs to be repaired or replaced. Care Homes for Older People Page 8 of 26 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 9 of 26 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 10 of 26 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 had the information they needed and were assessed before they moved into the home. Evidence: The manager told us that people were provided with written information about the home, which detailed the services provided and what standard of service people could expect. People are assessed before moving into the home. staff told us they had the information they needed before people moved in. Assessments included peoples needs in a variety of areas, this gave the staff the information they needed to build a plan of care. This made sure they had the information they needed to make a judgement about whether they could meet peoples needs. Care Homes for Older People Page 11 of 26 Evidence: The manager confirmed that the home does not provide intermediate care. Care Homes for Older People Page 12 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People had a plan of care,there health care needs were met and they were treated with respect and dignity. Evidence: Each person had a plan of care, which detailed their needs the action needed by staff and the desired outcome for the person using the service. There was evidence that people were consulted about their plan and relatives were able to contribute to the process. This meant that staff had the information they needed to support people in way that promoted their wishes and feelings. Records of care and support given were made three times a day and did in the main relate sufficiently with the care plan. This shows much improvement since the last inspection. It also shows that staff are carrying out care and support of people in a that has been identified though assessment for the individual. There was evidence that staff knew people well and when asked were able to tell us Care Homes for Older People Page 13 of 26 Evidence: about individual needs and risks. care plans were reviewed on a monthly basis however the written evidence of this review lacked detail and in the made stated care plan remains the same. This did not demonstrate that recordings for the previous month had been taken into consideration. There were some examples of small changes in behavior/condition being picked up in the daily recordings but this was not incorporated or referred to in the monthly review. Peoples files contained details of appointments and visits from health care professionals. In the questionnaires people using the service told us their health care needs were met. Staff were able to tell us about the action they took to promote peoples health and feeling of wellbeing. equipment such as hoists,wheelchairs,handling belts and stand aids were available and used by staff and nutritional screening formed part of the care plan. This means that peoples health care needs are met. Medication was in the main stored appropriately. Staff responsible for administering medication had received training. we observed medication being administered this was done appropriately and records of medication administration was made immediately following administration. Eye drops and one bottle of tablets were kept in a separate container in the fridge this container was not locked. The manager immediately provided a lockable container. There were procedures and practices in place to make sure controlled drugs are stored administered and recorded as required. This shows that people using the service are protected by the homes system for the management of medication. Staff told us there was one person who administered some of their own medication and that there were procedures in place to monitor this. Staff were observed approaching people in a sensitive and caring way. people were relaxed and cheerful in response to staff. In their questionnaires people told us staff were kind and always there for them. people were not left unattended for long periods of time staff told us the aim was to provided supervision to people in the lounge at all times. Staff were also able to tell us how on a daily basis they promoted privacy and dignity. They made sure people had the information they needed, offered choices wherever possible and people were able to move around freely and choose where to spend their time and who with. This shows that people are treated with respect and their right to privacy is upheld. Care Homes for Older People Page 14 of 26 Care Homes for Older People Page 15 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Activities are provided,choice is encouraged and people are provided with a balanced diet. Evidence: The home employs an activities co coordinator who plans and carries out activities with people. The activities provided include nail care, hairdressing,art and craft pamper session and a selection of quizzes which the people using the service told us they enjoyed. Staff were observed sitting and talking with people, and encouraging people who were living with dementia to engage with the activities and in conversation. We spoke to four relatives who told us they were always made welcome and encouraged to maintain contact with the person living in he home. This means that people were able to keep in touch with friends and family who were important to them. People were able to make choices and staff were able to tell us the steps they took on a daily basis to promote this,people had a choice at mealtimes, where to spend their day ,what activities to get involved in. Where choice was restricted or limited the reasons for this were recorded in peoples plan of care detailing any risk and the action Care Homes for Older People Page 16 of 26 Evidence: to be taken to protect people from harm. This showed that people were able to exercise choice over their lives with support and guidance from staff. People told us they were happy with the food provided. There was always a choice, food was presented in an appealing manner it was always hot and there was always enough to eat and drink. They added that drinks and snacks were offered in between meals. Nutritional assessments are carried out at the time of admission. These were seen in each of the care plans checked. Records were kept of peoples appetite whether or not they were eating well and their weight recorded on a monthly basis. Observations were made of lunch,people were given a choice, people who needed assistance was offered this in a dignified manner, the meal was not rushed the dining tables and the food was well presented and people were relaxed and enjoyed their mealtime experience. Care Homes for Older People Page 17 of 26 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. Complaints were taken seriously and people were protected from harm or abuse. Evidence: The manager told us the home had received no complaints since the last inspection. There was a complaints file which contained previous complaints. The information included details of the compliant,the outcome of the investigation and a response to the complainant. People told us they knew how to make a complaint and had someone to talk to is they were unhappy. This showed that complaints were taken seriously and action taken. Since the last inspection there has been one safeguarding referral regarding the lack of supervision of a person resulting in injury. Since this incident the staff provide closer supervision of people and have more awareness of the risk related to individuals. All staff have received training on safeguarding people and were able to tell us how on a daily basis they protected people from harm or abuse. People told us they felt safe and trusted the staff. Care Homes for Older People Page 18 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. the home was well maintained clean and hygienic. Evidence: The home was well maintained the staff told us many of the areas had been recently decorated. Peoples bedrooms were personalised and homely with personal possessions displayed. The corridor walls were made interesting and stimulating with pictures. Bedroom doors were different colors letter boxes and numbers. Carpets, curtains,furniture and soft furnishings were in good condition. The flooring in the lift on the EMI unit was uneven and could cause trips. The home was clean and on the day of the visit there were no offensive odour although the staff told us, keeping some areas free of odour was at times a challenge. Care Homes for Older People Page 19 of 26 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. There are enough trained and competent staff and the recruitment procedures protect people from harm. Evidence: The rotas showed that the staffing levels assessed as necessary were being maintained. The staff told us that in the main they felt there was always enough staff on duty. They added however that during periods when people were ill and needed extra care they would benefit from one extra staff member. People told us that staff were always there when they needed them on the day of the visit staff were available and spent quality time with people talking ,listening and offering reassurance. Staff told us they worked well as a team and felt they provided a good service. This showed there were enough staff employed to meet peoples needs. The manager told us the majority of staff were trained to national vocational level 2 in care. This shows that staff have the skills and knowledge to support and care for people appropriately. The recruitment procedures are robust. The staff files checked showed that appropriate checks were made including work history, references, criminal record, Care Homes for Older People Page 20 of 26 Evidence: identification and qualifications. All applicants are interviewed and there was evidence that gaps in employment history and other questions about previous conduct was checked before people were employed. This showed that people were protected by the homes recruitment procedures. There was one persons file which did not contain a recent photograph. The records showed that staff received regular training. Staff told us they were able to identify training they felt they needed. Since the last inspection staff training has included,health and safety ,safe handling of medication,dementia training,managing challenging behavior and Protection of vulnerable adults. This shows that staff are trained and competent to do their job. Care Homes for Older People Page 21 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed run in the best interest of the people using the service and there are procedures to promote the health, safety and welfare of people. Evidence: The home is well managed,staff and people using the service spoke positively about the manager and told us she was approachable and encouraged good working relationships. The manager carries out audits on different areas of the service on a three month rolling programme. Records were seen of these audits which showed areas meeting the standards and where areas could be improved. The manager told us that the home does not manage peoples monies. People are invoiced for all expenditure and next of kin manage finances. Observations were made of good practice regarding health and safety. Staff told us they had received training and were provided with the equipment needed to carry out Care Homes for Older People Page 22 of 26 Evidence: their job safely. Accidents were appropriately recorded and monitored by the manager. A fire risk assessment was completed checks were made on the fire system and staff received training to make sure they knew what to do in the event of a fire. The records showed that equipment and services were serviced regularly. This made sure that the health safety and welfare of people using the service and the staff was promoted and protected. Care Homes for Older People Page 23 of 26 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 24 of 26 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 1 19 13 The floor covering in the lift must be repaired or replaced. To reduce the risk of trips or falls 20/02/2009 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 1 7 Care plans and daily recordings should be used to inform the monthly review of the care plans. This will make sure that changes in peoples needs or identified. Care Homes for Older People Page 25 of 26 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). 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