Inspection on 20/03/06 for The White House, Falmouth

This inspection was carried out on 20th 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The White House, Falmouth 12/03/09

The White House, Falmouth 25/03/08

The White House, Falmouth 11/10/07

The White House, Falmouth 06/06/07

The White House, Falmouth 23/08/06

The White House, Falmouth 04/01/06

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE The White House The White House 128 Dracaena Avenue Falmouth Cornwall TR11 2ER Lead Inspector Ian Wright Announced Inspection 20th March 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The White House DS0000065484.V279033.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 DS0000065484.V279033.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The White House Address The White House 128 Dracaena Avenue Falmouth Cornwall TR11 2ER 01326 318318 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) Mrs Helen Judith Christopher Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places The White House DS0000065484.V279033.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th January 2006 Brief Description of the Service: The White House is a care home for 17 elderly service users situated in Falmouth. All service users have their own bedrooms, and there is a large lounge / dining room for service users. The home has small gardens at the front and rear, and suitable parking for staff and visitors. Mrs Christopher has just become the new owner on 15th December 2005. The ground floor is wheelchair accessible. There is a chairlift to the first floor. The White House DS0000065484.V279033.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over five hours. The ownership of the home changed on 15th December 2005. The inspector met with Mrs Christopher, (Registered Provider), and discussed the changes she has made since she has acquired the home. The inspector also was able to meet many of the service users, and several care staff. The inspection was based around requirements set at the last inspection, which was completed in January 2006. The building, care and staff records were inspected. What the service does well: What has improved since the last inspection? What they could do better: Facilities, furniture and fittings need upgrading. The registered provider recognises this, and it is appreciated this process will take time as financial resources become available. The registered provider needs to investigate whether service users receive a genuine choice regarding when they have their breakfast. Some service users The White House DS0000065484.V279033.R01.S.doc Version 5.1 Page 6 said they were being served their breakfast at six am, when they would have preferred it later. Staff training, and staff personnel files need improving to enable service users to be assured they are in safe hands. Information available to service users e.g. statement of terms and conditions of residency and a service user guide, need to be provided so service users are aware of their rights and responsibilities. Although health and safety precautions are generally satisfactory, health and safety risk assessment procedures need to be introduced so service users can be assured they live in a safe environment. Although this is an extensive list of issues that need improvement, the Commission for Social Care Inspection is pleased by the progress Mrs Christopher has made since taking over the ownership of the home, and it is hoped the pace of improvement continues. 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 DS0000065484.V279033.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 DS0000065484.V279033.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): 1,2 The registered provider needs to make available her statement of purpose / service user guide, so service users have suitable information regarding services at The White House. The registered provider must issue a contact / statement of terms and conditions of residency to service users. EVIDENCE: The registered provider has supplied a statement of purpose to the Commission and this has been agreed as satisfactory. The registered provider must produce a new service user guide. The service user guide must be issued to individual service users. The statement of purpose and service user guide must be available for inspection. A suitable contact / statement of terms and conditions of residency was inspected. However this information needs to be issued to all service users. The White House DS0000065484.V279033.R01.S.doc Version 5.1 Page 9 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, 9, 11 The registered provider is currently developing a suitable care planning system to help ensure service users’ care needs are met. This must be finalised and fully implemented. Medication procedures and practices are satisfactory to ensure service users medication is managed safely. The registered provider has developed a suitable policy regarding the care of service users who are dying. EVIDENCE: The registered provider has developed a new care planning system and currently six service users have a new care plan. These care plans are comprehensive. They enable staff to know service user needs and how these needs should be addressed. These care plans must be developed for all service users, and reviewed regularly. Service users should be involved in the process. The medication system was inspected and is satisfactory. Administration records appear to be accurate. Staff have received suitable training regarding the handling of medication. There is evidence the pharmacist inspects the medication system. A suitable policy and procedure regarding the care of the dying was inspected. The White House DS0000065484.V279033.R01.S.doc Version 5.1 Page 10 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): 12, 13, 14, 15 Suitable activities and opportunities for religious observation are available to service users if they wish to participate in these. Service users are able to receive visitors when they wish. Information regarding advocacy services needs to be made available to service users, for example, in the service user guide. Where necessary, service users monies are looked after appropriately. Meals are provided to a satisfactory standard, however breakfast times need to be flexible. EVIDENCE: The registered provider said she has begun to develop day activity opportunities for service users. For example a musician visits the home monthly. Staff also carry out activities with service users each afternoon such as bingo and beauty therapy. The registered provider outlined opportunities for service users to attend church services. For example service users have recently visited the Baptist church, and Communion takes place each week. Activities are optional and service users can also spend time in their own bedrooms if they wish. The inspector spoke to several service users who all said they really enjoyed the new activities, which are available, particularly the bingo and entertainer. Service users have the opportunity to receive visitors when they wish. The inspector met two relatives who both said they were encouraged by the changes the new registered provider is making. Information regarding The White House DS0000065484.V279033.R01.S.doc Version 5.1 Page 11 advocacy services e.g. age concern needs to be included within the service user guide. Some moneys are held on behalf of service users. The inspector checked the amounts stored, and these were correct. Suitable records are maintained and receipts maintained if expenditure is made on behalf of service users. Service users are able to bring their own possessions to the home. For example some service users have their own furniture in their bedrooms. Some service users said breakfast was served at six in the morning. The registered provider said she did not know if this was the case, but if this was not service users’ choice, the situation was not acceptable. Breakfast must be available at a suitable time for service users and they must be given a choice when this is offered. The inspector shared a meal with service users, and this was satisfactory. The registered provider said a choice of meal is available and special diets are catered for. Staff provided service users with suitable support during the mealtime. The White House DS0000065484.V279033.R01.S.doc Version 5.1 Page 12 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): 18 The registered provider has developed a suitable adult protection policy, which is effectively implemented. EVIDENCE: A suitable adult protection policy was inspected and this is effectively implemented. The registered provider said all staff have a Criminal Records Bureau check, and where appropriate, a Protection of Vulnerable Adults check. Four staff will be completing adult protection training shortly. The White House DS0000065484.V279033.R01.S.doc Version 5.1 Page 13 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): 19, 26 The building is suitable for it’s purpose, and provides a satisfactory environment. However office facilities must be developed to improve confidentiality. Bathroom / toilet facilities, decorations, and fixtures and fittings, are becoming noticeably shabby. These will require replacement / refurbishment at some stage in the foreseeable future. EVIDENCE: The building was inspected. The inspector was able to look at several service users’ bedrooms. Service users said they were happy with the accommodation provided and it met their needs. Service users share a large lounge / dining room where the majority of service users spend their time. One area of the carpet in the lounge is badly frayed at a join. This needs attention as there is currently a potential trip hazard. Carpets, curtains, furniture, fixtures and fittings are becoming shabby and will need to be replaced over the next few years. The registered provider is aware of this. The registered provider said all bedrooms would be upgraded as they became vacant. This process has commenced. The White House DS0000065484.V279033.R01.S.doc Version 5.1 Page 14 There are several bathrooms / toilets. Bathrooms are dated, and offer only limited accessibility for people with mobility problems. They will need upgrading in the next few years. The provision of an assisted bath would be an improvement. However a walk in shower facility is provided, although the registered provider said she would be improving this. A bidet in one bathroom is covered over with cardboard, which looks unsightly. It should be repaired or removed. Some aids and adaptations are provided for example grab rails in bathrooms and toilets, two hoists, a turntable and handling belts. The upstairs of the home is accessible via a chair lift. The home currently does not have an office. However the registered provider has said she will enclose the current administrative area shortly. Bedrooms are decorated according to individual tastes, and service users are able bring in their personal possessions to the home. All bedrooms can be locked from the inside. Heating and lighting are suitable. The home was clean and free from offensive odours throughout, on the day of the inspection. The White House DS0000065484.V279033.R01.S.doc Version 5.1 Page 15 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): 27, 29, 30 Staffing levels appear to be satisfactory. Staff recruitment / personnel files, and staff training, need to be improved to meet regulatory requirements. EVIDENCE: The registered provider said two staff are always on duty at any one time. At night there is one waking night member of staff, and one member of staff sleeps in. Rotas were available for inspection and demonstrate satisfactory staffing levels are provided. The registered provider has developed a comprehensive induction checklist for new staff. However this has not yet been used, as there has not been a need to recruit new staff. The registered provider is in the process of improving staff records, and training provision. The registered provider said four staff are currently in the process of completing a National Vocational Qualification (NVQ) in care at level 2. Three staff will also be commencing NVQ level 3 and one at level 4. The registered provider said she is qualified to train staff in various skills. She said over the next six months she will be arranging staff training in fire prevention, manual handling, infection control, first aid, health and safety and food hygiene. If the registered provider provides the training herself, she must be able to demonstrate to the Commission she has satisfactory skills e.g. certificates of competence as a trainer. These need to be regularly updated. She must produce a copy of individual training programmes for each course. The White House DS0000065484.V279033.R01.S.doc Version 5.1 Page 16 As necessary she must agree with other regulatory authorities the training she intends to provide meets legal requirements. There needs to be evidence that individual staff have attended the training. Although staff files were not inspected on this occasion, the registered provider assured the inspector that all staff have a Criminal Records Bureau check, and a Protection of Vulnerable Adults check (where necessary). The White House DS0000065484.V279033.R01.S.doc Version 5.1 Page 17 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, 38 The registered provider has appropriate skills, knowledge, ethos and experience to manage the home. A suitable quality assurance system is in place. An updated copy of the registered provider’s business plan must be provided to the Commission. Health and safety precautions are generally satisfactory, although there needs to be a suitable process of health and safety risk assessment in place. EVIDENCE: Mrs Christopher has owned the White House since December 2005. She has begun to make positive changes to improve the care home. The registered provider displays a positive attitude to developing the home, and towards ensuring service users receive a good quality service. Staff and service users spoke positively regarding the change of ownership. Residents meetings and staff meetings have taken place. Effort has been made to ascertain staff and service users views regarding what changes are required. Staff and service users spoke positively about some changes which have taken The White House DS0000065484.V279033.R01.S.doc Version 5.1 Page 18 place, for example, an increased service user focus and attempts to improve choice e.g. regarding food. The registered provider has a satisfactory quality assurance system in place. The registered provider has completed a service satisfaction survey to ascertain the views of staff, service users, relatives and other stakeholders regarding the service. The results of this are subsequently being used to help guide improvements to the service. A suitable business plan was provided to the Commission as part of Mrs Christopher’s application to become registered provider. This is currently being redrafted as the registered provider wishes to fund further improvements. A copy of the new business plan must be forwarded to the Commission when completed. Information regarding health and safety precautions was inspected. Satisfactory records regarding testing of portable electrical appliances, the electrical hardwire circuit, gas appliances and the fire system were inspected There is evidence the stair lift has been serviced. Health and safety risk assessments (outlining, where appropriate, control measures in place) need to be developed. This must include a risk assessment for the prevention of Legionella.) The White House DS0000065484.V279033.R01.S.doc Version 5.1 Page 19 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 2 2 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 3 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 2 X X X 2 The White House DS0000065484.V279033.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP1 Regulation 4, 5, 6 Requirement The registered provider must produce a new service user guide. This should include information regarding advocacy services e.g. age concern. The service user guide must be issued to individual service users. The statement of purpose and service user guide must be available for inspection. Service users must be issued with a copy of a statement of terms and conditions of residency / contract (e.g. as part of the service user guide). This information must also be made available for inspection. The registered provider is required to provide care plans which are more comprehensive. These must include: • the service users likes / dislikes. • a brief ‘pen picture’ of the service user’s life. Care plans must be reviewed regularly, and service users should be involved in the process. DS0000065484.V279033.R01.S.doc Timescale for action 01/07/06 2 OP2 5 01/07/06 3 OP7 15 01/07/06 The White House Version 5.1 Page 21 4 OP12 16 The registered provider needs to investigate current practices regarding when breakfast is served. Breakfast must be available at a suitable time for service users and they must be given a choice when this is offered. 01/05/06 5 OP19 16, 23 6 7 OP19 OP30 8 The lounge carpet is frayed in one area on the join. The registered provider must attend to this as it currently presents a trip hazard. 17, 23 The registered provider must provide an office facility for staff. 13, 14, 18 Staff must receive appropriate training as required by regulation (e.g. fire, first aid, moving and handling, infection control and food hygiene) so they can meet service users needs. 18, 19 Suitable recruitment / personnel records and training records, must be maintained, and kept up to date for each individual member of staff. Records must be available for inspection. 25, 41 13, 23 01/05/06 01/09/06 01/09/06 01/09/06 9 10 OP34 OP38 A copy of the business plan must 01/05/06 be forwarded to the Commission. The registered provider must 01/07/06 develop a suitable process of health and safety risk assessment. This must include, where appropriate, what control measures are in place. A risk assessment must include measures taken regarding the prevention of Legionella The White House DS0000065484.V279033.R01.S.doc Version 5.1 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The White House DS0000065484.V279033.R01.S.doc Version 5.1 Page 23 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. 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