Inspection on 07/11/08 for The White House Nursing Home

This inspection was carried out on 7th November 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

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Mendip House

Beaconsfield Court Care Home

Ann Charlton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The White House Nursing Home The White House Nursing Home Monkton Village Jarrow Tyne And Wear NE32 5NN     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: Suzanne McKean     Date: 0 7 1 1 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. the things that people have said are important to them: They reflect 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 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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 27 Information about the care home Name of care home: Address: The White House Nursing Home The White House Nursing Home Monkton Village Jarrow Tyne And Wear NE32 5NN 01914213242 01914213252 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Doson Limited Type of registration: Number of places registered: care home 36 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 36 The registered person may provide the following category of service only: Care Home with Nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following categories: Old Age, not falling within any other category, Code OP - maximum number of places 36 Physical Disability, Code PD - maximum number of places 2 Date of last inspection Brief description of the care home The White House is a converted building with a purpose built extension providing accomodation for thirty six residents. It has level or lift access to all parts of home occupied by residents and the corridors are spacious and offer easy movement around the home. The dining areas and lounges are spacious and well equipped. It is situated Care Homes for Older People Page 4 of 27 Over 65 36 0 0 2 Brief description of the care home in a pleasant residential area but there is access to local amenities. There is a lawned area to the rear of the building and the residents can sit outside when the weather permits. The home has recently changed owership but the magement and the staff have remained in post making the changes for the residents minimal. The home charges fees ranging between £408 and £550.80 depending upon the individual needs of the person living in the home. Care Homes for Older People Page 5 of 27 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: Summary This is an overview of what the inspector found during the inspection and how the inspection was carried out. Before the visit we looked at: Information we have received since the home was registered. How the service deals with any complaints and concerns. Any changes to how the home is run, and the providers view of how well they care for people. The views of, people who use the service and their relatives, staff and other professionals. The visit was unannounced and was made on 7th November 2008 it was completed in Care Homes for Older People Page 6 of 27 approximately six hours. During the visit we: Talked with people who use the service, relatives, staff, the manager and visitors. Looked at information about the people who use the service and how well their needs are met. Looked at other records which must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building to make sure that it was clean, safe and comfortable. Checked that improvements had been made since the last visit. We told the manager what we found. 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 27 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 27 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. Good admission assessments and information gathered before the placement makes sure that the home is prepared for the person moving in and that the person can be confident that their needs will be met. Evidence: The home uses an assessment which is designed to give the staff in the home information about the needs of the people who are considering moving into the home or staying for a short period. The tool assists the staff to find out about all of the aspects of peoples lives and needs. The manager is confident that it gives her the information she needs to make the judgment about offering a place but she is also aware that she can review the document to make sure that it continues to be useful and the best way to carry out the assessment. Care Homes for Older People Page 10 of 27 Evidence: Potential residents can visit the home and spend time in the communal areas prior to making the decision to move in but those spoken to on the day had relied on their relatives to make the choice for them. Care Homes for Older People Page 11 of 27 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 living in the home have their health and personal care needs met in a planned way and delivered in a respectful way. Ongoing improvements to the care planning will better show how this is achieved. Evidence: Each person living in the home has an individual care plan developed from the admission assessment and added to throughout their stay. These care plans show that the personal and health care needs of the residents are being met and how that is being achieved. The staff were knowledgeable about the contents of the care plans. They were able to describe the needs of the residents and were clear about how they had to record the care given and the need to report any relevant issues to senior staff. Care plans are in place for both physical needs and the social care needs of the people living in the home. Risk assessments are completed for a selection of areas including falls, nutrition and deterioration in skin condition. These were generally reviewed frequently but some were out of date for this. Some areas of the care plans were Care Homes for Older People Page 12 of 27 Evidence: varied in their level of detail, an example of this being that they did not contain sufficient detail about the equipment that should be used for moving and assisting. They say hoist but not the type of hoist or the specific sling to be used. However in other plans they were very person centered one in particularly around communication was very well completed. They were generally up to date and easy for staff to follow. The care plans are currently being changed to a new model, and the work already carried out shows that they will be further improved as a result of this. The staff have worked hard to make these changes and are continuing to make sure that this does not impact on time they are spending with the residents. Residents are supported to access NHS services and facilities as and when they need to. The care plans showed that the specialist advisors are used for individual people living in the home. The residents and their representatives are supported to take part in the review of their care. CSCI surveys returned suggested that they were happy with the care they were receiving, an example of this was the head staff and nurses are first class and always there for me. Residents were dressed for the activities they were undertaking and looked comfortable and tidy. A number of residents were positive about the care they were being given and were complementary about the staff. An example of this was that they thought it was nice living here and that the staff were lovely. Care was given in a discreet manner taking into account the individual residents previous lifestyles and the way they want to spend their time. Staff are knowledgeable about residents preferences and needs. They were being kind and polite with cheerful banter taking place throughout the day. The residents are encouraged to maintain contact with their families, friends and visitors and can use either their own rooms or the communal areas. The home manages the administration of prescribed medication appropriately. There are appropriate systems in place to arrange for the ordering of the residents medication and the records were up to date and in good order. The home has a contract for the disposal of the medication which is no longer required and the records of this were in place. Controlled drugs are managed appropriately. Specific routes of administration are followed and any omissions or changes to the way that the medications are given are recorded. Care Homes for Older People Page 13 of 27 Care Homes for Older People Page 14 of 27 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. The people living in the home are supported to live active and fulfilled lives in line with their choices, abilities and previous lifestyles. Evidence: The staff are knowledgeable about the social and recreational care needs of the people living in the home. This was shown in the care plans where there is a individual social activities sheet, and social history sheets. This was confirmed by residents. There are regular activities for the service users. One service user described some of the opportunities they had been offered and although they felt that this was enough they did not always want to take part. The social activities co-ordinator has carried out a survey of residents choices in July 2007 and is to be repeated again in the near future. There is a residents committee which includes relatives and gives them the opportunity to discuss their views and hear news about the home. The manager has also informed us that there is a residents newsletter, giving news and forthcoming events. The residents are supported to continue their religious practices and there are Care Homes for Older People Page 15 of 27 Evidence: opportunities for residents to participate in services which are appropriate to their particular faith and beliefs. Service users confirmed that they are free to join in social activities if they wish and that they are not made to join in activities if they do not want to. A relatives commented that they are aware of the activities that the staff organises for the service users. The home supports the relatives to make positive contribution to the care provided in the home. The meal time was well organised and staff were sensitive when assisting the residents with their meals. The residents were observed enjoying their meal which looked appetizing and well presented. There is a monthly catering audit carried out which looks at the documentation kept and the food being provided. Care Homes for Older People Page 16 of 27 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. There are good policies and procedures in place which are followed by the staff to make sure that complaints are dealt with effectively and that residents are safeguarding from harm. Evidence: The complaints procedure is made available to residents and relatives through the service user guide. Relatives confirmed that the staff and the manager listened to their views and opinions. The manager and the senior staff are committed to responding to any concerns raised, even those that are minor in nature. There is a good system for the management of complaints. The records of complaints were particularly well organised and identified the level of satisfaction of the complainant and the action taken in response to any investigation. There is an appropriate protection of vulnerable adults policy and staff were aware that any events which would affect the welfare of the residents must be looked at with reference to the safeguarding guidance and CSCI need to be informed. The home have been involved in safeguarding procedures in the past and the manager has participated actively in the process as necessary working well with the local authority to ensure the safety and wellbeing of the residents. Care Homes for Older People Page 17 of 27 Care Homes for Older People Page 18 of 27 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 offers accommodation which is clean and well maintained and has design features to help people of this client group and to promote their dignity, comfort and welfare. Evidence: The building is sited in a predominantly residential area in a particularly pleasant area. It has been appropriately maintained and access into and within it is good and meets the needs of those people who have mobility difficulties or have use of waling aids or wheelchairs. There are assisted bathing facilities for residents who have moving and handling needs and require assistance from staff to bath safely. All bedrooms and toilets have suitable locks on the door to ensure privacy. This provides the opportunity for residents to remain independent and to enjoy good levels of privacy. There are sufficient numbers of communal areas for people living in the home to choose from. These include a range of lounges, dining rooms and communal spaces that residents can use. The bedrooms are of varied shapes and sizes and they were well decorated, furnished Care Homes for Older People Page 19 of 27 Evidence: and were personalised to the taste of the occupant. The manager has a good understanding of Health and Safety issues and she is responsible for facilitating good practices that safeguard the people living there. It is well decorated and furnished and there was no unpleasant odours anywhere in the home. Safety checks are carried out in line with the homes policies. Ongoing improvements are planned as part of the general redecoration programme to both the communal areas and the bedroom areas. The staff are knowledgeable about control of infection procedures and were using these practices throughout the day to minimise the risk of cross infection. Care Homes for Older People Page 20 of 27 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 skilled, well trained, and competent staff employed in sufficient numbers to make sure that they can provide good care to the people living in the home. Evidence: The home maintains good staffing levels and on the day of the visit there was, the Manager, two qualified nurses and five care staff. The homes management structure gives good leadership to the nurses, carers, and domestic staff. There were sufficient numbers of domestic and catering staff on duty. These levels are appropriate for the number and dependencies of the people living in the home and to make sure that their personal and health care needs are being met. Currently there are 50 of care staff who have completed National Vocational Qualifications in care and once the staff who are undertaking the course have completed it then the number will be more than 70 . The nurses and care staff are encouraged to go on a variety of courses. They are given the necessary training to make sure that they are able to carry out their roles safely including moving and assisting, fire, control of infection, first aid and food hygiene. Staff records are kept of recruitment and selection. A sample of these were examined and found to contain the necessary information to make sure that the residents are Care Homes for Older People Page 21 of 27 Evidence: safeguarded from harm by good processes. The induction of staff is in line with current good practice guidance. Additional training is given to staff around other areas such as learning disability and medication training. During the visit ten staff were undertaking Skills for Life, Protection of Vulnerable Adults training. This is an eight week course when a trainer visits the home to support the staff to complete the training. Care Homes for Older People Page 22 of 27 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 managed in line with good health and safety practices and in the best interest of the residents, making sure that their needs are met and that the staff are supported in the roles they undertake. Evidence: The manager provides good leadership in the home and has appropriate qualifications, experience and skills to make sure that the home is managed in the best interest of the people living there. She is also a registered nurse. Staff said that they felt well supported and were able to work toward relevant qualifications and that the manager would listen to any views they had about the home. There is a quality assurance system in place, which is used to identify any necessary improvements. Residents and relatives are asked their views on the service provided through annual surveys carried out by the company. There is a residents committee and the surveys are used to elicit the views of relatives and residents. These are Care Homes for Older People Page 23 of 27 Evidence: analysed centrally with anonymous information given to the home so that they can make changes if necessary. Residents described the open door policy of the manager and that she regularly tours the home to speak with both residents and staff. Although the manager is in regular contact with the owners the requirement for them to undertake formal visits to the home to under Regulation 26 of the Care Homes Regulations 2001 is not being met. The last record of such a visit was dated 17th March 2008. The home has a system to assist residents in managing their personal finances/allowances. The individuals money is kept separately and the records are maintained well. There are receipts kept for any purchases made on behalf of the residents and there are systems in place to make sure that people in the home are provided with money for them to have the items they need. The records are audited. Care Homes for Older People Page 24 of 27 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 25 of 27 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 1 33 26 The registered provider must visit the home at least once a month and prepare a report of the visit. The proprietor must ensure by visiting that the home in run in the best interest of the residents and that they are safe and well cared for. 31/01/2009 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 should be completed in sufficient detail to show how the service users needs in respect of their health and welfare are to be met. Care Homes for Older People Page 26 of 27 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 © (2008) 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 27 of 27 - 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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