Inspection on 16/01/07 for The White House Residential Home

This inspection was carried out on 16th January 2007.

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

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

Other inspections for this house

The White House Residential Home 30/11/05

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE The White House Residential Home Ashmans Road Beccles Suffolk NR34 9NS Lead Inspector Iain Smith Unannounced Inspection 16th January 2007 09:00 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 Residential Home DS0000065171.V323703.R01.S.doc Version 5.2 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 Residential Home DS0000065171.V323703.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The White House Residential Home Address Ashmans Road Beccles Suffolk NR34 9NS 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) 01502 717683 01502 716333 Healthcare Homes Limited Mr Terry Mason Care Home 33 Category(ies) of Dementia - over 65 years of age (2), Old age, registration, with number not falling within any other category (33) of places The White House Residential Home DS0000065171.V323703.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. One named person over the age of 65 with the diagnosis of dementia DE,E as per application dated 5/1/06. To offer care and accommodation to two named older persons with the diagnosis of dementia as per applications dated 5.1.06 and 9.10.06. 30th November 2005 Date of last inspection Brief Description of the Service: The White House is situated in a quiet residential area of Beccles but within close proximity of the shopping centre and railway station. The home has been registered since 1987 and is currently owned by Healthcare Homes. The White House is set in its own grounds. The main house is a Victorian building, which has been purpose extended and adapted to provide comfortable and good quality accommodation for up to 33 older people. The accommodation comprises twenty-one single and six double bedrooms, the majority of which have an en-suite toilet and wash hand basin. Communal areas, which include two lounges, a dining room and a conservatory, are located on the ground floor and toilet and bathroom facilities are available on both floors. The Registered Manager is responsible for the day-to-day running of the home and is assisted by a senior staff team including a deputy manager, senior care assistants and care assistants. Ancillary staff includes a cook, kitchen assistant, domestic and laundry staff. The White House Residential Home DS0000065171.V323703.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is based on the pre arranged key inspection of the care home and has been written using information gathered prior to and during the inspection. The core standards were assessed on this occasion, in addition to standard one.The home provided a completed pre inspection questionnaire. The inspection took place on Tuesday 16th January 2007 and lasted 5 hours. The registered manager Terry Mason was present throughout the inspection. The inspection included examining two care plans, two personal files, interviewing staff including the deputy manager and two senior carers. Several service users were spoken to during the inspection and some of the comments are included in the report. What the service does well: What has improved since the last inspection? The opportunities for staff training and development has improved and the deputy manager has been charged with the responsibility to arrange and ensure that all staff attend the events that are organised, both in the home and externally in the company. The appointment of a dedicated activities organiser for the home has given the service users the opportunity to be involved and pursue their interests and particularly as the person is not involved in the direct care of the users. The introduction of new care plans by Healthcare Homes has given the staff the opportunity to review the assessment process and risk assessments and then to plan the appropriate care for each service user. There has been significant improvements in the redecoration and refurbishment programme both internally and externally. The White House Residential Home DS0000065171.V323703.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The White House Residential Home DS0000065171.V323703.R01.S.doc Version 5.2 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 Residential Home DS0000065171.V323703.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 1 and 3 were assessed with standard 6 not relevant to this care home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and their relatives can expect to be provided with information relevant to the home. The service users needs assessment are completed prior to them being admitted to the home to ensure their care needs can be met. EVIDENCE: The statement of purpose was assessed and there was relevant information included. The home stated that they provide long term care and respite care for 33 service users. The document included one named person with the diagnosis of Dementia. The White House has produced a colour brochure giving prospective service users information about the home, activities and those directors who are responsible for Healthcare Homes, the organisation who owns the home. The care needs of each of the service users were assessed prior to their admission to the home. There was evidence in the two care plans that a senior The White House Residential Home DS0000065171.V323703.R01.S.doc Version 5.2 Page 9 member of the care home had visited the prospective service users prior to their admission to the home. One service user stated that nobody had been to see them however; the care plan included an assessment. The assessment identified the personal information and care needs of the service user, including the reason for the admission. In addition there were pre admission assessments from a social worker and a Consultant Geriatrician. The White House Residential Home DS0000065171.V323703.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7,8, 9 and 10 were inspected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each service user can expect a care plan identifying their care needs, preferences and personal goals. Service user’s health care needs are met ensuring they receive the appropriate care. Medication policies and practices protect the service users and their privacy and dignity is respected. EVIDENCE: Two service users care plans were examined. The home has recently introduced new care planning and this includes a comprehensive assessment of each persons needs. One service user stated ‘I can do what I like, I sit on my own and read the papers’. The home evidenced that they promote service users health. Examples were included in the care plan with nutritional assessments, pressure sore prevention assessments and service user having access to a GP. The medication policy was examined. This was assessed as appropriate for a care home. The lunchtime medication round was observed with a senior carer The White House Residential Home DS0000065171.V323703.R01.S.doc Version 5.2 Page 11 having the responsibility for the administration. The medicine trolley was placed in a convenient area of the home to ensure that the carer did not have to leave the trolley unattended, if so, the trolley was seen to be locked during the administration of the service users medication. The senior carer demonstrated that the Medication Administration Records (MAR) were read and the medicines selected and administered to the service user prior to the signature on the record. There was evidence at the front of the MAR sheets of a list of signatures of staff that were permitted to administer the medication. There was evidence that these staff had received appropriate medication training. One senior carer stated ‘only staff who have been trained undertakes the medication’. There were a number of examples that service users were being treated with respect and their right to privacy was upheld. One carer was observed to ask a service user ‘how are you today Mrs B and another stated ‘ I choose to sit in my room as I do not like to mix and have my meals and I am quite satisfied’. Two carers were seen to knock on doors before entering the bedroom. Two service users stated that they were able to choose their own clothes in the morning. The White House Residential Home DS0000065171.V323703.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14 and 15 were inspected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can expect their lifestyle in the home to match their expectations and maintain contact with their family and friends. Meals and mealtimes are offered to service users in a flexible way and are given the choice prior to each meal. EVIDENCE: The manager confirmed that an activities person had been appointed for the home. There was evidence of an activities programme displayed in the home, this included word games, crafts and one to one discussion with the service users. One service user stated ‘I sit and read the Peoples Friend magazine and can join in with the activities.’ The activities person was seen arranging a word search game for the service users on the afternoon of the inspection. They stated ‘I organise the activities and do not get involved with caring as I am employed to plan, organise and do the activities’.They also said ‘some service users have made a design for their own place mat’. The White House Herald was the newsletter the staff produce to inform service users of the events that are arranged, interesting facts and monthly activities programme. There were two events arranged for the service users wishing to attend a religious service or event, one was the Holy Communion and the other was a Songs of Praise. The White House Residential Home DS0000065171.V323703.R01.S.doc Version 5.2 Page 13 Service user were able to maintain contact with their families and one service user stated ‘my friend comes to see me’ and another stated ‘ I can invite people in my room who I wish to see.’ The manager stated that the home does not administer service users monies and their families are informed of this. The statement of purpose states the range of fees and the service the users are expected to fund for example hairdressing and clothes. The home offers flexibility when they serve the service users meals. There were two dining areas, one where service users where more independent and the other where staff offered and gave assistance to the more dependent service user. One service user stated ‘I like to have my meals in my own room’. During the lunch time period staff were seen sitting with service users who required assistance with their meals. One member of staff was sitting at the same level as the service user and offering the meal in an unhurried way and the service user was given sufficient time to eat their food. The cook prepared the lunchtime meal and each meal was served in the kitchen area on a plate. The cook referred to the menu to assist them to determine the choice of each of the service users. Staff were seen to take the plates, on trays, to the service users bedrooms or to the dining rooms. Vegetables were taken in turreens to one of the dining areas and placed on the tables. This gave the service users who were in that dining room the opportunity to serve themselves with a selection of sprouts, swede and potatoes. Sausage casserole was one of the choices for lunch and omelettes were made and served as an alternative meal. The pudding choices were apple crumble, peaches and cream, jelly of ice cream. These choices were displayed on the menu that the home takes to each of the service users in the mornings. One service user stated ‘I like roast beef’ and a member of staff stated that the home were serving this meal the following weekend. The teatime menus were seen and they offered a wide range of choices to each service user. Examples included a hot choice, sandwiches and a selection from the sweet trolley. The manager stated that the home had produced a cookbook, this is offered for purchase by visitors and the public. The White House Residential Home DS0000065171.V323703.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users can expect that their complaints will be listened to, taken seriously and acted upon. The service users can expect the home to safeguard them by having the appropriate policies and staff training in place. EVIDENCE: The home complaints complaints user guide names and evidence that they had a complaints log. There had been no received since the last inspection in November 2005. The policy was available in the statement of purpose and the service and contained all relevant information to ensure that the correct address were included. The homes policy for the Protection of the Vulnerable Adult (POVA) was available and three staff stated that they had received training. The training records for staff evidenced that this training had been delivered and an additional session was arranged for March 2007. One member of staff stated ‘I do know what to do if there was an allegation of abuse in the home’. The White House Residential Home DS0000065171.V323703.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can expect the home to be suitable for their needs to be met. The appropriate health and hygiene policies and practices of the home ensure that safe control of infection procedures are operated. EVIDENCE: The manager stated that the home had been externally redecorated and stray foliage had been cleared to ensure the home presented as a well maintained building. Internally a number of projects had been completed relating to upgrading the furniture and furnishings. Examples were that three bedrooms had been redecorated, one refurbished and a carpet laid in another. The home had commenced the building of two ensuite single bedrooms in the disused day centre. This would ensure that two of the existing double rooms would be used as single rooms and the home do not propose to increase their registered service user numbers of 33. The White House Residential Home DS0000065171.V323703.R01.S.doc Version 5.2 Page 16 The home had policies and procedures to cover infection control. The policy included the safe handling and disposal of infected waste, dealing with spillages and the provision of protective clothing. The staff were seen to wear protective aprons and gloves during the inspection when they were dealing with linen and waste. The White House Residential Home DS0000065171.V323703.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27,28,29 and 30 were inspected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users can expect adequate staff to care for them and who have the appropriate qualifications and training to meet their needs. The home however has not all the appropriate documentation required to ensure the recruitment policies are followed. EVIDENCE: At the time of the inspection there were five care staff on dutyin the morning, including a senior carer who was in charge of the shift. The afternoon carers amounted to one senior and two carers and at night the rota indicated two waking carers. The support staff included three domestics, a cook and a kitchen assistant. In addition to the day staff the manager was on duty and supernumerary and a senior carer was undertaking administrative duties, including interviewing a prospective member of staff. This staffing reflected adequate numbers on duty to meet the needs of the service users and the layout of the home. Ten carers had achieved their NVQ level two or above therefore representing 50 of the total staff numbers. No agency staff work in the home. Two staff files were examined to assess if the home had followed the appropriate recruitment policies and the requirements of the national minimum standards. The files included an enhanced Criminal Records Bureau (CRB), The White House Residential Home DS0000065171.V323703.R01.S.doc Version 5.2 Page 18 contract of employment and training certificates. However there was no evidence of a photograph or proof of identity for either of the two staff whose files were examined. To ensure that staff are trained to meet the needs of the service users the deputy manager has the responsibility to arrange events both in the home and externally. The staff records were examined and found that a wide range of training had been attended for example fire safety, medication, moving and handling, abuse training and dementia care. There was evidence that additional training sessions had been scheduled, for example, food hygiene, health and safety and infection control. Two members of staff stated that’ We have a lot of training which is good’. There was a notice board displaying forthcoming events that staff could access. The White House Residential Home DS0000065171.V323703.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31,33,35 and 38 were inspected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can expect to live in the home that is well managed by a person who is fit to be in charge. The home is run in the best interests of the service users and their financial interests are safeguarded. The health, safety and welfare of the service users and staff are promoted and protected with the appropriate policies and staff training. EVIDENCE: The registered manager evidenced that he has attended a number of courses since the last inspection that has enhanced his knowledge and skills to manage the home. Examples of the training were, the completion of the Registered Managers Award (RMA). Additional training included principles of care, health and safety, medication and diabetes. A job description for the manager was seen and this was assessed as reflecting the responsibilities of the home and The White House Residential Home DS0000065171.V323703.R01.S.doc Version 5.2 Page 20 management of the staff. There are clear lines of responsibility in the home, the manager, deputy manager, senior carers and carers each have a job description. Since the last inspection the home operates within the Healthcare Homes Ltd quality assurance systems. However, the home has distributed questionnaires to service users, staff and relatives to gain their opinions and views of the service. There were no results of the survey available at the inspection as the return of the questionnaires was awaited. One service user stated the staff were ‘very nice and obliging’, and another stated ‘ the staff were kind and helpful’. The manager stated that the families would be encouraged to manage financial affairs on behalf of the service users. The home has some petty cash for incidentals for example postage. There was evidence that the manager was responsible for the cash and had receipts that were kept secure. The registered manager ensures that staff adhere to safe working practices with the deputy manager arranging appropriate training to support this. The policies and procedures are kept in the care office for all staff to read and refer to. The policies include infection control, fire safety, first aid and moving and handling. There was evidence in staff files that training related to these subjects had been attended by staff. All accidents and incidents were reported and the home had a logbook to record all such occurrences. The White House Residential Home DS0000065171.V323703.R01.S.doc Version 5.2 Page 21 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 The White House Residential Home DS0000065171.V323703.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP29 Regulation 7,9 and 19. Timescale for action The registered person must 16/02/07 ensure that all existing staff provide evidence of identity and have a photograph on file and that these are obtained at the time of future recruitment. Requirement 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 Residential Home DS0000065171.V323703.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The White House Residential Home DS0000065171.V323703.R01.S.doc Version 5.2 Page 24 - 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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