Inspection on 15/05/07 for Whitby House Nursing Home

This inspection was carried out on 15th May 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

Whitby House Nursing Home 22/12/05

Whitby House Nursing Home 11/08/05

Whitby House Nursing Home 22/12/04

Whitby House Nursing Home 17/06/04

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

CARE HOMES FOR OLDER PEOPLE Whitby House Nursing Home 99 Pooltown Road Whitby Ellesmere Port Cheshire CH65 7AE Lead Inspector A Gillian Matthewson Unannounced Inspection 15th May 2007 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 Whitby House Nursing Home DS0000018820.V327927.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. Whitby House Nursing Home DS0000018820.V327927.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Whitby House Nursing Home Address 99 Pooltown Road Whitby Ellesmere Port Cheshire CH65 7AE 0151 3571007 0151 3568679 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) Ashbourne Homes Limited Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Whitby House Nursing Home DS0000018820.V327927.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 40 service users to include: Up to 40 service users in the category of OP (old age not falling within any other category). The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidance which may be issued through the Commission for Social Care Inspection. 22nd December 2005 * 2. 3. Date of last inspection Brief Description of the Service: Whitby House is a care home providing nursing care and/or personal care for up to 40 older people. The home is a purpose built, two-storey building set in its own grounds in the Whitby area of Ellesmere Port. It is close to local amenities and is convenient for the local bus service. There is parking space at the front of the building and a garden to the rear. Bedrooms are on both floors. There are 34 single rooms and three double rooms. All bedrooms have washbasins and nurse call points. There are no ensuite facilities. Day space consists of a lounge and a separate dining room on the ground floor and a lounge with combined dining room on the first floor. A passenger lift and a staircase provide access to the first floor. Fees range from £343.34 to £626.00 per week, depending on the level of care required. Whitby House Nursing Home DS0000018820.V327927.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit took place on 15th May 2007 and lasted seven hours. This visit was just one part of the inspection. Before the visit the home manager was asked to complete a questionnaire to provide up to date information about services in the home. Questionnaires were also made available for residents, families and health and social care professionals to find out their views. Other information received since the last key inspection was also reviewed. During the visit various records and the premises were looked at. A number of residents and staff were also spoken with and they gave their views about the service. What the service does well: All new residents receive a comprehensive needs assessment before admission, undertaken by a senior member of staff. Information is gathered from relevant professionals, the resident and their family. This is to ensure that the home can meet the resident’s needs. Residents receive effective personal and healthcare support using a person centred approach. Residents’ individual plans clearly record their needs and detail how they will be met. Staff respond sensitively in situations involving personal care, ensuring that it is conducted in privacy. Medicines are well managed. Meals are well balanced and nutritional and cater for varying dietary needs. The ethos of the home is that it welcomes complaints and suggestions, using them positively to learn from them. All staff are trained in safeguarding adults and know how to respond in the event of an allegation of abuse. The home is clean and well maintained. Good recruitment practices are followed, which have the needs of the residents at their core. Management prioritise training and facilitate staff members to undertake appropriate qualifications to ensure they can provide a good standard of care to the residents. Residents have confidence in the staff that care for them. Whitby House Nursing Home DS0000018820.V327927.R01.S.doc Version 5.2 Page 6 The home is well managed and there is a good standard of record keeping. What has improved since the last inspection? 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. Whitby House Nursing Home DS0000018820.V327927.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 Whitby House Nursing Home DS0000018820.V327927.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): 3. (Standard 6 is not applicable because the home does not provide intermediate care). Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All prospective residents are visited and assessed by a senior member of staff from the home prior to admission to ensure that the home can meet their needs. EVIDENCE: All prospective residents are visited and assessed by a senior member of staff from the home before a place is offered. The member of staff completes a preadmission assessment document, which allows a draft care plan to be drawn up before admission. Whitby House Nursing Home DS0000018820.V327927.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of Dignity in Care are put into practice. EVIDENCE: A sample of care plans for residents receiving nursing care were inspected. All had been well completed and kept up to date. The care plans were reviewed monthly by the named nurse and review meetings were held three monthly with the home manager, the care manager and the resident’s representative. Whitby House Nursing Home DS0000018820.V327927.R01.S.doc Version 5.2 Page 10 The home has a weekly visit from the nursing homes’ doctor, and the nurses who work alongside the doctor provide support with tissue viability and with prescriptions for dressings. At the time of this inspection two residents had a pressure sore. Wound assessments and treatment were recorded in their care plans and appropriate aids and equipment were provided. District nurses provide a nursing service for residents receiving personal care at the home. There was evidence that residents have access to all health services in the community. Those whose care plans were reviewed had been seen by various health care professionals including GP, tissue viability nurse specialist, continence adviser, optician and dietician. Two GPs completed comment cards saying they were satisfied with the overall care provided to their patients. Policies and procedures, including a full risk assessment, are available for staff to implement for any resident who wishes to self-medicate. Policies and procedures are in place for the ordering, storage, administration and disposal of medicines. The home uses a monitored dosage system. Repeat prescriptions are all checked at the home before being sent to the pharmacy. Administration records were completed in full. A contract is in place for the disposal of unused medicines. Medicines for residents receiving nursing care are handled only by registered nurses. Senior care staff have responsibility for medicines for residents receiving personal care, under the supervision of the home’s care manager. There was evidence that staff had received medication training from the care manager and an assessment of their competency to carry out the task. The local NHS Primary Care Trust had carried out an audit of the home’s medication arrangements in September 2006 and was satisfied with them. Those residents the inspector spoke to on the day of the visit said that staff responded appropriately and sensitively to their personal care needs and ensured that their privacy and dignity were maintained. Whitby House Nursing Home DS0000018820.V327927.R01.S.doc Version 5.2 Page 11 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): 12, 13, 14, 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who live in the home are able to make choices about their activities of daily living, but have limited opportunities to fulfil their social and recreational needs. EVIDENCE: Residents are able to make choices in relation to activities of daily living. For example, they can choose when to get up and when to go to bed and whether they want to stay in their room or mix with other residents in the lounge or dining room. Whitby House Nursing Home DS0000018820.V327927.R01.S.doc Version 5.2 Page 12 Residents’ life histories and their social and recreational interests are recorded soon after admission. However, they are provided with limited opportunities to take part in social and recreational activities. Relatives who completed surveys before the inspection said there was a lack of leisure activities for residents to participate in. The manager was aware that this was a problem, and said it was due to the fact that there had not been a permanent activity coordinator in post since last summer. However, on the day of the inspection an individual attended for a second interview for the post and was employed. The manager had met with relatives in March to ask for suggestions for social activities and to see whether any relatives would like to be involved in assisting with providing them. There was no activity programme in place but some activities were being provided. These included bingo and musical entertainment. On the afternoon of the inspection some residents were enjoying singing along to songs from the 40s. One relative commented “it would be nice to hear of a priest or vicar calling at the home from time to time”. The manager said this used to happen but was no longer the case. There are no restrictions on visiting and a number of visitors were present in the home during the inspection. Residents may see visitors in the lounge or in their own room. Residents are able to bring personal belongings into the home and there was evidence of this in their bedrooms. Residents spoken with were all satisfied with the meals provided and said that they were offered variety and choice. One resident said that staff knew her likes and dislikes and made sure she wasn’t given anything she didn’t like. The manager and chef were in the process of implementing a new system of analysing menus to ensure the nutritional content was satisfactory. Whitby House Nursing Home DS0000018820.V327927.R01.S.doc Version 5.2 Page 13 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): 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their representatives are able to express any concerns and know they will be acted upon. Residents are protected from abuse. EVIDENCE: There are appropriate policies and procedures for dealing with complaints. These are displayed in the reception area of the home and complaints forms are available for anyone who wishes to make a complaint. Residents and relatives were aware of the complaints procedure. Four complaints had been received since the last inspection in December 2005, mostly in relation to shortfalls in care provision. These had been fully investigated and addressed. All complaints had been resolved. The home also has policies and procedures for the protection of vulnerable adults. There was evidence that staff had received company training regarding abuse as part of their induction, and that this was updated regularly for all staff. Whitby House Nursing Home DS0000018820.V327927.R01.S.doc Version 5.2 Page 14 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): 19 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a home that is clean, safe and well maintained. EVIDENCE: The home was purpose built and all areas are accessible for residents. Space is limited, however an ongoing programme of redecoration has ensured that all areas are well presented. Since the last inspection an unassisted bath on the first floor has been replaced by a wheel-in shower. Some corridors have been redecorated and lounge furniture has been replaced. All areas of the home were clean, tidy and free from offensive odours. Whitby House Nursing Home DS0000018820.V327927.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff in the home are trained and skilled to support the people who live there. EVIDENCE: At all times there was a registered nurse on duty with six carers in the morning, five in the afternoon/evening and two or three at night. Staffing levels had been lower in recent months, but the manager had recruited more staff to address the shortfall. As well as registered nurses, 57 of care staff working at Whitby House have an NVQ qualification. Recruitment records for three new members of staff were inspected. Staff files were well maintained and contained the information detailed in Schedule 4 of the Care Homes Regulations, including two written references and evidence that criminal records checks had been carried out. Whitby House Nursing Home DS0000018820.V327927.R01.S.doc Version 5.2 Page 16 The files also contained a record of all training attended by staff including induction training. All new staff received induction training that met Skills for Care specifications. Records demonstrated that all care staff had received training in the following areas: Moving and handling Food Hygiene Resident Welfare Health and Safety Fire Safety Annual updates are carried out and training audits flag up if any training is overdue. Staff receive more than the minimum of three days training per year. Staff records are kept in very good order. Residents spoken with were very complimentary about the staff. One resident said “Staff are all, without exception, very good. They are all very friendly and have endless patience.” Whitby House Nursing Home DS0000018820.V327927.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Quality assurance systems ensure that the home is run in the best interests of residents. Safeguards are in place to ensure the health and safety of staff and residents. Whitby House Nursing Home DS0000018820.V327927.R01.S.doc Version 5.2 Page 18 EVIDENCE: The manager had been in post for 10 months at the time of this inspection. She has eight years experience of managing care homes and was previously registered by the Commission as the manager of a care home in Liverpool. She had submitted an application for registration with the Commission in respect of Whitby House. She has City & Guilds qualifications in Community Care Practice and Business Management in Care. She is also a qualified NVQ Assessor and has started working towards the Registered Managers’ Award (NVQ Level 4). She is not a registered nurse, but the home also employs a Care Manager who is a registered nurse and has accountability for the clinical care of all residents who need twenty four hour nursing. The inspector spoke with the home manager and the care manager regarding their respective responsibilities. Both were fully aware of what their responsibilities were, but the Care Manager’s job description did not reflect the full extent of her role. The manager said she would address this. A range of quality monitoring tools are in place over a twelve-month cycle. The manager audits: Health and Safety, Documentation, Medication, Food, Training, Housekeeping, Care, Infection Control, Facilities, Activities, Customer Care. In addition to this the operations manager carries out validation audits. Any shortfalls found result in an action plan being produced and this is reviewed as required. Regulation 26 visits are carried out by the operations manager and are reported to the Commission for Social Care Inspection. A service user survey had been conducted in February, but the results of this were not available at the time of the inspection. Most residents have a small amount of personal money in safekeeping at the home. Records were examined and found to be well maintained. Two or three residents had quite large sums of money held by the home. The manager said that the registered provider was currently in discussion with the bank and the Commission to agree a system whereby these people could receive interest on the sum held. The manager provided evidence that all plant and equipment had been serviced and maintained as required. Training records showed that staff received training in moving and handling and other health and safety topics on a regular basis. A satisfactory inspection report was received from the environmental health officer in January 2007. Whitby House Nursing Home DS0000018820.V327927.R01.S.doc Version 5.2 Page 19 Health and safety warning notices were displayed appropriately. Some residents had bedrails fitted. Risk assessments had been carried out and protective covers were in place. Whitby House Nursing Home DS0000018820.V327927.R01.S.doc Version 5.2 Page 20 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 X 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 2 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 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 X X 3 Whitby House Nursing Home DS0000018820.V327927.R01.S.doc Version 5.2 Page 21 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 OP12 Regulation 16 (2) (m&n) Requirement The registered provider must consult with the people who live in the home about their social and spiritual needs and make sure there is a programme of activities to meet those needs. Timescale for action 31/07/07 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 Whitby House Nursing Home DS0000018820.V327927.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Whitby House Nursing Home DS0000018820.V327927.R01.S.doc Version 5.2 Page 23 - 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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