Inspection on 14/12/05 for Whitchurch House

This inspection was carried out on 14th December 2005.

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

Whitchurch House 22/07/09

Whitchurch House 27/05/09

Whitchurch House 25/11/08

Whitchurch House 27/11/06

Whitchurch House 19/05/05

Whitchurch House 25/10/04

Whitchurch House 14/04/04

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Maple Lodge

Heathlands

Aston Court Nursing Home

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Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Whitchurch House Whitchurch Ross-on-wye Herefordshire HR9 6BZ Lead Inspector Wendy Barrett Unannounced Inspection 14th December 2005 11:20 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 Whitchurch House DS0000024747.V273516.R01.S.doc Version 5.0 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. Whitchurch House DS0000024747.V273516.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Whitchurch House Address Whitchurch Ross-on-wye Herefordshire HR9 6BZ 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) 01600 890655 Mr Keith Arnold Brown Mrs Heather Mary Jones Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (29) of places Whitchurch House DS0000024747.V273516.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Conditions of Registration 1. The home may admit one named service user who has a learning disability. 2. Staff must be trained in the needs of people with a learning disability. . Date of last inspection 19th May 2005 Brief Description of the Service: The Provider is registered in respect of Whitchurch House to offer residential services to older people over the age of 65 who may be too frail to continue to live in their own homes. Some may have developed some level of physical disability so for example may need to use a walking frame, some may experience occasional confusion associated with mild memory loss.Whitchurch House is a period property which has been extended and is registered to provide accommodation for up to 29 people. There are some bedrooms on the ground floor, others at first floor level. The first floor is in two separate areas, one served by a staircase and lift, the other by another staircase and chair lift.The home is situated in attractive gardens in a rural situation within walking distance of a church and nearby park attractions. It is within the flood plain and following extensive flooding in the area three years ago, in 2002 a floodwall protection system was installed around the home. Whitchurch House DS0000024747.V273516.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place between 11.20am and 3.30pm. The home was sent a supply of questionnaires before this inspection and was asked to distribute them to residents, relatives and health care visitors. This exercise was to gain the views of other stakeholders. 23 relatives and 4 health care professionals responded. One resident feedback questionnaire was sent back. The focus of this inspection was on the key National Minimum Standards that were not scored at the last inspection. The report of the last inspection should be referenced to gain an overall view of the service. The Deputy Manager was in charge of the home at the time of the visit. The Provider was present for part of the time. The Care Manager also popped into the home. She was on a study day in respect of her Registered Manager’s Award qualification. Some records and documentation were inspected. What the service does well: What has improved since the last inspection? Whitchurch House DS0000024747.V273516.R01.S.doc Version 5.0 Page 6 Future programmes of social activities are advertised on a poster so that residents know what opportunities are coming up. Work has started on upgrading utility areas at the home. The managers at the home have worked alongside other professionals as part of an investigation following a complaint (which was not substantiated). This has given them experience of working as part of a multi agency team of professionals in protecting the vulnerable adults at the home. 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. Whitchurch House DS0000024747.V273516.R01.S.doc Version 5.0 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 Whitchurch House DS0000024747.V273516.R01.S.doc Version 5.0 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): EVIDENCE: Whitchurch House DS0000024747.V273516.R01.S.doc Version 5.0 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): 9 and 10 Systems of medication management are good and staff follow given procedures to make sure residents are protected. Relatives are able to visit residents in private and they are confident the residents are treated with respect and kindness. EVIDENCE: Arrangements for medication management were inspected with the assistance of the Deputy Manager. Policies, procedures and records of receipt, administration and disposal were seen. A sample of 3 medication regimes for specific residents was looked at in more detail. Storage facilities and the way these are used was discussed. There is a proposal to create new and improved storage arrangements in the near future. A recommendation is made to consult the Commission’s Pharmacy Inspector about this work so that advice can be given before any new arrangements are in place. This should include attention to dispensing and storage arrangements for Temazepam medication that may need review. A relatively new procedure has been adopted to strengthen security of storage i.e. Staff sign to confirm when they have handed over medication keys to a second staff member for safekeeping. Whitchurch House DS0000024747.V273516.R01.S.doc Version 5.0 Page 10 The evidence indicated a thorough recording system with good reference to specific requirements for individual residents e.g. instruction to check medication has been swallowed before leaving the resident. The information recorded allows staff to monitor stock balances. Handwritten entries are checked by a second staff member to reduce the risk of error in transcribing. Feedback from relatives reflected a high level of satisfaction with the service. Comments included – ‘she is treated with kindness, consideration and respect’, ‘so grateful for their sensitivity and understanding in caring for him’, ‘he’s happy, relaxed and being well looked after’. A relative explained that his father had recently died – ‘looked after my father with great care and kindness during the last year’. Whitchurch House DS0000024747.V273516.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 Residents are offered a variety of group activities so that there is likely to be something to suit everyone. Residents who prefer to pursue their interests more privately are also supported by staff who understand about their individual preferences. EVIDENCE: Written programmes of social activities were available at the home. The programme for December provided a variety of activities for residents to choose from. It included 4 music and movement sessions, a concert, visiting theatre company, bingo, games, Holy Communion. A care assistant showed good awareness of the personal interests and preferences of a resident when a sampled care plan was discussed with her. The above information indicates a positive response to a recommendation arising from the last inspection. Whitchurch House DS0000024747.V273516.R01.S.doc Version 5.0 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): 16 and 18 There is written information to tell people how to make a complaint. When complaints are received they are taken seriously and investigated thoroughly. Recent work undertaken by staff at the home has confirmed a commitment to the protection of residents and a willingness to work openly with other professionals to this end. EVIDENCE: There is written guidance available to residents and visitors describing how to express concerns or make a complaint about the service. Most relatives confirmed their awareness of this guidance in their feedback questionnaires. A health care professional was aware of an unsubstantiated complaint – ‘full and reasonable explanation given’. The three remaining health care professional feedbacks confirmed that no complaints had been made about the home. A Complaint register contained details of two complaints received at the home since the last inspection and action taken in response to these. The information reflected a robust approach from staff e.g. attention to heating system and provision of oil filled heater, discussion in staff meeting regarding personal care practice and letter to complainant to confirm outcome of complaint investigation. The Commission has received one complaint about the service. This was investigated under the local multi-agency strategy for adult protection and was not substantiated. A care assistant was aware of policies and procedures implemented at the home in respect of adult protection. She had attended a Whitchurch House DS0000024747.V273516.R01.S.doc Version 5.0 Page 13 training session provided by the local authority Co-ordinator of the local protocols for protection of vulnerable adults and had found this session useful. The Provider responded to a recommendation arising from the last inspection with confirmation of the home’s aim to be positive and pro-active in promoting all adult protection issues. This attitude was confirmed in the positive staff response to recent multi agency investigation. Whitchurch House DS0000024747.V273516.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 26 The home is clean and pleasant with systems in place to address hygiene issues. It is not possible to make an overall judgement of the National Minimum Standard until work on upgrading laundry facilities is completed. EVIDENCE: The home was clean and tidy with no evidence of malodour when this inspection took place. An Environmental Health Officer inspected the home in October 2005. There was evidence of the Care Manager’s attention to work identified as a result of this visit e.g. purchase of new freezer, provision of a water chlorination certificate. Utility areas, including the laundry facility are being upgraded and work had already begun when this inspection took place. The relevant National Minimum Standard (26) will be scored at a later inspection when this work is completed. Staff are supplied with disposable protective clothing and there are policies and procedures implemented to guide them in maintaining a hygienic environment e.g. cleaning rotas. Staff also receive health and safety training as part of the overall training programme. Whitchurch House DS0000024747.V273516.R01.S.doc Version 5.0 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): EVIDENCE: Key standards were inspected last time and were mostly met. The Provider has since responded to a recommendation for induction programmes to include reference to national specifications. A commitment has been made for current paperwork to be adapted to deal with this. Outcomes of this work will be reviewed at a future inspection. Whitchurch House DS0000024747.V273516.R01.S.doc Version 5.0 Page 16 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): 33 and 35 Relatives feel they are kept informed about the residents’ wellbeing and are able to contribute their views about the service provided to make sure it suits the individual. Residents or their relatives are properly encouraged to manage personal monies. When staff do help residents with this there are good records to account for transactions made on the residents’ behalf. EVIDENCE: The Care Manager has been approved for registration with the Commission since the last inspection. All relatives who sent back feedback questionnaires feel they are appropriately consulted about the care provided to the resident. A representative Power of Attorney stated ‘ I have always found the staff most helpful and caring’. Whitchurch House DS0000024747.V273516.R01.S.doc Version 5.0 Page 17 An independent advocate has recently been invited into the home to support a resident in expressing his wishes about the service he receives. There are policies and procedures implemented at the home to guide staff in their work. Arrangements for formal consultation as part of a system of quality assurance will be reviewed at a future inspection. The Care Manager and Deputy Manager act as appointees for one resident. This is a long-standing arrangement and the Deputy Manager confirmed that residents or relatives are now encouraged to undertake this responsibility. This is good practice. Arrangements for managing personal monies held in safekeeping for residents were inspected. A sample of cash balances accurately cross-referenced with written records of transactions. The records were detailed to show a clear picture of receipts and expenditures. Two staff sign the records when transactions take place so that there is good security and monitoring. Whitchurch House DS0000024747.V273516.R01.S.doc Version 5.0 Page 18 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 x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 x x x x x x x x STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x 3 x x x Whitchurch House DS0000024747.V273516.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP9 Good Practice Recommendations The Pharmacy Inspector should be consulted about storage arrangements in the proposed new facility with particular attention to satisfactory storage of temazepam medication. It would be advisable to refer to the detail of Regulation 24 and NMStandard 33 to ensure satisfactory quality monitoring systems are in place at the home. 2 OP33 Whitchurch House DS0000024747.V273516.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Hereford Office 178 Widemarsh St Hereford Herefordshire HR4 9HN 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. Extracts may not be used or reproduced without the express permission of CSCI Whitchurch House DS0000024747.V273516.R01.S.doc Version 5.0 Page 21 - 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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