Inspection on 28/09/06 for White House Care Home, The

This inspection was carried out on 28th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

White House Care Home, The 06/01/06

White House Care Home, The 03/06/05

White House Care Home, The 10/02/05

White House Care Home, The 12/11/03

White House Care Home, The 08/08/03

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE White House Care Home, The 30 Millbourne Road Hanworth Middlesex TW13 6NQ Lead Inspector Ms Susan Woolnough-Singh Unannounced Inspection 13.50 28 September 2006 th 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 White House Care Home, The DS0000022904.V307250.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. White House Care Home, The DS0000022904.V307250.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service White House Care Home, The Address 30 Millbourne Road Hanworth Middlesex TW13 6NQ 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) 020 8384 4746 Mr Bhiwsen Nowjee Mrs Laure Nowjee Mr Bhiwsen Nowjee Care Home 3 Category(ies) of Old age, not falling within any other category registration, with number (3) of places White House Care Home, The DS0000022904.V307250.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. As agreed on 15th March 2006, one named service user with a mental health condition can be accommodated within the home. This is approved for as long as there is no deterioration of the service user that affects the wellbeing of any other person living at the home. The home must advise CSCI when the service user no longer resides at the home. As agreed on the 26th April 2006, one named service user (male) with a mental health condition can be accommodated within the home. 6th January 2006 2. Date of last inspection Brief Description of the Service: The White House is a privately run residential care home for three older people. It was originally registered in 1993. The Registered Providers are Mr. and Mrs. Nowjee. Mr. Nowjee is the Registered Manager. In addition to Mrs. Nowjee, there is one member of staff. There are two bedrooms upstairs, and one downstairs, occupied by service users. There is one bathroom with a toilet upstairs, which is used by the service users. There is an additional bathroom with a shower, and a separate toilet, available on the ground floor. Mr and Mrs Nowjee also live on the premises. The home is situated in a residential street in Hanworth. Local shops are within walking distance from the home. White House Care Home, The DS0000022904.V307250.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection of Whitehouse Care Home. The inspection commenced at 13.50 and was completed at 20.00. The Inspector spoke with the Registered Manager and the three service users: one service user was new to the home. The Inspector spoke with the three service users about their experience of the home. A tour of the building took place; records relating to service users, staff and health and safety were examined. What the service does well: 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. White House Care Home, The DS0000022904.V307250.R01.S.doc Version 5.2 Page 6 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 White House Care Home, The DS0000022904.V307250.R01.S.doc Version 5.2 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, and 6 The Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The information provided to prospective service users needs to be amended and updated. Service users who move into the home have had their care needs assessed and identified. EVIDENCE: The Inspector received a copy of the Service Users Guide. This is a brief guide. The home is small and there is little movement in the service user and staff group. The Service Users Guide needs to be amended and updated to include all of the information set out in Standard 1.2. The current Service Users Guide does not include a copy of the Complaints Procedure or information on the qualifications and experience of staff at the home. White House Care Home, The DS0000022904.V307250.R01.S.doc Version 5.2 Page 8 The Needs Led Assessment of the service user who had recently moved into the home was seen. This had been provided by the placing Local Authority and gave background information and identified areas of care needed. The home does not offer intermediate care. White House Care Home, The DS0000022904.V307250.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, and 10 The Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Records seen indicate that service users daily health and personnel care needs are met; service users also confirmed this. There is a basic system for the administration of medication in the home mainly managed by the Registered Manager. All staff must have training in safe administration. EVIDENCE: All of the service users have a care plan the Inspector saw these. The care plan is brief but contains the relevant information on daily care, physical and social needs. A review for the new service user had taken place. There was a record on the service user plans of dates service users had seen health care professionals. Two service users who where spoken with said that their care needs were being met, one service users was unable to give his verbal opinion White House Care Home, The DS0000022904.V307250.R01.S.doc Version 5.2 Page 10 to the Inspector. Daily notes are completed for each service user, this is done by the Registered Manager/Provider. There has been no change to the system of medication administration since the last inspection. The Registered Manager/Provider is generally responsible for this. A part time member of staff administers medication when the Registered Manager is not on the premises. Services users are registered with a local General Practitioner who is responsible for repeat prescriptions. The Inspector did not see any evidence that staff had received training in the safe handling of medication. Two services users spoken with commented that they were satisfied with their care at Whitehouse Care Home. One service user raised an issue with the Inspector about an aspect of his care, which was relayed back to the Registered Provider after the inspection. White House Care Home, The DS0000022904.V307250.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 The Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users appeared to be satisfied with the care offered in the home. Service users are given the opportunity to go out most days with the Registered Provider and are generally included in the daily routines of the home. Service users receive a varied menu although there is room for improvement to the selection of puddings offered. EVIDENCE: The Inspector looked at notes relating to activities and spoke with service users who said that they went out to the shops with the Registered Manager and sometimes to a local pub. The records seen confirmed this. One service user is involved with some minor household tasks such as cleaning and laundry. One service user has regular contact with a relative. Service users indicated that they were reasonably satisfied with their daily lives and routines. White House Care Home, The DS0000022904.V307250.R01.S.doc Version 5.2 Page 12 A menu is available of mainly traditional British Dishes; there is an alternative if this is requested. One service user likes an authentic curry, which he said he had had that day. The care staff in the home cook meals and a record is made of meals taken by service users. Service users indicated that they were pleased with the food provided. The Inspector was of the opinion that the variety of puddings/sweets should be improved, as yogurt is a very regular feature on the menu. Hounslow Environmental Health department have provided the home with a self-assessment folder. This is used for monitoring safety in the kitchen, and also provides information on good practice. White House Care Home, The DS0000022904.V307250.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 The Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A complaints procedure is available; the home must make this more readily accessible to all service users. A Whistle Blowing Procedure is available for the guidance of staff. The home needs to evidence Protection of Vulnerable Adults Training undertaken by staff. EVIDENCE: A complaints procedure is available but this is not contained in the Service Users Guide. The Inspector was advised that a relative of the new service user had been given a copy of the complaints procedure. No complaints had been received since the last inspection. A Whistle Blowing Policy is available this was seen and is kept in the Staff Policy file. The Inspector was advised that staff have received training in Protection of Vulnerable Adults. (Please refer to standard 30 Staff Training) The protection of service users finances was discussed with the Registered Manager. Service users personal allowances are managed either by family or the service user with some staff assistance. White House Care Home, The DS0000022904.V307250.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 The Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A well-maintained, comfortable and homey environment is offered to service users. EVIDENCE: White House is a small family care home with a comfortable homely atmosphere. Service users have their own bedroom, and a shared bathroom on the first floor. The service users use the main lounge and dining room during the day. The home is clean and generally well maintained with an attractive rear garden. Since the last inspection radiators have been covered. The service users bathroom is clean and functional although it is looking in need of redecoration; the tiles over the sink should be replaced. White House Care Home, The DS0000022904.V307250.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, and 30. The Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A sufficient and experienced staff team looks after the service users. Improvements need to be made with regard to training. All staff must receive Moving And Handling and NVQ Training must be introduced for staff. A record and evidence of all training must be available for inspection. EVIDENCE: Three members of staff work at the home, the two Registered Providers and a part time member of staff. The Registered Manager is generally the main member of staff on duty. The part time member of staff works one day a week and some weekends. In the Inspectors judgement which is based on the size of the home and the dependency levels of current service users this is satisfactory. The Inspector was advised that the Registered Manager had a meeting planned for the following week with regard to undertaking the Registered Managers Award. White House Care Home, The DS0000022904.V307250.R01.S.doc Version 5.2 Page 16 Members of staff do not have an NVQ Level 2. The Inspector was informed that the part time staff was not able to undertake this as she is on a Student Visa. Improvements have been made to staff training. The part time member of staff has received training in safe working practices such as First Aid, Infection Control, Food Hygiene, and Moving and Handing. The Registered Manager and Registered Providers do not have Moving and Handling Training. At the present time all three service users are mobile, however it is necessary to ensure that this training has been undertaken when working with this service users group. Training courses are recorded on a Calendar. The Registered Manager needs to improve the record of training undertaken by staff, this must include a training profile for each member of staff with dates of training and evidence of training such as the certificates or if the training is in-house; the format for the training must be available for inspection. The personnel file of one member of staff was seen. The required documents were on file. This member of staff has been employed for a number of years and no new staff have been recruited. White House Care Home, The DS0000022904.V307250.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, and 38 The Registered Manager is also the Provider and is directly involved with the care of service users and the running in the home. This is done in a competent manner. There is room for improvement in some areas of management. The home is aware of the need to have appropriate financial procedures in place to ensure service user’s interests. A Quality Assurance System needs to be put in place for the home. Fire safety systems for service users need to be improved. EVIDENCE: White House Care Home, The DS0000022904.V307250.R01.S.doc Version 5.2 Page 18 There has been no change to the management of the home for a number of years. The Registered Manager/Provider has been in post for a number of years. Although the White House is a small family run home a Quality Assurance System is still required by the National Minimum Standards. The home does not have an internal Quality Assurance system. There are systems in place for the management of service users money. These were discussed with the Registered Manager. The Radiators have been covered since the last inspection. The Inspector looked at a number of health and safety records mainly pertaining to fire safety. The Inspector was advised that the Fire Alarm System was serviced approximately 2/3 years ago. The Fire Alarm System must be serviced on an annual basis. Fire Drills take place; the Inspector was informed that Service Users are not good at responding to these in appropriately and refuse to move sometimes. This situation must be risk assessed and improved. White House Care Home, The DS0000022904.V307250.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 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 2 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 X x 2 White House Care Home, The DS0000022904.V307250.R01.S.doc Version 5.2 Page 20 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 2 3 4 Standard OP1 OP9 OP16 OP28 Regulation 5. & 6 18 (1) (a) (i) 22 18 (1) (a) Requirement Timescale for action 01/02/07 The Service Users Guide must be amended and updated to include all the necessary information. Staff must receive training in 01/12/06 basic knowledge of medicines and safe administration. The home must ensure that the 01/11/06 complaints procedure is available for the service users. A Minimum of 50 of staff in the 01/12/06 home must be trained to NVQ Level 2. An action plan of how this will be achieved must be forwarded to the Inspector by the given date. 5 OP30 18 (c) (1) All staff must have Moving and Handling Training. This has been a requirement of previous inspections and must now be addressed. Evidence of staff training must be in place. An annual review of the Quality of care must take place. The Fire Alarm System must be serviced on a regular basis. DS0000022904.V307250.R01.S.doc 02/02/07 6 7 8 OP30 OP33 OP38 18 (c ) (1) 24 13 (4) (a) 01/12/06 01/02/07 01/12/06 White House Care Home, The Version 5.2 Page 21 9 OP38 13 (4) (a) Fire risk assessments must be completed for all service users. Service user’s lack of cooperation with fire drills must be addressed. 01/12/06 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. 2. Refer to Standard OP15 OP30 Good Practice Recommendations A better variety of puddings served in the home should be considered. A formal system for recording training should be developed. White House Care Home, The DS0000022904.V307250.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection West London Area Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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 White House Care Home, The DS0000022904.V307250.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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