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Inspection on 03/06/05 for White House Care Home, The

Also see our care home review for White House Care Home, The for more information

This inspection was carried out on 3rd June 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home offers care in a family setting. The environment is comfortable and the standard of fixtures and fittings is good. The small staff team who have worked at the home for a number of years offer consistent care and have a good working knowledge of service users and their needs.

What has improved since the last inspection?

Since the last inspection the Registered Manager has started a book to record the meals taken by service users and has amended the Complaints Procedure to include information on contacting CSCI.

What the care home could do better:

The standard of professional recording needs to be improved; with particular reference to service user care plans. A formal training programme for staff must be put in place. This is now overdue as staff do not have mandatory training in areas of care associated with health and safety. The Manager should attend a Managing Health and Safety course; although health and safety for service users appears satisfactory there must be a health and safety policy and radiator risk assessment.

CARE HOMES FOR OLDER PEOPLE White House Care Home 30 Millbourne Road Hanworth Middlesex TW13 6NQ Lead Inspector Susan Woolnough-Singh Unannounced 3 June 2005 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 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 G61 G10 s22904 White House (Mill Rd) v214416 030605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service White House Care Home Address 30 Millbourne Road, Hanworth, Middlesex TW13 6NQ Telephone number Fax number Email 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 Mr Bhiwsen Nowjee Care Home 3 Category(ies) of Old age, not falling within any other category registration, with number of places White House Care Home G61 G10 s22904 White House (Mill Rd) v214416 030605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Not applicable. Date of last inspection 10/2/2005 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. The current service users have lived in the home for ten years. 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 G61 G10 s22904 White House (Mill Rd) v214416 030605 Stage 4.doc Version 1.30 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 Registered Manager and one service user were spoken with. The Inspection took place between 12.25pm and 4.30pm. Six requirements had been made at the last inspection; three requirements had not been complied with within the timescales set. Two immediate requirements were made as a result of this inspection. Not all of the key standards were assessed at this inspection; standards not assessed will be assessed at the next inspection. Service users looked comfortable and there was a calm atmosphere in the home at the time of the inspection. 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 G61 G10 s22904 White House (Mill Rd) v214416 030605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection White House Care Home G61 G10 s22904 White House (Mill Rd) v214416 030605 Stage 4.doc Version 1.30 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 standard(s) 0 The above key standards were not assessed at this inspection. These standards will be assessed at the next inspection. EVIDENCE: Standard 3 was not assessed at this inspection. Standard 6 was not assessed; the home does not offer an intermediate care service. White House Care Home G61 G10 s22904 White House (Mill Rd) v214416 030605 Stage 4.doc Version 1.30 Page 8 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 standard(s) 7 8 9 10 The small staff team at Whitehouse Care Home are able to offer consistent and personal care to service users. The Care Plans must be improved with regard to the information contained in them to meet the National Minimum Standards. EVIDENCE: The care plans of three services users were examined. The information contained under the care plan headings was satisfactory although the care plans do not comply with the standard in that they do not cover information on the holistic needs of service users. One care plan had not been reviewed and was dated 29/11/04. The Registered Manager said he was in the process of reviewing this care plan. An Immediate Requirement was issued with regard to the presentation of care plans. The home is small and personal with a staff team of three who are aware of the services users daily needs, however the care plans do need to be formally and professionally presented. The three service users are registered with the same General Practitioner and Dentist. Appointments for the Chiropodist and Optician are made as required. Improved care plans would set out health care needs more clearly. Visits to health care professionals are entered in the daily log. A recommendation was White House Care Home G61 G10 s22904 White House (Mill Rd) v214416 030605 Stage 4.doc Version 1.30 Page 9 made for a format to be developed to record and list all visits made to health care professionals for individual service users. The medication administration record and medication cabinet were seen these were in good order. A brief medication policy is available. The Registered Manager had signed for the administration of medication and is responsible for this. The part time member of staff has received in-house training on the administration of medication. The General Practitioner reviews medication on a six monthly basis, the inspector was informed. On this occasion only one-service users was able to talk with the inspector. He/she was commented that his/her care needs were being met and confirmed that he/she was happy living at the home. White House Care Home G61 G10 s22904 White House (Mill Rd) v214416 030605 Stage 4.doc Version 1.30 Page 10 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 standard(s) 0 The above standards were mot assessed at this inspection. The above standards will be assessed at the next inspection. EVIDENCE: The Registered Manager was able to demonstrate that a record of food provided is now kept. This requirement was made at the last inspection. White House Care Home G61 G10 s22904 White House (Mill Rd) v214416 030605 Stage 4.doc Version 1.30 Page 11 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 standard(s) 16 A clear Complaints Procedure is available for service users. EVIDENCE: The Complaints Procedure is clearly written and this now includes the telephone number of the CSCI. The inclusion of the CSCI telephone number was made as a requirement at the last inspection. White House Care Home G61 G10 s22904 White House (Mill Rd) v214416 030605 Stage 4.doc Version 1.30 Page 12 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 standard(s) 19 26 Whitehouse Care Home is a small establishment which is able to offer an informal, well-maintained family style environment to service users. An infection control policy must be in place. EVIDENCE: The home was being maintained to a high standard. The standard of cleanliness in the home was good at the time of the inspection. The communal areas and service users bedrooms looked homely and comfortable. Information given to the Inspector indicated that incontinence was not an issue in the home. Domestic style laundry facilities are available. The home did not appear to have an infection control policy. White House Care Home G61 G10 s22904 White House (Mill Rd) v214416 030605 Stage 4.doc Version 1.30 Page 13 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 29 30 Standard 30 (appropriately trained staff) has not been met. The Registered Manager must now take action to ensure staff are offered the relevant training for the protection of service users. EVIDENCE: There are three staff in employment at Whitehouse Care Home which is a family run home; the Registered Providers are husband and wife and in addition to this there is one member of staff who works on a part time basis. A rota of staff shifts is available. The Registered Providers have worked in the home since registration in 1993 and the part time member of staff has been in post for over five years. There has been no recent recruitment. An Immediate Requirement was issued with regard to staff training. The Registered Manager has information from training companies but no action had been taken to provide mandatory training for staff. The Registered Manager needs to ensure that all staff has training in Moving and Handling, Food Hygiene, First Aid and Infection Control. A training plan must be forwarded to CSCI by 1st July 2005. The Registered Managers said he would be undertaking the Registered Manager award and the part time member of staff was due to commence the NVQ Level 2 White House Care Home G61 G10 s22904 White House (Mill Rd) v214416 030605 Stage 4.doc Version 1.30 Page 14 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 38 The Registered Manager monitors health and safety in the home but health and safety systems need to be improved. Risk assessments where necessary must be put in place. The homes performance in this area would be enhanced if the Registered Manager attended a Health and Safety course. EVIDENCE: The home has a brief Business Plan, which states the aim of the home. There is no annual development plan at the present time. A requirement was made at the last inspection that a risk assessment must be carried out on all uncovered radiators this had not been done. The Registered Manager said that the radiators were turned down and would be turned up again in the winter. He said he checks the radiators. A formal risk assessment must be completed on all uncovered radiators. The home does not have a Health and Safety Policy. A recommendation was made that the Registered Manager attends a formal Managing Safely Course. A new Gas boiler was purchased approximately nine months ago. An electrical appliance check was White House Care Home G61 G10 s22904 White House (Mill Rd) v214416 030605 Stage 4.doc Version 1.30 Page 15 carried out on 16/3/05. The accident book was examined. There had been no accidents recorded since 2003, service users are physically mobile. A record of fire drills is held the last fire drill took place on 3/2/05. White House Care Home G61 G10 s22904 White House (Mill Rd) v214416 030605 Stage 4.doc Version 1.30 Page 16 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION 3 x x x x x x 2 STAFFING Standard No Score 27 3 28 x 29 3 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x 3 x x x x 2 White House Care Home G61 G10 s22904 White House (Mill Rd) v214416 030605 Stage 4.doc Version 1.30 Page 17 YES 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. 1. Standard 7 Regulation 15 (2) Requirement The content of the care plan must be sufficient to identify service users holistic care needs and how these will be monitored.The timescale set at the last inspection 1.6.05 had not been met. An infection control policy must be made available for the guidance of staff. The Registered Person must ensure that training is provided in Moving and Handling, Food Hygiene, First Aid and Infection Control. The timescale set at the last inspection of 1.5.05 had not been met. A risk assessment must be carried pout on all uncovered radiators. The timescale set at the last inspection of 1.4.05 had not been met. A Health and Safety Policy must be made available. Timescale for action 3.7.05 2. 3. 26 30 13 (3) 18 (1) 1.9.05 1.7.05 4. 38 4 (a) and (c) 1.9.05 5. 38 13 (4) (a) and (c) 1.9.05 White House Care Home G61 G10 s22904 White House (Mill Rd) v214416 030605 Stage 4.doc Version 1.30 Page 18 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 8 38 Good Practice Recommendations A form should be developed to list health care appointments attended by service users. The Registered Manager should consider attending a Managing Safely Course. White House Care Home G61 G10 s22904 White House (Mill Rd) v214416 030605 Stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection Ground Floor 58 Uxbridge Road Ealing, London W5 2ST 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 G61 G10 s22904 White House (Mill Rd) v214416 030605 Stage 4.doc Version 1.30 Page 20 - 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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