Inspection on 06/01/06 for White House Care Home, The

This inspection was carried out on 6th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.

Other inspections for this house

White House Care Home, The 28/09/06

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 Ged Durkin Unannounced Inspection 11:30 6 January 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.V275165.R01.S.doc Version 5.1 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.V275165.R01.S.doc Version 5.1 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.V275165.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd June 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. Two of 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, The DS0000022904.V275165.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted between 11:20 am and 3:00 pm. The Inspector saw all three service users and spoke to two of them. The Inspector also spoke at length with the Registered Manager, had a tour of the premises and examined various documentation and policies. What the service does well: What has improved since the last inspection? What they could do better: There still remains an outstanding requirement around the issue of a risk assessment on unguarded radiators. Please contact the provider for advice of actions taken in response to this White House Care Home, The DS0000022904.V275165.R01.S.doc Version 5.1 Page 6 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.V275165.R01.S.doc Version 5.1 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 White House Care Home, The DS0000022904.V275165.R01.S.doc Version 5.1 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): 3, 4, 5 and 6. The home ensures that prospective service users receive a satisfactory assessment, service users and their representatives are also given opportunity to visit the home prior to visiting to ensure that those assessed needs are met. EVIDENCE: The Inspector examined the assessments undertaken by the Registered Manager in relation to the most recent admission to the home. The home uses its own assessment format, which had not been fully completed by the Registered Manager. There was a local authority needs led assessment completed and the Registered Manager explained that prospective service users and their families are invited to visit the home before beginning any part of the admission process. This is not always possible because the service user may be in hospital or not have any relatives, but the Registered Manager was able to recount previous occasions when this had happened. Prospective service users are invited to visit and then have a short stay during which time all parties can make up their minds as to whether to make the stay permanent. Because of the small size of the home the Registered Manager is also careful to ensure, as far as possible, the compatibility of any new service White House Care Home, The DS0000022904.V275165.R01.S.doc Version 5.1 Page 9 user with the existing ones. As a result of a discussion with the Registered Manager the home should apply for a variation in its conditions of registration in order that its certificate of registration is an accurate reflection of the category of registration of the service users living in the home. White House Care Home, The DS0000022904.V275165.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 11 The home ensures that service user’s health and personal care needs are met in a pro-active way this is reflected in individual plans of care. The home has satisfactory medication systems in place and the home has ascertained service user’s wishes in the event of their death. EVIDENCE: A previous requirement had been made about the home needing to have more holistic care plans, which includes social care needs as well as medical ones. The Registered Manager showed the Inspector updated care plans that were now more holistic in nature. All care plans are reviewed every six months and the placing authority review the placements on an annual basis. The Inspector saw the minutes of these reviews. An ongoing record is kept about each service user although this is not done on a daily basis. Because of the small number of service users the home does not have a key worker system in place. The Registered Manager informed the Inspector that all the service users needed varying degrees of support in tending to personal care needs. All the service users are registered with the same GP and other community services such as chiropodists, dentists, opticians and district nurses. The Registered Manager and staff have been actively involved and supportive in ensuring that White House Care Home, The DS0000022904.V275165.R01.S.doc Version 5.1 Page 11 service users health care needs are treated in a pro-active manner. The Registered Manager cited the advantage of having a small number of service users meant health care issues were picked up and attended too quickly. The home has a very good relationship with the local GP. The medication systems were inspected and there is a secure storage cupboard and good administration systems in place. Service user care plans also indicated service user’s wishes at the time of their death. White House Care Home, The DS0000022904.V275165.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. The home ensures that service users enjoy a lifestyle in keeping with their expectations and ensures that service users are able to keep in contact with family or friends. In addition, service users are able to exercise a high degree of choice and control in their lives and eat attractive, well portioned meals in pleasing surroundings at a time convenient to them. EVIDENCE: The Registered Manager informed the Inspector that all the service users go out most days in the local community. These trips include going to the local shops, going out for coffee/tea or else for a meal. In the summer the service users will go out for a drive or visit the local park. Although encouraged to go out service users may stay in the home if they wish. All the service users enjoy reading and two both take a daily paper while the third one enjoys reading books. All will watch television, usually “soaps” and war films, but apart from those the service users do not have any particular favourites. One service user has occasional contact with family but the other two service users do not have any known family. The home tried to engage advocates for those service users but they did not wish to pursue this option. Service users are able to get up/go to bed when they like, wear what they wish and come and go as they wish. The reality is that the service users do not go out by themselves because of their age and associated infirmity. Service users are always escorted when White House Care Home, The DS0000022904.V275165.R01.S.doc Version 5.1 Page 13 out in the community. The Inspector witnessed the service users having lunch, which consisted of fish and chips. The service users confirmed that they enjoyed the food cooked for them in the home. The Registered Manager told the Inspector that service users are encouraged to eat healthily and menus reflected service user’s likes and dislikes. White House Care Home, The DS0000022904.V275165.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 and 18 The home has satisfactory systems in place to ensure service users complaints are acted upon, their legal rights are protected and they are kept safe from abuse. EVIDENCE: The Registered Manager explained how he would seek to resolve any issues/complaints from service users as soon as possible and inform the appropriate agencies, as necessary. All the service users are on the electoral register and voted in last year’s general election. The Registered Manager has undertaken recent adult protection training and he told the Inspector that all staff are aware of the necessary procedures to follow in the event of any allegation of adult abuse. The home has its own adult abuse policy and has the appropriate local authority guidance as well. White House Care Home, The DS0000022904.V275165.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, 24 and 26. Service users live in a safe, well maintained and clean home, have individualised bedrooms and have the necessary specialist equipment needed to ensure they are able to maximise their independence. EVIDENCE: The service users live in a well maintained home with access to communal facilities such as conservatory and well kept garden. The home is clean and tidy. The home has appropriate grip rails on the stairs and a disabled parking space for ease of access to the home for the service users if they have been on an outing in a car. Service user bedrooms viewed by the Inspector appeared to have a good degree of personalisation. A previous requirement regarding the home having an infection control policy has been met. White House Care Home, The DS0000022904.V275165.R01.S.doc Version 5.1 Page 16 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, 29 and 30. A sufficient and experienced staff team looks after the service users. One of the home’s staff files did not contain all the necessary information and there was still some outstanding training matters for the staff team. EVIDENCE: The home has a small but experienced staff team who all have good working relationships with the service users. An examination of one of the staff files revealed that not all the information required under the regulations was kept in the file. A requirement around staff training from the previous report had been partly met. Training that had been arranged for staff had been cancelled for external reasons beyond the Registered Manager’s control. This training has been rescheduled for the near future. The Registered Manager has started on the Registered Manager’s Award. White House Care Home, The DS0000022904.V275165.R01.S.doc Version 5.1 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): 35, 36 and 38 The home is aware of the need to have appropriate financial procedures in place to ensure service user’s interests. Staff receive regular supervision and although health and safety is promoted there has been an unsatisfactory response by the Registered Manager in relation to the need to undertake a risk assessment on the unguarded radiators in the home. EVIDENCE: Two of the service users manage their own money and withdraw whatever money they need from the bank where they hold their accounts. Staff oversee the service user’s interactions with the bank but are not actively involved. The third service user’s finances are managed by his/her placing authority who liaise directly with the home who reimburse the home for any spending done on behalf of this service user. The Inspector saw records of staff supervision that indicated regular supervision was given. There had been a previous requirement around the need of the home to have an infection control policy White House Care Home, The DS0000022904.V275165.R01.S.doc Version 5.1 Page 18 this has now been done. The Inspector looked at a number of health and safety records that were all in order. However it is disappointing to note that the Registered Manager has still not met a previous requirement around the need to carry out a risk assessment on the unguarded radiators in the home. This was discussed with the Registered Manager who said this would be done as a matter of priority. White House Care Home, The DS0000022904.V275165.R01.S.doc Version 5.1 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 x x 2 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 x x 3 x 3 x 3 STAFFING Standard No Score 27 3 28 x 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x 3 3 x 1 White House Care Home, The DS0000022904.V275165.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? Yes 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. Standard OP3 OP3 Regulation 14 1 (a)(d) 14 1 (a) (d) 19 (1) (i) Sch 2 18 (1) Requirement There must be full assessment undertaken by the Registered Manager. The home must not admit service users for whom an assessment has indicated is outside its current category. The home should maintain all staff records as outlined in the relevant regulations. The Registered Manager must ensure that training is provided on first aid and moving and handling. A risk assessment must be carried out on all uncovered radiators. The timescale set at the last inspection of 1.9.05 had not been met. This requirement is re-stated. Timescale for action 13/02/06 13/02/06 3. 4. OP29 OP30 13/02/06 13/02/06 5. OP38 4 (a) and (c) 13/02/06 White House Care Home, The DS0000022904.V275165.R01.S.doc Version 5.1 Page 21 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 OP8 OP38 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, The DS0000022904.V275165.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection West London Area Office 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. 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