Inspection on 19/09/05 for White House Nursing Home, The

This inspection was carried out on 19th September 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

White House Nursing Home, The 16/10/07

White House Nursing Home, The 28/11/06

White House Nursing Home, The 03/05/05

White House Nursing Home, The 19/10/04

White House Nursing Home, The 04/05/04

White House Nursing Home, The 06/02/04

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 Nursing Home, The 274 Malden Road New Malden Surrey KT3 6AR Lead Inspector Diane Thackrah Unannounced Inspection 19th September 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address White House Nursing Home, The DS0000026255.V252115.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. White House Nursing Home, The DS0000026255.V252115.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service White House Nursing Home, The Address 274 Malden Road New Malden Surrey KT3 6AR 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) 0208 949 0747 Mr Badru Manji Mrs Sater Manji Mrs Lesley Elizabeth Carnegie Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places White House Nursing Home, The DS0000026255.V252115.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd May 2005 Brief Description of the Service: The White House provides accommodation for up to twenty five people who require nursing care. Accomodation is provided in mostly single bedrooms. There are communal areas and a small garden. The home is situated on a main road close to the centre of New Malden. Public transport, shops and other amenities are within close distance of the home. Parking facilities are available. White House Nursing Home, The DS0000026255.V252115.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, which took place between 10.00 and 17.30 on 19th September 2005. A partial tour of the premises took place and care records were examined. The Registered Manager, Administrator, six staff members, two visitors and a visiting GP were spoken with. Ten service users were also spoken with. What the service does well: What has improved since the last inspection? A double bedroom in the home has been converted into two single bedrooms since the last inspection, and there has been an ongoing maintenance and redecoration programme. White House Nursing Home, The DS0000026255.V252115.R01.S.doc Version 5.0 Page 6 Criminal Records Bureau checks are now in place for all staff members and the Registered Provider is clear that these must be obtained, prior to any staff member commencing work. What they could do better: Since the last inspection, adult protection procedures have been instigated as a result of an incident in the home. The findings of a multi-agency investigation into this incident were that there was no evidence to substantiate any incident of abuse in the home. Issues that arose from this investigation, however, were that, the incident was dealt with as an accident and adult abuse procedures were therefore not instigated appropriately. There is a need for refresher training for all staff members in the home, in recognising, preventing and reporting elder abuse and a Requirement has been made regarding this issue. Further Requirements have been made regarding the need for structured, accredited Foundation training to occur, and for more staff members to be trained in First Aid. There is also a need for further training in the needs of people who have dementia Care plans are, in general, good. However, one care plan did not provide sufficient detail about how staff members should provide care. Care plans must be accurate in order that staff members are clear about how to meet the needs of service users. There was a minor error found on a Medication Administration Record. A Requirement has been made regarding the need for accurate recording, in order to keep service users safe. Generally, health and safety issues in the home are well managed. There was a sink surround that required cleaning thoroughly, and hot water from one tap in a bathroom was too hot. These areas must be made safe. Staff members receive support and guidance through formal supervision, however, there is a need for an increase in formal supervision sessions for care staff members in order that they are supported, and therefore able to provide consistent and quality care. There is a need to ensure that these service users have their needs reassessed, by a person trained to do so. Should any current service user be diagnosis as suffering from dementia, an application should be made to the Commission for Social Care Inspection for a variation in categories of registration to ensure that the home’s certificate of registration accurately reflects the situation in the home. White House Nursing Home, The DS0000026255.V252115.R01.S.doc Version 5.0 Page 7 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 Nursing Home, The DS0000026255.V252115.R01.S.doc Version 5.0 Page 8 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 Nursing Home, The DS0000026255.V252115.R01.S.doc Version 5.0 Page 9 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 and 6. There are good arrangements for ensuring that service users have their needs fully assessed prior to them moving into the home. Staff members therefore understand service users needs and are able to meet them. EVIDENCE: Inspection of records for a random sample of service users detailed that a full assessment of needs had been carried out prior to them moving into the home. A member of the senior nursing team visits the prospective service user in their home, or in hospital, as part of the admissions process. When a service user is referred to the home through Care Management arrangements, a Care Management assessment of needs is obtained. Records detail that a GP and other health care professionals had been consulted with, prior to service users being admitted to the home. From observations, and discussions with service users, it is evident that the home is able to meet the needs of the current service user group. Staff members spoken with were aware of the individual needs of service users and feedback received from a number of visitors confirmed this. One visitor said, White House Nursing Home, The DS0000026255.V252115.R01.S.doc Version 5.0 Page 10 “The staff are very caring” “There is always someone around to help” and another reported that service users were “treated with respect” Feedback from a service user was that “I am very happy here” Staff members spoken with said that they had received training and were able to describe skills and experience relevant to providing good care. A Requirement is made in relation to staff training, details of which are provided later in this report. The home is not registered to provide a service to people who have dementia, however, the Registered Manager reported that a number of current service users present as suffering from a dementia like illness. Care records detail that the home is currently meeting the needs of these service users and discussions with staff members confirmed this. There is a need to ensure that these service users have their needs reassessed, by a person trained to do so. Should any current service user be diagnosis as suffering from dementia, an application should be made to the Commission for Social Care Inspection for a variation in categories of registration to ensure that the home’s certificate of registration accurately reflects the situation in the home. Records indicate that some staff members have undertaken training in the needs of people who have dementia. It is recommended that training in the needs of people who have dementia be provided for all staff members. Also, that the physical environment of the home is reassessed, and environmental adaptations are made in line with specialist and clinical guidelines regarding dementia. The home does not provide intermediate care. White House Nursing Home, The DS0000026255.V252115.R01.S.doc Version 5.0 Page 11 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. There are arrangements for ensuring that service user’s needs are identified, this ensures that needs will be met. Medication is, in general, handled safely, ensuring that service users are protected. However, a minor error was found in recording on one Medication Administration Record. This practice is potentially detrimental to service users well being. EVIDENCE: Each service user has a care plan that has been generated from an initial needs assessment. The care plans of three service users were examined in depth. In general, there was good detail in care plans of the action needed to be taken by staff members to ensure that all aspects of the health, personal and social care needs of service users were met. Risk assessments were in place detailing risks in relation to moving and handling, weight loss and falls. One service user had a risk assessment in place in relation to the use of cot sides. Consent had been acquired from this service user’s family member regarding the use of cot sides. Care plans, in general, reflected the outcomes of risk assessments. One care plan detailed that it was necessary for two White House Nursing Home, The DS0000026255.V252115.R01.S.doc Version 5.0 Page 12 carers to assist a service user to be transferred from their bed, to have a bath and to use the toilet. The care plan did not however, detail the number of carers required to wash the service user in their bed. The Registered Manager was able to describe how this service user was appropriately cared for, however, it is necessary to record accurately in care plans how needs will be met. A Requirement is made in relation to this issue. Daily observation notes detailed that needs described in care plans were being addressed. There were records indicating that care plans are reviewed at least monthly and updated to reflect changing needs. There were also records that detailed that the needs of service users had been reviewed, in one case, yearly by the placing authority in conjunction with the home. Of the care plans examined, the family member of one service user had signed one, and two had not been signed. The Registered Manager said that opportunities are made available for service users, or their representative to be involved in the drawing up, and signing of care plans, but this is not always carried out due to lack of capacity, or family members not being available. It is recommended that further opportunities for service users and their family members to sign care plans be offered. Were service users, or their representatives have declined to be involved in the drawing up of a care plan, this information should be recorded. The Registered Manager said that each service user is registered with a GP as part of the admissions process. Service user’s files examined all contained contact details of their GP. Multi-Disciplinary sections in care plans detailed that GP’s are contacted, and visit service users in the home at regular intervals. A GP attached to the home was spoken with. This GP reported that they visited service users in the home every Monday. The GP spoke very positively about the home and confirmed that they were contacted appropriately regarding service users who need to be seen. Risk assessments were in place regarding pressure sores and records detailed the action to be taken to reduce risk. There were daily records detailing the treatment, observations and outcomes of this for one service user who has a pressure sore. Equipment for the promotion of tissue viability is provided and there were records detailing that the tissue viability nurse had been involved in the care of a service user. The home liaises with a number of health and social care professionals in order to promote and maintain the health of service users. Examination of one service user’s records highlighted that within a six-month period they had been seen in the home by a dentist, social worker, dietician, optician, GP (on six occasions), chiropodist and nursing needs assessor. An accident and incident book is maintained in the home. Twelve accidents had been recorded from July – September 2005. The Registered Manager said White House Nursing Home, The DS0000026255.V252115.R01.S.doc Version 5.0 Page 13 that the accident and incident book is monitored regularly and action taken to reduce any identified risks. This was reflected in care notes. There are policies and procedures in place for ensuring that medication is handled safely. Medication Administration Records examined were, in general, accurate and up to date. In-house audits of medication handling occur on a regular basis. One staff member confirmed that they had received training in the safe handling of medication. All medication was noted to be stored securely at the time of this inspection. Good practice occurs for the safe handling of controlled medication. There was feedback from a GP detailing that the home follows good practice when dealing with service user’s prescriptions. There was one instance, however, were a service user had medication that had been discontinued, but this was not reflected on their Medication Administration Record. A Requirement is made in relation to this issue. The home liaises with community nurses and GP’s regarding pain relief for service users who are dying, a health care professional who works with the home confirmed this. Were appropriate, arrangements are made for the service user to be made comfortable in their own bedroom at the time near their death. Some staff members have received training in bereavement and care of the dying. The Registered Manager said that service user’s wishes regarding what happens after death are discussed during the admission process. Records available confirm this. White House Nursing Home, The DS0000026255.V252115.R01.S.doc Version 5.0 Page 14 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 and 15. Social activities and meals are well managed, varied and take into account the needs and abilities of individuals. Therefore, service users experience a lifestyle that matches their preferences. EVIDENCE: There continues to be a worker employed in the home purely for the purpose of facilitating social and leisure activities. Some service users were involved in ‘gentle exercise’ at the time of this inspection. Service users were consulted with appropriately about whether they wished to take part in this activity and there was a notice board in the lounge detailing what activities were on offer. One visitor said, “There always seems to be things for service users to do” Activities are offered on an individualised basis and take into account the cultural needs of service users. The home supports service users to exercise choice in relation to religious observations. Care notes in relation to one service user detailed that they had received Holy Communion in the home. There was a weekly menu available that detailed that meals provided are varied, and that a choice is always available. Fresh, wholesome and nutritious food was available in the kitchen. A nutritious and well-presented hot meal of casserole and fresh vegetables, or Jacket potato with cheese and baked beans was served for lunch during this inspection. Puréed and soft meals were also White House Nursing Home, The DS0000026255.V252115.R01.S.doc Version 5.0 Page 15 presented well. Tables were set attractively and a choice of condiments was available. Staff members were available throughout the meal and provided appropriate support, including to those who required to be fed. Meals can be taken in bedrooms. One staff member said that hot and cold drinks are provided throughout the day, and on request. All service users spoken with said that meals in the home are enjoyable and of good quality. White House Nursing Home, The DS0000026255.V252115.R01.S.doc Version 5.0 Page 16 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 a system in place for the effective handling of complaints and service users and their relatives are encouraged to raise any concerns they have. Service users therefore know that their concerns will be acted upon. Vulnerable adults procedures in the home are generally adequate and serve to ensure that service users are protected from abuse. However, there has been one recent incident were there was a failure to notify relevant parties of an incident that may have constituted abuse, this has potential for service users best interests not being safeguarded. EVIDENCE: There are policies and procedures in place for dealing with complaints. Information is made available in the Service User Guide about how a compliant, concern or suggestion should be made, and how this will be handled. This information also includes details about how a complaint may be made to the Commission for Social Care Inspection. The Registered Manager said that service users and their relatives are encouraged to raise any concerns with staff members before they become problematic. No complaints have been made about the home since the last inspection There are policies and procedures in place for dealing with suspected or alleged abuse and the home has a copy of the Royal Borough of Kingston Upon Thames adult abuse procedures. Adult protection procedures have recently been instigated by the placing authority of one service user as a result of an incident in the home. The findings of a multi-agency investigation into this White House Nursing Home, The DS0000026255.V252115.R01.S.doc Version 5.0 Page 17 incident were that there was no evidence to substantiate any incident of abuse in the home. Issues that arose from this investigation, however, were that, the incident was dealt with as an accident and adult abuse procedures were therefore not instigated appropriately. Examination of staff training and development records, highlight that in- house training in Communication’, ‘Whistle Blowing’ and ‘Adult Protection’ is provided. Staff members spoken with confirmed this, and were able to describe good practice for preventing, identifying and reporting abuse. In 2004 the Registered Manager and Deputy Matron attended a Royal Borough of Kingston Upon Thames, Social Services led training day on ‘Protecting Vulnerable Adults. However, a Requirement is made that refresher training in recognising, preventing and reporting elder abuse is provided to all people working within the home. An external, accredited trainer must be sought to provide such training. It is acknowledged that the Registered Manager and Administrator have responded appropriately following this incident. Records indicate that staff members have been involved in in-house training in ‘Reporting, Communication and Team Work’ ‘Whistle Blowing’ ‘Reporting Incidents’ and ‘Moving and Handling’ since the incident. Additionally, there are one to one training sessions planned for specific staff members. White House Nursing Home, The DS0000026255.V252115.R01.S.doc Version 5.0 Page 18 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, 25 and 26. The home is, maintained, decorated and furnished to a good standard and in general facilities are clean and safe. This ensures that service users live in a pleasant, homely and comfortable environment. However, shortfalls in hygiene maintenance, and in the monitoring of water temperatures have potential for placing service users’ health and well being at risk. EVIDENCE: The home is a large detached property, situated on a main road close to New Malden High Street. There is a large car park at the front of the property, and a small, paved garden to the rear. The grounds and garden were tidy and safe and accessible to service users. The home was decorated and furnished to a good standard and there is a routine programme of maintenance and redecoration. The home is laid out over two floors, accessed by lift or stairway. A double bedroom has been made into two single rooms since the last inspection of the home, and the hallway was in the process of being redecorated. One service user spoken with said “I have a very comfortable bedroom” and a visitor reported, “The home always looks nice” The home White House Nursing Home, The DS0000026255.V252115.R01.S.doc Version 5.0 Page 19 complies with the Requirements of the local fire service and there are no CCTV cameras in operation. Bedrooms are naturally ventilated with windows conforming to recognise standards. There is central heating throughout the home, and radiators can be adjusted in individual bedrooms. Pipe work and radiators are covered and lighting is domestic in nature. Emergency lighting is provided throughout the home. Thermostatic valves are fitted on all hot water outlets in bedrooms, communal toilets and bathrooms and regular checks are made of hot water temperatures. Water distributed from a random sample of outlets throughout the home was found to be at a temperature close to 43 degrees. However, water distributed from a bath on the first floor was above 50 degrees. Records were available detailing that bath water temperatures are tested prior to service users being immersed in them. However, in order to ensure that service users are fully protected, water temperatures must not be able to exceed safe temperatures. A Requirement is made in relation to this issue. The home was found to be clean and free from offensive odours. The laundry is appropriate, there is a contract for the collection of clinical waste and the washing machine has a sluice facility. Policies and procedures are in place to deal with the safe handling of clinical waste and staff members receive infection control training. The kitchen was generally clean and well organised, however, the area around the hand washbasin in this room was very dirty. A Requirement has been made regarding the need for this area to be cleaned. One family member said that their relative’s bedroom was always kept “fresh and clean. White House Nursing Home, The DS0000026255.V252115.R01.S.doc Version 5.0 Page 20 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): 28, 29 and 30. There have been improvements in procedures for staff recruitment, which now offer protection to people living in the home. Staff members receive training, which, in general provides them with the skills necessary for meeting the needs of service users. However, there is a need for additional training in some areas, to fully ensure the well being of service users. EVIDENCE: The last inspection of the home highlighted that two staff members had commenced work with a Protection of Vulnerable Adults First check, but without a satisfactory Criminal Records Bureau check being in place. Criminal Records Bureau checks are now in place for these two, and all other staff members working in the home. Staff recruitment procedures in the home are now robust and all necessary checks are carried out regarding staff members, prior to them commencing work in the home. Staff members receive a statement of terms and conditions and a copy of the General Social Care Council code of conduct. Almost half of the current staff team have achieved an NVQ Level 2 in Care qualification, or equivalent and the Administrator said that the home hopes to only recruit new staff members who have this qualification. The Registered Manager is an NVQ Assessor. White House Nursing Home, The DS0000026255.V252115.R01.S.doc Version 5.0 Page 21 All new staff members undergo an induction programme that is in line with ‘Skills for Care’ specifications. Completed induction workbooks were in place for three of the most recent staff members to be employed in the home. These detailed that staff members receive training in the principles of care, safe working practices and conditions and experiences associated with old age. There were training records that detailed training provided in the home including Food Hygiene, ongoing Moving and Handling, Dementia Awareness, Bereavement Awareness, Infection Control, Foot Care, Flip-Flo Valves, Catheter Care and Elder Abuse. All staff members spoken with confirmed that they received training and were able to explain what to do in the event of a fire, when a service user may have been abused, and how to be respectful and to preserve the dignity of service users. Supervision records and staff meeting minutes detailed that training is ongoing, and is seen as important. Currently, there is a lack of structure to foundation training in the home. There are plans to implement ‘Skills for Care’ foundation training for all staff members, and compliance with this will be examined at the next inspection of the home. There must be individual records of training completed for each staff member, and training and development plans in place, which highlight training needed. Only one staff member has a First Aid qualification. A Requirement is made that at least one person who is on shift at any given time, has a qualification in First Aid. This includes nursing staff. A further Requirement regarding the need for additional, accredited training in adult abuse, has been made earlier in this report. White House Nursing Home, The DS0000026255.V252115.R01.S.doc Version 5.0 Page 22 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): 36. In general, staff members receive guidance through formal supervision. Further supervision sessions should be offered, however, to care staff members in order that service users receive consistent and quality care. EVIDENCE: Staff members spoken with reported that they received formal supervision. All grades of staff receive supervision and records of supervision sessions were available. However, regular supervision of care staff members has only occurred recently. Records were available of only one supervision session for two care staff members, and two sessions for one staff member. It is recommended that care staff members receive formal supervision at least six times a year. White House Nursing Home, The DS0000026255.V252115.R01.S.doc Version 5.0 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X 2 2 STAFFING Standard No Score 27 X 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X 3 X X White House Nursing Home, The DS0000026255.V252115.R01.S.doc Version 5.0 Page 24 Are there any outstanding requirements from the last inspection? No. STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP4 Regulation 12 (1)(a) Requirement The Registered Provider must: 1. Ensure that those service users, who it is suspected suffer from dementia, have their needs reassessed, by a person trained to do so. Should any current service user be diagnosis as suffering from dementia: an application for a variation in service user categories should be made to the Commission for Socail Care Inspection. This application must detail the number of service users who have a condition which falls outwith the catergories of the homes registration. The Registered Provider must 01/11/05 ensure that care plans descripe in detail the action needed to be taken by staff members to ensure that the needs of service users are met. The Registered Provider must 01/11/05 ensure that Medication Administration Records accuratley reflect prescriptions. DS0000026255.V252115.R01.S.doc Version 5.0 Page 25 Timescale for action 01/11/05 2 OP7 15 (1) 3 OP9 13 (2) White House Nursing Home, The 4 OP18 12 (1)(a) 18(1)(c) 5 OP25 12 (1)(a) 13 (4)(a) 6 OP26 23 (2)(d) 7 OP30 18 (1)(a)&(c) (i) The Registered Provider must ensure that an external, accredited trainer is sought to provide refresher training in recognising, preventing and reporting elder abuse, to all people working within the home. The Registered Provider must ensure that water is distributed at a temperature close to 43 degrees in bathrooms, toilets and bedrooms used by service users. The Registered Provider must ensure that the area around the hand washbasin in the kitchen is cleaned thoroughly. The Registered Provider must ensure that: 1. Individual records of training are completed for each staff member, and training and development plans are in place, which highlight training needed. 2. At least one person, who is on shift at any given time, has a qualification in First Aid. (Including nursing staff) 01/11/05 01/11/05 01/11/05 01/12/05 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 OP3 Good Practice Recommendations The Registered Provider should ensure that training in the needs of people who have dementia is provided for all staff members. Also, that the physical environment of the home is reassessed, and environmental adaptations are made in line with specialist and clinical guidelines DS0000026255.V252115.R01.S.doc Version 5.0 Page 26 White House Nursing Home, The 2 OP7 3 OP36 regarding dementia. The Registered Provider should make further opportunities for service users and their family members to sign care plans. And, keep a record of instances were a service user, or their representative have been offered opportunities for being involved in the drawing up of a care plan, but have declined. The Registered Provider should ensure that care staff members receive formal supervision at least six times a year. White House Nursing Home, The DS0000026255.V252115.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 Nursing Home, The DS0000026255.V252115.R01.S.doc Version 5.0 Page 28 - 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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