Inspection on 03/05/05 for White House Nursing Home, The

This inspection was carried out on 3rd May 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 19/09/05

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 The White House Nursing Home 274 Malden Road New Malden Surrey KT3 6AR Lead Inspector Diane Thackrah Announced 3 May 2005 rd 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. The White House Nursing Home X00021 S26255 The Whitehouse V178305 030405.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service The White House Nursing Home Address 274, Malden Road. New Malden, Surrey, KT3 6AR 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) 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 The White House Nursing Home X00021 S26255 The Whitehouse V178305 030405.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3 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 double, but 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. The White House Nursing Home X00021 S26255 The Whitehouse V178305 030405.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, which took place between 09.15 and 16.50. A partial tour of the premises took place. Care records were inspected. The Registered Manager, Home Administrator, five staff members and three visitors were spoken to. Many of the service users are very frail and do not have the mental capacity to give an accurate picture of life in the home. Nevertheless the inspector spent time sitting and chatting with them and observing how they were cared for and concluded that they appear well care for and were content with life in the home. Other service users reported that they were happy, and well care. Feedback received from relatives and service users on Commission for Social Care Inspection comment cards was very positive about the home. . What the service does well: There is a well trained staff team who know the needs of service users. Staff members receive good support and guidance from the management and owners. There is a strong emphasis on raising standards. Relatives report that there is a family like atmosphere in the home and that staff provide a high level of care. The physical environment is comfortable, safe and homely. Activities are well though out, varied and reflect the individual needs and preferences of service users. Meals are wholesome, presented well and provided in a pleasant environment. Staff members know how to treat service users with respect, and preserve their dignity. The home has consistently responded without delay to any Requirements and recommendations made during Commission for Social Care Inspection inspections. The White House Nursing Home X00021 S26255 The Whitehouse V178305 030405.doc Version 1.20 Page 6 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The White House Nursing Home X00021 S26255 The Whitehouse V178305 030405.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection The White House Nursing Home X00021 S26255 The Whitehouse V178305 030405.doc Version 1.20 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 standard(s) 2, 3, 4 and 5. Contacts are made available, allowing service users to know what services they are paying for. Service users know that their needs will be met as full assessments of need are carried out and there are good opportunities for visiting the home prior to moving in. EVIDENCE: The home has a statement of terms and conditions that includes all information required by Regulation. There were signed copies of these documents available for the most recent service users. There was also documentation detailing that families are given an opportunities to read this document before signing. There were detailed needs assessments in place for the most recent admissions. The Registered Manager obtains information through discussions with family members, service users and health and social care professionals. Discussion with one family member highlighted that staff members were well aware of their relatives assessed needs and able to meet these needs. The White House Nursing Home X00021 S26255 The Whitehouse V178305 030405.doc Version 1.20 Page 9 There was documentation detailing that service users placed in the home via Care Management arrangements undergo a six-week review to ensure that the home is meeting their needs. There are monthly reviews of Service User Plans to ensure that needs continue to be meet. Prospective service users and their family members are encouraged to visit the home before making a decision to live there. One visitor said that they had made several unannounced visits to the home to assess its suitability. They reported that they had found staff members to be welcoming. Also that staff members were caring and there was a friendly atmosphere in the home. The White House Nursing Home X00021 S26255 The Whitehouse V178305 030405.doc Version 1.20 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 standard(s) 7, 8, 9,10 and 11. The health and care needs of service users continue to be well met. Medication, in general, is handled safely ensuring the wellbeing of service users. There are arrangements in place for ensuring that service users are treated with respect. EVIDENCE: Individual plans of care were in place for each service user. These provided detailed information about how the needs of service users will be met. Care staff spoken with demonstrated a good knowledge of the individual needs of service users. Comments received from relatives included “Service users receive wonderful care from the staff” and “We are very happy with the care given” Regular reviews of care plans occur. Daily entries in case records detailed that care had been provided inline with care plans. An incident and accident log is maintained. All incidents and accidents are monitored on a monthly basis and action is taken to reduce any identified risks. The White House Nursing Home X00021 S26255 The Whitehouse V178305 030405.doc Version 1.20 Page 11 There is good communication between staff members allowing service users to receive care that is consistent, and that allows for their changing needs to be addressed. Multidisciplinary records are maintained. These detailed that action is taken by the home to ensure that service users have access to other health care professionals. There are policies and procedures in place for ensuring that medication is handled safely. A report was available detailing that a pharmacist, approved by the local Primary Care Trust, has recently examined medication systems in the home and found them to be satisfactory. Medication was stored securely and in accordance with instructions. Trained nursing staff members handle all medication in the home. Records are maintained and kept up to date. However, there was one instance were the dosage of medication for one service user had not been logged accurately. This was noted to be a ‘one off’ incident, as all other recording was accurate and up to date. Systems are in place for ensuring that the dignity of service users is upheld. Service users spoken with said that they were treated with respect and that their views were taken into account. This was observed to be the case during this inspection. There was feedback from relatives detailing the high of support that they had received from the home at the time of their family members death. Records were available detailing that family members and service users had been consulted with about arrangements for after death. The White House Nursing Home X00021 S26255 The Whitehouse V178305 030405.doc Version 1.20 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 standard(s) 12, 14 and 15. The home continues to provide service users with a very good range of activities and takes into account individual preferences. Service users are supported to exercise choice and control. Meals are of good quality, varied reflect the preferences of service users. EVIDENCE: Feedback received from relatives was that the activities programme in the home is of a high standard. One relative said that their family member was supported to join in activities, but also allowed to choose the activities they preferred. One service user said that they enjoyed baking. There are good opportunities for trips out with the home. Some service users have been supported to access the local dial-a-ride service. Activities are offered on an individualised basis and take into account the cultural needs of service users. Systems are in place for monitoring daily living activities. Service users spoken with said that they are consulted regarding daily living in the home. There were minutes of a recent service users meeting in the home. These detailed that service users were given opportunities for exercising choice. Care records detailed that service users wishes were respected. The White House Nursing Home X00021 S26255 The Whitehouse V178305 030405.doc Version 1.20 Page 13 Observation of staff interaction with service users and discussions with relatives backed this up. Menus were inspected and found to be balanced and interesting. Observation of a mealtime highlighted that individual preferences were accommodated and that staff members had the skills to provide sensitive and discreet support to service users. Records are maintained of service user’s dietary requirements and preferences. The White House Nursing Home X00021 S26255 The Whitehouse V178305 030405.doc Version 1.20 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 standard(s) 17 and 18. Service users have their legal rights protected. Policies and procedures are in place for ensuring a proper response to any suspicion or allegation of abuse. EVIDENCE: There is a policy on confidentiality and staff members spoken with demonstrated a good knowledge of their responsibilities in relation to this. Risk assessments were in place for service users who have bedrails. Consent forms had been signed by family members regarding the use of bedrails. All service users have been given the option to vote in the recent general election. Those who wished to do so were given support. Policies and procedures were in place for responding to any suspicion of, or allegations of abuse. Records detail that all staff members have undergone training in abuse. Discussion with some staff members confirmed this. Systems are in place for ensuring that a Protection of Vulnerable Adult list check is carried out on each staff member prior to them commencing work in the home. The White House Nursing Home X00021 S26255 The Whitehouse V178305 030405.doc Version 1.20 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 standard(s) 19, 23, 24, 25 and 26. Improvements have been made to the décor and hygiene standards in the home. Service users live in a home, which is safe, comfortable, homely and well maintained. EVIDENCE: A number of bedrooms have been redecorated since the last inspection of the service. Carpets identified as being in need of replacement have been replaced. There has been consultation with some family members about the redecoration. All areas viewed were decorated to a high standard. There is a routine programme of maintenance and high standards of maintenance in the home reflect this. The home complies with the requirements of the local fire service. All bedrooms provide space that is in line with regulation. Bedrooms viewed were well furnished and equipped and contained service user’s personal possessions. Service users spoken with said that they were happy with their bedrooms. Bedroom door keys are provided if this is requested. The White House Nursing Home X00021 S26255 The Whitehouse V178305 030405.doc Version 1.20 Page 16 Bedrooms viewed provided service users with appropriate heating, lighting, water supply and ventilation. Window restrictors are in place. Each bedroom has an overhead, and bedside light. Emergency lighting is provided in each bedroom, as well as all corridors. Testing for legionella occurs. Visiting relatives said that hygiene standards in the home were high. There are cleaning schedules, with records maintained. Policies and procedures are in place in relation to the control of infection. The home complies with the Water Supply (Water Fittings) Regulations 1999. The White House Nursing Home X00021 S26255 The Whitehouse V178305 030405.doc Version 1.20 Page 17 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) 28, 29 and 30. The procedures for the recruitment of staff do not fully provide the safe guards to offer protection to service users. There are good procedures in place for staff training and development. This ensures that staff members are competent to do their jobs. However, the home is not on target to having 50 of the staff team qualified at NVQ Level 2 in Care. EVIDENCE: 43.7 of the staff team have achieved a qualification at NVQ Level 2 in Care or equivalent. The home reports that it has experienced difficulties in achieving a 50 ratio of NVQ qualified staff due to staff turnover. It is also acknowledged that some staff members who do not have NVQ Level 2 in Care or equivalent have achieved other health and care related qualifications. Staff files were examined. Application forms, identification documentation, including photographs, references, pin numbers, Criminal Records Bureau and Protection of Vulnerable (POVA) Adult list checks were available. However, documentation available detailed that two staff members had commenced employment in the home, prior to satisfactory Criminal Records Bureau checks being obtained. Protection of Vulnerable Adult list checks had been made regarding these staff members prior to employment. All staff members undergo induction and foundation training that is in line with The National Training Organisation for Social Care specifications. There were records detailing that since the last inspection of the service, training has occurred in moving and handling, abuse, food hygiene, dementia awareness The White House Nursing Home X00021 S26255 The Whitehouse V178305 030405.doc Version 1.20 Page 18 and bereavement support. Certificates of food hygiene were available for inspection for all staff members working with food. Both relatives and service users stated that staff members were supportive and caring. The White House Nursing Home X00021 S26255 The Whitehouse V178305 030405.doc Version 1.20 Page 19 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) 31, 33, 34, 35, 36, 37 and 38. There is good leadership and guidance to ensure that staff members are able to provide consistent, good quality care. An effective quality assurance system allows service users to be involved in making decisions that affect them. Service users are safeguarded by the accounting and financial procedures in the home. Safe working practices ensure the safety and well being of service users. EVIDENCE: Staff members describe good support from the home’s management. Both service users and their relatives spoke highly of the Registered Manager. The Registered Manager has fifteen years experience of management of care homes. She has demonstrated a commitment to achieving a management qualification. The White House Nursing Home X00021 S26255 The Whitehouse V178305 030405.doc Version 1.20 Page 20 Good progress has been made in providing an effective quality monitoring system, based on seeking the views of service users and other stakeholders. The results of a recent survey were made available for inspection. Feedback from this survey has been made available to service users. A business plan has been produced and this reflects the views raised through the quality monitoring survey. Documentation was available regarding accounting and financial procedures in the home. Records are maintained of all money held on behalf of service users. One family member said that they were provided with receipts and access to records of financial transactions. Staff members spoken with were clear about their roles. There were records detailing that regular formal supervision occurs. Informal supervision is recorded to occur for non-care and nursing staff. Records maintained in the home were noted to be up to date, in good order and held securely. There was a detailed risk assessment in relation to fire and records indicate that the fire alarm, fire equipment and emergency lighting are tested on a regular basis. The local fire officer has recently visited the home. Staff members report that regular fire drills occur and there were records to confirm this. Documentation was in place detailing that up to date safety checks have been made on the gas, electricity and water system. The White House Nursing Home X00021 S26255 The Whitehouse V178305 030405.doc Version 1.20 Page 21 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 x 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x 3 3 3 3 STAFFING Standard No Score 27 x 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x 3 3 3 x 3 3 3 2 3 3 The White House Nursing Home X00021 S26255 The Whitehouse V178305 030405.doc Version 1.20 Page 22 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 29 Regulation 12 (1)(a) Schedule 2 Requirement Timescale for action 01.08.05 2. 36 18 (2) The Registered Provider must ensure that a satisfactory Criminal Records Bureau check is in place for each staff member prior to them comencing work in the home. The Registered Provider must 01.08.05 ensure that non-care staff members recieve formal supervision with records being maintained of each session. 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 9 Good Practice Recommendations The Registered Provider should ensure that refresher training is provided to all staff members who handle mediction with particular reference to the completion of Mediaction Administration Records. The Registered Provider should ensure that ongoing efforts are made for ensuring that at least 50 of the care staff team are qualified at NVQ Level 2 in Care or equivalent. 2. 3. 28 The White House Nursing Home X00021 S26255 The Whitehouse V178305 030405.doc Version 1.20 Page 23 Commission for Social Care Inspection CSCI 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. 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