Inspection on 08/10/08 for White House Residential Home (The)

This inspection was carried out on 8th October 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

White House Residential Home... 11/10/07

White House Residential Home... 01/11/06

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Snydale Care Home

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Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: White House Residential Home (The) The White House 29 Beverley Road Driffield East Yorkshire YO25 6RZ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jo Bell     Date: 0 8 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: White House Residential Home (The) 29 Beverley Road The White House Driffield East Yorkshire YO25 6RZ 01377257560 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Rachel Helena Merrills Type of registration: Number of places registered: Accomodating Care (Driffield) Limited care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home The White House is an adapted building with a purpose-built extension originally opened as a care home in 1986. It is situated in its own well-maintained grounds and public transport to Driffield town centre passes the door. Staff cover is maintained throughout any 24-hour period and includes personal care, catering, laundry and maintaining a clean environment. Each service user is registered with a general medical practitioner who addresses their primary health care needs and can access the more specialised health services as required. The original building is on three levels serviced by a passenger lift. The top floor is for private use only. Communal areas consist of two lounges and a dining room set out with individual tables and chairs. Care Homes for Older People Page 4 of 25 Over 65 0 20 20 0 Brief description of the care home There is also a well-used quiet area in the entrance with two easy chairs. The rear entrance doors give level access to the gardens provided with outdoor seating. There is a car park for approximately six cars. The home has sixteen single and two shared bedrooms. Fifteen of the bedrooms have en-suite facilities, two of them with showers. Two of the bedrooms are shared. The home has two bathrooms, one of which is unassisted and there are sufficient toilets on both floors. Information about the services provided is available in the home in the form of a service users guide and statement of purpose. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. We went to the home without telling them that we were going to visit. This report follows the visit that took place on the 8th October 2008. The visit lasted from 10.0 Care Homes for Older People Page 6 of 25 until 15.00. The weekly fees for the home are 286-385 Pounds, extra charges are made for chiropody, hairdressing and newspapers. The purpose of the visit was to make sure that the home was operating and being managed in the best interests of people living there. Information has been used from different sources for this report. These sources include: Reviewing information that has been received about the home since the last inspection. The annual quality assurance assessment. This is information, which details what has happened during the past 12 months. Notifications (Regulation 37) relating to incidents in the home affecting people using the service. Details of complaints and allegations raised by people connected to the service. Progress of the previous requirements and recommendations made at the last site visit. No survey information was received. At the site visit one inspector spent 5.0 hours at the home. During this time observations of care practices took place. People using the service were spoken with along with some relatives. Discussions with the manager regarding meeting needs, mealtimes, protecting people and the environment took place. The lunchtime meal was observed and time was spent inspecting care plans, looking at individual rooms and reviewing a selection of health and safety information. Staffing and management issues were discussed and feedback was given to the manager at the end of the inspection. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 8 of 25 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are effectively assessed prior to admission, which helps to ensure individual needs can be met. Evidence: Pre-admission assessments are undertaken on people who are funded through social services or self funding. The three pre-admission assessments looked at confirmed that a senior person completes an assessment before an individual moves to the home. This is to check what type of care and support the person needs and whether the staff have the skills and knowledge to provide that care if the individual chooses to move there. The process also reassures the individual and their family that they will receive the right support. The Annual Quality Assurance Assessment confirmed that people receive a welcome pack and a letter following the pre-admission assessment. This informs people if the home is bale to offer them a permanent place. Care Homes for Older People Page 11 of 25 Evidence: The home does not offer intermediate care. Care Homes for Older People Page 12 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their health and personal care needs met in a dignified manner. Though more detailed information regarding nutrition would be beneficial. Evidence: People looked clean and well cared for. Three care plans were looked at during this visit. These describe the care and support people need to stay in charge of their own lives as much as possible. The plans looked at contained a lot of information, so that an unfamiliar carer could look at them and would be able to work out how much support they needed. There were written assessments as to whether people were at risk of developing pressure sores, a health problem or needing help with moving and handling. Those identified as at risk had a care plan in place describing how that risk was to be managed. The care plans have improved since the last visit and key workers are more involved with these and staff have received training in how to effectively complete the plans. Monthly reviews and evauluations take place. This helps identify any changing needs. Care Homes for Older People Page 13 of 25 Evidence: People have their likes and dislikes regarding food and drink documented and people are weighed on a monthly basis. It would be beneficial having a nutritional assessment tool. This would identify which people were at risk of being underweight or overwieght and any potential problems. However, staff know how to liasie with doctors, dieticians, tissue viability and the community mental health team. The medicaiton system was inspected. Staff have received training in how to administer, record, store and dispose of medicaiton. The treatment room is also the laundry, and whilst this room was warm temperatures are taken to ensure it is not too hot to store medication. Medication charts are in good order and stock balances take place. Medication is stored correctly and the home have a medication policy and procedure for staff to refer to. No concerns were rasied regarding medicaiton. Throughout the day people were observed interacting with staff positively. Staff spoke in a pleasant, professional and dignified manner and privacy was maintained. People are able to bring their personal possessions into the home when they are admiitted. Three rooms were inspected which confirmed this. Care Homes for Older People Page 14 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People participate in a range of activities and visitors are welcomed. Staff encourage autonomy and choice, and people enjoy dining in pleasant surrounding with appealing food. Evidence: People participate in a range of activities. This includes dominoes, cards, television music and weekly exercise classes. One person said I love playing dominoes, another person said I like watching television. Currently there are eleven people using the service, staff spend time on an afternoon facilitating activities and offering one to one sessions. A jigzaw had been completed and in the future the home is hoping to have a jigzaw club during the evening for people to take part in. Social history inforamtion is obtained when people are admitted to the home, and the key worker is involved with this. Visotrs are welcomed into the home at anytime and autonomy and choice is encoruaged. One person sai I get up when I want, and the staff help me. The daily routines are dependant on the needs of the individual. Regligous needs are recorded in the care plan and Communion takes place on a regular basis. The Annual Quality Assurance Assessment confirmed that most people are from the smae religious backgound and many people have lived in the Driffield area for a number of years. Care Homes for Older People Page 15 of 25 Evidence: One Scottish person said she has been made very welcome by people using the service and staff, another person has been in the home for four months and said I like living here. The lunchtime meal was observed. The dining area is light and airy with enough chairs and tables for everyone to sit down at the same time. Some people choose to have their meal in their own room or another communal area, and the mealtimes are flexible with the pace been set by people using the service. The food is all home-made which people were observed enjoying. Staff have completed food hygiene training and are aware of how to adapt food to suit the individual. For example pureed diets, daibetic or specialised diets. One person was given a choice of dessert as they were diabetic. Oen main course is offered though alternatives are always available. The cook asks people what they liked about the food and adpats the menu accordingly. Teh kitchen area was clean and the cook ahs many years experience preparing and cooking food for older people. It was evident that the cupboards and some equip,ment was very old and could do with replacing. Care Homes for Older People Page 16 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their concerns listened to and acted upon, and staff are alert to signs of abuse which helps protect people from harm. Evidence: The home have a complaints procedure in place which everyone is made aware of when they come into the home. This includes people using the service and their relatives. A complaints file and form has been implemented to ensure complaitns are dealt with effectively in a timely manner. No formal complaints have been made in the past twelve months. The home has a grumbles book and people are encouraged to verbalise any issues with memebrs of staff when they arise. There is also a three monthly residents meeting where people discuss any issues of concern. People feel safe in their environment. Staff were observed treating people in a pleasant manner. Staff have undertaken abuse awareness trainign and are alert to signs of abuse. The home have a vulnerable adults procedure in place and staff know how to Whistle Blow. This helps protect people from harm. Care Homes for Older People Page 17 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a comfortable and clean environment. Evidence: People enjoy living in this welcoming, warm and odour free environment. Maintenance checks are carried out and plans for redecoration are in place. The communal areas are easily accessible, and the home has items on display which give it a homely feel. People spoken to all said they like their rooms. The area outside can be accessed via a ramp and people are kept secure within the grounds of the home. The call bell system is in good working order which means people get the assistance they need in a timely manner. There are enough domestic staff to keep the home clean. Staff have undertaken infection control training and know which protective clothing to wear to prevent crosscontamination. The laundry room is also a treatment room, having two separate rooms would be beneficial. People throughout the day were seen wearing clean and well ironed clothes. One person said staff do my washing, then it is put back in my room. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are cared for by enough staff, who are competent, well trained and generally safely recruited to meet individual needs. Evidence: The home employ enough staff to care for the eleven people living at the home. Senior care staff and carers work shifts throughout the day and night in order to meet individual needs. The client group includes older people who may have dementia. Staff undertake NVQ Level 2 in Care (90 are undertaking this) and three staff have commenced an NVQ Level 3 in Care. This helps to maintain good standards of care. All new staff complete induction training which is equivalent to Skills for Care . This details care practices, health and safety and mandatory training needed so staff are competent to carry out their role. Recruitement files were inspected and a discussion took place with the manager regarding the process. Two written references are obtained and new staff complete a police check and protection of vulnerable adults check prior to starting work. This helps protect people from harm. Staff have repeat police checks every three years. Care Homes for Older People Page 19 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is generally run in the best interests of the people using the service. Though minor improvements could me made to health and safety. This will help protect people. Evidence: The manager has worked in a care setting for eighteen years, she has recently completed her Registered Managers Award. She is enthusiastic, approachable and professional. People are happy to discuss issues with her and comments included The manager will sort things out for me. She is always chatting with people. The manager is supported by a deputy and care staff. Regulation 26 visits take place, these detail what has been happening in the home and what improvements are needed. The home have a Quality Assurance system in place whihc covers auditing of healht and safety, accidents and questionnaires which are sent out to people. There are regular meetings which are minuted and staff receive Care Homes for Older People Page 20 of 25 Evidence: verbal information regarding their likes and dislikes. The policy does not reflect what is happening in practice. Medication and care plan audits need to be recorded and the whole system needs to be more clearly documented so there is a robust audit trail. The home is currently working towards Investors in People which is an award for meeting a range of standards relating to care and running a home. People can access their personal monies in the home. Money is safely stored and records are kept regardign the money coming in and going out. This is discussed with people during their admission. Health and safety was discussed. Staff completed fire training, moving and handling, infection control and food hygiene training every year. Staff spoken with confirmed this, and records were in place which evidenced this. A maintenance person is available to ensure the home is kept safe. A fire risk assessment has been completed and staff know what to do in the event of a fire. Staff were observed moving and handling people safely throughout the visit. Water temperatures were discussed, some checks have previously taken place to identify the wtaer temperature in bedrooms. However, this is not done regularly and some rooms have not been checked since 2007. This needs to be carried out and recorded. This will show if the water is too hot or too cold, then action can be taken. Sample temperatures were taken and these were found to be normal. A selection of health and safety certificates were isnpected, and inforamtion in the Annual Quality Assurance Assessment detailed the policies and procedures in place. The electrical wiring certificate was not initially available, the electrician confirmed that there were twelve minor recommendations from 2006 that had not been completed. The manager had not been aware of this. A copy of the certificate was later obtained and the work will start shortly to address these issues. Care Homes for Older People Page 21 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 37 17 Well kept records of water temperatures must be in place. These must be completed on a regular basis. This will identify if the water is too hot or too cold for people, and provide a clear audit trail. Then action can be taken accordingly. 15/10/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 8 Staff should get more information regarding nutrition, an assessment tool would help this. This would ensure people have their nutritional needs understood and met. The manager should make sure that she is aware of the police and protection of vulnerable adults checks that existing staff have undertaken. The Quality Assurance policy should be updated to reflect the homes current practice. Any auditing needs to be well recorded. The recommendations identified in the electrical wiring certificate need to be addressed. The manager should be Page 23 of 25 2 29 3 37 4 38 Care Homes for Older People aware of all health and safety reports and the action needed to address any outstanding issues. Care Homes for Older People Page 24 of 25 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!