Inspection on 06/02/06 for White Lodge Residential Home

This inspection was carried out on 6th February 2006.

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 Lodge Residential Home 09/05/08

White Lodge Residential Home 14/11/07

White Lodge Residential Home 14/12/06

White Lodge Residential Home 15/08/05

White Lodge Residential Home 13/12/04

White Lodge Residential Home 06/07/04

White Lodge Residential Home 16/01/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE White Lodge Residential Home 67 Havant Road Emsworth Hampshire PO10 7LD Lead Inspector Mr Rodney Martin Unannounced Inspection 6th February 2006 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 Lodge Residential Home DS0000043778.V282285.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. White Lodge Residential Home DS0000043778.V282285.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service White Lodge Residential Home Address 67 Havant Road Emsworth Hampshire PO10 7LD 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) 01242 521812 Mrs Jill Cathryn Dowsett Mrs Kay Ellen Smy Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places White Lodge Residential Home DS0000043778.V282285.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Agreement to accommodate one named service user D.O.B 7/10/1945 in the category P.D (Physical Disability) Date of last inspection 15 August 2005 Brief Description of the Service: White Lodge is a residential care home providing care and accommodation for up to twenty-five service users aged 65 years and over; situated on the Havant Road, in Emsworth. The home is privately owned. White Lodge is a detached building set back from the main road. There are parking facilities and gardens to the front and rear of the home. The home has twenty-five single bedrooms, with sixteen provided with en suite toilet facilities. The home has added two new bedrooms, with en suite toilet facilities. However, the registered person decided to use the homes two double bedrooms as single bedrooms and as such did not want to vary the conditions of registration to increase from twenty-five to twenty-seven service users. Approval was given on 13 April 2005 for the two extra bedrooms. White Lodge Residential Home DS0000043778.V282285.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Since the last inspection, dated 15 August 2005, Kay Smy was registered as manager of White Lodge on 5 September 2005. There was no action required, following the last inspection. However, the manager had implemented the recommendations made in the last report. These are noted in the body of this report. The unannounced inspection took place between 9.30am and 12noon. The registered manager was available, on the day of the visit. On the day of the visit the home was accommodating twenty-three residents. Since the last inspection, there have been four admissions and four discharges, two through the death of the service user. The manager reported that the home had been full the previous week, with twenty-five residents. However, one service user went into a nursing home and another died at the weekend. All thirty-eight standards, including the key standards have been inspected during this inspection year. What the service does well: There is a commitment to providing good care in the home. Residents spoken to commented on the caring nature of the staff team. One resident said that the staff “are excellent”. There is a good choice of meals, which are varied, plentiful and well managed to meet residents’ individual taste and preferences. The home provides a safe environment to live in. The home has good systems in place and a good staff team. White Lodge Residential Home DS0000043778.V282285.R01.S.doc Version 5.1 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 report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. White Lodge Residential Home DS0000043778.V282285.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection White Lodge Residential Home DS0000043778.V282285.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 4 and 5 Residents assessed needs and aspirations are being met within White Lodge. Prospective residents are able to make an informed choice about whether or not the home is able to meet their particular needs. EVIDENCE: Since the last inspection on 15 August 2005, the home had four admissions and four discharges, two through the death of the service user. The manager reported that the home had been full the previous week, with twenty-five residents. However, one service user went into a nursing home and another died at the weekend. On the day of the visit a couple visited White Lodge, looking for a place for their aged mother. The manager gave them an information pack and advised them to contact Adult Services [previously known as Social Services] regarding an assessment for residential care and for the funding. Following a referral to the home the relative normally visits first and then the prospective service user is invited to view White Lodge. The prospective service user can also be White Lodge Residential Home DS0000043778.V282285.R01.S.doc Version 5.1 Page 9 visited in hospital or in their own home. Three of the last four admissions were from privately funded clients. The pre-admission assessment forms, which are kept separately, were viewed and there was evidence that service users were appropriately placed within White Lodge and that the home was meeting their assessed needs. Service users, spoken to, confirmed that they had settled in White Lodge and that caring staff met their care needs. Since the last inspection, the manager has produced a file for short stay clients, to be kept in their bedroom, to include the statement of purpose, service users guide, a copy of the home’s brochure, a copy of the terms and conditions of residency, useful information about meal times and sample menus, fire procedures, activities et cetera, and an exit questionnaire. White Lodge Residential Home DS0000043778.V282285.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 There is a clear consistent care planning system in place to adequately provide staff with the detailed information they need to satisfactorily meet residents’ needs. EVIDENCE: All the care plans are kept in one folder. The care plan covers activities of daily living, mental and emotional health, social interests, hobbies, religious and cultural needs and any carer/family involvement. Each care plan has a photograph of the resident, for identification. Residents have signed their care plan. The home has a separate care plan update file. All the care plans had been updated monthly and were last reviewed in January 2006. The home has separate files for the pre-admission assessment forms, the care plan, care plan update [monthly reviews] and contact sheet [for recording daily information about the resident]. The manager agreed to keep all the relevant information, assessments and care plans about residents, in separate, individual files, for ease of reference. The use of a separate hobbies/activities care plan was discussed and, again, this could be included in the individual resident’s file. White Lodge Residential Home DS0000043778.V282285.R01.S.doc Version 5.1 Page 11 Although the other standards were inspected and met on the previous inspection, it was confirmed that service users’ health needs are met. One resident said that they were waiting for a follow up visit from their GP, after a recent consultation and new medication prescribed. A district nurse also visited the home, on the day of the visit, to attend to the needs of three residents. The manager requested that the district nurse have a look at another resident, whilst in the home. White Lodge Residential Home DS0000043778.V282285.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 15 The quality and quantity of food provided is well managed and reflect variation for residents. Although there has been improvement in the activities programme residents would still benefit from a fuller programme during the week. EVIDENCE: White Lodge has a monthly calendar of activities, although there were gaps during each week. Currently residents participate in music and movement every Monday morning. The person taking the session was spoken to and they stated that the residents enjoy this activity. There is also bingo and a games afternoon. An outside entertainer has been booked for 7 February 2006. The mobile library bus visits the home to enable residents to be able to choose their library book. This is a service that is appreciated. The next visit is planned for 9 March 2006. One resident said they used to go to the Red Cross club but, unfortunately, this activity closed down. However, they enjoy going to church once a month and attending a senior citizens meeting at the church, in the week and the British Legion, once a week. There is a bird table that residents enjoy watching the birds and squirrels taking the nuts that are put out for them. White Lodge Residential Home DS0000043778.V282285.R01.S.doc Version 5.1 Page 13 The assistant manager has been given the responsibility of arranging activities within the home. Attendance on an activities course for the elderly was discussed as a way of obtaining further ideas and material for providing useful activities within White Lodge. Although the home has used a questionnaire to find out residents’ views on a variety of topics, including activities, it is recommended that individual resident’s interests, hobbies and preferred activities is sought to enable the home to plan more meaningful, activities. The use of an activities/hobbies care plan was discussed and the manager agreed that this would be a useful tool to meeting the needs of residents. Service users are mainly traditional in their preferences. However, they have a choice each day of main course. On the day of the inspection service users could choose from homemade chicken and ham pie, vegetarian quiche or cheese salad. There was apricot pancakes, fresh fruit or low fat yoghurt for dessert. One resident said that they had put on a lot of weight, since coming to White Lodge, as a result of the good food provided. Other residents, spoken to, said that the meals were good and there was always plenty to eat. The menu is displayed on a notice board to inform residents what meal is available each day. Residents, spoken to, were aware of were to look and found it useful. The cook was not aware that food hygiene legislation had changed from 1 January 2006. Homes need to have a documented food safety management system in place, where the handling and preparation of food is risk assessed. It was agreed that this would be implemented. White Lodge Residential Home DS0000043778.V282285.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 The home has a satisfactory complaints procedure, which residents feel able to use. EVIDENCE: The home’s complaints procedure is contained in the statement of purpose and service users guide and contains details of the steps for making a complaint and how someone can contact the Commission. The home has a complaints log. Although the Commission has not received an official complaint, two complaints were recorded in the complaints log, since the last inspection. These were in September 2005 and were from two separate relatives who had complained about the lack of hot water. It was recorded that over a period of some six weeks the home had five call outs from a plumber. However, on 19 September it was diagnosed that the boiler needed a new pump. This has resolved the problem and the matter had been dealt with within the timescale. White Lodge Residential Home DS0000043778.V282285.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 Residents live in a clean, safe and pleasant environment, where they have individualised their bedrooms, to meet their needs. EVIDENCE: The above standards were all inspected and met on the previous inspection. From a tour of the building there was evidence that the location and layout of the home is suitable, homely, safe and well maintained for residents’ use. The home is due to have a kitchen modernised in February 2006, with stainless steel units and more hygienic cupboards. Although the cook stated that she has all the equipment she requires, the addition of new work surfaces will be an improvement. White Lodge Residential Home DS0000043778.V282285.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Sufficiently trained and supervised staff ensure that residents’ needs are met. EVIDENCE: Since the last inspection one staff member has left, although the home has recruited a night staff care assistant and a day care carer, who lives on the premises in accommodation on the top floor. The home has taken the necessary recruitment checks for new staff. The manager reported that the home does not require any more staff members. Residents, spoken to, said there was evidence of more staff members on the shifts and that caring staff met their needs. One resident had written in their questionnaire about staff “they are excellent”. White Lodge has a deputy manager as well as an assistant manager. The latter works more in the evening and so there is more management cover throughout the day. Apart from the management team who have NVQ’s [nation vocational qualification] one carer has NVQ level 2 in care. However, the home has a good in-house basic core-training programme. This includes basic first aid, coping with aggression, dementia training, diet and nutrition, fire safety awareness, food hygiene, health and safety, infection control, manual handling and risk assessment. One staff member, spoken to, said that they appreciated the training and although they found the written work more difficult enjoyed the opportunity to learn and build on their knowledge and skills in the caring profession. White Lodge Residential Home DS0000043778.V282285.R01.S.doc Version 5.1 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 and 36 The manager provides good leadership, which ensures staff are supported and residents’ welfare and finances are promoted and protected through the home’s practices. EVIDENCE: Since the last inspection Kay Smy became the registered manager on 5 September 2005. She has nearly finished NVQ level 4 in management and care and then will go on to complete the extra units for the registered managers award for NVQ level 4 in both management and care. White Lodge has a deputy manager as well as an assistant manager. The latter works more in the evening and so there is more management cover throughout the day. The proposed manager communicates a clear sense of direction and leadership within White Lodge. There was a relaxed atmosphere in the home. White Lodge Residential Home DS0000043778.V282285.R01.S.doc Version 5.1 Page 18 Since the last inspection the manager had given out a questionnaire for residents to complete. This had eight questions about various aspects of living in White Lodge. One resident had written that the staff “are excellent”. They had also written about minor issues they felt they had within the home. The inspector spoke to this resident and they reported that the issues had been resolved. There is a condition that where the proprietor is not the registered manager there needs to be regular unannounced monthly visits to White Lodge, with a report made and a copy sent to the Commission [Regulation 26 reports]. Although visits had taken place [the last one was on 20 January 2006] it was noted that a copy of the report was not sent to the home or a copy sent to the Commission. It was agreed that reports would be sent and that there would be future compliance with the action required. The manager is not agent or appointee for any service user. Service users and/or their relative/representative manage their finances. The home has previously had money given them by relative(s) to hold for incidentals, the home does not currently manage any service user’s money or hold cash for them. For additional services such as hairdressing, chiropody, newspapers/magazines, the service provider bills the home, if residents do not pay at the time. This in turn is sent to the home’s accountant who adds the amount(s) to the resident’s monthly account. The manager has a stock of every day items such as shampoo, toothpaste, disposable razors et cetera. Residents can purchase these items either in cash or the manager would send the details to the home’s accountant for inclusion on the next monthly account. Some residents are subject to an enduring power of attorney or power of attorney order. A system of supervision is in place. Staff have had an annual appraisal and have regular supervision sessions. Staff gave positive feedback about the management of the home. White Lodge Residential Home DS0000043778.V282285.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 10 X 11 X 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 X 3 X X X X X X X STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X X White Lodge Residential Home DS0000043778.V282285.R01.S.doc Version 5.1 Page 20 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations White Lodge Residential Home DS0000043778.V282285.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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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