Inspection on 31/08/05 for White Lodge Rest Home

This inspection was carried out on 31st August 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

White Lodge Rest Home 26/09/07

White Lodge Rest Home 22/11/06

White Lodge Rest Home 12/12/05

White Lodge Rest Home 28/02/05

White Lodge Rest Home 19/11/04

White Lodge Rest Home 04/03/04

White Lodge Rest Home 20/01/04

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 Rest Home 79-83 Alma Road Portswood Southampton SO14 6UQ Lead Inspector Lorraine Parton Unannounced 31 August 2005 9:00 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. White Lodge Rest Home H55-H03 S11852 White Lodge V224289 310805.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service White Lodge Rest Home Address 79-83 Alma Road, Portswood, Southampton, Hampshire, SO14 6UQ 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) 023 8055 4478 Mr Michael J Foot Mr Michael J Foot Care Home 27 Category(ies) of Dementia (27), Dementia - over 65 years of age registration, with number (27), Mental disorder, excluding learning of places disability or dementia (27), Mental Disorder, excluding learning disability or dementia - over 65 years of age (27), Old age, not falling within any other category (27) White Lodge Rest Home H55-H03 S11852 White Lodge V224289 310805.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Up to 5 service users aged 60-65 years may be accommodated. Date of last inspection 28/2/05 Brief Description of the Service: Whitelodge is a large care home situated in Southampton and is close to local facilities. The home is registered for twenty seven service users within the categories of old age, dementia and mental health. The home is owned and managed by Mr Foot. The home provides accommodation in a range of double and single rooms and some rooms are on the ground floor. The home has two lounges and dining rooms a kitchen and suitably located bathrooms and toilets. To the front of the house is a small garden and to the rear is a nicely maintained garden and patio which are accessable to service users. White Lodge Rest Home H55-H03 S11852 White Lodge V224289 310805.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on the 31st August 2005 and took 5.25 hours. The inspector was assisted by the proprietors representative and the homes staff who were all found to be professional and helpful throughout the inspection. The inspector audited 23 standards only and the remaining standards where relevant will be assessed at the next inspection. The inspection involved a walk around the home, discussions with service users, two visitors and with the homes staff. The inspection also involved an audit of some of the homes documentation relevant to the provision of care for the service users living at the home. The inspector received one comment card from a service user, although the home advised the inspector that they had sent several comment cards to the Commission for Social Care Inspection. Comments received in the comment card and throughout the inspection were found to be positive about the services they or their relatives received. Service users confirmed that they were happy living at the home. What the service does well: The home provides a homely and welcoming environment that enables service users to access all areas of the home and garden. All service user rooms are personalised and service users are encouraged to have their own personal possessions in their rooms. Service users spoken to advised the inspector that the homes staff provide an excellent service and comments received included “nothing is to much trouble” and “ the staff are very caring and respectful”. The inspector witnessed staff interactions with service users and noted the obvious good relationships that were in place. Care plans were found to be in place and service users stated that the care that they received was good. All service users spoken to advised the inspector that the home provides an excellent choice of meals and that the quality of the meals are good. Service users stated that the home offers a variety of choices . White Lodge Rest Home H55-H03 S11852 White Lodge V224289 310805.doc Version 1.40 Page 6 Service user activities and leisure times provided by the home were found to be excellent, however, service users advised the inspector that they would like to go out more. The home aims to promote individual choices and the promotion of independence. Service users are able to participate in the home. The home provides a range of equipment and games for the use of service users. Many of the staff working at the home are trained to NVQ 2 level and staff spoken to displayed a commitment to providing a high standard of care and support to the service users living at the home. All staff displayed an understanding of service user needs. The home is committed to ensuring its staff team are trained in areas relevant to service user needs. What has improved since the last inspection? What they could do better: Whilst the home has started to undertake staff supervisions most of the staff have not received supervision. The proprietor’s representative agreed these would be implemented. A further requirement has been made. The proprietors representative advised the inspector that service user meetings are held occasionally and that on a daily basis service users are spoken with to see if there are any issues. The home has started to complete questionnaires and these are available for service users and visitors to the home. Service users spoken to confirmed that their views are listened to and that the home acts on their concerns. Following discussions, the home does not document the meetings and it is recommended that the home formalises their monitoring of the quality of the service it provides. White Lodge Rest Home H55-H03 S11852 White Lodge V224289 310805.doc Version 1.40 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 Lodge Rest Home H55-H03 S11852 White Lodge V224289 310805.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection White Lodge Rest Home H55-H03 S11852 White Lodge V224289 310805.doc Version 1.40 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 standard(s) 3, 5, 6 New service users are only admitted following an in depth assessment of their needs. The home offers prospective service users or their representatives an opportunity to visit the home prior to agreeing to move in. The home does not admit service users who require intermediate care. EVIDENCE: The home has had several new admissions and on audit of two new admission files these were found to contain an in depth assessment of needs undertaken by the homes care manager. The care manager had spoken to the service user either in their homes or hospital and had also ensured that family or carers views had been documented as part of the assessment. The home has a visiting policy that affords prospective service users or their representatives to visit the home prior to agreeing to move in. The inspector spoke to two new service users who confirmed that they or their family had White Lodge Rest Home H55-H03 S11852 White Lodge V224289 310805.doc Version 1.40 Page 10 visited the home on their behalf. One service user advised the inspector that they had visited twice and that the home had afforded them the opportunity to have a meal with the other service users, which they found beneficial to their decision to agreeing to move in. White Lodge Rest Home H55-H03 S11852 White Lodge V224289 310805.doc Version 1.40 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 standard(s) 7, 8, 9, 10 All service users have a care plan, which had been reviewed to include all specific information. All service users health care needs have been assessed and where necessary have access to relevant health care professionals. Service users confirmed that the homes staff, treat them with dignity and that their privacy is respected at all times. Medication practices were safe. EVIDENCE: The inspector audited five service user plans, which were found to contain relevant care planning information, risk assessments, health care professional involvement where necessary, occupational therapist assessments and guidance for moving and handling for service users requiring this assistance and records of monthly and 6 monthly reviews. Two new service users file displayed that an assessment of needs had been undertaken. The home had reviewed care plans of service users with a mental illness in conjunction with the mental health team and had developed the care plans to take into account White Lodge Rest Home H55-H03 S11852 White Lodge V224289 310805.doc Version 1.40 Page 12 specific issues. These were found to be in depth and included the action staff needed to take if these issues were being experience by the service users. The home had also completed risk assessments for specific issues associated with individual service users mental health. All service users are afforded access to relevant health care professionals and service users are registered with a general practitioner of their choice. Care needs are incorporated into service user plans. Any issues relating to health were found to be well documented in daily records, which included referrals to general practitioners and district nurses. Service users spoken to confirmed that the homes staff, respect their views and the need for their privacy and dignity to be up held. Staff were seen by the inspector to knock on doors before entering and interacting with service users in an equal and respectful manner. Service users confirmed that they receive personal care in private and are able to receive treatments and consultations in their bedrooms in private. The home operates within a medication policy and the home has a copy of the Royal Pharmaceutical Society guidelines. The home keeps a record of medication received, administered and returned to pharmacy. The home operates a monitored dosage system provided by the local pharmacist who visits the home on a regular basis. Only staff who are trained in the safe handling of medication course give medication. A refresher course has been booked with the pharmacist on the 12/9/05. On audit of the homes medication and records they were found to be satisfactory. White Lodge Rest Home H55-H03 S11852 White Lodge V224289 310805.doc Version 1.40 Page 13 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, 13, 14, 15 Service users are supported in their chosen lifestyles and encouraged to make choices about their lives. Service users are supported in whom they choose to have contact with. All service users are supported if necessary with access to the community. Service users confirmed that the home provides excellent food of their choice. EVIDENCE: All service users choices in lifestyles and preferences in activities are clearly documented in service user plans. Service users spoken to advised the inspector that the home provides activities and facilities that meet their personal wishes, however, several service users stated that they would like to go out more. The home occasionally arranges visits to local venues. Some service users go out alone and access local facilities of their choice. This includes shopping, hairdressers and going to church. One visitor advised the inspector that the home supports their relative to attend family occasions and that staff always support service users wishing to go out. White Lodge Rest Home H55-H03 S11852 White Lodge V224289 310805.doc Version 1.40 Page 14 The home offers a range of in house activities and this includes games, musical sessions/visiting musicians, singalongs and fitness sessions. Service users confirmed that the homes staff ask them what they want and do their best to provide it. The home provides a range of equipment for service users to use and this includes games, books, and puzzles etc. At the time of the inspection the inspector witnessed an arts and crafts session being held and staff offering manicures to service users. Arts and crafts was being undertaken by a visiting professional that they home had employed. Service users spoken to confirmed that the home supports their choices in involvement in the home and participation in activities provided by the home. Service users who wish have personalised their rooms and some rooms contain service users own furniture and belongings. Service users confirm that they have access to television and music in their rooms if they wish. The home has a visiting policy, which affords and encourages visitors at any reasonable time. Service users confirmed that they are able to see visitors in private in their own rooms and elsewhere in the home if not in use by other service users. Two visitors to the home confirmed that they were able to visit when they wished and that the homes staff always made them feel welcome. Service users spoken to stated that the home provides good food and offers a choice of menu. Menus display a well balanced and nutritious variation, which, the staff stated are based on service users likes and dislikes. Individual choices and needs in food are catered for and this includes likes, dietary needs and special requests. The inspector was present for the lunch time meal and it was noted to be well presented and nutritious. Meal times were noted to be relaxed and service users who were being supported were not rushed and their dignity was maintained. White Lodge Rest Home H55-H03 S11852 White Lodge V224289 310805.doc Version 1.40 Page 15 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) 16, 18 Service users are aware of how to make a complaint and to whom. The home has procedures and practices in place to protect where possible service users. EVIDENCE: The home has a complaints procedure that is on display in the entrance to the home. Service users confirmed that they were aware of the complaints procedure and several service users advised the inspector that they would speak to the homes staff if they had a concern. Some service users stated they would discuss their concerns with their families or social workers in the first instance, who would then speak to the owners of the home on their behalf. Neither the home or the Commission for Social Care Inspection have received any complaints since the last inspection. A record of a complaint would be maintained if necessary. The home has a copy of Hampshires Adult Protection procedure and a whistle blowing policy. The homes staff are aware of how to implement these procedures if necessary. The home has reviewed its procedures for recruitment of staff and managing service users money since the last inspection. The home has applied for CRB and POVA for all staff that this had not been completed for. The home has implemented suitable financial procedures and record keeping for one service White Lodge Rest Home H55-H03 S11852 White Lodge V224289 310805.doc Version 1.40 Page 16 user who they keep their money in the safe for. The home has obtained written confirmation from the service user representative of this arrangement. White Lodge Rest Home H55-H03 S11852 White Lodge V224289 310805.doc Version 1.40 Page 17 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, 20, 24, 25, 26 The home is clean, safe and well maintained and provides a homely environment for service users. Service users who wish have personalised their bedrooms with their own belongings. EVIDENCE: The inspector undertook a walk around the home and identified no issues in the rooms that were entered. The home was found to be homely, clean and suitable for service users. All areas of the home are accessible to service users and the rear garden was found to be well maintained. At the time of the inspection service users were seen to be moving around the home and several service users were in the garden as they chose. One service user advised the inspector that they ‘liked being in the garden because it was the most beautiful part of the home’. White Lodge Rest Home H55-H03 S11852 White Lodge V224289 310805.doc Version 1.40 Page 18 All rooms seen were found to include service users own possessions and some rooms contained service users own furniture. The inspector noted that these rooms were homely and service users own choice. The home has a maintenance programme and repairs are carried out as and when necessary. This provides a safe environment. The home has under taken risk assessments, however, these were not fully audited during the inspection. The inspector recommended that the home undertakes risk assessments for the first floor windows where restrictors have not been fitted. These will be audited at the next inspection. White Lodge Rest Home H55-H03 S11852 White Lodge V224289 310805.doc Version 1.40 Page 19 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) 27, 28, 29, 30 The home had adequate staff on duty, who were found to be well trained and competent to do their jobs. Service users are safe. The home has suitable recruitment procedures in place for the employment of new staff. EVIDENCE: Three staff and the proprietors representative were on duty at the time of the inspection. Staff confirmed that the home is covered by two or three carers, a cook, a cleaner and a manager during the day. The inspector had access to the homes rota, which also confirmed the above. Five of the twelve staff working at the home had completed the NVQ 2 and the proprietors representative has completed the NVQ 4. Two staff are also commencing the NVQ 2 in the near future. Staff advised the inspector that they have also completed additional training in dementia and mental health since the last inspection. Service users confirmed that they felt safe in the home and that the homes staff are always supportive and professional in their approach. The home has policies and procedures in place to protect vulnerable adults. On speaking and questioning staff they displayed their awareness and understanding of the homes policies on reporting any issues that may be abuse and how to maintain White Lodge Rest Home H55-H03 S11852 White Lodge V224289 310805.doc Version 1.40 Page 20 privacy and the dignity of the service users living at the home. Staff displayed an excellent awareness of service user needs. Three staff files were audited by the inspector and found to contain all the relevant information. This included references and CRB and POVA checks. White Lodge Rest Home H55-H03 S11852 White Lodge V224289 310805.doc Version 1.40 Page 21 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) 33, 36 The home is well run for the benefit of the service users. Service users are consulted about the running of the home, however, this needs formalising. The home needs to implement a system for staff supervision. EVIDENCE: Staff, service users and visitors to the home all spoke positively about the home and the care they received. Service users confirmed that the manager or representative is available in the home almost every day and that the manager or representative seeks their views about the service it provides. The home does occasionally hold service user meetings and on a daily basis service users are spoken with to see if there are any issues. The home has started to complete questionnaires and these are available for service users White Lodge Rest Home H55-H03 S11852 White Lodge V224289 310805.doc Version 1.40 Page 22 and visitors to the home. Service users spoken to confirmed that their views are listened to and that the home acts on their concerns. Following discussions with the proprietors representative, the home does not document the meetings and it is recommended that the home formalises their monitoring of the quality of the service it provides.. The home had started to implement staff supervisions but this was found to be in the early stages and not completed for the majority of staff. This remains outstanding from the last inspection and a further requirement has been made. White Lodge Rest Home H55-H03 S11852 White Lodge V224289 310805.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 x x x 3 3 3 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 Standard No 16 17 18 Score 3 x 3 x x 3 x x 2 x x White Lodge Rest Home H55-H03 S11852 White Lodge V224289 310805.doc Version 1.40 Page 24 yes 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 30 Regulation 18(2) Requirement Implement staff supervision meetings. These must be carried out at least three monthly for all staff. This remains outstanding from the last inspection. Timescale for action 30/11/05 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. 2. Refer to Standard 33 12 Good Practice Recommendations Formalise the homes quality monitoring system. This should include service user choices and involvement in the home. It is recommended that the home looks at ways to assist service users to go out more. White Lodge Rest Home H55-H03 S11852 White Lodge V224289 310805.doc Version 1.40 Page 25 Commission for Social Care Inspection 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. Extracts may not be used or reproduced without the express permission of CSCI White Lodge Rest Home H55-H03 S11852 White Lodge V224289 310805.doc Version 1.40 Page 26 - 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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