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Inspection on 20/01/06 for White Lodge & St Helens House

Also see our care home review for White Lodge & St Helens House for more information

This inspection was carried out on 20th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

White Lodge and St Helens House provides a service for older people in a welldecorated and comfortably furnished home. The home has an easy, relaxed atmosphere and residents are clearly at ease. The home is well organised and well managed by people with the skills, knowledge, qualifications and experience necessary. Community health professionals support the home staff in caring for residents. Staff were observed throughout the inspection to be treating residents with courtesy and kindness and residents confirmed that their privacy and dignity were respected at all times. Residents are able to do as they wish at the home and join in or not with the activities on offer. There is a programme of activities on offer at the home. Visitors are always welcome at the home and residents are encouraged to maintain and develop relationships with people in the home, with their families and friends and the local community. Meals are nutritious, varied and an alternative is always available on request. The dining room is pleasant and comfortable.

What has improved since the last inspection?

The home has worked hard on improving their care plans. Removing any ambiguities over the actual current needs of residents and the care that staff are to deliver.

CARE HOMES FOR OLDER PEOPLE White Lodge & St Helens House 15-17 Boscombe Spa Road Bournemouth Dorset BH5 1AR Lead Inspector Debra Jones Unannounced Inspection 20th January 2006 11:00 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 & St Helens House DS0000003986.V279872.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 & St Helens House DS0000003986.V279872.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service White Lodge & St Helens House Address 15-17 Boscombe Spa Road Bournemouth Dorset BH5 1AR 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) 01202 395822 01202 777414 Mr John Higginson Mrs Christine Higginson, Mrs Karen Frances Watt, Mr Peter John Higginson, Mrs Caroline Jane White Care Home 54 Category(ies) of Old age, not falling within any other category registration, with number (54) of places White Lodge & St Helens House DS0000003986.V279872.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named person (as known to the CSCI) under the age of 65 may be accommodated to receive care. 25th August 2005 Date of last inspection Brief Description of the Service: White Lodge and St Helens House are adjoining properties with an extension that links them on each level. The home is registered to accommodate fiftyfour residents in the old age category. All residents enjoy single rooms, which offer a wide variety of sizes and outlook. The buildings were constructed on sloping land and are on four levels, lower ground, ground, first and second floors. The home has a passenger lift. There are pleasant well-maintained gardens at the rear of the property, but access for frail residents is limited as there is a steep path and steps to gain access. The home is located within a ten-minute walk of the Boscombe shopping area and the local beach; the latter requires the negotiation of a small hill. The home has a regular programme of social activities and seasonal outings. White Lodge & St Helens House DS0000003986.V279872.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 3 hours on the 20 January 2006 and was the second of the two anticipated inspections of the year. The requirements made at a previous inspection were followed up to see if they had been addressed. The Inspector looked around some of the building and a number of records and related documentation were inspected. Staff on duty at the home assisted the Inspector. The Inspector chatted with some residents in order to get a feel for what it is like to live at White Lodge and St Helens House. One resident said ‘it is very good here. It’s all there for you’ What the service does well: White Lodge and St Helens House provides a service for older people in a welldecorated and comfortably furnished home. The home has an easy, relaxed atmosphere and residents are clearly at ease. The home is well organised and well managed by people with the skills, knowledge, qualifications and experience necessary. Community health professionals support the home staff in caring for residents. Staff were observed throughout the inspection to be treating residents with courtesy and kindness and residents confirmed that their privacy and dignity were respected at all times. Residents are able to do as they wish at the home and join in or not with the activities on offer. There is a programme of activities on offer at the home. Visitors are always welcome at the home and residents are encouraged to maintain and develop relationships with people in the home, with their families and friends and the local community. Meals are nutritious, varied and an alternative is always available on request. The dining room is pleasant and comfortable. White Lodge & St Helens House DS0000003986.V279872.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 & St Helens House DS0000003986.V279872.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 & St Helens House DS0000003986.V279872.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): 1. Standard 3 was met and exceeded at the last inspection. Whilst residents are provided with information to enable them to make an informed decision about moving to the home the information provided is, in part, out of date. EVIDENCE: The statement of Purpose seen was not dated. This document is in need of updating in some respects e.g. the name of the registered manager. (Standard 6 does not apply to this home.) White Lodge & St Helens House DS0000003986.V279872.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 and 10. Standard 9 was met at the last inspection. There is a good care planning system in place to make sure that staff have the information they need to meet the needs of the residents but the lack of risk assessments potentially put staff and residents at risk of harm and accident. The health needs of the residents are well met with evidence of good support from community health professionals. Residents confirmed that they were treated with dignity and that their privacy was respected. EVIDENCE: In the past the Commission has been critical of the care plans at the home raising concerns in respect of ambiguity of need and care provided. Care plans seen at this inspection demonstrated significant improvement. Plans were easy to read, to the point and informative about the needs of the individual resident and how the home was to meet them. Staff are directed to what the resident needs help with and how they are to support them e.g. ‘promote’ ‘encourage’ ‘monitor’ ‘participate.’ Plans are being reviewed regularly. White Lodge & St Helens House DS0000003986.V279872.R01.S.doc Version 5.1 Page 10 Daily records support and evidence the delivery of care to residents. These notes give a good picture of the daily care that is delivered to residents by staff in the home. Aspects of risk are included in care plans but there is not a risk assessment for every resident and those seen had not been reviewed recently. The home has a good format to use to assess risk and record action to be taken to minimise any identified risks. Records are kept of the interventions of health professionals e.g. GPs, Community Psychiatric Nurses and district nurses. Residents have access to community services such as chiropodists, dentists and opticians. Residents spoken to said that they felt well cared for,and that their privacy and dignity were respected. ‘I have no complaints.’ Staff were seen to be treating residents in a respectful and dignified way during the course of the inspection. White Lodge & St Helens House DS0000003986.V279872.R01.S.doc Version 5.1 Page 11 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, 13, 14 and 15. Residents’ lives are enriched by the social opportunities afforded by their visitors and the social activities available in the home. Visitors are made welcome at the home and can come whenever it suits the residents. Residents are helped and encouraged to exercise choice in their daily lives at the home. The meals in this home are good offering both choice and variety and are served in a pleasant dining area. EVIDENCE: Regular activities take place in the home e.g. keep fit and mental agility. Some outings are arranged in a minibus. Birthdays are celebrated. A hairdresser is available at the home for 3 days every two weeks. At the request of residents a communion service is held regularly at the home The library service visits residents to provide books. One resident attends a day centre. White Lodge & St Helens House DS0000003986.V279872.R01.S.doc Version 5.1 Page 12 The three residents who had recently completed quality assurance questionnaires for the home rated social activities as good (2) and excellent (1). One resident, when asked if there was enough to do at the home said ‘there’s enough entertainment, sometimes we need to rest!’ Visitors are always made welcome, are always given tea and can stay for lunch if they wish. One resident had a visitor from the USA on the day of inspection. The visitors’ book confirmed the number and range of visitors to the home. Some residents go out with their relatives. People are encouraged to make choices about how they live their lives at the home. Preferences are noted in the care records. Residents can do as they wish, choose to eat what they like and join in with activities as it suits them. When residents move into the home their food likes, dislikes and allergies are explored. The inspection took place on a Friday and fish and chips were served for lunch with peas, lemon and tartare sauce. Dessert was cheesecake and / or ice cream. The alternative was grilled or steamed fish with mash or boiled potatoes. Second helpings are usually available. Residents can have anything they want for breakfast. Alternatives are always available for any residents who do not want the main cooked lunch. Lunches can be held back or packed lunches made up for anyone going out. Homemade cakes are served with afternoon tea. A range of hot and cold alternatives is available in the evening. Evening drinks are served with sandwiches for those who want them. A good range of fresh fruit and vegetables are incorporated into the menus. Special diets are catered for e.g. diabetic. Residents are encouraged to have their meals in the pleasant dining room and to socialise with the other residents. They can have their meals in their rooms should they need to. The chef keeps appropriate records. Residents said the food was ‘very good’ and there was certainly ‘enough of it!’ White Lodge & St Helens House DS0000003986.V279872.R01.S.doc Version 5.1 Page 13 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): 18. (Standard 16 was met at the last inspection.) Arrangements for protecting residents from abuse are not as satisfactory as they could be thereby placing them at possible risk of harm. EVIDENCE: The home was asked to update their adult protection policy to reflect local guidance i.e. that Social Services would take the lead in directing any investigation and that staff should be made aware of the policy. The adult protection policy was recently reviewed. The policy was good in that it referred to the Protection of Vulnerable Adults list. The policy does not explicitly direct staff to the chapter ‘what action should be taken’ in the local guidance about protecting vulnerable people from abuse (No Secrets). Staff have not had training about adult protection / abuse and this is raised again as an area that the home needs to address. White Lodge & St Helens House DS0000003986.V279872.R01.S.doc Version 5.1 Page 14 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): All of these standards were met at the last inspection. EVIDENCE: None of these standards were assessed on this occasion. White Lodge & St Helens House DS0000003986.V279872.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28, 29 and 30. (Standard 27 was met at the last inspection.) Residents and staff would benefit from staff undergoing a broader range of training and of achieving care qualifications to ensure that the care needs of residents can be understood and met. Recruitment procedures are in place to protect residents from the risk of unsuitable staff working at the home but gaps in essential documentation leave residents at risk of having unsuitable people working at the home. EVIDENCE: Staff are encouraged and interested in studying for National Vocational Qualifications. The home is working towards having 50 of the care staff at the home formally trained to at least NVQ level 2 in care. Four members of care staff have NVQ 2’s in care. Some staff have had relevant training in their country of origin and have been issued with visas on the assumption that their qualifications are equivalent to NVQ3. The files of some of the latest members of staff to join the home were inspected along with a file that had been unsatisfactory at the last inspection. Four files were sampled. Each had gaps in the essential documentation that must be obtained for staff prior to employment at the home. One did not contain proof of identity, 2 did not have CRBs for the home (both had CRBs on file from previous employers) and there was nothing to evidence that POVA 1st checks had been obtained. White Lodge & St Helens House DS0000003986.V279872.R01.S.doc Version 5.1 Page 16 Another staff file did not contain a CRB at all and there was only one reference. Another contained no references. The same file that was missing the person’s proof of ID also lacked proof of the person’s right to work in the country / at the home. (An immediate requirement was issued in respect of staff documentation) The home keeps records to demonstrate that staff have completed relevant training courses. Records showed that staff have had training in food hygiene, administering medicine, manual handling, infection control and continence. An overview of each member of staffs training is kept on the back of their supervision file. The dates that staff attended these training courses were not on this record. A number of residents at the home have mental health and dementia diagnoses. Staff have not been trained in these areas. There was evidence on all files to show that new staff had had induction training, although records were minimal and the home is directed to the new Skills for Care guidance about induction. White Lodge & St Helens House DS0000003986.V279872.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 and 33 (Standards 34, 35, 36, 37 and 38 were met at the last inspection.) The home is managed and organised by people who have the skills, knowledge and experience to run the home. Whilst there is nothing to demonstrate that the home is not taking into account the views expressed by residents and other stakeholders in the running of the home a full quality assurance system has not been fully implemented yet. EVIDENCE: The registered people are actively involved in the day to day running of the home and take their responsibilities to providing a good standard of care to the residents very seriously. Experienced and well-qualified senior care staff support them. White Lodge & St Helens House DS0000003986.V279872.R01.S.doc Version 5.1 Page 18 A few recently completed questionnaires (3 from residents and 2 from relatives) were on file. The home carries out these quality assurance surveys to find out what people think about the home. No questionnaires had been completed by health professionals, care managers or other stakeholders. As a full survey has not been completed a report based on the analysis of the results of the survey and any action plan to address the findings were also lacking White Lodge & St Helens House DS0000003986.V279872.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 2 x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 2 x x x x x x x x STAFFING Standard No Score 27 x 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x x x x x White Lodge & St Helens House DS0000003986.V279872.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? Yes 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 OP1 Regulation 6 Requirement The registered person must keep the statement of purpose under review and where appropriate revise it and notify the Commission and residents of any revision within 28 days of the revision. The registered person must ensure that all residents are assessed in respect of risk. Where any risks to the health or safety of residents are identified they should be, so far as possible, eliminated. It is required that the homes adult protection policy be further reviewed to reflect local guidance. The registered person shall make arrangements, by training or by other means, to prevent residents being harmed or suffering abuse or being placed at risk of harm or abuse. (Previous time scale for action 1.3.05 and 1 6 05). Timescale for action 01/04/06 2. OP7 13 01/06/06 3. OP18 13 01/04/06 White Lodge & St Helens House DS0000003986.V279872.R01.S.doc Version 5.1 Page 21 4. OP29 19 and sch 2 5. OP29 6. OP33 It is required that staff records are to be kept for all staff according to the Care Home Regulations - Regulations 10 and schedule 2 (as amended through statutory instrument 2004 no 1770 - which came into force on 26 July 2004) (Previous time scale for action 1 3 05 and 1 6 05) 10(1)&17( It is required that the registered 2)sch 4 provider ensures that documents are obtained by the home that prove that staff from overseas have appropriate permissions to work at the home. (Previous time scale for action 1 3 05 and 1 4 05) 24 A system for reviewing and improving the quality of care provided at the care home must be established and maintained and a report of the review be submitted to the Commission. 01/03/06 01/03/06 01/04/06 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 OP28 OP30 Good Practice Recommendations 50 of care staff should have NVQ level 2 in care or equivalent by 2005. (Any asserted equivalence should be confirmed by appropriate NVQ assessors.) In respect of training it is recommended that • the overview training records show at a glance when training took place and when refreshers are due. • staff have training in dementia and mental health to better understand the needs of the residents. • the new Skills for Care documentation in respect of induction is obtained and, if appropriate, introduced. White Lodge & St Helens House DS0000003986.V279872.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 & St Helens House DS0000003986.V279872.R01.S.doc Version 5.1 Page 23 - 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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