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Inspection on 25/08/05 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 25th 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.

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 a comfortable and relaxed atmosphere and residents are clearly at ease. The home is well organised and the care and contentment of residents is at the heart of the way the home is run. A good admissions procedure is in place that ensures that only people whose needs can be met are offered places at the home. Prospective residents and their representatives have the opportunity to visit the home to see if they like it before they move in. The complaints procedure reassures residents that their well-being and comfort are important to the home and that any concerns raised will be properly investigated and resolved. The home is well maintained, comfortable and safe for the residents living there and anyone visiting. The home is kept clean and smells pleasant. The numbers and skill mix of staff are sufficient to meet the needs of residents. Systems are in place and records kept, that demonstrate the homes commitment to keeping residents safe.

What has improved since the last inspection?

Over the last year the home has been changing their medication handling system. This is now fully in place and its implementation has eliminated the concerns that the Commission once held. Residents can now feel even more confident in the system in place that ensures they get their prescribed medication as and when it is needed. Good records are kept of administration. There is now an alarm call emergency bell in every resident`s room should they or any member of staff or a visitor need to use it. The laundry has been cleaned up and a new ceiling fitted, which is an improvement to the environment. The home continues to promote the study of National Vocational Qualifications. A good, regular supervision system is now in place for care staff. Both staff and residents benefit from a well supervised, well motivated staff group. The Dorset Fire and Rescue service are satisfied that the home have rectified the areas of concern identified at their inspection and they are next due to visit in April 2006.

CARE HOMES FOR OLDER PEOPLE White Lodge & St Helens House 15-17 Boscombe Spa Road Bournemouth Dorset BH5 1AR Lead Inspector Debra Jones Unannounced 25 August 2005 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 & St Helens House D55 S3986 White Lodge & St Helens House V234063 250805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service White Lodge & St Helens House Address 15-17 Boscombe Spa Road Bournemouth Dorset BH5 1AR 01202 395822 01202 777414 enquiries@carehome.com.uk Mr John Higginson Mrs Christine Higginson Mrs Karen Frances Watt Mrs Caroline White Mr Peter John Higginson 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) CRH PC - Care Home Only 54 Category(ies) of OP Old Age (54) registration, with number of places White Lodge & St Helens House D55 S3986 White Lodge & St Helens House V234063 250805 Stage 4.doc Version 1.40 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. Date of last inspection 2 March 2005 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 D55 S3986 White Lodge & St Helens House V234063 250805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 3 hours on the 25 August 2005 and was one of the two anticipated inspections of the year. The requirements and recommendations made at the last 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. Caroline White– one of the registered people - assisted the Inspector. Her brother Peter Higginson -also registeredwas also on hand to assist along with the staff on duty at the home. The Inspector met and chatted with some residents in order to get a feel for what it is like to live at White Lodge and St Helens House. When asked if they were well looked after one resident said ‘it goes without saying!’ No new requirements or recommendations were made at this inspection, although a few are repeated. 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 a comfortable and relaxed atmosphere and residents are clearly at ease. The home is well organised and the care and contentment of residents is at the heart of the way the home is run. A good admissions procedure is in place that ensures that only people whose needs can be met are offered places at the home. Prospective residents and their representatives have the opportunity to visit the home to see if they like it before they move in. The complaints procedure reassures residents that their well-being and comfort are important to the home and that any concerns raised will be properly investigated and resolved. The home is well maintained, comfortable and safe for the residents living there and anyone visiting. The home is kept clean and smells pleasant. The numbers and skill mix of staff are sufficient to meet the needs of residents. Systems are in place and records kept, that demonstrate the homes commitment to keeping residents safe. White Lodge & St Helens House D55 S3986 White Lodge & St Helens House V234063 250805 Stage 4.doc Version 1.40 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 D55 S3986 White Lodge & St Helens House V234063 250805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection White Lodge & St Helens House D55 S3986 White Lodge & St Helens House V234063 250805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3. 6 is not applicable to this home. A good admissions procedure enables prospective residents to make informed decisions about moving to the home and ensures that only residents whose needs can be met by the home are offered places there. EVIDENCE: Files of 2 residents due to be admitted the next day showed that prior to people moving to the home their needs are fully assessed by a senior person from the home. Assessments are thorough and files demonstrate that information about the potential resident starts to be collected from the first time the home is contacted with an enquiry. Assessments cover personal care and health care needs, medication, social needs/ preferences and food choices. When the Inspector arrived Caroline White had just been meeting with the chef to discuss the new residents. People are given the opportunity to visit the home, as are their representatives, prior to any decisions being made. One of the new residents (arriving the next day) had been to see the home after their wife and sister had been to see it. The other had been assessed in hospital. White Lodge & St Helens House D55 S3986 White Lodge & St Helens House V234063 250805 Stage 4.doc Version 1.40 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 standard(s) 9 There is a medication system in place that residents can have confidence in which results in them getting the medication they are prescribed at the right times and it being properly recorded as given. EVIDENCE: Over the last year the home has introduced a new medication system. They have worked closely on its introduction with their pharmacy and staff have received training to operate the new system. The majority of medicines are now delivered in blister packs individual to residents and clearly coded for the different time of day they are to be administered. The home has a trolley that helps staff transport the medicines to the residents. The Commission considers this system to be an improvement on the previous system as it minimises risk of misadministration. The home is now administering medication directly from the pack the medicines arrive in that are labelled with the doctor’s directions. The Inspector sampled some medication administration records and these accorded with medicines held on the premises. A medicines return book was seen and this was in order. White Lodge & St Helens House D55 S3986 White Lodge & St Helens House V234063 250805 Stage 4.doc Version 1.40 Page 10 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) None of these standards were inspected on this occasion. EVIDENCE: White Lodge & St Helens House D55 S3986 White Lodge & St Helens House V234063 250805 Stage 4.doc Version 1.40 Page 11 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 and 18 A system is in place to deal with any complaints that might be made by residents. EVIDENCE: The home has a complaints policy / procedure that is available to residents and their supporters. No complaints have been received by the home since the last inspection or by the Commission. 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. On the day of inspection the updated policy could not be found and so the requirement that this be done and that staff should be made aware of the policy is repeated at the end of this report and will be followed up at the next inspection. White Lodge & St Helens House D55 S3986 White Lodge & St Helens House V234063 250805 Stage 4.doc Version 1.40 Page 12 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) 19,20,21,22,23,24,25 and 26 The home is well–maintained and a comfortable and safe environment is provided for the residents living there and anyone visiting. Bedrooms are well decorated, well furnished and personalised to suit the residents. Adequate facilities are available to meet the number and needs of the people living there. The home is kept clean and smells fresh thereby making daily life for all in the home more pleasurable. EVIDENCE: The home has a warm and homely atmosphere. The home is well decorated throughout. Lounges and dining areas are comfortably furnished. The garden is well maintained and attractive. There are a number of communal bathing areas in the home. All bedrooms are single occupation and most of them have en suite facilities. White Lodge & St Helens House D55 S3986 White Lodge & St Helens House V234063 250805 Stage 4.doc Version 1.40 Page 13 Aids and adaptations are available throughout the home e.g. raised toilet seats, grab rails etc - and some residents with particular needs have their own personal equipment to assist with their independence. Residents are able to personalise their rooms with furniture and general belongings as they wish and in agreement with the home. There is a passenger lift in the home, enabling easy access between the floors. There are emergency alarm bells throughout the home – in each bedroom and in communal areas. The home was clean and there were no unpleasant odours. The laundry was clean and tidy. A new ceiling has been fitted. White Lodge & St Helens House D55 S3986 White Lodge & St Helens House V234063 250805 Stage 4.doc Version 1.40 Page 14 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 and 29 Sufficient care staff are employed and deployed to ensure that the care needs of residents can be met. Robust recruitment procedures are in place to protect residents from the risk of unsuitable staff working at the home although some documentation was not on file / had not been received. EVIDENCE: Clear staffing rosters are in place that show who is on duty, when and what jobs they do. During the day there is always a good mix of senior and junior care staff on duty, numbers reflecting the needs of residents and busy times at the home. It is always clear who is in charge. In addition the responsible people take an active role in the running of the home and they are supported by staff working in the kitchen, doing the cleaning and maintenance work. 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. Well ordered staff records/ personnel files demonstrated the homes recruitment procedure in action. The files of some of the latest members of staff to join the home were inspected. On one file a few gaps were found in the documentation that must be obtained for staff employed at the home, the White Lodge & St Helens House D55 S3986 White Lodge & St Helens House V234063 250805 Stage 4.doc Version 1.40 Page 15 registered person thought this might have been as a result of information being sent off to the Criminal Records Bureau. The home was reminded that where CRB disclosures have not been returned POVA 1st checks must be applied for and proof of the application and the outcome of the check kept. The home employs some workers from abroad. It was clear from the files sampled that the home generally now gathers the right sort of information about people’s rights to work in the country and any restrictions on that work. 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. White Lodge & St Helens House D55 S3986 White Lodge & St Helens House V234063 250805 Stage 4.doc Version 1.40 Page 16 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) 32,35,36,37 and 38. The home is well organised and the daily management and running of the home centres round the care and contentment of residents. Good management practice, systems in place, and records kept, confirm the health and safety of all in the home. 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. All records were available as requested at the inspection. An up to date insurance certificate was on display along with the home’s registration certificate. White Lodge & St Helens House D55 S3986 White Lodge & St Helens House V234063 250805 Stage 4.doc Version 1.40 Page 17 The home keeps some money belonging to residents and a good system is in place to look after it. Clear records are kept of expenditure and balances along with receipts. A good supervision system is now in place. The Inspector talked with the member of care staff who takes the lead in this duty. One to one meetings are happening at appropriate intervals and records are made of the meetings. The areas listed in the standard are covered in supervisions and staff and residents benefit as a result through staff feeling valued, and being well supervised and supported in their work. Fire records were up to date and internal checks of fire safety equipment are being carried out at appropriate intervals. An external company carries out quarterly checks of the fire equipment. Fire training records for staff showed that all staff had had fire training at the required intervals. Dorset Fire and Rescue service visited the home in March 2005. The unsatisfactory items brought to the attention of the home have since been satisfactorily rectified. The home will next be inspected in respect of fire safety matters in April 2006. Accident records were looked at. These were well completed in that they were mostly clear about how staff came across accidents or if they had witnessed them. Analysis of such records provides the home with important information as to the effectiveness of the emergency systems in operation and of any further measures that could be put in place to minimise risks to residents. Day and night staff record accidents in different formats. On the form that day staff use they note the last time they saw the person prior to the accident. It is suggested that this good practice be adopted by the night staff as they sometimes find people in their rooms after they have fallen and it would be good to know roughly how long it might have been since that happened. White Lodge & St Helens House D55 S3986 White Lodge & St Helens House V234063 250805 Stage 4.doc Version 1.40 Page 18 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 4 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x 3 x x 3 3 3 3 White Lodge & St Helens House D55 S3986 White Lodge & St Helens House V234063 250805 Stage 4.doc Version 1.40 Page 19 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 18 Regulation 13 Requirement Timescale for action 1 10 05 2. 29 19 and schedule 2 3. 29 10 (1) and 17 (2) schedule 4 It is required that the homes adult protection policy be updated 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). The policy must always be avialble in the home. It is required that staff records 1 10 05 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) It is required that the registered 1 1 0 05 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) Version 1.40 White Lodge & St Helens House D55 S3986 White Lodge & St Helens House V234063 250805 Stage 4.doc Page 20 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations White Lodge & St Helens House D55 S3986 White Lodge & St Helens House V234063 250805 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Unit 4 New Field Business Park Stinsford Road Poole Dorset 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 D55 S3986 White Lodge & St Helens House V234063 250805 Stage 4.doc Version 1.40 Page 22 - 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. 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