Inspection on 20/04/05 for White Rock Nursing Home

This inspection was carried out on 20th April 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 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 Rock Nursing Home 28/10/08

White Rock Nursing Home 05/03/07

White Rock Nursing Home 23/01/06

White Rock Nursing Home 01/02/05

White Rock Nursing Home 01/07/04

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

CARE HOMES FOR OLDER PEOPLE White Rock Nursing Home 15 Chestnut Avenue Barton-on-Sea New Milton BH25 7BQ Lead Inspector Martin Bayne Unannounced 20.04.05 9:15am 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 Rock Nursing Home H54 S11454 White Rock V223394 200405.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service White Rock Nursing Home Address 15 Chestnut Avenue, Barton-on-Sea, New Milton, BH25 7BQ 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) 01425 613627 01425 613627 Mrs Siobhan Dodd Mrs Rosemary McLelland CRH 30 Category(ies) of DE(E) - 30; DE - 6 registration, with number of places White Rock Nursing Home H54 S11454 White Rock V223394 200405.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The number of service users for whom accommodation and nursing care is provided at any one time shall not exceed 30. 2. No more than 6 service users can be accommodated at any one time in the category of DE between the ages of 60-64 years. 3. No detained patients. Date of last inspection 01.02.05 Brief Description of the Service: White Rock Nursing Home is registered to provide nursing care for thirty people over the age of 65 who suffer from dementia. The home can also admit up to 6 people between the age of 60 –64. The home is situated in a quiet avenue in a residential area of Barton-on Sea and aims to provide a homely environment with high standards of care. The building is on two floors with the facility of a shaft lift. The home has three lounges, dining room and a large, well-maintained enclosed garden. There are five shared bedrooms and twenty single rooms. White Rock Nursing Home H54 S11454 White Rock V223394 200405.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home has a waiting list. A full assessment is carried our for any new person admitted to the home. The home maintains high standards of care in a homely environment. Care needs were documented clearly and carried out through a loyal and caring staff team. The home finds meaningful activities for residents both collectively and individually. The home has increased the staffing levels due to a deterioration of health of patients. There is a long-standing staff team who are committed to the patients and the home. Through inspection of one staff recruitment record, it was found that the home complies with recruitment standards. The building has a homely ambience, is in good decorative order and has a well-maintained garden accessible to patients. The home is well managed and a quality audit has taken place, consulting with relatives and visiting professionals. What the service does well: What has improved since the last inspection? Since the last inspection the home has recruited an additional member of staff to increase the staffing hours available to patients. This has allowed for better structuring of staff time in providing for the care needs of the patients. White Rock Nursing Home H54 S11454 White Rock V223394 200405.doc Version 1.30 Page 6 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 Rock Nursing Home H54 S11454 White Rock V223394 200405.doc Version 1.30 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 Rock Nursing Home H54 S11454 White Rock V223394 200405.doc Version 1.30 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) 1, 2, 3 and 4 Through clear admission criteria, policies and a thorough assessment process the home is able to meet the needs of people admitted into the home. EVIDENCE: The home has a Statement of Purpose and Service User Guide that are available to patients or their relatives. The home also has a brochure that is sent out to people interested in making a referral to the home. The home has the admission criteria that when people move into the home they are able to feed themselves and also have a degree of independent mobility. The home operates a waiting list and when a vacancy arises the manager liaises with relatives, social workers, community psychiatric nurses and relatives regarding people at the top of the list as to their suitability for admission. The manager and another senior member of staff then visit the person and carry out an assessment to see if the home can meet their needs. The assessment forms and other paperwork for the last person admitted to the home were inspected and these were found to be thorough and detailed, meeting all the standards. When a person moves into the home a full inventory of all their effects are White Rock Nursing Home H54 S11454 White Rock V223394 200405.doc Version 1.30 Page 9 recorded and an admission checklist procedure is followed through to ensure that the person settles into the home as best they are able. It was possible to have only limited discussion with patients as all have significant dementia and indeed many of the residents were now suffering from advanced stages of the disease; however all looked well cared for and the records maintained on their care supported this. White Rock Nursing Home H54 S11454 White Rock V223394 200405.doc Version 1.30 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 standard(s) 7, 8 and 10 Clear direction of the staff and a thorough care planning system, with up to date recording, ensures that the health and personal care needs of the patients are met. EVIDENCE: The personal file for the last person admitted to the home was inspected and there was a detailed care plan in place. The staff on duty were spoken with and discussions showed that they were aware of the care needs, reflecting what was in the care plans. The health needs were also detailed and there was evidence that these were being attended to appropriately with attention being paid to skin care, mobility and dietary needs. The home works closely with the specialist mental health services and the patients GPs. Other health needs are met by visiting services for dentistry, chiropody and eye care. During the inspection the staff were observed to be meeting patients needs respecting their dignity. The medication procedures were not inspected on this occasion. White Rock Nursing Home H54 S11454 White Rock V223394 200405.doc Version 1.30 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 standard(s) 12 & 13 Patients benefit from the employment of an activities co-ordinator. EVIDENCE: Visitors are welcome to visit at all times and a visitor’s book is kept in the front reception area. Personal files of patients record their interests and past times so that the staff can meet each persons’ individual needs. All activities are recorded and the home employs an activities co-ordinator. The home also arranges for outside entertainers to visit the home. White Rock Nursing Home H54 S11454 White Rock V223394 200405.doc Version 1.30 Page 12 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) Not inspected on this occasion. EVIDENCE: Not inspected on this occasion. White Rock Nursing Home H54 S11454 White Rock V223394 200405.doc Version 1.30 Page 13 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, 23, 24, 25 & 26 Patients benefit from a safe environment that is homely and in good decorative order. EVIDENCE: The home has been converted from a family dwelling and has developed and expanded over the years. A shaft lift is available to access the first floor. The building is kept secure with the front door locked so that patients cannot wander from the home and get lost. There is a large well-maintained garden that is enclosed to which patients have full access. The building has a homely feel and was well decorated throughout. The furnishings and fittings were seen to be in good repair. The manager informed that patients are encouraged to get up in the mornings and socialise in the communal areas. At the time of the visit there were five residents with very advanced stages of disease and due to their frailty remain in their rooms. Four of these residents are in shared rooms so that they have another person for company. None of the bedrooms have ensuite toilet White Rock Nursing Home H54 S11454 White Rock V223394 200405.doc Version 1.30 Page 14 facility, however only two of the patients are able to use the toilet without staff assistance. Commodes are offered for those residents who need this facility. The home has two sluicing areas, one on each floor. There is a fully equipped laundry area, fitted with commercial machines and driers. The laundry room complied with infection control standards. Alcohol gel and hand wipes are sited throughout the home and the manager informed that the home employs their own infection control nurse. White Rock Nursing Home H54 S11454 White Rock V223394 200405.doc Version 1.30 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 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 and 29 The additional post added to the staff team should ensure that the high standards of care to the patients are maintained. EVIDENCE: The home is owned by Mrs Dodd and she is present in the home on average three days a week. The registered manager is Mrs McLelland and she works in the home five days a week. The two deputy managers are RGN trained and report to the manager. The home also has four RGN nurses who oversee the care staff, four of whom are trained to NVQ level 3 and four to level 2. The home also employs laundry, cooking and domestic staff as well as a handyman. The manager reported that due to a deterioration of the health of many of the patients, their nursing and personal care needs have increased, stretching the resources of the staff team. It was reported that this situation has improved with the recruitment of an additional member of staff to the workforce. In general there is a core of staff who have worked for many years at the home. During their break they discussed working at the home with the inspector and it was clear that they formed a united team dedicated to providing high standards of care to the patients. The recruitment records for one of the new members of staff were seen and all the required checks had taken place. The requirements of Department of Health guidance for the protection of vulnerable adults were discussed with the manager and also the individual letters that should be supplied by employment agencies for the staff that they provide to work in the home. White Rock Nursing Home H54 S11454 White Rock V223394 200405.doc Version 1.30 Page 16 White Rock Nursing Home H54 S11454 White Rock V223394 200405.doc Version 1.30 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 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) 31, 32, 33 and 38 The registered manager provides a clear sense of leadership and direction for the home. EVIDENCE: The registered manager is a trained RGN and through discussion showed that she had clear direction and leadership for the home. The staff said that they were supported and there appeared an open and positive attitude prevailing in the home. A quality audit had taken place and views by relatives and staff on the home had been sought. Due to the mental frailty of the residents they were not able to contribute to this process. The results of the audit were available as part of the Service User Guide. It was found that health and safety issues with respect to the patients and the staff were addressed and tests to all equipment such as the fire safety system, White Rock Nursing Home H54 S11454 White Rock V223394 200405.doc Version 1.30 Page 18 equipment and services were taking place as required. Requirements made at the last visit from the Environment health Officer had been complied with. White Rock Nursing Home H54 S11454 White Rock V223394 200405.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION 3 3 3 3 3 3 x x STAFFING Standard No Score 27 3 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 3 3 3 x x x x 3 White Rock Nursing Home H54 S11454 White Rock V223394 200405.doc Version 1.30 Page 20 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 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. 1. Refer to Standard Good Practice Recommendations White Rock Nursing Home H54 S11454 White Rock V223394 200405.doc Version 1.30 Page 21 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. 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