Inspection on 28/10/08 for White Rock Nursing Home

This inspection was carried out on 28th October 2008.

CSCI found this care home to be providing an Good service.

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 05/03/07

White Rock Nursing Home 23/01/06

White Rock Nursing Home 20/04/05

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 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: White Rock Nursing Home 15 Chestnut Avenue Barton On Sea New Milton Hampshire BH25 7BQ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Patricia Trim     Date: 2 8 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: White Rock Nursing Home 15 Chestnut Avenue Barton On Sea New Milton Hampshire BH25 7BQ 01425613627 F/P01425613627 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Rosemary Ann McLelland Type of registration: Number of places registered: Mrs Siobhan Dodd care home 30 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: Service users must be over the age of 60 years Date of last inspection Brief description of the care home White Rock Nursing Home is a privately owned service, registered to provide nursing care for up to 30 older people with a diagnosis of dementia. The premises are a large detached property which has been adapted and extended. Accommodation is provided on both the ground and the first floor, with a passenger lift to provide step-free access to both floors. There are 20 single rooms and 5 shared. There are no en suite facilities, but all rooms have wash basins. The home is situated in a quiet residential street. To the rear of the property there is a large enclosed garden. There are no shops within easy walking distance. The fee, given at the time of the visit, was 850. 00 pounds per week. Additional charges apply for services such as chiropody and hairdressing. 6 Over 65 30 Care Homes for Older People Page 4 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The information used to write this report was obtained in the following ways. We looked to see if we had received any complaints about the home and saw that we had not. We also looked at any information the home had given us about what might have happened since we visited. We used some of the information the provider gave us about the home in a form called the Annual Quality Assurance Assessment (AQAA). This is a form the home has to fill out every year to tell us what they are doing to make sure the home gives the people who have used the service the care that they want. Care Homes for Older People Page 5 of 25 We sent six staff surveys to the home and asked them to give them to staff. We received three surveys back. A seven hour visit was made to the home by one inspector to carry out a key unannounced inspection. During the visit time was spent talking with two of the people who use the service to get their views about it. The majority of people who use the service are unable to express their views of the service they receive, so two hours were spent observing staff practice and the interactions between people who use the service and staff. This was done by using our observational tool, the Short Observational Framework for Inspection (SOFI). There was an opportunity to get the views of two members of staff who worked in the home. Time was also spent discussing the providers plans for the home and looking at the environment. A random selection of documents was viewed. Three people who use the service were case tracked. This means their records were looked at to see how the provider identified their needs and made sure they were met. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A comprehensive pre admission assessment is completed that ensures people who use the service will only be offered a place if the registered manager is confident their needs can be met. Evidence: The AQAA recorded people considering moving into the home had the information they needed to help them make a decision and that time was taken to answer their questions. It also recorded that a detailed pre admission assessment was completed to make sure the registered manager had all the information she needed to enable her to decide whether the service could meet the persons needs. The registered manager said she always visited the person to complete the assessment and to answer any questions the person and their family might have. She said people who use services and their families were encouraged to visit the home Care Homes for Older People Page 9 of 25 Evidence: before making a decision. Two visitors confirmed their families had been to visit the home prior to their relative moving in. Three people were case tracked to see what information had been obtained before they moved to the home. Each person had a detailed assessment, completed by the registered manager when she visited them. The assessment recorded what help staff would need to give and what equipment would be needed. It also identified any areas of risk, such as whether the person had a history of falls or poor diet. In addition, two files contained assessments completed by health care professionals and all three had a personal history, completed by their families to give information about their lives prior to moving in. Care Homes for Older People Page 10 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have comprehensive care plans that enable staff to consistently give care in the way people like it and in a way that maintains their privacy, dignity and respect. People who use the service have their health care needs monitored and met and staff have the guidance and training they need to manage peoples medication safely. Evidence: The information obtained in the assessment is used to develop a care plan that provides support where it is needed. For example, in the three care plans seen, staff were given guidance on how to support someone to move from bed to chair, how to assist someone with feeding and what clothes someone needed to wear to be comfortable. Care plans are regularly reviewed and amended to reflect changing needs. For example, one persons health has improved and they no longer need staff to assist them with feeding. The care plan had been updated so staff knew how to help the Care Homes for Older People Page 11 of 25 Evidence: person feed themselves. People who use the service have their health care needs monitored through the use of assessment tools, such as regular weight checks and tissue viability assessments. These are used, where required, to identify where there is cause for concern and action plans put into place to minimise the risk. Records showed the registered manager referred people who use the service to health care professionals when necessary. People who use the service were able to see their doctors when they needed to and had regular visits from the chiropodist and optician. Care plans recorded where people had items that needed regular servicing, such as hearing aids or glasses. The registered manager said the service worked closely with specialists in old age psychiatry and records confirmed this. The AQAA stated we ensure patients are treated with respect and their dignity and privacy is assured at all times, with personal choice respected. A two hour observation of the daily routines in the home showed that staff generally responded sensitively to the needs of people who used the service and gave care in a way that preserved their dignity and privacy. For example, they assisted people with feeding at their own pace, sitting at the same level and talking to them. Qualified staff were observed giving medication to people who used the service. They followed the Royal Pharmaceutical Guidelines, giving one person the medication, then signing the administration record. There were systems in place for monitoring what medication came into the home. Medication was stored correctly and the service had a contract for the disposal of unused medication. Care Homes for Older People Page 12 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are supported to make choices about their daily routines. A range of activities are offered that provide mental stimulation and that people who use the service enjoy. People who use the service are offered a well balanced diet that gives them choice and that they like. Evidence: The AQAA recorded that We endeavour to maximise our patients ability to exercise their personal autonomy and choice and staff thought one of the things that was good about the service was that theres always lots of activities going on for the service users. Care plans record some personal preferences about daily routines. For example, when someone liked to get up and go to bed, what bedding they liked and whether they liked the light left on or off. The registered manager said she wanted to develop this aspect of the care plan so that there was more guidance about the preferred daily routines of people who use the service. Information in the assessment is used to provide activities that people enjoy. For Care Homes for Older People Page 13 of 25 Evidence: example, the plan for one person recorded they liked reading the newspaper. A member of staff was seen reading the paper with the person and talking about what they had read. The home employs an activities co-ordinator for two afternoons a week and one of the staff is also employed in this capacity for 3 hours twice a week. They were seen spending one to one time with people, talking with them. The activities co-ordinator said having the life history of someone enabled staff to find out what things they liked to do. For example, one person loved fashion so time was spent looking at magazines with them, talking about the clothes the models wore. Staff levels are flexibly arranged so there is time in the afternoons for staff to spend time with the people who use the service. One member of staff was seen giving manicures and painting peoples nails. The activities co-ordinator said she had completed several courses about providing suitable activities for people with dementia. Meeting the needs of people currently living in the home meant working in very small groups or 1 to 1. One popular group activity was flower arranging. The service also arranges regular visits from entertainers and celebrates peoples birthdays. Visitors came to the home throughout the day and were made welcome. Comments included We are always offered a cup of tea. One person, visiting for the first time, said staff had made him very welcome and given him information about the home. Peoples spiritual needs are identified in the assessment. The AQAA recorded that people were able to take communion if they wished. The service employs cooks and kitchen staff who provide all the meals required. The main meal of the day was liver, mashed potatoes and fresh vegetables, followed by red cherry crumble, or sugar free banana whip. In order to support and encourage people who use the service to feed themselves, a range of finger food is also always available. A high proportion of people who use the service need help with eating and drinking. Staff support is arranged flexibly to ensure they are available at meal times. Staff were seen helping people to eat, discreetly and at their own pace. Care Homes for Older People Page 14 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have information about how to make complaints and there is a system in place for investigating and responding to them. Staff have the training and guidance they need to enable them to minimise the risk of abuse to people who use the service. Evidence: The AQAA recorded that the current complaints procedure is to be reviewed and an updated copy, together with the updated statement of purpose, given to everyone. Feedback from one relative showed people had information about how to make complaints and could be confident any issues would be addressed. People also had the opportunity to raise issues through an annual questionnaire, sent to relatives. The AQAA stated no complaints had been received by the service and the complaints log confirmed this. The commission had received no complaints about the service since the last inspection. The registered manager said staff were given training about safeguarding during their induction and the service had a policy and procedure in respect of safeguarding adults. Feedback, both from surveys and from talking to staff, showed they had an understanding of safeguarding issues and of their responsibility to report any allegations of abuse. Care Homes for Older People Page 15 of 25 Evidence: The need to provide staff with refresher training in safeguarding was discussed with the registered manager. She agreed to look at various training options. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to live in a comfortable, clean and safe home, that promotes their independence and that they like. Systems are in place that protect people who use the service from the risk of infection. Evidence: The service provides a homely environment that gives people choice about where they spend their day. There is a quiet room, where music is played in the background and a television lounge so people can watch that if they choose. There is a third lounge area and a dining room. Staff were seen helping people move from room to room throughout the day. Doors have been fitted with releases that operate in the event of a fire alarm, so they can be kept open without risk to help people move freely through the home. There is also a large, well maintained garden that the registered manager said people really enjoy using when the weather is warm. The service employs a handyman to carry out general maintenance and there is a renovation programme. The communal areas have recently been redecorated and several carpets have been replaced. Further improvements to the environment are planned. Domestic staff are employed to clean the home, which smelt fresh with no unpleasant odours. Care Homes for Older People Page 17 of 25 Evidence: Staff have regular training in infection control and knew the procedure for handling soiled linen. The laundry has two industrial washing machines with programmes with disinfection programmes. The service has a contract for the removal of clinical waste. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are supported by well trained and supervised staff in sufficient numbers to meet their needs. A thorough recruitment procedure is consistently followed to make sure the risks to people who use the service are minimised. Evidence: The staff rota is flexible to provide maximum support at busy times, for example, during meals. The flexibility also means that taff are able to spend time supporting peoples social and emotional needs as well as their physical ones. Feedback from staff showed they felt they had enough staff to care for the people who use the service. They commented that The pattern of each shift is highly maintained to meet service users needs and felt the registered manager responded quickly to changing needs. For example Staff increased when working with someone who is dying to ensure everyone has sufficient support and when short of staff through emergency The situation is redressed as quickly as possible. The rota showed there is always a qualified member of staff on duty. Staff are organised to work in pairs on each shift. A large number of people who use the service need two people and a hoist to help them transfer. The way staff are deployed means there are always two staff available to do this. Care Homes for Older People Page 19 of 25 Evidence: There is a good mix of qualified and experienced staff, many of whom have worked at the home for a long time. Staff felt they were supported to gain qualifications with 60 having achieved a National Vocational Qualification (NVQ) 2 or 3. The service has a good recruitment procedure in place. This enables the registered manager to make sure all pre employment checks are completed. The files for two staff were seen. These had all the required checks completed, such as two references, Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA). Feedback from staff showed they felt their recruitment had been thorough and fair. Staff said they were expected to complete an induction programme. Completed check lists were seen for two staff that showed they had worked with experienced staff and been given training before working unsupervised. The service has developed its own dementia training course and all staff are expected to complete it. Staff said they had found it very useful in understanding the needs of people with dementia. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is well managed for the benefit of people who use the service and there are systems in place to enable them to give feedback about the service they receive. The regular maintenance of equipment and staff training in health and safety makes sure the risks to people who use the service are minimised. Evidence: The registered manager has over 12 years experience in providing residential care and said she had applied to start the Registered Managers Award in January 2009. Feedback from visitors and observation of the daily routine of the home, showed she had an open door policy and was always available to speak to the families of people who use the service. Feedback from staff showed they felt they were well supported by the management to provide a good quality of care. Comments about what the service does well showed staff felt they were part of a team. One staff said the management supports the entire Care Homes for Older People Page 21 of 25 Evidence: team, care, housekeeping, catering and administration and staff felt the service was managed in a way that always put the needs of the people who used the service first. The people who use the service are not able to easily express their views about the care they receive. A two hour observation of practice showed the day to day running of the service was organised in a way that benefitted the people who use the service. The registered manager is supported in her role by the provider, who regularly visits the service and monitors the quality of care provided. Staff are supported through induction, training and regular supervision. The AQAA recorded that the service does not hold any money on behalf of the people who use the service. The registered manager confirmed this. Records are kept of any expenditure made on behalf of people who use the service and families receive an invoice. Staff records showed that staff received regular health and safety training, such as first aid, food hygiene and moving and handling. Records seen at the time of the visit, together with information given in the AQAA showed the registered manager ensures equipment is regularly serviced to ensure the risks to people who use the service are minimised. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 24 of 25 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!