Inspection on 05/03/07 for White Rock Nursing Home

This inspection was carried out on 5th March 2007.

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 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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE White Rock Nursing Home 15 Chestnut Avenue Barton On Sea New Milton Hampshire BH25 7BQ Lead Inspector Mark Hemmings Key Unannounced Inspection 5th March 2007 08:20 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 Rock Nursing Home DS0000011454.V331608.R01.S.doc Version 5.2 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 Rock Nursing Home DS0000011454.V331608.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service White Rock Nursing Home Address 15 Chestnut Avenue Barton On Sea New Milton Hampshire BH25 7BQ 01425 613627 01425 613627 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) Mrs Siobhan Dodd Mrs Rosemary Ann McLelland Care Home 30 Category(ies) of Dementia (6), Dementia - over 65 years of age registration, with number (30) of places White Rock Nursing Home DS0000011454.V331608.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users must be over the age of 60 years Date of last inspection 23rd January 2006 Brief Description of the Service: White Rock Nursing Home (the Service) is registered to provide nursing care for up to thirty people over the age of 64 years (patients) who suffer from dementia type care needs. The Service can admit up to six people who are between 60 and 64 years old. The premises are a large detached property which has been adapted and extended. The accommodation for the patients is provided on both the ground and the first floor. There is a passenger lift which gives step-free access around the accommodation. When full, there is provision for five of the bedrooms to be shared. All of the bedrooms have private wash hand basin. None of them have a private en suite service. There is a call bell system. This is designed to enable patients to alert members of staff should they need assistance. The Service is located 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. There is a limited amount of off-street parking. The Service is owned and operated by a private individual. She is referred to in this Report as being “the Registered Provider”. The Registered Provider is understood to supply information to prospective service users through a variety of routes. These include the provision of a Service Users’ Guide. This is a brochure which outlines the principal features of the facilities and services available in the Service. There is a document called a Statement of Purpose available for review in the Service. This gives a more detailed account than does the Guide. Also, the Registered Provider ensures that a copy of the most recent Inspection Report from the Commission, is available for reference in the Service if requested. The range of fees charged currently for residence in White Rock Nursing Home, runs from £513.00 to 783.00 per week inclusive of funded nursing care payments. White Rock Nursing Home DS0000011454.V331608.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Report is based upon a number of sources of evidence. These include a review of the correspondence in relation to the Service received by the Commission since the last inspection. Also, the Inspector completed an unannounced inspection visit to the Service. This took about five hours to complete. During this time, the Inspector spoke with or spent time, with ten of the 28 patients in residence. Some of these discussions/periods of time were in private. The Inspector spoke with the Registered Manager, with two of the nurses, with two of the care workers, with the cook and with one of the housekeepers. The Inspector examined various parts of the accommodation and he reviewed a selection of the key records and documents. The Registered Provider operates the Service suitably, so as to enable the patients to receive the support and assistance they need. There is a small number of matters which need the Registered Provider’s attention. The Registered Manager says that all of these points will be addressed and she has agreed reasonable timescales for the actions in question. What the service does well: Patients say or indicate that the Service provides them with a relaxed and generally comfortable setting within which to make their home. They consider that they receive all the assistance they need. Also, they say that the nurses and the care workers are attentive and kind in their manner. Patients say that they receive good quality meals. White Rock Nursing Home DS0000011454.V331608.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. White Rock Nursing Home DS0000011454.V331608.R01.S.doc Version 5.2 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 Rock Nursing Home DS0000011454.V331608.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this Service. Prospective patients have their needs and preferences assessed before they move in to the Service. EVIDENCE: The Registered Manager, in consultation with the person concerned, completes an assessment of each prospective patient’s needs for assistance. This is done before a decision is made about whether or not the Service is a suitable place for the person’s residence. Nurses and care workers say that the Registered Manager informs them about the needs of new patients, so that their needs for assistance can be met from the point of admission. White Rock Nursing Home DS0000011454.V331608.R01.S.doc Version 5.2 Page 9 White Rock Nursing Home DS0000011454.V331608.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this Service. The health and personal care which patients receive, is based upon their individual needs. Suitable arrangements are in place to retain and dispense medication. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Patients say or indicate by their relaxed manner, that the nurses and the care workers offer them all the assistance they need and that this is provided in a reliable and consistent manner. There is a written individual plan of care for each of the service users. These are important documents. This is because they form one of the means by which each patient can be informed about and can agree to the assistance he or she will receive. Also, the plans are a source White Rock Nursing Home DS0000011454.V331608.R01.S.doc Version 5.2 Page 11 of information for staff. This then helps them to provide support in a consistent manner. Sensible arrangements are in place to ensure that potential risks to the patients’ personal health and safety, are anticipated and managed. Patients are assisted to maintain their health. Nurses and care workers are alert to the need to identify occasions when someone is becoming unwell. This is so that medical assistance can be sought promptly. The Commission since the completion of the last inspection visit, has not received any expressions of concern from local health care providers about any aspect of their working relationships with the Service. Suitable arrangements are in place to enable patients’ medication to be retained and to be dispensed in accordance with the doctors’ instructions. Patients say that the nurses and the care workers are cordial in their approach. Also, that they are respectful of their individual preferences. White Rock Nursing Home DS0000011454.V331608.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this Service. There is a variety of social activities taking place. Patients are able to choose their life style and to keep in touch with family and friends. Patients have a normal diet which meets their requirements. EVIDENCE: There is a calendar of social events held in the Service. Patients consider themselves to be suitably occupied. Patients consider the pace of daily life in the Service to be relaxed and unhurried. They are free to decide what to do each day. As appropriate, they can retire to the privacy of their bedroom. White Rock Nursing Home DS0000011454.V331608.R01.S.doc Version 5.2 Page 13 Patients are assisted to keep in touch with members of their families, if this is necessary and if it is their wish. Family members and friends are welcome to call to the Service at any reasonable time. Patients are free to spend time in private with their relatives and friends, should they choose to do so. The Registered Provider does not become involved in the control of patients’ financial affairs. This is a good idea because it helps possible prevent conflicts of interest. Patients say or indicate that they receive good quality meals and that they have enough to eat. They consider meal times to be a relaxed and pleasant experience. White Rock Nursing Home DS0000011454.V331608.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this Service. There is a sensible system for addressing complaints. Patients’ wellbeing is promoted and they are protected from abuse. EVIDENCE: The Registered Provider is aware of the need to ensure that complaints about the Service are investigated thoroughly and resolved promptly. In the absence of any complaints having been received since the last inspection visit, the Inspector cannot assess the adequacy of how well this will be done in practice. The nurses and the care workers have a sound understanding of what is recognised to be good care practice. As part of this, they are aware of the need to be alert to instances in which the well being of a patient might become compromised. Patients say or indicate, that they feel safe living in White Rock Nursing Home. White Rock Nursing Home DS0000011454.V331608.R01.S.doc Version 5.2 Page 15 White Rock Nursing Home DS0000011454.V331608.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 22, 25 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this Service. Patients are provided with a generally comfortable environment, which promotes their independence. EVIDENCE: Patients say or indicate that they are comfortable living in White Rock Nursing Home. They consider the accommodation to be homely and welcoming. The Registered Provider has completed an organised assessment of the adequacy of the fire safety measures in use in the Service. She is now going to White Rock Nursing Home DS0000011454.V331608.R01.S.doc Version 5.2 Page 17 submit this to the Hampshire Fire and Rescue Service by 1 April 2007. This is so that this Agency can confirm the adequacy of the fire safety measures in place. The local Department of Environmental Health is understood not to have recommended any improvements in the kitchen, which remain outstanding. The kitchen is well equipped, orderly and clean. Patients are assisted by the nurses and the care workers to move around their accommodation safely. There are various aids such as hoists in the bathrooms and there are three mobile hoists which can be moved from room to room. The accommodation is kept comfortably warm. The radiators are fitted with guards. These are an effective means of helping to reduce the chance that a patient might be burnt accidentally in the event of a fall. There is an adequate supply of hot water available in the Service. It is understood that all of the baths and wash hand basins are fitted with thermostatic valves. These are designed to reduce the temperature of hot water to a level which is not likely to scald someone. Patent’s clothes are adequately laundered and they are returned promptly to them in a presentable condition. The laundry is equipped suitably and its operation is well organised. The Registered Provider needs to ensure that used water does not syphon back into the main pipe-work from appliances such as washing machines and the dishwasher. She is going to contact the local water supply company to find out if any additional safeguards need to be installed in relation to this matter. White Rock Nursing Home DS0000011454.V331608.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this Service. There are enough nurses and care workers on duty. Nurses and care workers know what they are doing. EVIDENCE: There is always at least one Registered Nurse on duty in the Service. They are supported in their clinical duties by a number of care workers. These latter members of staff provide a range of personal care services such as helping people to get dressed and helping them in the bathroom. At night time, there is a number of staff on waking duty in the Service. The nurses and the care workers are supported in their work by other members of staff, who complete most of the catering and housekeeping tasks. The Service is adequately staffed given the needs of the patients who are currently in residence. Over 60 per cent of the care workers employed in the Service have acquired a National Vocational Qualification (NVQ) in health and social care. This Award is White Rock Nursing Home DS0000011454.V331608.R01.S.doc Version 5.2 Page 19 useful. This is because it provides care workers with a range of opportunities to confirm elements of good care practice and to extend their range of skills. The Registered Provider is understood to complete a number of security checks in relation to new members of staff. This done to help to ensure that all members of staff are suitable to be entrusted with access to the patients. However, the Inspector could not check this matter because the relevant paperwork was not to hand in the Service. All new nurses and the care workers receive introductory training. This is designed to ensure that they have the basic knowledge and skills they need in order to be able to work effectively without direct supervision. This is important because the quality of care patients can expect to receive, largely depends upon the adequacy of the competencies members of staff bring to their work. After their introduction to the Service, nurses and care workers undertake a number of further training courses. These are designed to enhance their capacity to deliver care. The Registered Provider is going to complement this provision by completing a specific review of the adequacy of the knowledge and skills possessed by each of the existing care workers. This will be a very useful development, because it will double check that everyone knows what they should be doing. The Registered Provider says that this exercise will be completed by 1 January 2008. White Rock Nursing Home DS0000011454.V331608.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this Service. There are suitable management arrangements to organise the Service reliably. There is a quality assurance system. The health and safety of people who live and work in the Service, is safeguarded. EVIDENCE: The Registered Manager has a detailed knowledge of the running of the Service. White Rock Nursing Home DS0000011454.V331608.R01.S.doc Version 5.2 Page 21 Suitable arrangements are in place to enable nurses and care workers to coordinate their activities. This means that there is good team-work in the Service. The Registered Provider formally asks patients’ relatives and members of staff their views about how well the Service is performing. Also but more informally, the patients are invited to comment on the adequacy of the provision made for them. There is going to be ongoing consultation exercise which will involve each of the patients being asked to comment upon their home. The methods used will be designed specifically around the needs and abilities of each patient. The Registered Provider is going to summarise the results of this general consultation exercise in a written Quality Report. This will be completed 1 August 2007. The Registered Manager says that all items of equipment in use in the Service remain in good working order. There are various certificates which confirm this account. The Service’s fire detection and fire fighting equipment is being checked regularly. This is done to ensure that it remains in a serviceable condition. Arrangements are in place to double check that all members of staff are sure about what to do if there is a fire safety emergency. A limited number of accidents has occurred since the last inspection visit. Their nature is not a cause for concern. The Registered Provider monitors the premises and the accommodation so that potential hazards to health and safety can be identified and resolved. White Rock Nursing Home DS0000011454.V331608.R01.S.doc Version 5.2 Page 22 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X X X 3 X X 3 3 STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 3 X X X X 3 White Rock Nursing Home DS0000011454.V331608.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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. 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 OP19 Good Practice Recommendations The Registered Provider should submit to the Hampshire Fire and Rescue Service the assessment she has completed of the adequacy of the measures in place to prevent the occurrence of a fire safety emergency. Also, of the steps which have been taken to enable an emergency to be managed should the need arise. The Registered Provider should ensure that a copy of the most recent report by the local Department of Environmental Health is retained in the Service. The Registered Provider should consult with the local water supply company, to establish what (if any) further steps might need to be taken to prevent used water from leaking back into the main pipe-work. The Registered Provider should ensure that evidence is retained in the Service in relation to the completion of the required security checks for members of staff. The Registered Provider should ensure the completion of DS0000011454.V331608.R01.S.doc Version 5.2 Page 24 2. 3. OP19 OP26 4. 5. OP29 OP30 White Rock Nursing Home the review of the adequacy of the skills and knowledge of all of the care workers. White Rock Nursing Home DS0000011454.V331608.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 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 © 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 Rock Nursing Home DS0000011454.V331608.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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