Inspection on 11/05/05 for White Rose House

This inspection was carried out on 11th May 2005.

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

Other inspections for this house

White Rose House 17/07/07

White Rose House 14/07/06

White Rose House 14/09/05

White Rose House 22/11/04

Similar services:

Snydale Care Home

Abbey The

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE White Rose House Nursing and Care Centre 165 Huddersfield Road Thongsbridge Huddersfield HD9 3TQ Lead Inspector Sally McSharry Unannounced 11 May 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 Rose House Nursing and Care Centre J51J01_s44462_White Rose House_v223571_110505.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service White Rose House Nursing and Care Centre Address 165 Huddersfield Road Thongsbridge Huddersfield HD9 3TQ 01484 690100 01484 690101 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) Meridian Care Ltd Position Vacant CRH - N 60 Category(ies) of 60 OP registration, with number of places White Rose House Nursing and Care Centre J51J01_s44462_White Rose House_v223571_110505.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 12.01.05 Brief Description of the Service: White Rose House Nursing and Care Centre is a new, purpose built care home owned by Meridian Care Limited. The home is located behind the Holme Valley Hospital in Holmfirth and is built into the hill side. There are 60 single en-suite rooms for older people requiring nursing and personal care. Bedrooms are located on two floors, which are serviced by a passenger lift. Service users requiring personal care are accommodated on the ground floor and part of the first floor, while service users requiring nursing care are accommodated on the second floor. Communal lounges and dining areas are also provided on each floor. The lower ground floor area provides service facilities, kitchen, laundry, staff areas and storage. The home is located just off the main Huddersfield road, along which public transport travels. There is a relatively short walk up a steep gradient to the home. There is ample car parking at the home and a garden and patio area to the side of the home. White Rose House Nursing and Care Centre J51J01_s44462_White Rose House_v223571_110505.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspectors carried out an unannounced visit to the home on 11 May 2005. The inspectors spoke to some of the service users and staff. Care records, staff records and medications were audited and a partial tour of the building was carried out. Since registration in July 2004, the first registered manager of the home has left. Ms Joanne Hempstock is currently acting as manager of the home. The CSCI is waiting for the company to formally propose a new registered manager. Ms Hempstock was on annual leave at the time of this visit. The staff on duty at the time of the inspection assisted the inspectors. White Rose House Nursing and Care Centre has experienced some teething problems since opening and it is fair to say the registered manager leaving so early in the home’s history was unsettling for staff and service users. Ms Hempstock, however, appears to be providing stability and support for the staff. What the service does well: What has improved since the last inspection? Since the last visit in January 2005, work has been carried out on care planning. Systems for the management, storage, recording and handling of medication have improved greatly. Staff have also received training in relation to the administration of medications. Since the last visit the standard and choice of meals offered in the home have improved; at this visit service users complimented the menu and service. The general atmosphere has improved; the inspectors found staff to be more relaxed and confident. Service users are also more relaxed. Some staff have received training and this is evident in their practice. White Rose House Nursing and Care Centre J51J01_s44462_White Rose House_v223571_110505.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 Rose House Nursing and Care Centre J51J01_s44462_White Rose House_v223571_110505.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 Rose House Nursing and Care Centre J51J01_s44462_White Rose House_v223571_110505.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) These standards were not looked at during this inspection. EVIDENCE: These standards were not looked at during this inspection. White Rose House Nursing and Care Centre J51J01_s44462_White Rose House_v223571_110505.doc Version 1.30 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) 7, 8, 9 and 10. Service users’ individual plans fail to set out their health and welfare needs. There is evidence that some of the service users’ health care needs are not being fully met. Some service users felt their privacy and dignity is not being met fully by all staff. EVIDENCE: Care records failed to identify all service users’ needs in a care plan. Service users’ plans failed to identify specifically how identified needs were to be met, for example how often care was to be provided, which incontinence aid was to be used, which movement and handling equipment was to be used. Daily records failed to accurately reflect the care provided each day, for example the care records of a service user who is catheterised were read, the daily record failed to mention the provision of any catheter care. The daily record of the same service user reported that a discharge had been noted and this had been reported to the senior carer on duty. No record was made where the discharge was from and there was no record of any action or follow up being carried out. Each service user must have a detailed and specific care plan, which advises, staff what the service user’s health and welfare needs are and how these are White Rose House Nursing and Care Centre J51J01_s44462_White Rose House_v223571_110505.doc Version 1.30 Page 10 to be specifically met whilst in the home. The daily records should accurately reflect what care has been given each day and any outcomes of that care. Where health care needs are identified action must be taken to address these either within the home or by seeking further advice. Some risk assessments have been carried out. However where a nutrition assessment indicated a risk and that action is taken including writing a care plan to manage this risk, no care plan had been developed. Other risk assessments such as falls risk assessments were seen in care plans but had not been completed. Some care plans and assessments had been reviewed monthly but some had not. Some records are maintained separately such as the bath record, bowel record and toileting record. Staff fill these in when the service user has had a bath, had their bowels opened or been assisted to the toilet. The management of medications has improved in the home. All care staff that administer medications receive internal and external training to ensure they are competent to do this. Medications are appropriately stored in the home and action has been taken to ensure medication storage rooms remain cool. All medications entering and being returned to the pharmacist are recorded. Medications checked were found to be correct. There was one occasion where a member of staff had failed to sign the medicine sheet to indicate they had administered the medicine. The inspector noted that when the senior carer was administering medicines at breakfast time, the medicine trolley was left unattended whilst medicines were taken to the individual service users. This practice must be avoided. The medicine trolley must be securely locked when left unattended. No service users in the home administer their own medication. Service users who spoke with the inspectors gave a balanced view of life in the home. All said the nurses and senior carers were very good, with particular praise for two qualified nurses and the care staff on the nursing unit, however a couple of service users raised some concerns. One said that, “Some of the younger carers couldn’t care less” and another said, “Some of the young ones are little madams.” The manager must ensure that all staff are trained to respect service users. White Rose House Nursing and Care Centre J51J01_s44462_White Rose House_v223571_110505.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, 14, and 15. Service users are able to maintain contact with their family and friends. Service users have choices within the home and these choices are respect in some cases. Service users receive a wholesome diet in pleasant dinning areas. Insufficient activities are offered at the home. EVIDENCE: Service users were happy that they are able to receive visitors at any reasonable time and that contact with their friends is maintained. A visitor who spoke to the inspectors also confirmed they are able to call at any time. One service user also confirmed that they are able to maintain contact with the community and is assisted every week to attend her local church. There is some evidence that some service users have choice over their lives. Service users confirmed that they are able to choose what time they go to bed at and rise in a morning. One service user raised a particular issue regarding the frequency she has a bath. When the record was checked it was not always clear whether this service user had had a bath weekly. It should not be a problem to offer service users a daily bath if they wish. All service users who spoke to the inspector said there was a lack of activities. One service user said, “They say they will take you on trips out, but they White Rose House Nursing and Care Centre J51J01_s44462_White Rose House_v223571_110505.doc Version 1.30 Page 12 don’t.” Service users did say that there has been some activities offered lately and that they are able to choose whether to join in or not. Service users spoke of film shows being shown in the home, but also commented that some of the service users watching the film were disruptive and that smaller groups might be more appropriate, rather than everyone watching the film at once. Some service users receive a newspaper and that books are available. A service user who is partially sighted has books on audiotape delivered to the home. Service users were not aware of any resident groups or committee meetings, which might assist the manager and the staff at the home, obtain service users views about the home and the service provided, including activities which the service users might like to take part in. A service user who had a particular interest in politics had been unable to vote in the recent election as they were unaware they could have a postal vote. Staff need to have a greater awareness of what the service users in the home would like and work toward achieving this for service users ensuring they have true choice and control over their own lives. All service users commented on the improvements made at meal times. A wider choice is now offered at meal times and service users were much happier about the choice and standard of the meals. On arrival at the home service users were having their breakfast. The dining room was pleasantly laid out and as service users arrived they were asked what they would like with a choice of hot and cold beverages, cereal, porridge and a variety of cooked breakfasts. It was positive to see a good choice and service being offered. One service user said that she loved cups of tea and found it difficult that she could not have one when they wanted; action should be taken to ensure service users can have what they want, within reason, when they want it. White Rose House Nursing and Care Centre J51J01_s44462_White Rose House_v223571_110505.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18. Complaints are taken seriously and are acted upon. When all staff have received training in adult protection service users will be further protected. EVIDENCE: There is a comprehensive complaints procedure and a record of all complaints made and the action taken. Five written complaints have been made since February 2005 and this may indicate some of the problems the home has experienced since opening and filling up with new service users, relatively quickly. It is positive to see that service users and their relatives are raising concerns directly with the acting manager and that written details are available demonstrating that the acting manager and company are addressing these concerns. One complaint has recently been made directly to the CSCI; this complaint has been referred to the registered provider to investigate. The complaint relates to how staff were deployed and responded to service users during the evening hand over period; when the evening staff hand over to the night staff. Not all staff have received training in relation to the protection of vulnerable adults and the prevention of abuse. It remains a requirement of this report that all staff receive such training, as it is vital all staff understand what abuse is, how to prevent it as far as possible and how to report any possible occurrences. White Rose House Nursing and Care Centre J51J01_s44462_White Rose House_v223571_110505.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25 and 26. The home provides a comfortable place to live. Ample facilities and equipment are available to service users and staff. The home is clean and tidy. EVIDENCE: Service users confirmed that they felt the home was a pleasant and comfortable place to live. Communal and private areas are attractively furnished and fitted. Service users have been able to personalise their rooms. Some prefer to spend time in their rooms and in their own company. Others prefer to spend time in the comfortable lounges. White Rose House Nursing and Care Centre J51J01_s44462_White Rose House_v223571_110505.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, 29, and 30. Service users needs are not being fully met by the number and skill mix of staff. Appropriate recruitment processes are in place. Staff require further training to ensure they are competent to do their jobs. EVIDENCE: Staff are deployed in two groups - those caring for the service users on the residential unit and those caring for the service users on the nursing unit. There are six carers during the day and 3 carers at night on the residential unit and one qualified nurse and 4 carers during the day and one qualified nurse and one carer at night on the nursing unit. A recent complaint referred to the CSCI relates to where staff were and how they responded to the nurse call alarm during the period when the evening staff are handing over to the night staff. Two service users also made comments about the lack of staff around this time of day. One stated that the staff hand over took a long time and if you ring the call bell for assistance during this period staff ask that you wait as they are having hand over. Another service user advised that they like to go to bed early. They go at 7pm because if they go any later staff aren’t available to assist them, because the evening staff are getting ready to go home and the night staff are having a handover. Service users also confirmed their social needs are not being met in the home, there is no one specifically designated to provide and organise activities. Care must be taken to ensure there are sufficient staff on duty to meet service users needs be it social activities or at busy times of the day. Care must also White Rose House Nursing and Care Centre J51J01_s44462_White Rose House_v223571_110505.doc Version 1.30 Page 16 be taken to ensure that the staff on duty are situated throughout the home to safely supervise service users. A sample of recruitment records were audited and found to contain the required checks, references and information. There are staff training records which indicate that some staff have received fire, movement and handling, first aid and vulnerable adults training. However not all staff have received training in these key areas. Other areas covered in training included dementia awareness, infection control and basic food hygiene. Staff at the home confirmed they had had induction training, although induction booklets are not returned to the home until they have been completed and therefore written evidence was not available in all staff records. White Rose House Nursing and Care Centre J51J01_s44462_White Rose House_v223571_110505.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) 38 The health, safety and welfare of service users and staff are not being fully promoted and protected;as not all staff have received fire training. EVIDENCE: The fire records show that appropriate fire checks and test are carried out; however not all staff have received the recommended fire training. All staff must receive fire training. There is no regular maintenance person in the home and the staff on duty at the time of the inspection could not locate planned maintenance records, such as hot water temperature checks. Although the home is relatively new it is recommended that permanent arrangements be made to ensure planned maintenance is carried out without the acting manager having to do these tasks. White Rose House Nursing and Care Centre J51J01_s44462_White Rose House_v223571_110505.doc Version 1.30 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 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 2 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 1 28 2 29 3 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 1 x x x x x x x 1 White Rose House Nursing and Care Centre J51J01_s44462_White Rose House_v223571_110505.doc Version 1.30 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 7 Regulation 15 Requirement Service user plans must identify all the service users health and welfare needs and give specific advice to staff how these needs are to be met in the home. Timescale of 31.03.05 not met. Where issues are identified or where risk assessments indicate there is a risk to the service user, action must be taken to minimise or eliminate that risk. A record of the action taken must be recorded. The registered provider must ensure all care staff are trained to respect service users. Service users must be consulted about the program of activities offered and appropriate activities must be provided. All staff must receive training to enable them to recognise possible abuse and protect vulnerable adults. Sufficient staff on duty to meet service users needs be it social activities or at busy times of the day. Staff on duty must be situated throughout the home to safely supervise service users. All staff must be trained skilled Timescale for action 31.08.05 2. 8 13 31.08.05 3. 4. 10 12 12 16 31.08.05 31.08.05 5. 18 13 31.08.05 6. 27 18 30.06.05 7. 28 & 30 12 & 18 31.08.05 Page 20 White Rose House Nursing and Care Centre J51J01_s44462_White Rose House_v223571_110505.doc Version 1.30 8. 38 23 and competent to meet service users needs. All staff must receive fire training 31.08.05 as recommended by the fire officer. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard 7 7 7 9 14 Good Practice Recommendations Daily records should accurately reflect the care provided each day and any outcomes to that care. Care plans and should be completed and reviewed monthly. It is recommended that all records relating to an individual service user be held within that individuals care plan. The medication trolley should be locked when left unattended. Staff need to have a greater awareness of what the service users in the home would like and work toward achieving this for service users, ensuring they have true choice and control over their own lives. Action should be taken to ensure service users are able to have a cup of tea when they want one. Written evidence that staff have received a detailed induction should be avaiable. All staff should attend at least two fire drills and two fire lectures per year. Although the home is relatively new it is recommended that permanent arrangements be made to ensure planned maintenance is carried out. 6. 7. 8. 9. 15 30 38 38 White Rose House Nursing and Care Centre J51J01_s44462_White Rose House_v223571_110505.doc Version 1.30 Page 21 Commission for Social Care Inspection Park View House Woodvale Office Park Woodvale Road Brighouse. HD6 4AB 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 Rose House Nursing and Care Centre J51J01_s44462_White Rose House_v223571_110505.doc Version 1.30 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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