Inspection on 14/09/05 for White Rose House

This inspection was carried out on 14th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 11/05/05

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 165 Huddersfield Road Thongsbridge Huddersfield HD9 3TQ Lead Inspector Sally McSharry Announced Inspection 14th September 2005 08:30 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 Rose House DS0000044462.V250321.R01.S.doc Version 5.0 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 Rose House DS0000044462.V250321.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service White Rose House Address 165 Huddersfield Road Thongsbridge Huddersfield HD9 3TQ 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) 01484 690 100 01484 690 101 Meridian Care Limited Care Home 60 Category(ies) of Old age, not falling within any other category registration, with number (60) of places White Rose House DS0000044462.V250321.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th May 2005 Brief Description of the Service: White Rose House Nursing and Care Centre is a relatively 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 hillside. 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 DS0000044462.V250321.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection relates to an announced visit carried out by two inspectors on 14/09/05. The inspection commenced at 08:30 am and was completed at 5pm. During the inspection the inspectors spoke to some service users, staff and members of the management team. One service user comment card and one relative/visitor comment card was received by the CSCI before the inspection took place. Comments made were generally positive. What the service does well: What has improved since the last inspection? Since the last inspection the home has now employed an activities organiser and the service users and staff reported positively on the activities now being offered. At the last inspection some service users said some of the staff had poor attitudes. At this visit comments about the staff had improved. All the service users who spoke to the inspectors were very complimentary about staffs’ attitudes, the care provided and attention given. The general organisation and maintenance of the home has improved and the atmosphere was friendly and welcoming. The general management of medications has improved, however an issue was identified at this visit. White Rose House DS0000044462.V250321.R01.S.doc Version 5.0 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 DS0000044462.V250321.R01.S.doc Version 5.0 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 Rose House DS0000044462.V250321.R01.S.doc Version 5.0 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 the following standard(s): 3 and 6 An assessment is obtained before residents move into the home. EVIDENCE: The inspector examined the records for five service users and found that a full pre-admission assessment had been completed prior to the service users being admitted. Detailed pre-admission assessment information was available for a service user who had been admitted to the home recently. A care plan had been developed from the assessment information in order to inform staff of the needs of the resident. Evidence of service user/family involvement in this process was seen in the records. The home provides some respite care, but does not currently have an intermediate care contract. White Rose House DS0000044462.V250321.R01.S.doc Version 5.0 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 the following standard(s): 7, 8, 9 and 10. Service users have an individual plan, which identifies most of the service users needs. Service user’s health and welfare needs are being met. The management of medications has improved although an administration issue was identified. Service users said that staff treat them with respect. EVIDENCE: Service users’ plans on the nursing unit have improved. Plans are now in a standard format. Risk assessments are completed and any issue identified is then dealt with in a care plan, where clear advice is given to staff how to manage the need or risk whilst the service user is in the home. All care plans and risk assessments are updated monthly. There is written evidence to show that relatives and representatives are included in the care planning process and the review of care plans. Care plans on the residential unit are not quite as clear or organised. Risk assessments have been carried out, but in some cases where a risk has been identified, for example, the risk of falling, a detailed care plan has not been White Rose House DS0000044462.V250321.R01.S.doc Version 5.0 Page 10 written advising staff clearly how the risk is to be managed. This must be addressed. The nutritional assessment used on the nursing unit advises that when a certain score is reached, dietetic advice must be obtained. Records show that staff have developed a care plan when a nutritional risk is identified, but there is no evidence that dietetic advice has been obtained. The risk assessment advice should be followed. Care plans, service users and staff confirmed that the staff in the home call in other health care professionals and access NHS services when needed. The management of medications has improved. There are policies and procedures advising staff how to store, record, administer and destroy medications. The samples of medications audited were correct. Medications on the residential unit were also satisfactory. The inspector had some concerns about the security of the medicines trolley when placed in the small room opposite the dinning room. Steps were taken at the time of the inspection to make the room safer. The inspector noticed that some service users had not been receiving their morning medications because the service user was still in bed asleep, therefore the service user did not receive their medicines. Prescribed medications must be given and if service users are asleep, staff should return later in the morning to give medications. If the problem regularly occurs advice should be sought from the GP to see if the medication can be given at a more convenient time. At the last inspection service users made some comments about staff which indicated that staff were not always thoughtful or attended to service users promptly or respected service users’ wishes. During this inspection all service users who spoke with the inspectors were very complimentary about the staff, the care they provide and their kindness and consideration. White Rose House DS0000044462.V250321.R01.S.doc Version 5.0 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 the following standard(s): 12, 14 and 15. Service users’ recreational, cultural and religious needs are met. Choice is available in the home and service users’ choices are respected. Service users are complimentary about the meals provided, menus are varied and nutritious. EVIDENCE: Since the last inspection the home has recruited a full-time activities organiser. Group activities, one to one sessions and trips out are now offered to service users. Service users are keen and enthusiastic about activities. One service user commented that more out door activities would be nice. Religious services take place at the home every two weeks. On the day of the inspection the hairdresser was visiting. Five ladies were having their hair done and were enjoying pleasant banter with the hairdresser and one another. Since the last inspection, staff awareness of what service users want appears to have improved. The service provided to service users appears to be meeting the service users wishes. Due to mental or physical frailty some service users are limited in the choices they are able to make about their lives. However choice is offered, for example, during the daily living in the home, such as menu choices, where service users spend their time and whether they take part in activities. More able service users confirmed that they are able to determine and control their White Rose House DS0000044462.V250321.R01.S.doc Version 5.0 Page 12 own lives. Service users are able to maintain their independence and manage their own finances. Meals are varied and nutritional. Service uses were complimentary about the meals provided, however some service users did say that it was difficult to please everyone in the home. Meals can be served in any area of the home and there are two attractive dining rooms. White Rose House DS0000044462.V250321.R01.S.doc Version 5.0 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 the following standard(s): 16 and 18. The complaints procedure is clear; service users were aware how to make a complaint. Service users are protected in the home; the protection is being developed by ensuring all staff receive training about abuse and the protection of vulnerable adults. EVIDENCE: The complaints procedure is clear and is available in literature about the home and within the home. The home has had a relatively high number of complaints made via the home’s procedure. Twelve complaints have been made since January 2005. The manager has appropriately investigated these and a full record is made of the investigation, the outcome and any action taken. One complaint was made directly to the CSCI, this complaint related to nursing care and equipment in the home and was partly upheld. It is fair to say the home is still relatively new and some of the complaints received result from the problems associated with a new building, new staff team and new service users. Staff training has now commenced in relation to abuse and the protection of vulnerable adults. This is being delivered in house and weekly sessions are to continue until all staff have received the training. White Rose House DS0000044462.V250321.R01.S.doc Version 5.0 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 the following standard(s): 19 and 26. Service users live in a clean, tidy, safe well-maintained environment. EVIDENCE: The home provides an attractive homely environment. All areas are pleasantly decorated. At the time of this inspection the home was clean and tidy, there were no unpleasant odours. Service users are able to personalise their own rooms and all bedrooms are fitted with a lock to the door and a lockable drawer. Service users are able to have the keys to their rooms providing there is no risk to the individual. Liquid Soap is available in all communal bathroom and toilet areas. Sluice facilities are provided. During the inspection discussion took place about the provision of antibacterial alcohol hand wash for staff to use. This is recommended as a further infection control measure. White Rose House DS0000044462.V250321.R01.S.doc Version 5.0 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30. Staffing levels and the skill mix of staff are sufficient to meet the needs of the current service users. Training provided to staff helps to ensure service users are in safe hand and cared for by competent staff. There is evidence that staff are being trained. EVIDENCE: White Rose House Nursing and Care centre is now almost at maximum occupancy. Staffing levels have been increased to meet the number of service users. The residential and nursing area of the home are staffed separately. The residential unit generally has six carers and a care supervisor who is supernumerary during the morning and four carers and a care co-ordinator in the afternoon/evening. At night there are three carers on duty. The nursing unit has one nurse and four carers on duty during the morning and one nurse and three carers during the afternoon/evening. At night there is one nurse and one carer on duty. Ancillary and catering staff are also provided and since the last inspection the number of catering staff provided has been increased. An activities organiser and a maintenance man have also been employed since the last visit. White Rose House DS0000044462.V250321.R01.S.doc Version 5.0 Page 16 During this inspection there was clear evidence that new staff have received induction training. Staff also said that they have had movement and handling training, fire training, basic food hygiene training and some staff have had first aid training. NVQ training is going in the home, with thirty percent of staff having achieved NVQ level 2 or above. The company plans to have fifty percent of staff with NVQ level 2 by December 31st 2005; the CSCI recommends this level be achieved. A sample of staff records was audited and appropriate recruitment procedures have been followed. Staff have suitable references and have had the necessary checks carried out. White Rose House DS0000044462.V250321.R01.S.doc Version 5.0 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38. The proposed registered manager is currently being assessed by the CSCI to become the registered person. The home is run with the interest of the service users in mind. Service users’ finances are safeguarded. The health, safety and welfare of service users and staff is being promoted and protected. EVIDENCE: Mrs Joanne Hempstock is the acting manager. She has been proposed by Meridian Care Limited to be the permanent manager. Mrs Hempstock’s application is currently being processed by the CSCI. Mrs Hempstock has completed the registered manager award and is to commence NVQ level 4 in care. Since joining the home she has managed the home effectively. White Rose House DS0000044462.V250321.R01.S.doc Version 5.0 Page 18 Quality assurance measures are in place. There have been resident and relatives meetings, questionnaires have been circulated to service users and a copy of which is provided to the CSCI. The results of questionnaires and surveys carried out in the home are summarised and made available in the home; together with an action plan addressing any issues identified. Some service users are able to manage their own finances independently or with the help of their relatives. Facilities are provided to enable service users to store valuables securely in their rooms. The manager does hold small amounts of spending money for some service users. These monies were audited and found to be correct. Records clearly showed the amounts of money deposited and how this had been used, receipts were also available as proof of purchases made. Formal staff supervision has commenced and the manager aims to ensure all care staff have supervision at least six times a year as recommended. There is a regular maintenance programme and evidence of regular tests and servicing of equipment was seen. Since the last inspection a maintenance person has been employed at the home. The acting manager reported this to be of great benefit as routine maintenance is now addressed promptly. The maintenance records available include records of hot water test. These records consist of the date and a statement to say everything was all right. It is recommended specific records be maintained including the date, which outlet is being tested and the temperature recorded. White Rose House DS0000044462.V250321.R01.S.doc Version 5.0 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 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 1 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 2 X 2 White Rose House DS0000044462.V250321.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? Yes 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 OP8 Regulation 13 Requirement A care plan must be developed when a risk is identified. The care plan should provide detailed advice to staff as to how the risk is to be managed whilst the service user is in the home. (Previous timescale of 31 August 2005 not met.) Prescribed medications must be administered. Timescale for action 31/12/05 2 OP9 13 31/10/05 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 Refer to Standard OP8 OP26 OP28 Good Practice Recommendations When the risk assessment tool used indicates a risk and advises that specialist advice be sought, such as from the dietician, staff should ensure this advice is carried out. It is recommended staff be provided with antibacterial alcohol hand wash as a further infection control measure. Fifty percent of care staff should have obtained NVQ level 2 by 31/12/05. DS0000044462.V250321.R01.S.doc Version 5.0 Page 21 White Rose House 4 OP38 It is recommended hot water temperature check records include the date, which outlet is being tested and the temperature recorded. White Rose House DS0000044462.V250321.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Brighouse Area Office 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 DS0000044462.V250321.R01.S.doc Version 5.0 Page 23 - 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. 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