Inspection on 12/11/08 for White Waves

This inspection was carried out on 12th November 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

White Waves 14/05/08

White Waves 11/10/06

White Waves 26/10/05

White Waves 30/06/05

White Waves 14/12/04

White Waves 19/06/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: White Waves 17-19 Seal Road Selsey Chichester West Sussex PO20 0HW     The quality rating for this care home is:   one star adequate 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: Liz Palmer     Date: 1 2 1 1 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 22 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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 22 Information about the care home Name of care home: Address: White Waves 17-19 Seal Road Selsey Chichester West Sussex PO20 0HW 01243602379 Telephone number: Fax number: Email address: Provider web address: whitewaves@fsmail.net Name of registered provider(s): Type of registration: Number of places registered: Platinex Limited care home 19 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Only Persons Over sixty five (65) Years of age to be admitted. Date of last inspection Brief description of the care home White Waves is a privately owned care home registered to provide accommodation and personal care for up to nineteen elderly (over 65 years) persons. The registered provider is Platinex Limited for whom Mr Satchell is the responsible individual. Mrs J M Satchell is the registered manager. White Waves is a detached two-story building situated in a residential road in the village of Selsey. It is a short distance from local shops and the seafront. Accommodation is arranged in thirteen single and three double rooms. A lounge and dining area provide communal space on the ground floor. There is a passenger lift, which serves all rooms with the exception of three, which are on a mezzanine level. The homes weekly fees currently range from 400 to 750 pounds. 0 Over 65 19 Care Homes for Older People Page 4 of 22 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: one star adequate 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 inspection included a visit to the home over five hours by inspectors, Liz Palmer and Lesley Webb. We used the homes improvement plan and the last report to inform our judgements about the service. We also spoke to five residents and three staff during the inspection and a visiting practice nurse. Care Homes for Older People Page 5 of 22 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 6 of 22 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 7 of 22 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. People who use the service are assessed to ensure that only those whose needs can be met are admitted to the home. Evidence: Five new residents have been admitted to the home on a permanent basis and two have been admitted for respite since the last inspection. The files of three of these people were looked at and three people were spoken to about their experience of choosing the home. Two said they had enough information and their families had visited the home on their behalf before choosing it. They had originally come for respite care and have since decided to stay permanently. One said they were unable to visit the home prior to moving in but had received the brochure and had several telephone calls with the manager, which was really helpful. The home this resident had moved from assisted with the assessment and provided relevant information to White Waves. The assessments seen included relevant information about the person Care Homes for Older People Page 8 of 22 Evidence: including their medical history, social history, care needs, next of kin and the general practitioners (GPs) name and address. Care Homes for Older People Page 9 of 22 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Improvements have been made to care plans. Residents now benefit from them being clearer, more accessible to staff and kept under regular review. Improvements need to be made in the documentation of risk assessments for people to ensure their safety at all times. Evidence: Three care plans were sampled. These are drawn up from the initial assessments. The care plans contained relevant information and were noted to be kept under regular review and changes made as necessary. Staff spoken to said they had open access to the care plans and referred to the plans when talking to us. They were clearly working documents with up to date information. These things were required by us at the last inspection and were seen to be met. Risk assessments were seen to be in place for nutrition, falls and self-administering medication. One resident was found to have bed rails to prevent them falling out of bed at night. The home had gained permission for these from the resident and her power of attorney. Although it was apparent that these bed rails had been installed in the best interests of the resident there was no Care Homes for Older People Page 10 of 22 Evidence: evidence of a full multi-diciplinary assessment. Nor were there any protective covers on the rails. The bed rails were removed during the inspection by the management of the home and an immediate requirement was made by us to ensure a full risk assessment was undertaken to clearly identify the risks and any actions taken to ensure their safety at night. One resident was noticed to be using a wheelchair without foot rests. It was recorded as being her choice in her care plan, however, no risk assessment was in place for this. There was written evidence that medical assistance is sought when needed and residents spoken to confirmed they can ask to see a doctor if they need to. They said they felt well cared for and in safe hands. They are all registered with a local GPs practice of which the home has good links. One resident said the district nurse comes in daily to attend to them. A visiting practice nurse was spoken to about her experience of visiting the home. She has been coming to the home for approximately six years and spoke highly of the standard of care given consistently over the years. She said staff always follow the advice given by her and she has never had any concerns about the home. The proceedures for the administration, storage and recording of medication were sampled. The medication cabinet was seen to be suitably secure, clean and organised. No errors or omissions were seen on the records. The home uses a monthly blister pack system delivered by a local pharmacy. A risk assessment for one person who self-administers was seen. The residents spoken to all said they liked the staff. They said their privacy is respected. Staff were observed on the day spending time chatting to residents and speaking in a polite and friendly way to them. Care Homes for Older People Page 11 of 22 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. A range of activities is on offer in the home, some say they would like to be offered more group activities to join in. The home provides wholesome food to suit the needs and tastes of residents. Evidence: A range of activities is advertised in the home. Such as; sing-along, trip down memory lane, exercises and a visiting hairdresser. Two new residents spoken to said they were a bit disappointed that there had not been more group activities they could join in. They said they had enjoyed the weekly exercises. The manager responded that when they get to know them better they will plan some activities geared to their needs and preferences. Another resident said there was enough to do and they had the choice whether to join in or not. They all said they could choose how to spend their time and could go to their rooms if they wished. People are also encouraged to pursue their own hobbies and remain independent as far as possible. For example; knitting, reading the newspaper of their choice and magazines. The manager stated a knitting circle had recently been set up and a gardening club that involves relatives and friends. No activities were seen taking place during the inspection. Staff were observed Care Homes for Older People Page 12 of 22 Evidence: spending time with residents, chatting to them in the lounge. Visitors are welcome and some residents have their own telephones to enable them to keep in touch with friends and family. Those who do not have a telephone can request to use the homes telephone, which can be brought to their room. A new resident was receiving and making calls on the homes telephone during the inspection. There is a set menu in the home with alternative choices offered. Residents spoke highly of the food provided and said it was lovely and there was always plenty of it. Care Homes for Older People Page 13 of 22 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 who live in the home are able to complain and are protected by the safeguarding procedures and by staff being trained in this area. Evidence: A new complaints procedure is displayed in the home. A record of complaints was looked at; none have been made since the last inspection. Residents spoken to say they know how to make a complaint and feel that any concern they may have would be dealt with by the staff or the manager. One said staff were lovely and they would be happy to talk to them. Another said staff were easy to talk to. Three staff were asked about the homes procedure for safeguarding adults. All said they have received training and all were able to say what they would do if they suspected any abuse or were told of any. Training records confirmed that the requirement we made at the last inspection for staff to receive training in safeguarding adult procedures has been met. The homes policy on safeguarding adults was seen and all staff had signed to say they read and understood it. A copy of West Sussex County Councils policy is kept in the home. There are currently no ongoing safeguarding issues so the requirement we made at the last inspection for the home to maintain their records relating to this could not be tested on this occasion. Care Homes for Older People Page 14 of 22 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. Residents benefit from a comfortable, clean and homely environment. Evidence: A requirement for a bedroom carpet to be made free from hazard has seen to be met. Another carpet on the upstairs landing was noted to be posing a possible trip hazard. The manager stated this area of the home was part of the homes overall development plan and would be extended. At this time, they are intending to replace the carpet. The development plan states this work is due to take place in 2009, although it is not specified when in 2009. In the meantime, all carpets or other hazards should be risk assessed and actions taken to minimise the risk to service users. New curtains were being measured up for the lounge during the inspection. Residents say their rooms are cleaned regularly and the bedrooms and communal areas seen were clean and well decorated. Residents said they can bring in their own furniture which made it more homely for them. Care Homes for Older People Page 15 of 22 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Improvements to staff recruitment and training promote the saftey and well being of people living in the home. Staff vacancies and some staff still working excessive hours could put people at risk. Evidence: At the last inspection we made a requirement that suitable numbers of staff must be deployed so that staff do not work excessive hours. The home has partially addressed this by recruiting two new members of staff, one of these has since left. The rota shows some staff are on duty 7 days in a row. It also shows the manager as working two management shifts and six care shifts of which she is on sleep-in duty and then starts a care shift at 6am. The manager says she is never woken at night to assist the waking night care staff. No risk assessment is in place for the manager who says she has sufferred no ill affects by working these shifts. A risk assessment has been undertaken for all staff who work excessive hours. These assessments are generic and do not detail what the actual risks could be or how they could be minimised. There are still two full time vacancies in the home which they are currently recruiting to fill. The home does not use agency staff and they believe this offers consistency which outweighs the risk of staff working excessive hours. We will not pursue the requirement made as steps have been taken and the recruitment process is ongoing. We will monitor this at future inspections. Care Homes for Older People Page 16 of 22 Evidence: At the last inspection we made requirements for staff to receive training in Manual Handling, Safeguarding Vulnerable Adults, First Aid with at least one staff member undertaking the 4 day qualified First aider course. We spoke to staff who said they had undertaken this training and the certificates on their files confirmed this. At the last inspection we made a requirement that no staff should be employed without a thorough recruitment process being undertaken. The recruitment file of the person recently recruited was looked at. This included an application form, interview notes, three written references and a Protection of Vulnerable Adults check and an Enhanced Criminal Record check. This person said they were undergoing an induction programme and currently shadowing other staff, records seen confirmed this. Staff spoken to said they liked working in the home and thought it was a good place to work. Residents spoke highly of the staff saying things like they are lovely, they answer our call bells quickly, nothing is too much trouble. Care Homes for Older People Page 17 of 22 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A period of stability and time to embed the improvements already achieved will enhance the management of the home. The issue of excessive hours still poses a risk to residents and staff. Evidence: Since the last inspection the manager has almost completed a National Vocational Level 4 in management. Records seen confirmed she has also undertaken training in; Medication, Fire, Infection Control, Food Hygiene, Abuse Awareness, First Aid and Health and Safety. Other areas of improvements we asked for were seen. These include; a photograph of each resident, a sample signature of all staff, an improvement in the daily records and the morale of staff. The home has addressed all the requirements made by us at the last inspection. With the help of a consultant brought in to assist the manager improvements have been Care Homes for Older People Page 18 of 22 Evidence: achieved in care planning, training, recruitment and the overall running of the home. The issue of staff and the manager working excessive hours was raised at the last inspection and a requirement made. There was evidence to show that steps had been taken to reduce the excessive hours although this has not been fully achieved. The home say this is not having a detrimental affect on staff or residents. An area in need of further development is that of risk assessment. Two specific risk assessments needed have been highlighted in this report. One relates to bed rails and the other to non use of foot rests on wheelchairs. An immediate requiement was made regarding the bed rails, the Commission has since received confirmation that this has been met. Safety checks were sampled and it was noted that fire safety checks are regularly undertaken. The servicing of equipment such as hoists and the lift is up to date. Accidents are recorded and regular regulation 26 visits are undertaken. These include comments from residents. The home handles residents finances and keeps records of any transactions it is involved in. These were found to be accurate at the last inspection, they were not sampled at this inspection. Care Homes for Older People Page 19 of 22 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 20 of 22 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 1 7 15 Risk assessments must be clearly documented for all risks to residents. This includes for using bed rails and removal of foot rests on wheelchairs. To promote the safety of people at all times. 11/01/2009 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 21 of 22 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 © (2009) 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 22 of 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. 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!