Inspection on 26/01/10 for Whiteacres Residential Care Home

This inspection was carried out on 26th January 2010.

CQC found this care home to be providing an Poor service.

The inspector found no outstanding requirements from the previous inspection report, but made 15 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Whiteacres Residential Care Home 30/06/09

Whiteacres Residential Care Home 07/01/09

Whiteacres Residential Care Home 10/07/08

Whiteacres Residential Care Home 30/04/08

Whiteacres Residential Care Home 09/01/08

Whiteacres Residential Care Home 29/10/07

Whiteacres Residential Care Home 18/12/06

Similar services:

Trevayler Residential Care Home

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Extracts from inspection reports are licensed from CQC, this page was updated on 03/06/2010.

Key inspection report Care homes for older people Name: Address: Whiteacres Residential Care Home 40 Whitehill Road Ellistown Leicestershire LE67 1EL     The quality rating for this care home is:   zero star poor service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Debbie Williams     Date: 2 6 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. that people have said are important to them: They reflect the things 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. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Whiteacres Residential Care Home 40 Whitehill Road Ellistown Leicestershire LE67 1EL 01530260415 01530260415 genesishomes2003@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Genesis Homes (Essex) Ltd Name of registered manager (if applicable) Mrs Melanie Partridge Type of registration: Number of places registered: care home 18 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: No one in the category DE(E) may be admitted into Whiteacres Residential Care Home when there are already 18 persons of category DE(E) already accommodated in this home. No one in the category MD(E) may be admitted into Whiteacres Residential Care Home when there are already 18 persons of category MD(E) already accommodated within this home. No one in the category OP may be admitted into Whiteacres Residential Care Home when there are already 18 persons of category OP already accommodated in this home. Care Homes for Older People Page 4 of 26 Over 65 18 18 18 9 0 0 0 0 No one in the category PD(E) may be admitted into Whiteacres Residential Care Home when there are already 9 persons of category PD(E) accommodated in the home. No person to be admitted to Whiteacres Residential Care Home in the categories OP, PD(E), DE(E), or MD(E) when18 persons in total of these categories/combined categories are already accommodated in this home. Date of last inspection Brief description of the care home Whiteacres is a home situated on the main road in Ellistown, a village in the North of the County of Leicestershire. The home is situated on a bus route to Leicester and Coalville, and is closely situated to shops and green areas. The home can accommodate up to 18 people, and is registered to admit residents within the Dementia (DE) Mental Disorder (MD), Old age (OP), Physical Disability (PD) groups. The home has 18 single bedrooms some having en-suite facilities. A number of bedrooms are under the current regulation size, though this has been recognised appropriately with information contained in the Statement of Purpose. Resident accommodation comprises of 2 lounge areas and a dining room, bedrooms are split between both floors in the home and a passenger lift services both floors of the home. A copy of the latest Care Quality Commission inspection report is available at the home. 0 7 0 1 2 0 0 9 Care Homes for Older People Page 5 of 26 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: zero star poor 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: This key inspection included a visit to the service. We visited the home on the 26th of January 2010. The main method of inspection used was case tracking which meant selecting three residents and tracking the quality of their care by checking records, discussion with them and with staff and observation of care practices. We also spoke with two relatives. We checked all the standards which the Care Quality Commission have decided are key standards during this inspection. In some sections we have also checked additional standards, these will be detailed in the main report. At the time of this inspection, Social Services had imposed a suspension of placements, this means that no new admissions can be made at the home. This was in response to Care Homes for Older People Page 6 of 26 a safeguarding incident that occurred at the home. We are monitoring the actions of the providers to address the concerns that have been raised. We will undertake a further inspection of this service and issue an updated report within the next six months. Care Homes for Older People Page 7 of 26 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 26 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 9 of 26 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with the information they need to make an informed choice before moving in. Assessment procedures were not robust and therefore some people had moved into the home and were not getting their needs fully met. Evidence: The service is registered to accommodate people who need care because of old age, dementia or mental health problems. Staff did not have the training they required to meet the specialist needs of people living at Whiteacres residential home. The providers have produced a statement of purpose and service users guide which sets out the service and facilities provided and this is given to all prospective residents before they move in, this enables people to make an informed choice about moving in. The acting manager carries out a needs assessment before people move in, this is to ensure the service can meet peoples needs. However, it was evident that the service Care Homes for Older People Page 10 of 26 Evidence: and staff working at Whiteacres were not equipped to meet the needs of some people living at Whiteacres. Care Homes for Older People Page 11 of 26 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Whiteacres did not always have their health, personal and social care needs met. Evidence: We looked at care plans for three people we case tracked. Care plans were not person focused and contained very little detail about peoples life histories, cultural and religious needs, psychological or social needs. Care plans seen contained little detail of how to keep people safe or how to manage any challenging behaviour. Risk assessments were in place but staff did not always take appropriate action where risk was identified such as making a referral to a health care professional such as a GP or dietitian. We looked at medication administration records, policies and procedures. Staff responsible for managing medication had received appropriate training. Medication administration records appeared accurate and up to date. We had concerns about the medication prescribed for one person and did not feel the medication prescribed had been reviewed or its effects on the person monitored correctly. Care Homes for Older People Page 12 of 26 Evidence: We made a requirement that a separate medication fridge be purchased for the safe and secure storage of medicines that require refrigeration. Interactions observed between staff and residents appeared positive and respectful. We observed one incident where a residents privacy and dignity was not protected. Care Homes for Older People Page 13 of 26 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People did not always experience a lifestyle that met their individual preferences and and needs. Evidence: We case tracked three people living at Whiteacres and looked at the opportunities available to them for recreational and leisure activities. There were a range of activities on offer such as hand massage and manicure, some people were able to go out of the home for lunch or to go shopping. However, some people living at Whitacres were not being provided with activities that were meaningful to them. Staff had collected some information about peoples life histories and preferences but more of this information was required. This is important for people who may have difficulties communicating their needs and preferences. Staff had made some efforts to provide activity for people who have dementia but this was not individualized or person focused. Some people were unoccupied for the majority of time during this inspection and appeared to be asleep or withdrawn. We spoke with one visitor who told us they were always made welcome when they visited. There were no restrictions on visiting time. Care Homes for Older People Page 14 of 26 Evidence: People spoken with told us they were able to decide how to spend their day, for example, what time to get up in the morning or what time to go to bed at night. Care records for people with communication difficulties did not provide enough information for staff about preferences regarding routines of daily living. We observed the lunchtime meal and this appeared appetizing and nutritious. Staff were seen assisting some people with their meals in an appropriate and sensitive manner, however two people did not receive the assistance they required. One person had some difficulty reaching their meal, equipment provided was not suitable for their needs. We looked at menu records, a choice of meal was available and people told us they could have a snack or drink at anytime. Care Homes for Older People Page 15 of 26 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Whiteacres were not always protected from abuse. Evidence: Shortly before we visited the home, an incident occurred that was referred to social services. However, it was evident that staff did not respond to this incident in line with safeguarding adults policies and procedures and that some staff had a poor understanding of the actions they should take to protect people from harm. Further evidence was seen during our visit to the home of staff not responding appropriately to episodes of challenging behaviour such as verbal and physical abuse. Staff had not received training in the safe management of challenging behaviour. People spoken with told us they could speak with staff about any concern or complaint and felt that staff would listen to them and take them seriously. Care Homes for Older People Page 16 of 26 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. The environment appeared, homely comfortable and well maintained. Evidence: We undertook a partial tour of the premises and looked at the rooms of people we case tracked. The home appeared clean, tidy and homely. One persons room had a stained carpet but the providers were aware of and taking action about this. The provider was responsible for maintenance at the home. Information sent to us in the providers Annual Quality Assurance Assessment confirmed that all routine maintenance and safety checks of equipment and premises had been carried out. We looked at the personal rooms of people we case tracked, rooms seen were homely and personalized. Staff had received training in infection control but this had not been updated for some time. This training is necessary to minimize the risk of cross infection. Care Homes for Older People Page 17 of 26 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff had not received all the training they required to meet peoples needs and to keep them safe. Recruitment procedures minimized risk for people living at Whiteacres. Evidence: All but two of the care staff employed have achieved a National Vocational Qualification in care. All staff receive induction training when the first commence employment. Mandatory training and other training staff need to do their jobs had not been updated for some time. We looked at staffing rosters and spoke with residents about staffing levels at the home. People spoken with told us that staff attended to them quickly and they were not left waiting. However, during this inspection we observed people left unsupervised when they needed help or were unsafe. Many people had high dependency needs and the numbers of staff on duty were not sufficient to meet these needs. Since this inspection the providers have taken some action to address this. We looked at staff recruitment procedures and found that all necessary checks had been carried out and references obtained, this ensures that staff employed are suitable to work at the home and promotes safety for people living at the home. Care Homes for Older People Page 18 of 26 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There was not a clear sense of leadership and direction and therefore the home was not always run in the best interests of people living there. Evidence: At the time of this inspection the acting manager was on leave and the service was being managed by the owners. There has not been a registered manager at this service for some time, we have made a requirement about this. A system of quality assurance was in place but the effectiveness of this must be questioned considering the shortfalls identified at this inspection. We looked at records for fire equipment testing and maintenance and saw these were up to date and in line with local fire authority regulations. Risk assessments were in place for all working practices and these had recently been reviewed. Information sent to us in the providers Annual Quality Assurance Assessment Care Homes for Older People Page 19 of 26 Evidence: confirmed that all routine maintenance and safety checks of equipment and premises had been carried out. Health and safety training had not been updated for some time, this is necessary in order to promote safety for people working and living at Whiteacres. There was a facility for secure storage of small amounts of personal money, we looked at transaction records, in order to minimize risk of financial abuse, two signatures are required for each transaction. Staff had not followed this procedure for all transactions. Care Homes for Older People Page 20 of 26 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 21 of 26 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 3 14 The registered person must not provide accommodation to a person unless their needs can be fully met. This is to ensure that people have their needs met. 14/03/2010 2 4 18 Staff must collectively and individually have the skills required to meet the specialist mental health and dementia care needs of people accommodated. This is to ensure that people have their needs met and their safety promoted. 01/04/2010 3 7 14 Care plans must provide 31/03/2010 clear instruction for staff regarding the health, personal and social care needs of people living at Whiteacres. Care plans must include individual needs and preferences. Care Homes for Older People Page 22 of 26 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 This is to ensure that people have their individual needs and preferences met. 4 8 13 Where risk is identified, appropriate professional advice must be sought. This is to ensure that people receive the treatment they require to maintain their safety. 5 9 13 The effects of prescribed medication must be monitored and regularly receiwed. This is to ensure that people have their safety and wellbeing promoted. 6 9 13 A separate locakable fridge must be purchased for the storage of medicines that require refridgeration. This is to ensure that medication is stored safely. 7 10 12 Staff must maintain peoples privacy and dignity at all times. This is to ensure that people have their privacy and dignity maintained. 8 12 12 People must be given opportunities to participate in recreational and social 26/03/2010 18/03/2010 31/03/2010 14/03/2010 14/03/2010 Care Homes for Older People Page 23 of 26 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 activities that are meaningful and meet their individual needs. This is to ensure that people have a fulfilled lifestyle. 9 15 12 People must be offered the assistance they require at meal times. This is to ensure that people receive a nutritious diet. 10 18 13 Staff must follow national safeguarding adults policies and procedures. This is to protect people from harm. 11 26 13 All staff must have training regarding infection control. This is to minimize the risk of cross infection. 12 27 18 Staffing levels were not 17/03/2010 always sufficient to meet the complex and challenging behaviour needs of some people living at Whiteacres residential home and must therefore be reviewed. This is to ensure that people have their needs met and are protected from harm. 30/04/2010 19/03/2010 26/03/2010 Care Homes for Older People Page 24 of 26 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 13 30 18 Staff must receive all the 30/04/2010 training they require to meet the needs of people living at Whiteacres. This is to ensure people have their needs met and are kept safe. 14 31 8 A suitable person must be appointed as manager and be registered as the manager with the Care Quality Commission. This is to ensure the home is run in the best interests of people living there. 29/04/2010 15 35 13 Two signatures must be obtained for all financial transactions for peoples personal money. This is to minimize the risk of financial abuse. 20/03/2010 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 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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. 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