Inspection on 30/04/08 for Whiteacres Residential Care Home

This inspection was carried out on 30th April 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Whiteacres Residential Care Home 26/01/10

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 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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Whiteacres Residential Care Home 40 Whitehill Road Ellistown Leicestershire LE67 1EL Lead Inspector Debbie Williams Unannounced Inspection 09:00 30 of April 2008 th 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 Whiteacres Residential Care Home DS0000068031.V363812.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Whiteacres Residential Care Home DS0000068031.V363812.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Whiteacres Residential Care Home Address 40 Whitehill Road Ellistown Leicestershire LE67 1EL 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) 01530 260415 01530 260415 genesishomes2003@yahoo.co.uk Genesis Homes (Essex) Ltd Mrs Melanie Partridge Care Home 18 Category(ies) of Dementia - over 65 years of age (18), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (18), Old age, not falling within any other category (18), Physical disability over 65 years of age (9) Whiteacres Residential Care Home DS0000068031.V363812.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 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 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. 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 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. 9th January 2008 Date of last inspection Brief Description of the Service: 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. The weekly fees range from £319 to £379 per week - this information was provided on the day of the visit. There are additional costs for expenditure such as hairdressing, private chiropody, toiletries, newspapers, and the social fund that pays for outings, outside entertainments etc. Whiteacres Residential Care Home DS0000068031.V363812.R01.S.doc Version 5.2 Page 5 A copy of the latest Commission for Social Care Inspection, inspection report is available from the home. Whiteacres Residential Care Home DS0000068031.V363812.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 0 star. This means the people who use this service experience poor quality outcomes. The focus of the inspections undertaken by the Commission for Social Care Inspection is upon outcomes for residents and their views of the service provided. The primary method of inspection used was ‘case tracking’ which involved selecting three residents and tracking the care they received through looking at their records, discussion, where possible, with them, their relatives and care staff and observation of care practices. Despite requirements made and improvement plans developed at the last two inspections this service has remained poor. While the service does have some significant strengths such as the positive relationship between staff and residents and the relaxed and homely environment provided, medication management and staffing levels have remained poor and put people who live at the home at risk. What the service does well: What has improved since the last inspection? Since the last inspection a second choice is now available at meal times, this provides a better variety and choice for people living in the home. All care staff have received safeguarding adults training, this promotes better protection for people living in the home. An individual activity sheet is in place for each resident and a programme of activity is planned to meet individual needs and preferences. Whiteacres Residential Care Home DS0000068031.V363812.R01.S.doc Version 5.2 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Whiteacres Residential Care Home DS0000068031.V363812.R01.S.doc Version 5.2 Page 8 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 Whiteacres Residential Care Home DS0000068031.V363812.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1,2 and 3 (standard 6 not applicable to this service). Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are provided with the information they need to make an informed decision about moving in. Prospective residents have their needs assessed. EVIDENCE: Before moving into the home an information pack is provided to all prospective residents and a full needs assessment is carried out in order to ensure the service can meet the resident’s needs. Where possible prospective residents are encouraged to come and visit the home and possibly stay for lunch before deciding whether or not move in. Whiteacres Residential Care Home DS0000068031.V363812.R01.S.doc Version 5.2 Page 10 People living at the home have a contract and this sets out the terms and conditions of residency. We looked at assessment records these were detailed and included the psychological, social needs and individual preferences of people as well as the physical needs and personal support needs. Where possible information was obtained from relatives or friends regarding the life history and personal profile of residents, this was useful where residents had difficulty with communication and provided staff with a fuller picture of the residents individual needs. Risk assessments were also in place and part of the assessment process. Whiteacres Residential Care Home DS0000068031.V363812.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7,8,9 and 10. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The health and welfare of people living in the home is put at risk by poor medication management and conflicting instruction given to staff. EVIDENCE: The atmosphere at the home was very relaxed and homely; people living in the home appeared relaxed and content. A calm and relaxed atmosphere is considered conducive to the wellbeing of people with dementia. Interactions observed between staff and residents were very positive. One relative spoken with felt that staff were kind and respectful to people living at the home. Relatives spoken with and care records seen confirmed that people living at the home had good access to healthcare services such as GP’s and community nurses. Whiteacres Residential Care Home DS0000068031.V363812.R01.S.doc Version 5.2 Page 12 Medication administration records and storage areas were checked and stocks of medication for one person were found to be inaccurate. The correct dispensing syringe and bung for liquid medication was not being used, a syringe from a different liquid medication system was being used. Staff responsible for ordering medication did not feel confident or competent to carry out this task. The acting manager addressed this during this inspection and gave this responsibility to a more experienced staff member. This means that medication was not being managed effectively and people living at the home were put at risk. Requirements have been made regarding medication at previous inspections. Enforcement action is now being considered regarding medication management. Care records were inspected and confirmed that people living at the home had good access to healthcare services. The majority of care plans seen addressed all assessed needs and included risk assessments and individual needs and preferences. Two care plans seen did not fully meet the needs of residents and these were put in by the provider, staff spoken with said they were not following these care plans as they were aware that the instructions may put people at risk. This does not meet the health and welfare needs of people living in the home and therefore a requirement was made regarding this. Whiteacres Residential Care Home DS0000068031.V363812.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live in the home are helped to exercise choice and autonomy. Routines of daily living are flexible in order to meet individual expectations and preferences. EVIDENCE: Since the last inspection staff have worked hard to improve the choice of activities available to people who live in the home. Activities were designed and provided on an individual basis in order to meet individual preferences and expectations. The acting manager said that residents occasionally went out to the local workingmen’s club. One relative spoken with said that in warmer weather they often went for a walk in the garden and that entertainers occasionally come into the home. At the time of this inspection residents appeared comfortable and relaxed and were observed socialising in the lounge and dining areas. There are no restrictions on visiting and visitors are made to feel welcome. Whiteacres Residential Care Home DS0000068031.V363812.R01.S.doc Version 5.2 Page 14 Staff spoken with said they were instructed to promote choice and autonomy for residents and that residents were given choice over how to spend their day, when to get up and when to go to bed etc. Arrangements were in place for people to meet their religious needs. No specific cultural or dietary needs were being provided at time of inspection. Special diets provided included diabetic and pureed meals. The lunchtime meal served during this inspection appeared appetizing and nutritious. Since the last inspection a second choice of meal has been introduced, so providing more variety choice for residents. Whiteacres Residential Care Home DS0000068031.V363812.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. People who live at the home were put at risk due to conflicting instructions given to staff. EVIDENCE: The provider has a complaints procedure and this is included within the service users guide. One relative spoken with said they would feel comfortable making a complaint to staff members and felt that any complaint would be take seriously. Staff spoken with were able to demonstrate a good awareness and understanding of complaints and safeguarding adults policy and procedure. All care staff had recently attended safeguarding adults training. The provider’s complaints and safeguarding policy was in line with national guidelines. Residents were put at risk because care plans for two residents contradicted advice provided regarding safeguarding their wellbeing, despite this contradiction, staff had sought advice from the relevant professionals and were following this advice. Whiteacres Residential Care Home DS0000068031.V363812.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe, comfortable and homely environment. EVIDENCE: We undertook a partial tour of the premises and looked at the rooms of case tracked residents. All areas of the home seen appeared clean, well maintained and homely. A programme of refurbishment and redecoration was in place. The first floor bathroom had recently been refurbished. People who live in the home were able to personalise their rooms. Whiteacres Residential Care Home DS0000068031.V363812.R01.S.doc Version 5.2 Page 17 One relative spoken with said the home was always fresh and clean. The outside area was attractive and accessible to people living in the home. Staff have received infection control training and were following the correct procedures to minimise cross infection. Staff were carrying out routine checks and risk assessment as required by the local fire service and environmental health department. Whiteacres Residential Care Home DS0000068031.V363812.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27,28,29 and 30. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Staffing numbers did not meet the needs of people living in the home. Staff were trained and competent to do their jobs. EVIDENCE: There were 18 residents living in the home at the time of this inspection, many residents had complex and high dependency needs. For the majority of daytime hours there were 3 care staff on duty but between 8 and 10 in the morning and 9 and 10 at night there were only two care staff. We were concerned that these staffing levels did not meet the needs of people living in the home. Requirements had been made at previous inspections regarding staffing levels. The acting manager said that it was very difficult to recruit care staff but did start to address this issue during this inspection and said that a minimum of 3 care staff would be on duty during daytime hours as soon as this could be arranged. One relative spoken with said the home was short staffed but staff managed well. Whiteacres Residential Care Home DS0000068031.V363812.R01.S.doc Version 5.2 Page 19 A staff training and development programme was in place. This included induction training, which followed national training organisation guidelines. The majority of care staff had achieved a National Vocational Qualification in care. Recruitment procedures were robust and promoted the protection of people living in the home. Recruitment procedure included obtaining two references for every staff member, however there were no references in place for one staff member who had been employed prior to the current provider taking over the home, a requirement was made regarding this. Whiteacres Residential Care Home DS0000068031.V363812.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31,33,35,37 and 38. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Improvements are needed to communication and record keeping in order to ensure the safety of people living in the home. EVIDENCE: At the time of this inspection there was an acting manager in post. Staff and relatives spoken with said that the management approach was open and supportive. Regular staff and relative meetings are held; minutes of these were seen. Whiteacres Residential Care Home DS0000068031.V363812.R01.S.doc Version 5.2 Page 21 A programme of quality monitoring was in place and this included seeking the views of residents and their relatives. Procedures are in place for handling resident’s personal money, which minimises the risk of financial abuse. All mandatory health and safety training was provided to staff. One staff member was undertaking an occupation health and safety qualification. Risk assessments are carried out and regularly reviewed and this promoted protection for people living in the home and for staff. Regular routine maintenance work and testing was carried out in line with the relevant legislation and requirements. All accidents are reported and recorded. Safe working practices are included within staff induction training. Records of the providers visits were seen, while a record of visits was maintained, these records provided very little detail on the conduct of the home or of the actions taken by the provider during each visit. This is despite a requirement being made at the last inspection and the absence of the registered manager. Whiteacres Residential Care Home DS0000068031.V363812.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 3 x x x x x x 3 STAFFING Standard No Score 27 1 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x 1 3 Whiteacres Residential Care Home DS0000068031.V363812.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action 1. OP9 13 (2) Medication must be administered 02/05/08 in line with the homes’ policy and procedures and as instructed by the prescriber. This is to ensure people receive the medication that is prescribed for them and in a safe manner. 2. OP9 13 (2) The correct equipment supplied must be used to administer liquid medication as instructed by your pharmacist. This is to ensure that medication is managed accurately and safely. 02/05/08 3. OP9 13 (2) Staff with the responsibility for ordering medication must be trained and competent to do so. This is so that people living at 02/05/08 Whiteacres Residential Care Home DS0000068031.V363812.R01.S.doc Version 5.2 Page 24 4. OP27 18 the home benefit from the safe and efficient management of medication. Staffing levels need to be reviewed and increased to ensure that residents’ needs are met. This is to ensure that people living in the home have their needs met. (This requirement with an original timescale for action of 19/02/08 remains unmet). 02/05/08 5. 6. OP7 OP29 15 19 7. OP37 26 (4)(c ) Care plans must be based on 02/05/08 assessed needs. Two written references must be 30/06/08 in place for all staff employed at the home. This is to ensure protection for people living at the home. The provider must prepare a 30/05/08 monthly written report on the conduct of the home. This is to ensure that the home is run effectively and in the best interest of people living in the home. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Whiteacres Residential Care Home DS0000068031.V363812.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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