Inspection on 20/03/08 for Whitebriars Care Home

This inspection was carried out on 20th March 2008.

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

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

Whitebriars Care Home 18/02/09

Whitebriars Care Home 23/01/07

Whitebriars Care Home 08/11/05

Whitebriars Care Home 20/05/05

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Whitebriars Care Home 20 Bedford Avenue Bexhill on Sea East Sussex TN40 1NG Lead Inspector Kathryn Emmons Unannounced Inspection 20th March 2008 11:30 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 Whitebriars Care Home DS0000062356.V359540.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. Whitebriars Care Home DS0000062356.V359540.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Whitebriars Care Home Address 20 Bedford Avenue Bexhill on Sea East Sussex TN40 1NG 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) 01424 215335 01424 215335 info@whitebriars.co.uk Whitebriars Ltd Sally Ann Devlin Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places Whitebriars Care Home DS0000062356.V359540.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. From time to time the home may admit people below the age of sixty five (65) years. Date of last inspection Brief Description of the Service: Whitebriars is a care home providing personal care and accommodation for up to 19 older people. The home is located a short walk from Bexhill sea front and town centre with its shops, churches and other community services. There is good access to bus and rail routes. The house is a detached property set in its own grounds. Accommodation is provided on three floors, stair lifts are fitted to assist residents to access first and second floor accommodation, however those with bedrooms on these floors are still required to manage some stairs that are not covered by the stair lifts. The home has a large lounge and dining room area, whilst the outside of the building has a pleasant paved garden and fishpond. Fees are £340.00 to £450.00 per week. Whitebriars Care Home DS0000062356.V359540.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. A visit to the service took place on 20 March 2008. This visit was unannounced and took place over 6.5 hours. The registered manager was present throughout the inspection. Care received by three residents was looked at in detail. This is a method called case tracking. This included looking at their personal records, a range of general home records and staff detail records. Staff were spoken with and the care they provided was observed. Three residents and one staff member completed the comment cards we had sent out before the visit. We also received a completed self-audit document completed by the manager, to provide information before we did a site visit. We also looked at how the provider makes information about their service, including CSCI reports available to prospective service users. What the service does well: There was evidence that information about residents has been obtained before they went to live at the home. This means that staff can have an understanding of residents needs to ensure these can be met before an offer of admission is made. Residents and a relative made positive comments about the activities provided and examples were given of the variety. This means that residents have opportunities to engage in worthwhile activities. Residents said there is a good choice of food available and they are consulted regarding the choice of food. This means that residents are able to express their opinions and are provided with a varied diet. Staff receive on going training and are engaged in a National Vocational Qualification training programme. This means that they have more knowledge and skills to provide care for residents. Resident live in a clean and tidy home and are able to enjoy the newly landscaped garden areas. Residents made very positive comments regarding the staff and feel they are well cared for. Staff said they had a good relationship with the manager and that she is approachable and listens to them. Whitebriars Care Home DS0000062356.V359540.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Whitebriars Care Home DS0000062356.V359540.R01.S.doc Version 5.2 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 Whitebriars Care Home DS0000062356.V359540.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,4,5 and 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Through pre admission assessment systems residents can be confident that the service knows their needs but residents need to receive written conformation that their needs can be met. Up to date information needs to be provided to enable residents to make an informed choice regarding living at the service. EVIDENCE: From looking at three resident files we could see that information regarding residents needs had been obtained before they had been admitted to the home. One relative told us that they had been able to visit the service and ask questions before a decision was made for the resident to be admitted. Two documents are in place called the service user guide and the statement of purpose. These two documents are available to residents and their relatives Whitebriars Care Home DS0000062356.V359540.R01.S.doc Version 5.2 Page 9 and inform them of the services they can expect if they live at the home. Details also include who the staff are and what jobs they do, what the environment is like and what to do if they have any concerns. These are in the process of being updated to reflect staff and other changes in the service. We saw that contracts were in place, which had been signed by the resident or their relative. We didn’t see and the manager confirmed that letters are not currently sent to prospective residents to confirm their needs can be met. This needs to happen so that residents can have confidence that they are going to live in a home where staff can meet their individual needs. The service does not provide intermediate care. Whitebriars Care Home DS0000062356.V359540.R01.S.doc Version 5.2 Page 10 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): 7,8,9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans and risk assessments enable residents to be confident that their needs can be met. Lack of signing for and insufficient detail on medication sheets places residents at risk of not receiving their medication correctly. Systems in place provide access to health care professionals. Resident’s dignity and privacy are maintained. EVIDENCE: Through case tracking we looked at three residents care files. There was sufficient detail for staff to deliver care safely. Since the last inspection a daily record is maintained on the residents welfare and progress. This enables staff to see if a resident has any changes to their health and any action that needs to be taken. Where possible residents had signed their care plans. One relative told us they recalled seeing some written information about their relative and that when they saw staff they were always given an update on their relative. Whitebriars Care Home DS0000062356.V359540.R01.S.doc Version 5.2 Page 11 We spoke with six residents during the visit and received comment cards after the visit, which indicated that staff knew residents care needs. The care plans that were in place had been reviewed monthly and a record was maintained to show this. Residents who spoke to us said they had access to Doctors and opticians and dentists when they needed them. During the visit we saw that a couple of residents had been referred to the district nurses and two district nurses were visiting the service. We saw in records that doctors were called when residents needed medical support. A chiropodist visits the home every four weeks. Medication records were seen for all residents. Generally records had been competed correctly but we saw that there were a few signatures missing and the correct coding system was not always being used to show why a resident had not received their medication. We also saw another record where a drug had been handwritten by staff and did not include the maximum dosage, frequency or strength the resident could have. Stocks of medication are stored in a locked facility. We had to ask for the keys to this facility to be made secure as they were hanging on a hook in an office, which was at times unattended. We saw a member of staff dispense medication at lunchtime. This was undertaken in a clear and safe manner. Staff told us and we saw from staff files that medication training had been carried out by a local pharmacist. Residents told us they were treated with respect and their privacy was respected. A relative told us they were always spoken to in an appropriate way and they always hear staff speak to residents in a “kind and patient” way. We saw interactions between staff and residents and these were valuing and appropriate. Staff were seen to knock on the doors to bedrooms and toilet doors before entering. Whitebriars Care Home DS0000062356.V359540.R01.S.doc Version 5.2 Page 12 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): 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. Residents are provided with appropriate activities and are supported to continue with hobbies they enjoyed before living at the service. Staff have an awareness of residents spiritual and emotional needs. Residents have control over who visits them. Dietary needs and preferences are catered for. EVIDENCE: Residents and relatives made very positive comments regarding the activity programme in place at the home. A list of activities was on display in the main lounge area and we saw residents watching television, reading books and magazines and playing board games. Residents told us that in warmer weather they were able to go for walks along the seafront and that the staff would take them to the local shops. Residents told us they felt they had their spiritual needs met and that a vicar visited the service monthly to carry out communion. We were also told that a priest visits one of the residents on a regular basis. The manager was able to discuss equalities and diversity and was aware of how to ensure staff gave Whitebriars Care Home DS0000062356.V359540.R01.S.doc Version 5.2 Page 13 consideration to this in the care they delivered. The manager stated that staff treated all residents as individuals and understood that their needs were unique to them and that residents would want their care delivered in their chosen way. Residents can have visitors when they chose and there were various spaces around the home where residents can meet with visitors in private if they don’t want to use their bedroom. Staff were seen to be welcoming and accommodating to visitors who attended the home during our visit. The pre inspection information we received informed us that Resident meetings take place and residents have this opportunity to raise any issue they have. One of the relatives we spoke with also said they were given every opportunity to raise comments. Residents spoken to made positive comments about the food. They said there was a good choice available and that the chef would ask them often about the menu provided. Soft diets and diabetic diets are also catered for. Residents confirmed that they received the food they chose and that they were able to change their mind if they wanted to. We observed during our visit and saw from the pre inspection self audit information that residents can choose what time they take their meals. The inspector observed lunchtime. Lunch was well presented and residents took their meals in an unhurried setting. The chef told us that an environmental health officer had made a visit to the service and no issues had been raised. Whitebriars Care Home DS0000062356.V359540.R01.S.doc Version 5.2 Page 14 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): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A complaints policy on display enables people to know how to make a complaint. A Safeguarding adults policy and staff training in safeguarding adults enables residents to be confident they are cared for by staff with a working awareness of what constitutes abusive practice. EVIDENCE: Prior to the visit pre inspection self audit information was sent to the commission. This recorded that there had been no complaints since the last inspection and no safeguarding adult referrals. A complaints file was in place. A complaints procedure is in place and is on display in the main entrance area of the service. Pre inspection information informed us that all residents have their own copy of the services complaint procedure. Staff spoken with were aware of the complaints procedure and said what they would do if a relative or resident wanted to make a complaint. Comment cards received showed that residents knew who to speak to if they had any concerns. Residents spoken to during our visit said, “I would speak to Sally or one of the Girls” and “I have never had anything to complain about”. A safe guarding adults policy is in place. Two staff when asked said they had received Safe Guarding adult training. Both of the staff spoken with were Whitebriars Care Home DS0000062356.V359540.R01.S.doc Version 5.2 Page 15 given a scenario regarding safeguarding adults and asked what action they would take. They answered appropriately and said that they were sure that all staff knew what constituted abuse and had an awareness of this. Whitebriars Care Home DS0000062356.V359540.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): 19,25 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 clean, safe and comfortable environment. Adaptation aids are in place to meet some needs and other equipment is obtained when needed so residents can be as independent as possible. EVIDENCE: The home was clean and tidy and fresh throughout and residents we spoke with told us they were satisfied with their bedrooms. We could see that residents had been supported to personalise their rooms. We were able to look at two residents bedrooms, one in the new wing of the service and the other in the original part of the home. One resident required a hoist to be assisted to get out of bed, but the bed in the resident’s room and the size of the room does not allow for a hoist to be used. Currently the service do not Whitebriars Care Home DS0000062356.V359540.R01.S.doc Version 5.2 Page 17 have a hoist but are in the process of purchasing one so they are able to meet the increasing mobility needs of some residents. An infection control policy is in place and staff were seen wearing gloves and aprons. Since the last inspection the gardens have been landscaped and new bathroom hoists fitted to baths. There is a maintenance plan in place and further redecoration of the home is planned. When we arrived at the service three designated fire doors had been wedged open. This situation was rectified immediately by sound activated door releases being fitted to the doors. This means that residents are able to have their bedroom doors open but in the event of a fire the door automatically shuts, enabling any fire to be contained and not placing residents and staff at greater risk. Whitebriars Care Home DS0000062356.V359540.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): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. An enthusiastic and trained care team cares for residents. The organisation’s recruitment procedures are followed. Induction needs to take place for all staff to ensure residents are cared for by staff who know how to provide care in a safe way. EVIDENCE: Residents spoken with made positive comments about staff such as “they are smashing”, “good to me and help out a lot”. Resident’s comments indicated that they had no issues with the staffing levels. Staff said that sometimes the morning shift was busy and this was due to the increasing needs of a couple of the residents. The manager said that new staff were being recruited and this would enable more staff to be on duty if this was needed. We spoke with 2 staff that told us that they had worked in the service for some time and enjoyed working at the home. We had comment cards received back following the visit to the service from staff. These indicate that staff were happy working at the service and had received training. We saw staff go about their jobs in an unhurried manner and were able to sit and talk to residents at various times during our visit. Whitebriars Care Home DS0000062356.V359540.R01.S.doc Version 5.2 Page 19 One staff said they would like more staff meetings. The manager confirmed that these would be taking place on a more regular basis. Pre inspection information showed that staff have been trained in National Vocational Qualifications and that 80 had NVQ 2 or above. Staff informed us that they did receive training such as medication training and health and safety. A training plan was on display in the manager’s office. Three recruitment files were looked at. A recruitment policy is in place and all files seen contained the correct checks such as references, completed application form and Criminal Records Bureau checks and identification. This means that staff have been recruited safely and residents can be confident that they are cared for by people who have the necessary skills and attitude to care for them. We saw that one of the three staff had not received an induction programme. This training needs to take place and meet Skills for Care Standards, which is a nationally recognised competency based tool, which enables residents to be confident that staff have at least the minimum skills and knowledge to care for them safely. Whitebriars Care Home DS0000062356.V359540.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): 31,33,35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A manager who has a good rapport with residents, and visitors manages the service. Residents are protected by the services health and safety polices and procedures. Financial management systems keep residents monies safe. Quality assurance systems show how the service is run in the best interests of the residents. The proprietor needs to make a record, monthly of a visit to the service. EVIDENCE: The services registered manager is Ms Sally Devlin. Ms Devlin has been the registered manager for the past two years and is in the process of starting the Registered Managers Award. Staff told us that the manager was approachable Whitebriars Care Home DS0000062356.V359540.R01.S.doc Version 5.2 Page 21 and would listen to them. Relatives told us that they found the manager to be “lovely and will answer any questions I have” “she is lovely to all the residents”. A quality assurance system is in place so residents and visitors to the home can see how the providers intend to improve the service and action any points residents raise. Residents and relatives and other stakeholders are given a questionnaire to complete every year. We spoke with a couple of health care professionals during the visit who made positive comments regarding the service such as “we find the care here to be good and know any instructions are carried out”. The provider visits the home at least three times a week and spends time speaking with residents, manager and staff. As part of the quality assurance system a report needs to be produced monthly by the provider or a representative. This is to provide evidence of the conduct of the home and to show how the service continues to improve and develop. We looked at financial records for three of the residents as part of the case tracking process. Records showed that monies were held in a safe way and a clear audit trial was in place to ensure resident’s money was safeguarded. Pre inspection information evidenced that polices and procedures are maintained and had been updated in the latter part of 2007. Records are in place at the home, which show that servicing of equipment and systems such as the fire safety system, heating system and gas are up to date. Whitebriars Care Home DS0000062356.V359540.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 2 X 3 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 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 3 3 X X X X X 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Whitebriars Care Home DS0000062356.V359540.R01.S.doc Version 5.2 Page 23 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 OP9 Regulation 17(1)(a)S ched. 3 (3)(i) Requirement MAR sheets must indicate the date, quantity, frequency and signature of member of staff dispensing medication and a correct code recorded if medication is not given. Medication storage keys must be kept safe at all times. A monthly report must be produced by the provider or a representative to report on the conduct of the service. Residents must receive written confirmation that their assessed needs can be met if they are admitted to the service. The registered provider must provide induction training for new staff to Skills for Care requirements. This is a requirement not met from the previous inspection report timescale was 02/04/07 Timescale for action 30/04/08 2. OP33 26 31/05/08 3. OP4 14 31/05/08 4.8. OP30 18(1)(c)(i ) 31/05/08 Whitebriars Care Home DS0000062356.V359540.R01.S.doc Version 5.2 Page 24 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 Whitebriars Care Home DS0000062356.V359540.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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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