CARE HOMES FOR OLDER PEOPLE
Whitecliffe House 30-40 Whitecliffe Mill Street Blandford Dorset DT11 7BQ Lead Inspector
Joanne Pasker Unannounced Inspection 30th November 2005 10.00 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 Whitecliffe House DS0000020446.V255767.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Whitecliffe House DS0000020446.V255767.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Whitecliffe House Address 30-40 Whitecliffe Mill Street Blandford Dorset DT11 7BQ 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) 01258 450011 01258 488905 whitecliffehouse@coltencare.co.uk Colten Care Limited Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places Whitecliffe House DS0000020446.V255767.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The home may accommodate a maximum of 19 service users who require nursing care. 2nd March 2005 Date of last inspection Brief Description of the Service: Whitecliffe House is situated centrally to all major routes into Blandford and is a five-minute walk to the town centre. Adjacent to the home is a Doctor’s surgery. The home is registered to provide both personal and nursing care to older people, nineteen places are available for people requiring nursing care and the remaining twelve for those with personal care needs. Whitecliffe House is an older style building, which has been extended and adapted to provide a full range of accommodation and ample communal space. There is a passenger lift to all three floors making access possible for all service users. All rooms have en suite facilities. There is a communal lounge, dining room and shared garden area with seating. Visitors are always welcome and offered generous hospitality and there is a high standard of “hotel style” catering and domestic services. Colten Care Limited owns the home, a company who have a number of care homes in Dorset and adjoining counties, and is managed on a day to basis by a registered nurse. Colten Care Limited aims to provide residents with a secure, relaxed and homely environment in which their care, well-being and comfort are of prime importance. Whitecliffe House DS0000020446.V255767.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was the first of two statutory inspections required in accordance with the Care Standards Act 2000. The lead inspector was Jo Pasker who was accompanied by Marion Hurley. The inspection took place on 30 November and started at 10.00hrs and was completed by 12.30hrs. The total inspection time, including preparation, travelling, inspection and report writing was 9 hours. The inspectors spoke to 3 residents, 4 staff and gathered information from the manager and assistant operational manager and all documentation requested was made readily available. During the course of the inspection they also observed staff interaction with residents, the carrying out of routine tasks and conducted a tour of the premises. Additional information used to inform the inspection process included formal notifications of events and monthly reports regularly provided to the Commission by the registered provider. Since the last inspection there have been no complaints made and there has been a change of manager. The previous requirement that a minimum ratio of 50 trained members of care staff gain an NVQ Level 2 or equivalent by 2005 is still not met but the manager and staff are working hard towards achieving this target. The inspectors were grateful for the time and contributions made throughout the day by service users and staff. This report should be read in conjunction with the previous report, dated 2 March 2005. What the service does well:
Whitecliffe House provides a good standard of care to residents with a range of needs, varying from low to high dependency. It offers a welcoming, friendly environment to residents and visitors. The premises are homely and comfortable, with a communal lounge, dining room and shared garden area with seating. The manager has established a good rapport with staff and works closely with the deputy matron, both of whom ensure that they spend regular time
Whitecliffe House DS0000020446.V255767.R01.S.doc Version 5.0 Page 6 together out of the office and working ‘on the floor’ with the staff team. This in turn enables the management to work as a team and address any issues quickly and improves communication. Staff were observed to be kind to residents, treating them with respect and appeared well aware of their individual needs and choices. Residents spoken with on the day of inspection confirmed that they were well looked after and that their needs were adequately met. What has improved since the last inspection? What they could do better:
Residents’ finances must be carefully managed and all monies and records must tally. Staff supervision needs to be regularly carried out and well documented. The home should continue to work towards at least 50 of staff achieving a minimum of an NVQ 2 award. Recruitment documentation must be appropriately signed in a timely manner. Also all staff records held would benefit from containing contemporary photographs for identification purposes. It is recommended that the home consider the use of a matrix/spreadsheet system for recording and identifying staff’s training received and needed. This would ensure that information is more easily accessed and recorded in a central document. Whitecliffe House DS0000020446.V255767.R01.S.doc Version 5.0 Page 7 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. Whitecliffe House DS0000020446.V255767.R01.S.doc Version 5.0 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 Whitecliffe House DS0000020446.V255767.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed during this inspection. EVIDENCE: Whitecliffe House DS0000020446.V255767.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): . These standards were not assessed during this inspection EVIDENCE: Whitecliffe House DS0000020446.V255767.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed during this inspection. EVIDENCE: Whitecliffe House DS0000020446.V255767.R01.S.doc Version 5.0 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Complaints are well managed and residents spoken to on the day, said they felt confident that their concerns are listened to and taken seriously. The home has adequate policies in place to ensure that it is a safe environment where residents are protected from harm and abuse. EVIDENCE: No complaints against the home have been received or investigated since the last inspection. One resident spoken with during the inspection visit said they would have “no hesitation” in approaching the matron with any concerns and had previously spoken to her regarding issues “…I was not happy about”. Some issues raised had been dealt with well and were well documented. These related to the quality of the pureed food and staff response times to a new call bell system. In both cases meetings had been called with relevant staff members and positive outcomes achieved in resolving both issues. The members of staff spoken to also expressed their confidence in being able to talk to the manager if they had any concerns or issues, regarding their work or care of the residents. The home has a clear policy and procedure in place to respond to any suspicion or allegation of abuse or neglect. Staff were able to demonstrate knowledge of the “No Secrets” guidance from the Department of Health, through discussion during the inspection. Several staff had also attended Elder Abuse training and were currently due for a refresher course.
Whitecliffe House DS0000020446.V255767.R01.S.doc Version 5.0 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 The home is attractive, comfortable and well maintained, making it a safe, pleasant environment to live in. The home is clean and free from offensive odours, providing a pleasant and hygienic place to live. EVIDENCE: During discussion and a tour of the premises, the manager was able to demonstrate how the home was maintained and explain the on going programme for upkeep and maintenance. There is a yearly refurbishment programme and at the time of the inspection some seating was in the process of being recovered. Some curtains had been replaced, together with new dining furniture, office chairs and a new carpet in reception. Windows are also regularly cleaned.
Whitecliffe House DS0000020446.V255767.R01.S.doc Version 5.0 Page 14 There is a dedicated ‘maintenance’ man employed by the home who also has planted the small garden areas, making them more attractive to look at. All areas of the home were clean and there were no unpleasant odours. The laundry is separate to the main building and is adequate to cope with the washing needs of the residents and a dedicated laundry assistant is employed from Monday to Friday. Whitecliffe House DS0000020446.V255767.R01.S.doc Version 5.0 Page 15 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 The home was appropriately staffed to meet the needs of the residents. Service users expressed confidence in the staff group, indicating that they felt safe and able to voice any concerns. Recruitment procedures are in place to ensure that unsuitable staff applicants are not recruited and therefore service users are not put at risk. However some staff records were found to have some recruitment details missing and this must be addressed. The home must endeavour to provide more reliable evidence that staff receive appropriate training and are competent to carry out their jobs. EVIDENCE: The staffing rota was seen and levels of staff appear adequate to cover the needs of the residents, with an overlap of care staff on at recognised busy periods. • • • 1 qualified staff and 2 carers cover night shifts. Day shifts are covered by 1 or 2 qualified staff and 5 carers in the morning and 3 carers in the afternoon. 6 carers work during the day at weekends to help cover for laundry. Whitecliffe House DS0000020446.V255767.R01.S.doc Version 5.0 Page 16 Two staff currently have attained an NVQ Level 2 (or equivalent), with four working towards it currently, two staff working towards NVQ Level 3 and the deputy matron is also an NVQ assessor. The manager is aware of the previous outstanding requirement regarding this and together with Colten Care, is working hard to achieve it. 5 staff files were looked at and most were found to contain: • completed application forms • letter of offer/acceptance of employment • enhanced CRB checks • two references • terms and conditions • training records • proof of identity In 1 staff file the terms and conditions were not signed and there was no photograph of the staff member. It is important that all elements of a personal file are complete to provide a full record and history of a person’s employment. These minor omissions were discussed with the manager and will now be addressed. Induction records were clearly documented in 2 newly employed staff files and staff were able to confirm in discussion that they had received appropriate induction training. Training records were available for all staff although they would benefit from being all filed together in possibly a comprehensive spreadsheet. There was evidence that individual staff members have training in various subjects including Food Hygiene, Manual Handling, Health and Safety and dementia care. Whitecliffe House DS0000020446.V255767.R01.S.doc Version 5.0 Page 17 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35, 36 & 38 The home has a good system in place for protecting residents’ finances, with all handling their own money and some choosing to let the home manage small amounts. However, records do not show that this is well managed though. An appropriate supervision system is in place but not all staff receive regular sessions. Therefore individual’s training needs and practice may not be thoroughly assessed. The home demonstrates that there are measures in place to ensure that the health, safety and welfare of residents and staff are maintained. EVIDENCE: The home does not manage large amounts of money for any individual resident and main financial affairs are dealt with by residents’ families or
Whitecliffe House DS0000020446.V255767.R01.S.doc Version 5.0 Page 18 solicitors. Most people have deposited a small amount of personal allowance with the home to cover expenses for hairdressing, chiropody and other personal expenditure. The financial accounts of 2 residents were sampled and although all receipts and transaction records matched, the monies held did not. There was more money held than what was documented, by small amounts in each account. Only the manager and the deputy matron manage the money, although care staff do buy individual residents’ shopping for them. Supervision records were also evident in staff files although sessions held with some staff appeared irregular. All maintenance and servicing records checked were found to be up to date, including electrical testing, lift and wheelchair servicing, heating and gas installation servicing. Whitecliffe House DS0000020446.V255767.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 2 2 X 3 Whitecliffe House DS0000020446.V255767.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP35 Regulation 17 Requirement The home must keep accurate records of all service users’ money held and ensure that amounts kept tally with documentation. The home must ensure that all staff receive regular formal supervision at least 6 times a year. Timescale for action 15/05/05 2 OP36 18 (2) 15/05/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP28 OP29 OP30 Good Practice Recommendations NVQ Level 2 or equivalent must be achieved by a minimum of 50 of care staff. All staff files should contain a comprehensive record of employment and identity. It is recommended that all staff training needs and attendance be recorded on a dedicated matrix. Whitecliffe House DS0000020446.V255767.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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