Inspection on 30/01/06 for Whitegates

This inspection was carried out on 30th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Whitegates 13/01/07

Whitegates 21/09/05

Whitegates 04/02/05

Whitegates 11/08/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Whitegates 25 Hereford Road Bromyard Herefordshire HR7 4ES Lead Inspector Wendy Barrett Unannounced Inspection 30th January 2006 09:30 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 Whitegates DS0000024748.V281394.R01.S.doc Version 5.1 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. Whitegates DS0000024748.V281394.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Whitegates Address 25 Hereford Road Bromyard Herefordshire HR7 4ES 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) 01885 482437 01885 489206 Ms Karen Anne Rogers Mrs Susan Winifred Brown Care Home 22 Category(ies) of Dementia - over 65 years of age (6), Learning registration, with number disability over 65 years of age (1), Mental of places Disorder, excluding learning disability or dementia - over 65 years of age (6), Old age, not falling within any other category (22), Physical disability over 65 years of age (22) Whitegates DS0000024748.V281394.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The category LD(E) relates to a named person Date of last inspection 21st September 2005 Brief Description of the Service: Whitegates is a large, older house situated in its own grounds on the outskirts of the small market town of Bromyard. There is work currently underway to extend the accommodation. The home will provide transport to access the local shops, post office and pubs. The home is registered to accommodate 22 older people whose care needs arise primarily from old age or physical disability. Up to 6 places can be used for people who have dementia or mental health difficulties. One place is registered to accommodate a named individual who is over 65years of age and has a learning difficulty. There are 18 bedrooms. Four of these accommodate two residents. The communal rooms, which open onto each other, are on the ground floor. There is a quiet room/library on the second floor. The gardens are well maintained with partial access for people who have mobility problems. Whitegates DS0000024748.V281394.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was pre-arranged so that the recently registered Care Manager could be present and participate in the process. The Provider visited the home during the inspection. There are a number of core National Minimum Standards that must be inspected each year and this inspection focused on the standards that were not addressed during the last inspection. Action taken to comply with requirements made at the previous inspection was also reviewed. In order to gain a comprehensive picture of the service the last inspection report should be referenced. Staff were observed handing over between shifts and there was a brief discussion about their experiences at the home. The cook provided information about the catering arrangements. Two visiting relatives were interviewed and residents were met in communal areas. They were also observed participating in a group activity. A visiting district nurse was introduced to the Inspector. Parts of the accommodation were inspected and a number of records and other documentation held at the home were seen. What the service does well: The home is kept clean and hygienic and the Provider regularly spends money on new furniture, equipment to make sure the accommodation is attractive and good quality. The staff keep detailed written records of the way they make sure each resident gets the care they need. Attention to the safety of residents is very well described in these records. Other health care professionals and relatives are consulted as part of this work. There is a good choice of meals and special foods are prepared for residents who are not well or who have particular dietary needs. New staff are chosen carefully to make sure they will be suitable to work with vulnerable adults, and they get support and guidance to introduce them to their new job. Existing staff are given the training they need to be able to maintain or improve their skills. Whitegates DS0000024748.V281394.R01.S.doc Version 5.1 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. Whitegates DS0000024748.V281394.R01.S.doc Version 5.1 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 Whitegates DS0000024748.V281394.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Residents are provided with written details of the contract/terms and conditions of residence. EVIDENCE: A random check of residents’ records identified Contracts of Residence that had been signed by the Provider and the resident or their representative. Whitegates DS0000024748.V281394.R01.S.doc Version 5.1 Page 9 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): 9 and 10 Residents’ medication is safely managed. Residents are treated sensitively with due regard to their dignity and right to privacy. EVIDENCE: Care records, medication charts, and information from the Care Manager illustrated a thorough process of medication management. Regular amendments to medication regimes following consultation with health care professionals were clearly recorded and monitored. A Senior Care Assistant was familiar with the home’s medication policy and procedure when the home was last inspected. She had also completed an accredited medication training course through a local college. Records of receipt, administration and disposal enable staff to track medication stocks. The Care Manager was aware of the need to keep stock balances to a minimum, to double check hand written entries, and to date containers of medication with short shelf life, when opened. Care records included risk assessments for self-medicating residents and signed consents from residents who prefer staff to manage their medication. Whitegates DS0000024748.V281394.R01.S.doc Version 5.1 Page 10 The current arrangement for securing the medication trolley outside the office in a narrow corridor is not ideal but the Care Manager explained that new storage arrangements would be introduced as part of the extension to the building. An interviewed relative described a sensitive and gradual introduction to the home to allow his mother the time she needs to adjust to her new circumstances. Residents have previously confirmed that staff treat them kindly but respectfully and that they are able to control their lives as far as they wish. Most residents prefer to spend their days in the company of others in the communal areas but the right of those who prefer more privacy is respected. Whitegates DS0000024748.V281394.R01.S.doc Version 5.1 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): 13 and 15 Residents can receive visitors as they wish, and they are encouraged to stay in touch with the local community and wider world events. Residents are offered a variety of meals that accommodate their needs and preferences. EVIDENCE: Several residents received visitors during the course of the inspection. They were observed chatting to staff and other residents and visitors. An activity programme included a ‘News Review’ hour, which is a nice idea to help residents stay in touch with the wider world. Residents have previously mentioned going out to a local church and other opportunities to go out with relatives or staff. Records show that meals are varied so that residents have a choice. Nutritional assessments are undertaken for each resident and staff keep a check on weight variations. The cook has the resources she needs and feels that the Provider is responsive to any requests for repairs or purchase of new equipment e.g. a new dishwasher purchased a month ago and a new microwave due to be supplied in the near future. There were up to date records of fridge and freezer temperatures. The temperature of hot food was also being checked and recorded before being served. Whitegates DS0000024748.V281394.R01.S.doc Version 5.1 Page 12 Whitegates DS0000024748.V281394.R01.S.doc Version 5.1 Page 13 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): 18 The arrangements for protecting residents are satisfactory. EVIDENCE: Induction programmes for new staff include familiarisation with the home’s adult protection and whistle blowing policies and procedures. The Care Manager discusses abuse awareness to ensure new staff understand the possible indicators. The local co-ordinator of the multi-agency protocol for adult protection has been invited into the home to talk to staff. There are procedures in the overall care planning arrangements that are designed to protect residents e.g. personal activity risk assessments, body charts for recording unexplained skin abrasions. Whitegates DS0000024748.V281394.R01.S.doc Version 5.1 Page 14 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): 26 The accommodation is generally well maintained and the Provider is spending money regularly to maintain and/or improve the overall standard. Staff are making sure that suitable bedrooms are allocated to meet the residents’ needs. EVIDENCE: When the extension work is complete the overall accommodation will be improved e.g. separate hairdressing facility. Some new bedroom commodes have been purchased since the last inspection. These are sensitively designed to provide a nice piece of furniture for residents. A care record referred to a decision to move a resident’s bedroom downstairs so that staff could more closely observe her and keep her safe. There was evidence of good attention to infection control e.g. staff were observed using colour coded bags to carry soiled laundry through the building, induction for new staff includes familiarisation with an infection control policy Whitegates DS0000024748.V281394.R01.S.doc Version 5.1 Page 15 and associated procedures, clean linen and clothing stored away from the laundry room, provision of a separate sluice room. The Provider has also fitted anti-bacterial soap dispensers on corridor walls to encourage hand washing by staff and visitors. The cook has a kitchen-cleaning rota although the record of cleaning had not recently been kept up to date. A relative was met in a lounge where her husband and two other frail residents were seated. The room felt uncomfortably cold and the hands of one resident were cold to the touch. This was pointed out to the Care Manager at the time of the inspection and she agreed to make sure the temperature was acceptable. There did not appear to be any heating on in this area although the adjoining lounge where most residents were sitting was comfortably warm. Whitegates DS0000024748.V281394.R01.S.doc Version 5.1 Page 16 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): 29 and 30 Residents are protected through careful selection of new staff and ongoing training to help each staff member do their job well. EVIDENCE: The picture about the adequacy of staffing levels was unclear. The care staff met on the day felt they needed more staff due to the increasing dependency levels of residents. They had discussed this with the Care Manager. The Care Manager was monitoring the situation through her practice of working care shifts herself from time to time. She anticipates that care staff will need to have more separate ancillary support e.g. laundry worker, to cope with the increase in resident numbers when the extension is completed. A relative commented that she would like to see staff spend more time in the lounge where her husband sits, and that care staff (particularly seniors) should not have to spend so much time on laundry duties. A staff recruitment file contained all the necessary documentation and information to confirm a thorough recruitment process. Completed induction records were seen. The induction programme is in line with national specifications. There were also records of staff supervision sessions. These were well organised with confirmed dates agreed for future sessions. The training history of each member of staff is being kept up to date and the Care Manager was using this information to plan future training in order to maintain staff competence and professional development e.g. she had identified a need for more training in communication skills when working with Whitegates DS0000024748.V281394.R01.S.doc Version 5.1 Page 17 people with dementia and was currently seeking a suitable course. Health and safety training was ongoing with refresher training programmed in as required. Whitegates DS0000024748.V281394.R01.S.doc Version 5.1 Page 18 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 Relatives are appropriately encouraged to look after any personal money and valuables belonging to residents. EVIDENCE: The Care Manager has recently successfully completed her Registered manager’s Award training. The current arrangements for internal quality monitoring of the service were not inspected this time. This work will become increasingly important in future regulatory work with care services and so a recommendation is made to give priority to ensuring a process is in place. There are already some elements of quality monitoring in place e.g. review of policies and procedures at the home, health and safety audits. Whitegates DS0000024748.V281394.R01.S.doc Version 5.1 Page 19 There were no residents who had money or valuables in safekeeping at the home. The Provider’s preference for relatives to undertake this responsibility is in line with recognised good practice under the National Minimum Standards. Whitegates DS0000024748.V281394.R01.S.doc Version 5.1 Page 20 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 3 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 3 x x x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x x x 3 x x 3 Whitegates DS0000024748.V281394.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? no 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 OP19 Regulation 23 (2) p Requirement There must be regular staff monitoring of the room temperature of the small lounge adjoining the main lounge. Residents who use this room may be least likely to be able to tell the staff if they feel cold. (This was pointed out to the Care Manager at the inspection) Timescale for action 30/01/06 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 Refer to Standard OP12 OP33 Good Practice Recommendations Some residents may have difficulty reading the activity programme. It would be advisable to write the programme in large print. The Provider is advised to give priority attention to ensuring the quality monitoring system at the home is fully developed. Whitegates DS0000024748.V281394.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Hereford Office 178 Widemarsh St Hereford Herefordshire HR4 9HN National Enquiry Line: 0845 015 0120 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. Extracts may not be used or reproduced without the express permission of CSCI Whitegates DS0000024748.V281394.R01.S.doc Version 5.1 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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