Inspection on 22/06/05 for Whitegates Care Home

This inspection was carried out on 22nd June 2005.

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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Whitegates Care Home 25/01/07

Whitegates Care Home 09/11/05

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Whitegates Care Home Sparken Hill & 5/7 Park Place Worksop Nottinghamshire S80 1AP Lead Inspector Jayne Hilton Unannounced 22 JUNE 2005 @ 14:00 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 Care Home C53 C03 S8771 Whitegates V234327 220605 Stage 0.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Whitegates Care Home Address Sparken Hill 5/7 Park Place Worksop Nottinghamshire S80 1AP 01246 810101 01909478746 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) NORSACA Mr Keith Lancaster Care home 18 Category(ies) of LD Learning disability registration, with number of places Whitegates Care Home C53 C03 S8771 Whitegates V234327 220605 Stage 0.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: NONE Date of last inspection 7 March 2005 Brief Description of the Service: Support is provided for 18 younger adults with learning disabilities and or a diagnosis of an autistic spectrum disorder. Care is undertaken by a consistent and well trained staff team. The accommodation consists of a main house set in large enclosed grounds for 12 service users, a smaller terrace style property nearby where 5 service users reside and an adjacent flat for one service user. Both properties are close to the Town Centre of Worksop. The homes are not accessible for service users with physical disabilities. Whitegates Care Home C53 C03 S8771 Whitegates V234327 220605 Stage 0.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on 24th June 2005 at 2.30pm by Regulation Inspector Jayne Hilton. The main house where twelve service users reside was inspected on this occasion. A brief visit was made to the annexe home. Many of the standards had been assessed and found, to be met at the previous inspection and therefore not all were duplicated at this time. The methodology used included, a tour of the building, examination of three service users care files and bedrooms and a sample of records. Due to the complex needs of service users the inspector was not able to fully engage in communication with service users. The unit manager and the registered manager contributed to the inspection. Observations were made of staff and service user interaction and the judgements of the inspector are based on the above. What the service does well: What has improved since the last inspection? The home continues to provide a service, which embraces the ethos of the Care Standards Act with positive outcomes for service users. Whitegates Care Home C53 C03 S8771 Whitegates V234327 220605 Stage 0.doc Version 1.30 Page 6 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 Care Home C53 C03 S8771 Whitegates V234327 220605 Stage 0.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Whitegates Care Home C53 C03 S8771 Whitegates V234327 220605 Stage 0.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, 3, 5 Service users needs are assessed, which include their wishes and preferences to ensure that staff can support them, in a way, which meets their individual and specialist needs. Evidence suggests that service users are provided with contracts, however, further evidence is required to confirm this. EVIDENCE: Three service users care files were examined and evidence was provided that service users needs are fully assessed prior to moving to Whitegates. All prospective new service users are fully assessed prior to admission and additionally applications are submitted to an admissions panel for approval. A transition plan for each new service user is produced. Prospective service users have a full assessment of their needs and the approval of the application by the admissions panel prior to any transition to the home. Each transition is planned to meet an individuals unique needs. The home does not take emergency admissions. The assessment documentation includes all topics as specified in Standard 2.3, apart from adequate income, which should be included. Staff were observed in their practices and appeared to be skilled in supporting the service users in a calm and professional way. The home provides specialist Whitegates Care Home C53 C03 S8771 Whitegates V234327 220605 Stage 0.doc Version 1.30 Page 9 input for the service users with autistic spectrum disorders and evidence was seen of progress made through structured programmes. The terms and conditions/contract between the home and service user were not available for inspection, due to the administrator not being available at the time of the inspection. The registered manager confirmed their existence. It is recommended that a copy be kept with the individual service users file. Whitegates Care Home C53 C03 S8771 Whitegates V234327 220605 Stage 0.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8, 9, 10 Service users are supported by an effective care plan structure, which enables them to participate and make decisions about their daily lifestyle and promotes independence and responsible risk taking where they are able to do so. Limitations and restrictions on freedom are generally recorded, however this was not always the case and action is required to improve in this area. Confidentiality is promoted within the home. EVIDENCE: Each service user has an individual plan of care. These plans cover all aspects of care and support needs. Service users are encouraged to participate in care planning and reviews. All service users have a named keyworker with a co-keyworker as needed. There was no evidence of service user or their representative’s agreement to the plan and this should be implemented where possible. Care plans were reviewed every six months. Some limitations /restrictions that had been implemented were documented in the care plans and justified to be in the persons best interests, however there was a door alarm on one service users room which although appeared justified, had not been fully documented in the individual care plan. The registered Whitegates Care Home C53 C03 S8771 Whitegates V234327 220605 Stage 0.doc Version 1.30 Page 11 manager was advised that all limitations on facilities, choices or human rights to prevent self harm or self neglect or abuse or harm to others should be fully documented in the individuals care plan and agreed by the relevant representative and professionals involved in the service users care. Not all service users are able to make safe and informed decisions and choices all the time due to the complex nature of their needs. Staff, do try to ensure service users are involved or informed in respect of all decisions made on their behalf. Service users preferred term of address is documented in the care plan. There was clear evidence in care plans examined that risk assessment and risk planning is undertaken and supportive of individual service users. The home reviews risk assessments and updates and amends as required. The home has a policy for confidentiality and all records were stored securely. Whitegates Care Home C53 C03 S8771 Whitegates V234327 220605 Stage 0.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13,15, 16,17 The staff at Whitegates, provide service users, with opportunities for personal development, by supporting them to engage in activities, in house and in the community. The service recognises the need to support service users with appropriate relationships and for making decisions within their daily lives. Service users enjoy a healthy diet. EVIDENCE: The kitchen is designed to allow service users to be involved in snack making and accessing drinks with supervision. There is a large allotment area, although presently not being utilised due to staff illness, this facility allows service users to grow vegetables and salad items. And learn horticultural skills. Most service users have a program of day care that provides the routine and structure needed to support their needs. There are college opportunities for some service users and community access and health and leisure groups are also organised. Cultural and religious needs are fully reflected within individual care plans. Whitegates Care Home C53 C03 S8771 Whitegates V234327 220605 Stage 0.doc Version 1.30 Page 13 Regular trips and outings are arranged. There are individually structured activity programmes these include opportunities to take part in bowling, swimming, pub and theatre visits. Holidays are undertaken regularly and the planning of these is service user needs led. The manager reports that the home is part of the community and well known locally. There was evidence on care plans examined that service users are well supported with maintaining family links including birthday lists, which is good practice. There were also some guidelines re support for addressing individuals needs and rights with regards to relationships and sexual needs. As already stated, due to the specific needs of service users at the home there is a need for routine, structure and consistent approaches with regards to day to day routines and support needs. All the current service users need supervision and support to access the community safely. The home has a large secluded and secure garden, which service users can access. One of the service users has his own workshop in the garden. A mealtime was observed and staff were noted to be assisting service users with eating in a calm and discreet manner. Staff, sit and eat with service users and encourage a homely atmosphere. There is a balanced menu offering a range of nutritious meals and a range of choices. Meal choices are recorded on a daily basis. Service users likes and dislikes are documented within the care plan. Service users were seen eating different choices of meals. A Service user confirmed that he had can chosen what they eat for tea and that he liked the food. Special dietary needs can be met. A regular check is made of peoples weight and a record is kept of this. Dining arrangements are flexible in order to meet individuals presenting needs. A good supply of food items, including fresh fruit and vegetables were seen in the fridge and store cupboards. Whitegates Care Home C53 C03 S8771 Whitegates V234327 220605 Stage 0.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, 20 Although service users personal and healthcare needs are generally met, there are some areas, which could further improve this. Service users wishes for the end of life are documented. EVIDENCE: No nursing care is provided. Staff work within service users preferences where possible and personal hygiene support needs are fully documented within care plans. Each individual is supported to make choices wherever possible, and to lead an independent lifestyle as possible. Staff demonstrated an awareness of dignity issues when working with service users. The organisation provided service users with a special clothing allowance. Healthcare needs of service users are well monitored and documentation is kept of routine chiropody dental and ophthalmic checks. There was however no record of annual healthcare checks, smear tests etc. It is recommended that these be implemented and where not possible to undertake, a statement of the effect should be made in the care plan and the reason why. Written policies and procedures include those on dealing with death and bereavement. Records are kept of individual/family wishes in the event of a service user’s death. The home has devised a bereavement questionnaire Whitegates Care Home C53 C03 S8771 Whitegates V234327 220605 Stage 0.doc Version 1.30 Page 15 which involved a specialist bereavement counsellor and which is sent out to relatives. Whitegates Care Home C53 C03 S8771 Whitegates V234327 220605 Stage 0.doc Version 1.30 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22, 23 Service users are protected by relevant policies procedures and practices for dealing with complaints and abuse awareness. EVIDENCE: The complaints procedure is being developed to include versions that service users may find more accessible. The home has a contractual arrangement with an external advocacy service should this type of support be needed with making a complaint. The complaints procedure has appropriate time scales for response and action. The home has no recorded complaints being made through the homes complaints procedure, however there has been a recent complaint made via social services and the adult protection procedures, which has been investigated and found to be not upheld. The manager reported that despite the complaint not being upheld a number of action points have been agreed for the future. Relevant policies and procedures are in place for adult protection. [training programmes were not inspected at this visit this was found to be met at the previous inspection] Whitegates Care Home C53 C03 S8771 Whitegates V234327 220605 Stage 0.doc Version 1.30 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28, 29, 30 The homes have been well maintained and do not look out of place in the community in which they are placed. The homes are maintained and decorated to provide a homely and safe environment and bedrooms were in reasonable decorative order and reflected the tastes of the occupier. The communal spaces are well equipped with TVs, music centres and computers for service users to use, and there is a sensory room available for those needing such activities. No service user currently requires physical adaptations to the building. Necessary policies and procedures were in place to maintain standards. EVIDENCE: The homes have been well maintained and do not look out of place in the community in which they are placed. The homes are maintained and decorated to provide a homely and safe environment. The window frames on the front elevation of the main house are in need of repair or possible replacement. Most of the bedrooms were in reasonable decorative order, some individual rooms have had some wear and tear due to service users needs. Bedrooms were well personalised and reflected the tastes of the occupier. Some of the Whitegates Care Home C53 C03 S8771 Whitegates V234327 220605 Stage 0.doc Version 1.30 Page 18 service users are able to have key to their bedroom and service users were seen using during the inspection. Where service users wish to have loose rugs, risk assessments should be carried out. Each bedroom has been designed to meet the current needs of the service users and to resist the pressure they place upon their surroundings. Many of the rooms contain equipment which aids service users rest and relaxation needs. There is a variety of washing and bathing facilities throughout the home and two service users have bedrooms with en-suite facilities. Some washbasins and baths have taps removed due to risk assessments highlighting unsustainable risks of flooding from service users. Where this has happened it is clearly written on individuals care plans. In both properties there are a total of eight lounge / quiet / other areas available. A small conservatory provides a comfortable heated seating area, which is designated for smoking. The room has good natural ventilation and there is no necessity to provide artificial ventilation. The communal spaces are well equipped with TVs, music centres and computers for service users to use, and there is a sensory room available for those needing such activities. The unit manager was shopping for a new three-piece suite on the day of the inspection. No service user currently requires physical adaptations to the building, although safety measures have been taken to protect fire doors and fire glass panels. There is no alarm call system for service users to use, but in some key areas of the home staff can signal for assistance if needed. Staff were observed to respond promptly where assistance was required in managing challenging behaviour. As stated one service users room had an alarm fitted, which requires documentation. Radiators were noted to be either the low surface type or covered. The home was well clean and well maintained. Necessary policies and procedures were in place to maintain standards. Laundry facilities were satisfactory. Whitegates Care Home C53 C03 S8771 Whitegates V234327 220605 Stage 0.doc Version 1.30 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: None of the above standards were inspected at this visit. All were assessed as met at the last inspection. Whitegates Care Home C53 C03 S8771 Whitegates V234327 220605 Stage 0.doc Version 1.30 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 40, 41, 42 The management of the home has changed and the acting unit manager should submit an application to be registered promptly. Service users rights and interests are safeguarded by effective policies and procedures. The health, safety and welfare of service users are overall promoted. Not all of the records required by regulation were not available for inspection, those that were, were satisfactory EVIDENCE: The current registered manager has now been promoted and therefore an application for the unit manager to become registered must be submitted promptly. The policies and procedures file was examined, all appear to be well formatted and access friendly. The registered manager reported that staff, cover policies and procedures in their induction and that all policies and procedures can be translated into pictorial form on request if needed. The organisation has a speech and language therapy department who can facilitate this. Policies and procedures are reviewed regularly with the service manager and the registered Whitegates Care Home C53 C03 S8771 Whitegates V234327 220605 Stage 0.doc Version 1.30 Page 21 manager reported that he also reviews policies that are available on the Internet to keep up to date with current and good practice Health and safety and maintenance issues are entered into a logbook as they arise, and there are 2 maintenance staff employed and this ensures on-going damage or breakdowns to the building and equipment are quickly repaired. It was reported by the registered manager that the appropriate testing and servicing of equipment is recorded as per requirements, however these records were not available due to the administrator and handymen not being around at the inspection. All records must be available for inspection and the manager should make appropriate arrangements for this to happen for future inspections. Staff have a health and safety meeting on a quarterly basis and all issues discussed and agreed actions are documented and acted upon, the minutes of these meetings were seen during the inspection. Fire alarm and emergency lighting test records were examined and found to be satisfactory. The manager reported that a recent audit has been carried out under the Disability Discrimination Act. The fridges were checked and food was appropriately stored and date labelled after opening. Copies of the gas safety certificate, electrical safety certificate, water outlet temperatures testing, and evidence of systems in place for the prevention of legionella and the most recent Environmental Health Inspectors report, should be forwarded to CSCI. Whitegates Care Home C53 C03 S8771 Whitegates V234327 220605 Stage 0.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 3 x 2 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 2 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Whitegates Care Home Score 3 3 x 3 Standard No 37 38 39 40 41 42 43 Score 2 x x 3 2 x 3 C53 C03 S8771 Whitegates V234327 220605 Stage 0.doc Version 1.30 Page 23 NO 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. 1. Standard YA7 Regulation 15 Requirement Any limitations imposed on service users must be fully documented within the individuals care plan. Repair or make good the windows on the front elevation Ensure all records required by regulation are available for inspection. Timescale for action 24th August 05 24th August 05 24th August 05 2. 3. YA 24 YA 41 23 17 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. 4. 5. Refer to Standard YA5 YA6 YA19 YA37 YA42 Good Practice Recommendations Ensure service users are issued with a contract from the home and keep a copy in the individual care plan. Service users or their representatives should sign their agreement to the care plan Ensure all service users access an annual well person check and that this is documented in the care plan. The unit manager should submit an application for registration promptly Provide copies of the gas and electrical safety certificates, the Environmental Health Officers report, water outlet test records and evidence of systems to prevent legionella to CSCI C53 C03 S8771 Whitegates V234327 220605 Stage 0.doc Version 1.30 Page 24 Whitegates Care Home Whitegates Care Home C53 C03 S8771 Whitegates V234327 220605 Stage 0.doc Version 1.30 Page 25 Commission for Social Care Inspection Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Care Home C53 C03 S8771 Whitegates V234327 220605 Stage 0.doc Version 1.30 Page 26 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!