Inspection on 25/01/07 for Whitegates Care Home

This inspection was carried out on 25th January 2007.

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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Whitegates Care Home 09/11/05

Whitegates Care Home 22/06/05

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 Dawn Podmore Unannounced Inspection 25th January 2007 09:30a Whitegates Care Home DS0000008771.V309613.R01.S.doc Version 5.2 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 Care Home DS0000008771.V309613.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 Adults 18-65. 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 Care Home DS0000008771.V309613.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Whitegates Care Home Address Sparken Hill & 5/7 Park Place Worksop Nottinghamshire S80 1AP 01909 478746 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) whitegates@norsaca.fsbusiness.co.uk NORSACA Ms Marjory Brenda Stevenson Care Home 18 Category(ies) of Learning disability (18) registration, with number of places Whitegates Care Home DS0000008771.V309613.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Whitegates is registered to provide accommodation and personal care to a maximum of 18 people whose primary care needs fall within the following category:Learning Disability (LD) 18 Date of last inspection 9th November 2005 Brief Description of the Service: Whitegates Care Home offers support to 18 younger adults with learning disabilities and or a diagnosis of an autistic spectrum disorder. It is situated in a residential area, south of Worksop town centre. Twelve residents live in the main house, which is set in large enclosed grounds off the main road. Five other residents live in a smaller terrace style property nearby and an adjacent flat is available for one other person. Neither house is accessible for residents with physical disabilities. Car parking is available at both properties. At the time of the inspection the home confirmed that the weekly fees ranged from £1025 - £1711.92 depending on the residents assessed needs. Information about these costs as well as the day-to-day operation of the home, including a copy of the last inspection report, can be obtained from the main house. Whitegates Care Home DS0000008771.V309613.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and took any previous information held by C.S.C.I. about the home into account. The inspection included a site visit, which took place over five hours. The main method of inspection used was called case tracking. This involves selecting a proportion of residents and tracking the care they receive through the checking of records, discussions with staff that care for them and observation of care practices. On the day of the visit residents were only present at lunchtime, as they attend various activities throughout weekdays. A partial tour of both houses was also conducted which included looking at bedrooms, communal areas, kitchens and the laundry facilities. Documentation was sampled and the care records of three residents were examined. Observation was used to establish how care and support was provided. Interviews with visitors and staff took place; this included the Registered Manager. On the day of the visit 18 people were living at the home. What the service does well: What has improved since the last inspection? Since the last inspection care planning records have improved especially in relation to decision making and annual well person checks. The Manager has introduced records to show who has visited the home, as well as the meals provided for individual residents. Recruitment practices have been improved so that no one starts working at the home until all essential checks have been undertaken. At the last inspection the testing of the electrical installation circuit was out of date, checks have since been made and a new certificate has been issued. The Statement Of Purpose and Service User Guide have been updated to include the details of the new manager and are available at the home. Whitegates Care Home DS0000008771.V309613.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Whitegates Care Home DS0000008771.V309613.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Whitegates Care Home DS0000008771.V309613.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information is available to help people decide if the home can meet their needs and to tell them how the home operates. A satisfactory admission procedure ensures that prospective residents receive an assessment before admission to ensure that the home is able to meet their needs. EVIDENCE: Since the last inspection the home has reviewed the Statement of Purpose and additional information has been included so that people can decide if the home offers the type of care they are looking for. The home has an admission policy, which includes assessing residents before admission. Records and staff comments confirmed that detailed assessments had taken place before people moved into the home. Staff confirmed that people had the opportunity to visit the home prior to admission. Whitegates Care Home DS0000008771.V309613.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from having detailed care plans that reflect assessed needs and risk, but documentation could be improved. People are able to have control of their daily lives within their capabilities. EVIDENCE: Each resident has an individual plan, which contains information about his or her care needs and any risks or restriction associated with their care. Plans covered the main areas of need such as behaviour and health. However the detail provided about the level of support required in relation to peoples personal care, such as washing and dressing, was limited and would benefit from additional information. Although some plans had been signed by the resident or their representative others had not. The manager said that this was because they were unable to do so or did not wish to sign them. It was recommended that in such cases staff should document the reasons for the lack of agreement and sign and date the entry. Whitegates Care Home DS0000008771.V309613.R01.S.doc Version 5.2 Page 10 Care plans had been reviewed regularly and gave good evaluations of any changes in the resident’s condition. The home holds regular reviews of peoples care; this includes person centred approach meetings with residents, their families and key staff. During the visit to Park Place one of these meetings was taking place and the parties concerned said that they found them very useful. Not all service users are able to make safe and informed decisions and choices due to the complex nature of their needs. Staff said that they tried to make sure that residents were as involved as possible in making choices and close contact with families helped this process. Care plans contained details of peoples likes and dislikes and relatives spoken to confirmed that they were encouraged to share information about resident’s preferences. One relative said that a booklet was being produced that would outline the residents aims and preferences. Information provided before the visit and comments on the day showed that appropriate communication systems were in place for those residents who cannot verbally communicate. For example symbols or pictures are used to inform staff what people want to eat and drink as well as the activities they would like to participate in. Although most of the residents were unable to give their opinion of the care they received one resident and two visitors spoke positively about the home. Comments included: ‘they provide a good standard of care’ and ‘we are very pleased with the care’. Staff demonstrated a good understanding of resident’s needs and how to minimise any behavioural issues. Whitegates Care Home DS0000008771.V309613.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have access to a good range of social and leisure activities and maintain good contact with their families, friends and the local community. People living at the home benefit from a healthy and well balanced diet. EVIDENCE: Records showed that each resident has a programme of activities that meets their needs and preferences. Written and picture plans for the weeks activities were displayed on the notice board in each house, but it was suggested that these be included in the care planning file as well to provide a clearer picture of the residents daily activities. Residents and relatives said that activities provided included swimming, gardening, horse riding, life skills, walks and outings. One relative said that the home arranged for their relative to go on holiday every year, which they really enjoyed. There are college opportunities available for some residents and health and leisure groups are also organised, this included one resident attending a local slimming group. Whitegates Care Home DS0000008771.V309613.R01.S.doc Version 5.2 Page 12 Residents were observed eating their lunchtime meal in the dining room at Whitegates. The meal served was nutritionally balanced and well presented. Many of the residents have one to one care so their care worker was sitting with them eating lunch and offering support and assistance as necessary. Relatives said that they were happy with the menu options available. Since the last inspection the manager has implemented the recording of residents food intake as recommended at the last visit. The cook is now keeping a record of the menu for the day and any different meals provided for individual residents. Whitegates Care Home DS0000008771.V309613.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are robust processes for the provision of personal and health care support, which meet the needs and wishes of the residents. Medications are stored, administrated and disposed of safely. EVIDENCE: Records showed that residents had access to outside agencies such as, doctors, dentists, opticians and speech therapists. Records and staff comments showed that regular health checks were taking place, but if residents had not attended the checks the reason was documented. Relatives spoken with said that they were very happy with the health care provided. One said ‘staff are very good at keeping us informed of any changes in her condition’. The home has satisfactory policies and procedures concerning the receipt, storage, administration and disposal of medications. Medications were stored safely and records were well maintained. Records and staff comments showed that the staff who gave people their medication had received training to enable them to do so safely. Whitegates Care Home DS0000008771.V309613.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has satisfactory procedures for handling complaints and relatives felt confident that any concerns would be addressed appropriately. Residents are protected by the home’s procedures for handling allegations of adult abuse. EVIDENCE: The home has a complaints procedure, which tells residents and relatives how to make a complaint and how it will be handled. It is available in various formats to make it more accessible to residents. Information provided showed that the home had received no complaints in the last year. Although residents were unable to comment on their satisfaction with the care service two relatives said that they knew how to make a complaint and felt confident that any concerns would be dealt with promptly. The home has a contractual arrangement with an external advocacy service should this type of support be needed with making a complaint. There are satisfactory procedures in place relating to adult protection. Staff comments and records showed that staff had received adult protection training and further sessions were planned. Since the last inspection visit an adult protection issue had been managed and resolved appropriately. Whitegates Care Home DS0000008771.V309613.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living at the home live in a clean, comfortable and homely environment but improvements are needed. EVIDENCE: A partial tour of both houses took place; this included 5 bedrooms, kitchens, communal areas and bathrooms. It showed that although some redecoration had taken place, some areas of the Whitegates property were looking tired and in need of redecoration and repair. For example the window frame in the music room at Whitegates was rotten in places and in need of repair or replacement and the wall below it showed signs of damp with flaking paint. Preinspection information provided by the manager said that a new spa bath, a shower and a toilet had been fitted since the last inspection. The house at 5 Park Place was in good repair with a homely atmosphere. Two relatives at Park Place said that they were very happy with the accommodation and the home’s general facilities. Bedrooms at both properties were personalised to suit the resident concerned. Whitegates Care Home DS0000008771.V309613.R01.S.doc Version 5.2 Page 16 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are safeguarded by the robust recruitment procedure used by the home. Staff receive comprehensive training to meet the needs of people living at the home. Records do not demonstrate that staff have received regular supervision. EVIDENCE: The home has a good recruitment procedure in place. Records included an application form, 2 satisfactory written references and a C.R.B. (Criminal Records Bureau) certificate. Although one file did not contain any recruitment details these were faxed from head office during the visit. As stated at the last inspection it is recommended that all essential records required for inspection be available at the home, this includes the original C.R.B. certificates for new staff. The manager responsible for recruitment said that service users had been involved in some staff interviews and this had proved very successful. Staff files contained records of their inductions to the home, which is given to make sure that new staff have all the essential information they need to carry out their job. It included essential training, such as fire awareness, as well as Whitegates Care Home DS0000008771.V309613.R01.S.doc Version 5.2 Page 17 shadowing a senior member of staff and working with the day care services team. Records and staff comments confirmed that staff had received essential training as well as specialist training. Training provided included L.D.A.F, which helps staff understand the needs of people with a learning disability, challenging behaviour, health and safety and basic food hygiene. Information provided by the manager showed that 14 of the 25 care staff employed at the home had completed an N.V.Q. (National Vocational Qualification) course in care, with 7 others currently undertaking the course. This was confirmed by records and staff comments. This course helps to make sure that carers have the knowledge and skills to provide a good standard of care. Staff said that they felt very well trained and supported. One said ‘the training is very good’. Records and staff comments demonstrated that they had received annual appraisals and attended regular staff meetings. Although staff said that they received regular informal supervision and support there was minimal evidence that regular formal supervision had taken place. One staff member said that they felt well supported but another commented, ‘you don’t get enough supervision, there is always someone there but it could be better’. Whitegates Care Home DS0000008771.V309613.R01.S.doc Version 5.2 Page 18 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 41 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good leadership, guidance and direction are provided to staff to ensure that residents receive a good standard of care. The company consults people about the service it provides. The home has health and safety policies and procedures, which help to safeguard staff and residents. EVIDENCE: Since the last inspection Mrs Marjory Stevenson has been registered with the Commission as the Registered Manager of the home. Mrs Stevenson has worked at the home since 1994 and from April 2001 held the position of unit manager. She is a qualified nurse with many years experience of working with people with learning disabilities. She has recently completed the Registered Managers Award and is also qualified to assess staff undertaking their N.V.Q. course. Staff said that Mrs Stevenson was very approachable and supportive. Whitegates Care Home DS0000008771.V309613.R01.S.doc Version 5.2 Page 19 The company have a system in place to find out if people are happy with the way the home is run. This includes regular staff meetings, one to one meetings with residents and their families, regular phone contact with relatives and reviews of care provision. It also has a Quality Network group, which involves parents, and professionals in improving the service it offers. Staff said, ‘the company supports us well, through domestic or work issues’ and ‘there is a stable staff team, some of them have been here 20 years, I think that speaks for itself’. Relatives said that they were very happy with the way the home operated. The provider or their representative has to visit the home at least once a month. The purpose of these visits is to ensure that the home is being well managed and any issues are identified and appropriate actions taken. Following the visit they must produce a report highlighting what they found. Although there was documentation to show that these visits have taken place the content of the reports were basic and did not reflect the current situation at the home. For example the damaged window frame and damp patch in the music room had not been commented on. At the last inspection it was identified that the manager was not keeping a record of all visitors to the home but since then a record is being maintained. There are a range of policies and procedures regarding health and safety available to guide and instruct staff. There is also a programme in place to service and maintain the equipment in the home on a regular basis. Information provided to the Commission prior to the visit and sampling on the day of the visit showed that appropriate checks on equipment such as the electrical installation and gas appliances had taken place. Records showed that the fire officer had visited the home and made several recommendations all of which the manager said had been addressed. A review of the fire risk assessment had taken place and this had been forwarded to the fire officer for his comments. Whitegates Care Home DS0000008771.V309613.R01.S.doc Version 5.2 Page 20 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 Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 X 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 2 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X 2 3 X Whitegates Care Home DS0000008771.V309613.R01.S.doc Version 5.2 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 YA6 Regulation 15 (1) Requirement Care plans must identify all areas of care and support needed and provide comprehensive guidance to staff as to how this care should be delivered. This must include the arrangements for the provision of personal care such as meeting people’s hygiene needs. The manager must arrange for the repair or replace the window frame and damaged paintwork in the music room at the Whitegate property. The Registered Manager must be able to demonstrate that staff have received regular supervision and support. Timescale for action 01/04/07 2. YA24 23 (2) (b) 01/06/07 3. YA36 18 (2) 01/04/07 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. Refer to Standard YA6 Good Practice Recommendations Residents or their representatives should sign the care DS0000008771.V309613.R01.S.doc Version 5.2 Page 22 Whitegates Care Home 2. 3. YA6 YA34 4. YA41 plan to show that they agree with the planned care, or staff should record the reasons why this is not possible. The activities plan for each resident should be included in the care plan, as this will provide a more holistic record of his or her needs. All essential records pertaining to the recruitment of staff should be held at the home. This includes the original C.R.B. certificates for staff that have been at the home for less than a year. The provider should review the content of the providers report to make sure that all essential subjects are covered during the visit and documented comprehensively. Whitegates Care Home DS0000008771.V309613.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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. Extracts may not be used or reproduced without the express permission of CSCI Whitegates Care Home DS0000008771.V309613.R01.S.doc Version 5.2 Page 24 - 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. 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