CARE HOMES FOR OLDER PEOPLE
Whitegates Westfield Lane Westfield East Sussex TN35 4SB
Lead Inspector Jeanette Denereaz Unannounced 12 April 2005 10:30am 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 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 Version 1.10 Page 3 SERVICE INFORMATION
Name of service Whitegates Address Westfield Lane Westfield East Sussex TN35 4SB 01424 754865 01424 752185 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) Whitegates Retirement Home Ltd Jane Patricia Jarrett Care Home 20 Category(ies) of Old age, not falling wtihin any other category registration, with number (OP) 20 of places Whitegates Version 1.10 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The maximum number of service users to be accommodated is (20) 2. Service users should be over the age of 65 years on admission Date of last inspection 5 October 2004 Brief Description of the Service: Whitegates is a care home providing personal care and accommodation for 20 older people (19 in residence at the time of this inspection) which most are over 90 years old. It is owned by Whitegates Retirement Home Limited and the Proprietors are Mr & Mrs Courtney. The home is located on the outskirts of the village of Westfield. It is in walking distance to the local post office, pubs church and doctors surgery. The Property is a spacious two-storey purpose built house. There are several attractive and comfortable communal rooms, and the home is furnished and decorated to a very high standard throughout. Residents accommodation is sited on the ground and first floor, which is served by a passenger lift. There are large and well-maintained gardens onto which the ground floor bedrooms open. Whitegates Version 1.10 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the first in the year running from April 1st 2005 to March 31st 2006. The inspection took place between 10.30am and 2.30pm. The overall focus of the inspection was focussed on meeting with the manager and going through various records and documentation, a full tour of the home including an invite to join the residents and staff for lunch. Time was spent meeting with residents, in groups and individually in their rooms. The Inspector was introduced to the Proprietor Mrs Courtney, the Manager Mrs Jane Jarrett and all the staff on duty. What the service does well:
Whitegates care home offers a high quality standard of accommodation, with all bedrooms offering light and space with en-suite facilities and the communal areas are also decorated and furnished to the same high and tasteful standard. The home during this inspection, which was a pleasant spring day, had windows open and fresh air was circulating the whole house, and the home was found to be very clean. The food was also very good, with the daily menu displayed offering variety and choice. The residents sitting the lounge express their satisfaction with the menu, cooking and presentation of the food. The dining room is very attractive with table linen, napkins and fresh flowers on each table. Most residents eat in the dining room, meeting at 12 noon for an aperitif, however if desired they can have a tray taken in their own rooms. The atmosphere of the home is friendly, unhurried and gentile with all residents receiving attention. Five residents spoken to praised the manager, their care from the staff and the freedom they had within the home and gardens, many stated they would not want to live anywhere else. Whitegates Version 1.10 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office.
Whitegates Version 1.10 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 Standards Statutory Requirements Identified During the Inspection Whitegates Version 1.10 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 standard(s) 1,3,4 and 5 The Inspector found that the home provides a brochure, service guide and prospectus to prospective residents, which is attractively presented. The aspect of the home including the entrance hall is very welcoming and by the visitors’ book many people including family and friends of the residents visit frequently. The home has a very stable clientele, the majority have lived in the home for many years and vacancies for the home are rare, however, the home has a waiting list for prospective residents. EVIDENCE: A copy of the home resident’s (service user) guide including a details of the home’s complaints procedure and most recent CSCI Inspection report, it is displayed in the hallway of the home. The guide also includes the results of a recent quality assurance questionnaire, in which residents were encouraged to complete, thus giving visitors and prospective residents an insight to the home and good information for the management of the home to improve the service offered. Whitegates Version 1.10 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 standard(s) 7,8,10 and 11 The home was found to be meeting resident’s health and general needs and was fully aware of what additional support was required. The Inspector judged through observation and talking to residents, that their rights were strongly upheld. Medication arrangements were found to be soundly and competently managed. EVIDENCE: The care plans inspected were found to be adequate, however, the manager is in the process of introducing a revised care planning system to the home, which will be more user friendly. At present the manager and deputy manager only write in the care plans from information given to them by staff. There is a notebook, staff memory and ‘post it ‘ used for information gathering. The is not a satisfactory method of communication, the manager must devise a more appropriate method of care plan recording, and involve staff more in the process as they undertake most of the caring activities within the home. The medication within the home was found to meet all aspects of the standard relating in relation to storage, dispensing, training, and overall record keeping. The manager informed the Inspector that one resident was supported to see neurologist on the 11th April 2005 following concerns regarding her mental and physical deterioration.
Whitegates Version 1.10 Page 10 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 standard(s) 12,13,14 and 15 The home has a real feeling of being the residents’ real home, with tasteful furnishings, fully stocked library, and well kept gardens to walk and view from the home. The residents’ individual rooms are of the same high standard of décor, with some of their own furniture and personal belongings. The majority of the residents are in their nineties, and the morning are a relaxed affairs with many having breakfast and morning coffee in their rooms and getting ready for lunch and aperitifs at 12 noon. There are various activities organised for residents and the many are members of the local parish church. The food served was exceptional in terms of taste, variety and choice, and all the resident interviewed praised the menus and the cooking staff. EVIDENCE: The resident spoken to during the inspection were either in the lounge reading, or in their own rooms, getting ready for lunch or watching television. The library is well stocked with large print books and the librarian from Battle library re-stocks the books regularly. There is a variety of activities offered to residents, which include outings, keep fit, the crossword group. There is a friendship club at the local village hall, and any resident who wishes to go would be supported. There are visits from a pianist and the W.I. Daily broadsheet papers are delivered daily to the home. The manager photocopies the Telegraph crossword to large scale for residents to complete in the afternoons if they wish.
Whitegates Version 1.10 Page 11 The Inspector saw a few residents walking around the garden, or just sitting in the sunshine. The meal eaten by the Inspector it was of an exceptional quality, hot, tasty and all freshly prepared and cooked during the morning. Whitegates Version 1.10 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 standard(s) 16, 17 and 18 The home operates in an open and pro-active manner. The manager and staff demonstrated a sound understanding on how to prevent abuse, with all staff receive relevant training through NVQ and a video training package within the home. All residents are placed on the electrical roll and most have chosen to register for postal votes It was observed that the staff acted very respectfully toward the residents. They addressed the residents by surname and titles only, and only use first names when invited to do so, and at this inspection the manager was the only person who used first names towards residents when invited to do so. EVIDENCE: The home operates in an open and pro-active manner. The manager and staff demonstrated a sound understanding on how to prevent abuse, with all staff receive relevant training through NVQ and a video training package within the home. Whitegates Version 1.10 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 standard(s) 19,20,21,22,23,24,25 and 26 The home’s location and layout is very impressive. It is well maintained to a very high standard with elegant furnishing and décor. All the residents’ benefit from excellent rooms with en-suite facilities and most with views across the countryside and gardens. There is a range of comfortable communal areas, including lounge, library and dining room. These communal rooms are enhanced by the presence of flowers, plants and attractive furnishings and fittings. The home was found to be clean and free from odour, and windows were open and fresh air was circulating the whole house. The home has recently had an assessment by an Occupational Therapist, following a recommendation from the last inspection report EVIDENCE: The Inspector toured the home and visited all the communal areas, most bedrooms and the kitchen. All bedrooms have an en-suite toilet and bathroom and there are additional toilet facilities close to communal areas.
Whitegates Version 1.10 Page 14 The Inspector read through the assessment of care at the home by an Occupational Therapist on the 14th March 2005. The Occupational Therapist commended the proprietors, manager and staff on the support and care offered to residents. The recommendations following the assessment have been prioritised and are to do with avoiding trips and hazards with level pathways and more ramping and are part of the overall maintenance and repair plan for the home. Consideration was requested to be given with the replacement of baths with level showers (when the need arose) and a simple portable loop system to be purchased, which would benefit residents with hearing difficulties. Whitegates Version 1.10 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 and 30 There are sufficient staff on duty to meet the needs of the residents and keep the home clean. The staff are experienced and most have worked at the home for a long time, however, new staff receive a good induction. Training is very important to the manager and staff and the home has just had an Organisational Training Needs Analysis undertaken, which has identified the training needs within the home. This training needs analysis was taken following the disappointing outcome for the staff who had undertaken a Distance Learning ASET course level 2 in care practices organised by Hasting College, which was found after the staff had completed the course could not be accredited to an NVQ. EVIDENCE: Staffing levels include 5 care staff each morning and two in the evening, with one sleep in and waking staff at night. There is always a member of senior management on call every night. There is good training being offered, but there has been a disappointing experience with the Hasting College for 7 staff, who must enrol again onto another course to complete their NVQs. There are a range of qualified staff within the home with the manager having a CSS and certificate in management, the deputy is studying for her NVQ 3 and 2 other staff have NVQ 2/3. All the residents spoken with were very complimentary of the staff. The home has yet to achieve 50 of care staff having NVQ 2, but it was evident the home is working toward this standard. Whitegates Version 1.10 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,33,36 and 38 The home benefits from a well-established and motivated manager, who is supported by a motivated Proprietor and enthusiastic staff team. The home was found to be conducted in an open and friendly manner with staff supported to carry out their roles. The manager has started to formally supervise the staff. However, the number of staff is too large for the manager to adequately carried out meaningful supervision and appraisal. It was discussed with the Inspector that the deputy manager would undertake supervision training and then support the manager with supervisions. EVIDENCE: Both staff and residents reported that they thought the home was run very well. Fire records were inspected and records indicated that the staff undertake regularly fire training six monthly and on the 24th April 2005 the White Watch Fire Service are visiting the home to discuss fire issues and for the fire Service to familiarise themselves with the layout of the home. Fire drills are carried
Whitegates Version 1.10 Page 17 out regularly, but the reports following the drills lacked vital information to assess the drills and implement improvements. The Inspector was informed that the all safety checks are carried out by contractors and by the maintenance person, the service records for the fire equipment, lift and nurse call systems were seen, but water temperatures records could not be found during the inspection. A risk assessment on all windows was required at the last inspection and restrictors placed as required, however, windows during this inspection were found not to have restrictors and other with restrictors were not in placed. The staff team do meet regularly for handover and staff meetings, but sometimes there are issues that are confidential and need to be discussed in private supervision. Health and safety documentation was inspected, however not all records were available for inspection. Maintenance has been carried out but there is a need for more information, accuracy and clear storing of this information Whitegates Version 1.10 Page 18 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 4 3 3 4 4 2 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 x 3 x x 2 x 2 Whitegates Version 1.10 Page 19 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 7 Regulation 15 Requirement It is required that Care plans must set out in detail the action which needs to be taken by care staff to ensure that all aspects of the health, personal and social care needs o the service user are met. This is outstanding from the last Inspection (5.10.04). The Manager has started revising care planning within the home and this is on-going. It is required that a record should be maintained of the hot water temperatures and this record must be available in the home for Inspection. This is outstanding from the last Inspection (5.10.04) It is required that the home must keep accurate Health and Safety records and that these records are available in the home for Inspedtion Is requried that the registered person must ensure that all staff receive formal written supervisions to occur at least 6 times a year. It is required that a risk assessment must be undertaken on all windows and restrictors
Version 1.10 Timescale for action 1.06.05 2. 25 13 1.06.05 3. 38 17 1.06.05 4. 36 18 1.09.05 5. 38 13 1.06.05 Whitegates Page 20 placed as required. This is outstanding from the last Inspection (30.11.04). Work has started and is on-going. 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 28 Good Practice Recommendations That the home ensures that as soon as practically possible that at least 50 of its staff achieve at least NVQ Level 2 Whitegates Version 1.10 Page 21 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Version 1.10 Page 22 - 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!
