CARE HOMES FOR OLDER PEOPLE
Whitegates Westfield Lane Westfield East Sussex TN35 4SB Lead Inspector
Jeanette Denereaz Unannounced Inspection 20th September 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Whitegates DS0000021287.V250970.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Whitegates DS0000021287.V250970.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Whitegates Address Westfield Lane Westfield East Sussex TN35 4SB 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) 01424 754865 01424 752185 Whitegates Retirement Home Limited Jane Patricia Jarrett Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Whitegates DS0000021287.V250970.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The maximum number of service users to be accommodated is (20) Service users should be over the age of 65 years on admission Date of last inspection 12th April 2005 Brief Description of the Service: Whitegates is a care home providing personal care and accommodation for 20 people, with many residents over 90 years old. It is owned by Whitegates Retirement Home Limited and the Proprietors are Mr and 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, which are all en-suite are sited on the ground and first floors, which is served by a passenger lift. There are large and well-maintained gardens onto which the ground floor bedrooms open. Whitegates DS0000021287.V250970.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the second in the year running from April 1st 2005 to March 31st 2006. The inspection took place between 10.00am and 2.00pm. The overall focus of the inspection was on meeting with the manager and reviewing the progress of the requirements from the previous inspection, a full tour of the home including an invite to join the residents and staff for lunch. Time was spent meeting with residents, individually in their rooms, or in the lounge and dining room. Whitegates agreed to take part in a pilot scheme involving service users in the CSCI inspection process. Early in the year the inspector asked a resident to give out and collect questionnaires from the other residents living at Whitegates. The response was excellent and the majority of residents taking part. The comments were helpful to the inspector to assess and make informed judgements about the quality of service that the residents receive at Whitegates. The inspector would like to thank all the residents and especially the lead resident for taking the time to organise the distribution and collection of the questionnaires. As this report was made following the second unannounced visit, and does not cover all the standards, therefore for the reader to make a judgment about the home, it is recommended that a copy of the last inspection report of the 12th April 2005 also be obtained to have a clearer picture of the home. 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 quality and quantity of the food is very good, however, many residents commented to the inspector on the day of the inspection and through the comment cards that their would prefer a more plain and homely menu. The lunch menu on the day of the inspection was hotpot and after the meal most residents said they enjoyed the meal. However, 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. 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, and felt very lucky to be living at Whitegates.
Whitegates DS0000021287.V250970.R01.S.doc Version 5.0 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 DS0000021287.V250970.R01.S.doc Version 5.0 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 DS0000021287.V250970.R01.S.doc Version 5.0 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&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. EVIDENCE: Each resident has a written contract, containing the home’s statement of purpose, and terms and conditions The manager confirmed that any prospective service user and their families or their representative have an opportunity to visit the home and are given a copy of the home’s brochure and service guide, with also includes the CSCI inspection report. When it is not possible for the prospective service user to visit the home, the manager will visit the person and undertake a full assessment of needs. Whitegates DS0000021287.V250970.R01.S.doc Version 5.0 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): 7&9 The home was once again found to be meeting the residents’ health and general needs and were fully aware of what additional support was required. EVIDENCE: The health and general needs of the resident has improved since the last inspection with the reviewing and the introduction of a new care planning system in which all the care staff complete daily, with the monitoring of the system undertaken by the senior management. The inspector discussed with the manager the arrangement for the dispensing of medication. There are three residents who wish to hold their medication, and this is supported by the home, with the individuals having one week supply in a cassette, and one resident who has decided just to be responsible for his medication daily. It is only senior staff that have access to the medication and they are all fully trained. The manager is writing a dictionary of all the drugs that are taken within the home, explaining symptoms and remedies, to enable care staff to have a better understanding of the residents. One of the resident sadly died a few weeks ago, and the home has received letters from the family, thanking the staff for the care and kindness given to their relative whilst living at Whitegates and for being with her at her death.
Whitegates DS0000021287.V250970.R01.S.doc Version 5.0 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 the following standard(s): 12,14 & 15 All the standards in this section were inspected and found to meet the standards at the last inspection. However, following this inspection and the results of the questionnaire the home needs to consult with residents to ensure the home is meeting their expectations and preferences. EVIDENCE: The residents all expressed their satisfaction with the home and the facilities, however, there were comments made regarding the food and activities. The inspector interviewed ten residents and seven of them expressed that the food was sometimes too rich with many sauces. The general feeling was they would prefer plainer, more homely cooking. It was evident to the inspector that the quality and quantities of the meals was exceptional, but the menu was not the choice of the residents. With regards to the activities, this was raised as a concern to the inspector, and on the day of the inspection people were busy, in their bedrooms, sitting in the lounge and some residents were sitting in the sunshine. However, the response from the comment cards was that the majority of the writers stated the home does not provide suitable activities. It is evident that the home needs to consult with resident more regarding the planning of the menus and activities. Whitegates DS0000021287.V250970.R01.S.doc Version 5.0 Page 11 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): EVIDENCE: These standards were inspected at the last inspection on the 12th April 2005 and were fully met. Whitegates DS0000021287.V250970.R01.S.doc Version 5.0 Page 12 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): 25 All these standards were assessed at the last inspection on the 12th April 2005 and all were met, except standard 25. EVIDENCE: At both inspections the environment of the home was found to be of a very high standard. However, at the last inspection there was a requirement regarding the recording of the water temperatures and that the record of the readings must be available in the home for inspection. The water is now tested regularly and now the temperatures are recorded weekly and entered into a book, which was inspected and found to be in order. Whitegates DS0000021287.V250970.R01.S.doc Version 5.0 Page 13 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): 28 All these standards were assessed at the last inspection on the 12th April 2005 and all were met. However, it was recommended that within standard 28, 50 of the staff team achieve at least NVQ level 2. EVIDENCE: It is evident the home is very committed to staff training and now there are five staff working towards NVQ 2/3. Whitegates DS0000021287.V250970.R01.S.doc Version 5.0 Page 14 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): 32,34 & 35 The home continues to benefits from a well-motivated and experienced manager, who is supported by a motivated Proprietor and enthusiastic staff team. EVIDENCE: During this inspection the home was conducted in an open and friendly manner with staff supported by the management to carry out their roles. The residents’ financial interests were found to be in order and adequately safeguarded by the home’s policy and procedures. Since the last inspection the manager has started to introduce supervision to the staff, and following supervision training the other senior staff will start to supervise all the staff and will ensure they all receive formal supervision at least 6 times a year. Whitegates DS0000021287.V250970.R01.S.doc Version 5.0 Page 15 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 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 X 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 X 3 3 X X X Whitegates DS0000021287.V250970.R01.S.doc Version 5.0 Page 16 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 OP15OP14 OP12 Regulation 16(2)mn h(3) 12(2)(3) Requirement The registered manager must ensure that residents are consulted and their views taken into account. They must be given the opportunity to exercise their choice in relation to leisure, social activities, food and meals. Timescale for action 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Whitegates DS0000021287.V250970.R01.S.doc Version 5.0 Page 17 Commission for Social Care Inspection East Sussex Area Office 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
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