Inspection on 13/03/07 for Whitegates (The Cottage)

This inspection was carried out on 13th March 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Whitegates (The Cottage) 07/02/06

Whitegates (The Cottage) 05/07/05

Whitegates (The Cottage) 11/01/05

Whitegates (The Cottage) 06/05/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Whitegates (The Cottage) Elizabeth Fitzroy Support Farnham Road Liss Hampshire GU33 6JE Lead Inspector Mr Rodney Martin Unannounced Inspection 13th March 2007 10:00 Whitegates (The Cottage) DS0000011809.V328302.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 (The Cottage) DS0000011809.V328302.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 (The Cottage) DS0000011809.V328302.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Whitegates (The Cottage) Address Elizabeth Fitzroy Support Farnham Road Liss Hampshire GU33 6JE 01730 897503 01730 895607 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) www.efitzroy.org.uk Elizabeth Fitzroy Support Miss A Lashbrook Care Home 14 Category(ies) of Learning disability (14) registration, with number of places Whitegates (The Cottage) DS0000011809.V328302.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th February 2006 Brief Description of the Service: Whitegates [The Cottage] provides a service for fourteen adults with a learning disability, some of whom may have associated physical disabilities, in two separate establishments that are managed by one registered manager, Mandy Lashbrook. Whitegates provides support for eight adults and The Cottage for six adults, each with their own separate support team. The home is situated in a rural part of Hampshire, within the village of Liss. Transport facilities are provided for service users to access local facilities and larger towns in the area. The home has well-established links with local General Practitioners and the community nursing team. One of three registered services on this site, developed and managed by Elizabeth Fitzroy Support, Whitegates and The Cottage are well established in the local community. The current fees are £700 to £900 per week, although extra funding is agreed with the Local Authority for several service users. This information was contained in the pre-inspection questionnaire received in the Commission’s office on 9 February 2007 and was confirmed on the day of the inspection. There are additional charges for hairdressing, toiletries, activities, aromatherapy and chiropody. Whitegates (The Cottage) DS0000011809.V328302.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the first key standard inspection this inspection year, April 2006 to March 2007. There were two action points that the home was required to make in the previous inspection report, dated 7 February 2006. The Commission received a letter, confirming compliance with the two issues raised. The inspector was able to confirm, on the day of the inspection, that the home had complied with these. Confirmation of the action taken by the home is detailed in ‘what has improved since the last inspection?’ The unannounced inspection took place between 9.13am and 3.10 pm. The process included an examination of documents and records, observation of staff practices, where this was possible without being intrusive. The inspector also had the benefit of reviewing the pre-inspection questionnaire, received on 9 February 2007 as well as five survey forms from service users, received on 5 February 2007. The majority of residents have communication difficulties and so service users were not specifically interviewed, although the inspector was able to observe the interaction they had with staff, during various periods in the day. Three parents of service users were also interviewed and the inspector also spoke to staff. An opportunity was also taken to look around the home, including communal/shared areas, the home’s kitchen and laundry and a sample of bedrooms. The home’s registered manager and assistant manager were in the home throughout the visit and were available to provide assistance and information when required. On the day of the visit fourteen residents were accommodated and of these four were male and ten were female, whose ages ranged from 25 to 50 years. Two residents have been in the home since 1969 and 1974, with the majority having lived in Whitegates 9 to 10 years. Care, medication, fire and staffing records were inspected. These were relevant and up to date. In line with the Commission’s policy, all the key standards were inspected on this occasion. What the service does well: The home provides a safe environment for residents, where there is a feeling of spaciousness within the home. Whitegates and The Cottage is light, bright and there is a pleasant atmosphere within the home. Residents are looked after by dedicated and caring staff, who are suitably supervised and trained. Whitegates (The Cottage) DS0000011809.V328302.R01.S.doc Version 5.2 Page 6 The home is managed efficiently and service users benefit from a well run home with their views being sought on the running and development of the service. The home enables residents to participate in appropriate activities, including access to community services and provides flexibility over meal times. There is continuity of care and residents support needs are met within Whitegates [The Cottage]. 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. The summary of this inspection report can be made available in other formats on request. Whitegates (The Cottage) DS0000011809.V328302.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 (The Cottage) DS0000011809.V328302.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s admission procedure ensures that prospective service user have opportunities to visit the home. Service users assessed needs and aspirations are met within Whitegates and are supported to maximise their potential. EVIDENCE: Whitegates [The Cottage] is currently accommodating fourteen service users, where the majority have been together for nine to ten years. Two service users have been in Whitegates since 1969 and 1974. The last but one resident was admitted in 1999 and a vacancy was then filled in December 2006. Two residents in The Cottage have been together over twenty years, three moved in 2002 and the last resident was admitted in 2004. The service has four male and ten female service users, whose ages range from 25 to 50 years. Since the last inspection, dated 7 February 2006, there has been one admission, in Whitegates and no discharges. Elizabeth Fitzroy Support, who has the responsibility for this service, is planning to re-provision the service users in 2008, with Whitegates being demolished in favour of smaller units. Three service users, through family, advocacy and keyworker support, have already been identified as being able to move into supported living. Preliminary work has been done with the residents in discussing the eventual move to other establishments. This will be been Whitegates (The Cottage) DS0000011809.V328302.R01.S.doc Version 5.2 Page 9 done at the pace and understanding of each service user and in some cases not to overly burden them with information to raise unnecessary anxieties, in view of the delayed timescale. The inspector met the parents of the most recently admitted resident. They were full of praise for the home and the way the assessment visits had been conducted, ensuring that Whitegates was an appropriate placement and that there was sufficient time to integrate into the home, with the other residents. They said, “we are delighted with the place, the staff are very helpful”. Another parent, spoken to, said that their daughter was, “very settled in the home and enjoyed the facilities provided”. Since the last inspection, the home has complied with the need to ensure that all service users have a contractual agreement. All five service users, who completed the survey form, with help from a staff member, had replied “yes” to the question, “were you asked if the wanted to move to this home?” They had also answered “yes” to the question, “did you receive enough information about this home before you moved in so you could decide if it was the right place for you?” One service user had written, “I like living at Whitegates”. From discussion with the manager, staff, and observation of service users as well as a sampling of residents’ files, individual aspirations and needs are clearly identified, based on the wishes of residents. Relevant risk assessments were in place as well as appropriate measures to manage any potential challenging behaviour and minimise risks for residents. Whitegates (The Cottage) DS0000011809.V328302.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can make decisions about their lives with assistance as needed. There is a clear and consistent care planning system in place to adequately provide staff with the information they need to satisfactorily meet service user’s needs. EVIDENCE: Each service user has a comprehensive file, which is indexed for ease of reference and includes important relevant information; various risk assessments and a list of the various health professionals involved. The home uses a person centred planning approach [PCP] and has separated out the care plan from the main file. Each service user has an individual file entitled, ‘Essential life care plan’ [ELP] which is in an easy format, with symbols, pictures and photographs, was easy to read and gave a very good pen picture of the individual service user, as well as a very good picture of the individual’s needs and preferences. Included in the ELP was a section headed, ‘my Whitegates (The Cottage) DS0000011809.V328302.R01.S.doc Version 5.2 Page 11 aspirations’, which were divided down into ‘how I like to spend my holiday/leisure time, ‘my cultural and spiritual needs’, my dietary needs and foods I like to eat’ and how I like to spend my birthday/special occasions’. Staff had signed to say when they had read the ELP. These were reviewed, inhouse, every month. One file seen, the parents and care manager were involved in the ELP process. The manager reported that for one service user the parents had requested a copy of the ELP [with consent from the service user] which they bring it to the six-monthly review meeting. The home operates a keyworker system, enabling staff to get to know certain residents much better, which in turns helps in the delivery of care to the individual resident. The key worker’s responsibilities are to help the service user with personal shopping, health matters, maintaining family contact, completing the support plan, the service user’s leisure activities, attend their review, supporting health professionals, help them at residents’ meetings, support the service user with “friendship across the web”, menu planning and their bedroom. Staff are actively encouraged to help service users make decisions in promoting independence. Individual choices are documented in the service user’s ELP. Service users take it in turn to choose the daily choice of main meal. They also attend a monthly residents’ meeting. They are also involved in their reviews. A separate activities’ plan for each service user was available, indicating that service users participate in an extensive list of activities. Risk assessments and manual handling assessments are carried out as part of the referral procedure and are updated, as appropriate. Records are kept in the office. The home has a policy on confidentiality. Service users have access to their records. All five service users in the survey forms had responded “always” to the question, “Do you make decisions about what you do each day?” One service user wrote, “I can choose to do my puzzle, I can choose to ring my friends and I can choose to go out”. Another service user had written, “I always make decisions about my daily activities at home and I attend day services throughout the week”. Whitegates (The Cottage) DS0000011809.V328302.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are able to engage in a variety of activities in the home and the community, enabling independence, development and choice. Service users have good relations and support from friends and family. Meals are well managed, creative and provide daily variation and interest for the residents living in the home. EVIDENCE: Day services/activities and the resident’s social life is part of the service users plan. Each resident has a timetable of activities, with a full programme for each one, including; horticulture, hydrotherapy, trampolining, rambling, art, bowling, IT, sensory, art shop, Staunton Park, a well woman clinic and car boot sales. Some residents attend ‘On track’, day services in Petersfield. Whitegates (The Cottage) DS0000011809.V328302.R01.S.doc Version 5.2 Page 13 Residents enjoy a variety of outdoors and community activities during the week that are varied, interesting and appropriate for the needs of the individual service user, including eating out. One service user wrote in their survey form, “I like to go out to the Harvester restaurants, I went to the market with my friend”. Another service user had written, “We go out for dinner, which I like to do”. Whitegates and The Cottage both have separate vehicles to transport service users to their various activities, leisure pursuits and courses. On the day of the inspection two residents were enjoying a lie-in, as they were still in bed at 10am. Whitegates has a sensory room, which contains a ‘leaf’ chair, various sensory equipment, a karaoke machine, and foot spas as some staff have been trained in aromatherapy. The home also has a computer for residents to use. Each service user has their own email user identity. Residents also have access to ‘friendship across the web’. One resident has no next of kin but keeps in contact with their ex-keyworker by email and is also able to send photographs over the Internet. They have also been on holiday with them. The home is on the mailing list for local theatres. Some residents recently enjoyed going to the ‘Mayflower’ in Southampton to see ‘Swan Lake on ice’. Plans were underway to go to the Phoenix at Bordon to see a Cole Porter musical. Each service user has £250 allocated for an annual holiday. One service user has three holidays to Centre Parcs each year. Another service user has been to Disney World three times. Usually no more than two service users go away together. A staff member would support each service user and one service user requires 2:1 support. Two service users do not like going on holiday so spend their money on days out. There are no areas in the home which are restricted to service users as they have freedom to spend time on their own if they so wish in the lounge and their individual bedrooms. All doors in the home are lockable with service users having their own bedroom and front door key. From discussions held with staff and the manager and an inspection of residents’ files it was evident that service users are supported to maintain family links and friendships with all visitors welcome to Whitegates, with the individual’s agreement. This was evidenced on the day of the inspection with two sets of parent(s) visiting. Visitors can meet with service users in their bedroom or communal areas of the home if they so choose. The home has a relationships and sexuality policy and procedure. As noted above one service user does not have any next of kin. The home uses an advocacy service, whereby the advocate comes into the home every 2/3 weeks. Other residents are also able to access the advocate’s services. Several residents go regularly to church. Whitegates (The Cottage) DS0000011809.V328302.R01.S.doc Version 5.2 Page 14 Three service users have a cooked breakfast. Lunch tends to be snack meal, where residents can help themselves, with staff support. Residents have their main meal in the evening, as well as Sunday, as some go to church and others enjoy going to car boot sales. Service users can express a view about meals and each resident take it in turn to choose the main meal. On the day of the inspection residents were due to have lasagne and mixed vegetables with ice cream for dessert. The manager reported that two residents would probably choose something different, which would be cooked for them. There was evidence that mealtimes and meals are flexible to suit individual’s needs and preferences. The resident making the day’s choice has their photograph displayed on the menu notice board with a picture of the meal. The home has a variety of meals in picture form to enable residents to make a more informed choice. From an examination of the essential life care plans, it was noted that residents enjoy their food. Residents were observed having various snacks at lunchtime. The menu indicated that meals were well balanced and nutritious. The staff have obtained a current basic food and hygiene certificate. Whitegates (The Cottage) DS0000011809.V328302.R01.S.doc Version 5.2 Page 15 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 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents’ physical and emotional needs are being met, with evidence of good support from health care professionals. The home has clear arrangements in place ensuring the medication needs of residents are met. EVIDENCE: All service users receive an annual ‘OK health check’, which covers 123 questions and is very comprehensive, covering every aspect of a service user’s health, including their mental and physical health as well as a dietary assessment. The resident’s doctor is also involved in the health check and is used as part of the GP’s annual medication review. There are risk assessments on file for each service user, including the management of epilepsy. The residents are registered with Swan surgery in Petersfield and Hillbrow surgery in Liss. Service users have access to health professionals on an as needs basis. Whitegates (The Cottage) DS0000011809.V328302.R01.S.doc Version 5.2 Page 16 All, bar one, service users are on some form of medication. The home operates a monitored dosage system from a local pharmacist, plus topical medication and liquid medication, which is kept in the pharmacist bottle. The medication administration record [MAR] sheets were satisfactorily recorded. None of the residents are able to self medicate. The drugs’ cabinet was found to be clean and tidy. Staff have received medication update as well as received training in giving rectal diazepam and epilepsy. Whitegates (The Cottage) DS0000011809.V328302.R01.S.doc Version 5.2 Page 17 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 and 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 a satisfactory complaints procedure to safeguard and protect residents. Adequate adult protection training has been undertaken and relevant information is available within the establishment. EVIDENCE: The home has a complaints book. There has been one complaint recorded, since the last inspection, in August 2006. A parent had some issues and the manager suggested it would be better dealt with under the complaints procedure. The manager met with the parent and an action plan was agreed and the matters were satisfactorily resolved. However, the Commission has not received any concerns, complaints or allegations. Whitegates has a complaints procedure, which is also in a pictorial format. It was confirmed that service users and their families are aware of the complaints procedure. All five service users who completed the survey form had ticked “yes” to the question “Do you know how to make a complaint?” One service user wrote in the survey form, “I have signed and read the complaints procedure, which is kept in my daily support plan”. Another service user had written, [I would] “tell staff or Mandy in the office”. The home has all the relevant documentation relating to adult protection. Additionally staff have received adult protection training on abuse, ensuring that residents are safeguarded from abusive practices. A staff member, Whitegates (The Cottage) DS0000011809.V328302.R01.S.doc Version 5.2 Page 18 spoken to, was aware of the various forms of abuse and the issues involved. The manager reported that the protection of vulnerable adults from abuse is one of the mandatory core-training subjects. All the residents have two bank accounts, as well as a cash account, held by the home. Service users receive the statutory personal allowance plus the mobility allowance at either the lower or higher rate. This is paid directly into the service user’s current account. When the account is over £250 the balance is transferred into their savings account. If the service user requires money a cheque is drawn and money taken out of their current account and held in the office. Only the manager and the two assistant managers can sign along with the service user. The financial records and money were satisfactory. There have been no incidents of abuse recorded in the home or referred to Social Services or the Commission. Whitegates (The Cottage) DS0000011809.V328302.R01.S.doc Version 5.2 Page 19 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A good standard of accommodation is provided ensuring residents live in a homely, comfortable and safe environment. EVIDENCE: Whitegates is a three-storey building and has been a residential care home since the 1960’s. There is a large garden and there are commanding views of the Liss and Petersfield countryside. There is sufficient parking to the front allowing for the home’s vehicles, staff and visitors cars to park without causing any obstruction. The home is bright, clean, cheerful and warm. A tour of the building was undertaken. There are eight large single bedrooms, with only one bedroom, provided with en suite toilet facilities. The home has a separate lounge and dining room. There is a large kitchen, which residents like to congregate in. There is a shower and two bathrooms on the first floor. The home does not have a lift and so residents have to be ambulant to manage the stairs. Whitegates (The Cottage) DS0000011809.V328302.R01.S.doc Version 5.2 Page 20 The Cottage, which was opened by HRH Princess Alexandra on 19 November 1992, is adjacent to Whitegates and is a bungalow, with six single bedrooms, none provided with en suite toilet facilities. The home has a separate lounge and a kitchen cum dining room, a walk-in shower room and a separate bathroom. On the day of the inspection two residents were in the Cottage, with an additional service user going out with their mother, for a swim and lunch out. The Cottage has an in-out board to indicate who is in the building, both residents and staff and any visitors. The manager reported that a new settee is on order. As noted in the ‘Lifestyle’ section, Whitegates has a sensory room, which contained various sensory equipment, to help residents relax and, amongst other things, enjoy the experience of the music and the aromatherapy of the foot spas. The room was pleasantly decorated and much used by residents. Both homes provide sufficient communal space for the service users. The homes have various hi-fi, television and video equipment. Each resident has a personalised their rooms with their own possessions and electrical equipment. Furnishing and fittings were seen to be domestic in appearance. The laundry room is situated away from the kitchen and food preparation. Control of Substances Hazardous to Health assessments [COSHH] policies and procedures are in place, to ensure that staff and residents’ health and safety is promoted. There were no unpleasant odours in the home. The five service users who completed the survey form replied positively to the question, “is the home fresh and clean?” One service user wrote, “I help clean up my mess when I’ve finished doing something”. Whitegates (The Cottage) DS0000011809.V328302.R01.S.doc Version 5.2 Page 21 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 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are well supported by a sufficient, well-trained and consistent supervised staff team, who offer continuity of care. EVIDENCE: Whitegates employs twenty-two support workers, two assistant managers and a domestic. One assistant manager works in Whitegates and the other in The Cottage. There are two separate staff teams, with six support workers in a core team that can work in both homes. The homes operate a three-shift system, with an early shift of 7am to 2.30pm, a late shift of 2pm to 9.30pm and a night shift from 9.15pm to 7.15am. Staff can also work a middle shift of 9am to 4.30pm or 10am to 5.30pm and there is a minimum of three support workers in Whitegates and two support workers in The Cottage, at any one time, during the day. Both homes have a waking night staff member and there is also a sleep-in support worker in Whitegates. Currently nine staff have obtained NVQ [national vocational qualification] in care at level 2 or 3 and three support workers are currently on an NVQ level 2 course. This will result in 55 of staff having obtained a national vocational Whitegates (The Cottage) DS0000011809.V328302.R01.S.doc Version 5.2 Page 22 qualification. The manager and one of the assistant managers are internal assessors for NVQ. Elizabeth Fitzroy Support is an NVQ centre for around forty-eight of its establishments, nationwide, which helps with continuity and consistency for staff training. Since the last inspection the home has recruited seven support workers as there were some vacancies last time and Elizabeth Fitzroy Support gave extra funding for the recruitment of more staff. During this period two support workers left, one moving to ‘On track’ in Petersfield and the other for financial reasons. The home is currently advertising for staff as they are 34.5 hours down, as well as having three support workers on maternity leave. The three support workers hours are covered by bank hours. Adverts have been placed in the Petersfield ‘Herald’, Portsmouth ‘News’ and in the local newspaper in Bordon and Alton. The manager reported that they are interviewing two candidates on 26 March 2007. The inspector viewed the file of the new staff member. The file was modular and indexed in ten sections, was comprehensive and easy to read. This file contained the necessary checks for employment, including a criminal records bureau check [CRB]. Staff have many years experience in this field of work and have received appropriate training. Elizabeth Fitzroy Support has mandatory training of manual handling, first aid, food hygiene, health and safety, care of medication, adult protection [abuse] epilepsy and rectal diazepam, foot/oral hygiene and fire safety. Mandatory induction training is now condensed into two weeks, apart from medication training, as a new support worker would need more time before being allowed to administer medication. One support worker said, “I am very impressed with Elizabeth Fitzroy Support, the staff are very good and we get good training”. Another said, “If I ask for training I get it”. The manager reported that she had asked the staff team what extra training they would like, to take to the regional office for consideration. Staff requested training on dementia, the ageing process, bereavement, dual diagnosis, intensive interaction and aromatherapy. Apart from the above mandatory training, support workers also receive LDAF training [learning disability award framework], completing five units of the safe practitioner, which covers health and safety, food hygiene, manual handling, emergency first aid and fire safety, learning disability, which covers values and attitudes and managing challenging behaviour, understanding positive communication, understanding abuse and positive approaches to antioppressive practice. Staff receive one-to-one supervision, every three months. The inspector spoke with one of the assistant managers who supervise seven night and part-time staff. The various forms of supervision were discussed, including one-to-one, work practice issues dealt with in-group supervision or supervision covering all aspects of the staff member’s practice. There was evidence that staff had received regular supervision. Whitegates (The Cottage) DS0000011809.V328302.R01.S.doc Version 5.2 Page 23 As well as supporting one another, support workers attend monthly staff meetings. The last one was on 8 March 2007, although the minutes were not available as they were in the process of being typed up. However, the minutes of the previous meeting held on 7 February 2007 were available. The manager operates an “open door policy”, where staff can approach her at anytime. Staff, spoken to, confirmed that they felt supported by management. One support worker said, “we get very good support from Mandy, she is a very good manager”. Whitegates (The Cottage) DS0000011809.V328302.R01.S.doc Version 5.2 Page 24 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 and 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Whitegates [The Cottage] is a well run home by a qualified and experienced manager, who provides effective leadership. Service users rights and interests are safeguarded and protected by the home’s policies and procedures and health and safety measures. EVIDENCE: Amanda [Mandy] Lashbrook is the registered manager. She has a wealth of experience having worked with adults with a learning disability in residential care settings and day care for twenty-four years. She has obtained the registered managers award for NVQ level 4 in management and care, as well as obtaining City & Guilds D32 and D33 as an internal assessor for NVQ training and completing a diploma in managing health and social care. As noted in the previous section, one support worker said, “we get very good Whitegates (The Cottage) DS0000011809.V328302.R01.S.doc Version 5.2 Page 25 support from Mandy, she is a very good manager”. There are clear lines of responsibility within the two homes. Some staff have been given specific responsibilities within the home. There is a staff forum representative, a support worker responsible for the following: first aid, maintenance, health and safety, Makaton [a unique language programme offering a structured, multimodal approach, using signs and symbols, for the teaching of communication, language and literacy skills for people with a learning disability], menu/PCP [person centre planning] and fire safety. There are regular monthly residents’ meetings to gain the views of service users as well as plan forthcoming events. Occasionally there are two residents’ meetings a month, which happened in January 2007. The last residents’ meeting was on 1 March 2007. Although some residents have speech difficulties, they can understand what is being said to them. Staff can communicate through pictures and Makaton. The home uses an advocacy service, whereby the advocate comes into the home every 2/3 weeks. As noted in the lifestyle section [standards 11 to 17] residents enjoy a full range of activities as well as social events. The majority of residents have been together for over nine years and have gelled well together as a group. The manager has developed person centre planning for each service user by producing a very comprehensive and informative essential life care plan and this is to be commended. The home has all the relevant policies and procedures, which are readily available. Staff sign to say they have read them. Fire safety and food safety and nutrition were updated, in October and November 2006; other policies and procedures are updated as appropriate. As noted in concerns, complaints and protection section [standards 22 and 23] all the residents have two bank accounts, as well as a cash account, held by the home. The financial records and money were satisfactory. Relevant records were satisfactorily maintained. The fire logbook was inspected and fire safety equipment had been tested and serviced regularly, where appropriate. Staff have received fire instruction and there was evidence of this in the fire logbook, as well as two fire drills taking place in 2006. The home has a current fire risk assessment, which was reviewed in June 2006. One support worker is the person responsible for fire matters within the home. The health, safety and welfare of residents is promoted and protected by the manager ensuring that Whitegates [The Cottage] is a safe environment to work in, by staff having received current training in first aid, manual handling, health and safety and fire safety. Water temperatures are checked weekly as well as under checks under health and safety, for example checking the first aid boxes. Relevant assessments have been carried out. From a check of the records and practices observed in the home during the inspection, the health Whitegates (The Cottage) DS0000011809.V328302.R01.S.doc Version 5.2 Page 26 and safety measures taken in the home ensure the welfare and safety of residents. Whitegates (The Cottage) DS0000011809.V328302.R01.S.doc Version 5.2 Page 27 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 X 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 3 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 X 3 X X 3 X Whitegates (The Cottage) DS0000011809.V328302.R01.S.doc Version 5.2 Page 28 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. Standard Regulation Requirement Timescale for action 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 (The Cottage) DS0000011809.V328302.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 (The Cottage) DS0000011809.V328302.R01.S.doc Version 5.2 Page 30 - 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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