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Inspection on 29/11/05 for Whitehall Lodge Care Home

Also see our care home review for Whitehall Lodge Care Home for more information

This inspection was carried out on 29th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The registered person is also the registered manager and has constant involvement with the home. The home only provides care to three residents` enabling individualised care packages and choice. The home actively encourages residents` to maintain contact with family and friends. All three residents` living at the home have lived there for some time and have developed good relationships with staff. The home is well maintained and is fit for purpose. Overall records seen were of a good standard.

What has improved since the last inspection?

Since the last inspection fly screens have been installed to the kitchen windows. This year staff have received training in the following areas; Abuse awareness, record keeping and documentation, first aid update, medication management and challenging behaviour. All staff at the present time are undertaking a comprehensive course on equality and diversity. The one resident`s care plan identified in the last inspection report has been updated.

CARE HOME ADULTS 18-65 Whitehall Lodge Care Home 109 Whitehall Road Greets Green West Bromwich West Midlands B70 0HG Lead Inspector Mrs Cathy Moore Unannounced Inspection 29th November 2005 09:15 Whitehall Lodge Care Home DS0000030498.V268568.R01.S.doc Version 5.0 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 Whitehall Lodge Care Home DS0000030498.V268568.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 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. Whitehall Lodge Care Home DS0000030498.V268568.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Whitehall Lodge Care Home Address 109 Whitehall Road Greets Green West Bromwich West Midlands B70 0HG 07773327464 0121 353 6067 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) Mr Pradeep Kumar Gunputh Mrs Soobhawtee Gunputh Mr Pradeep Kumar Gunputh Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places Whitehall Lodge Care Home DS0000030498.V268568.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 05/09/05 Brief Description of the Service: Whitehall Lodge is located in a residential area of Greets Green, West Bromwich. The home is registered to provide care to a maximum of three residents at any one time who have a mental health diagnosis. The home is in a fortunate location, as it has a number of local amenities and facilities. There is a shop nearby and a park nearly opposite. The home itself is a traditional style semi-detached property. It has gardens at the rear and car parking at the front. The home is well maintained, comfortable and clean. Bedrooms are all single occupancy. There is an office and bathroom on the first floor, the lounge/dining area on the ground floor. The ground floor houses the homes kitchen and laundry. A toilet is located outside of the kitchen and a conservatory is available for residents which is located to the rear of the property. Whitehall Lodge Care Home DS0000030498.V268568.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried during one morning between 09.15 and 12.25 hours by one inspector. The inspection was carried out as the second of the homes two routine inspections for this year. The home is only registered to provide care to three residents’. One resident was spoken to before he went to day centre, another resident had already left the home before the inspection started the third did not want to participate in the inspection. A brief discussion was held with the staff member on duty. One residents’ care plan and all residents’ medication records were assessed. Medication records, policies and procedures were examined as were staff training and supervision records. The registered person/manager was involved in the inspection process. Not all standards were assessed during this inspection. For a full overview of service delivery this report should be read together with the last inspection report dated 5 September 2005. What the service does well: The registered person is also the registered manager and has constant involvement with the home. The home only provides care to three residents’ enabling individualised care packages and choice. The home actively encourages residents’ to maintain contact with family and friends. All three residents’ living at the home have lived there for some time and have developed good relationships with staff. The home is well maintained and is fit for purpose. Overall records seen were of a good standard. Whitehall Lodge Care Home DS0000030498.V268568.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. Whitehall Lodge Care Home DS0000030498.V268568.R01.S.doc Version 5.0 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 Whitehall Lodge Care Home DS0000030498.V268568.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The home knows how to assess prospective residents’ needs. EVIDENCE: Three residents’ have permanently lived at the home for over 3 years. Therefore no new residents’ have been admitted. The registered person is fully aware of the assessment process he must follow if a vacancy occurs in the future. The home has a written admission policy in operation. Whitehall Lodge Care Home DS0000030498.V268568.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 0 No standards in this section were assessed during this inspection. EVIDENCE: No standards in this section were assessed during this inspection. Whitehall Lodge Care Home DS0000030498.V268568.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 Residents’ rights are respected and responsibilities recognised in their daily lives. EVIDENCE: Daily routines are discussed with residents’. They are encouraged to assist in daily chores a timetable for this is available within the home. It was observed that staff only enter residents’ bedrooms with the individuals permission. All residents’ are offered a key to their bedroom door. Staff do not open residents’ mail. It is given to the resident unopened this confirmed by one resident and one staff member. Residents’ can and do spend time alone in their bedrooms when they want to. Residents’ have unrestricted access to the home with the exception of each others bedrooms and the office when unoccupied by staff. Whitehall Lodge Care Home DS0000030498.V268568.R01.S.doc Version 5.0 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20 Residents’ physical and emotional health care needs are met. Fine tuning of the homes medication systems and procedures is needed to ensure full safety to residents’. EVIDENCE: Ample evidence was available to demonstrate that the healthcare needs of the residents’ are being met. All residents’ see a hospital specialist at least every 4 months to monitor their mental health. Two residents’ receive dental checkups on a regular basis the third refuses to have a check up. All residents’ see either a doctor or nurse on a regular basis for routine well person checks. Other doctor visits are arranged on an as needed basis. Most residents’ like to be involved in making their own appointments and where possible attending the doctor’s surgery independently. Staff do escort residents’ to appointments where this is necessary. The home has a medication policy which is acceptable, but does need to be reviewed annually. Similarly, the staff example signature/ initial list must be updated. Staff have received recent medication training. The registered person / manager confirmed that plans are being made for all staff to receive accredited medication training. Whitehall Lodge Care Home DS0000030498.V268568.R01.S.doc Version 5.0 Page 12 The home does not have a valid contract with its pharmacy provider. The pharmacy provider last carried out an audit of the homes medication/ medication systems in March 05. Generally the home does not hold large stocks of medication. No service user at the present time self medicates, no controlled drugs are being prescribed. It was noted that at least 2 medication records have been handwritten however, there was no evidence available to demonstrate that the information being transferred from medication containers to the records is being verified as correct by two staff. Whitehall Lodge Care Home DS0000030498.V268568.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Residents’ are protected from abuse. EVIDENCE: It is positive that all staff received abuse awareness training this year. The registered person/ manager confirmed that he is intending to secure additional training from Sandwell MBC. Sandwell MBC adult protection procedures were available within the home. Staff have signed to say that they are aware of these policies. A discussion was held with the registered person about having a flow chart for quick reference for staff to follow if an incident occurs. The registered person did not feel this necessary as staff are all aware of what they must do; firstly informing him or the on-call person who has a folder with instructions and phone numbers. No allegations or incidents of abuse have occurred. Whitehall Lodge Care Home DS0000030498.V268568.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 0 No standards in this section were assessed during this inspection. EVIDENCE: No standards in this section were assessed during this inspection. Whitehall Lodge Care Home DS0000030498.V268568.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35,36. Residents’ are supported by competent and qualified staff. Residents’ are protected by the homes recruitment practices. Residents’ needs are met by trained staff. Further development is needed to ensure that residents’ benefit from well supported and supervised staff. EVIDENCE: The home has over 50 of staff who have achieved N.V.Q level 2 or equivalent. The home has an adequate recruitment process which includes the acquiring from, or for, each staff member before they commence employment; two written references, a CRB/ POVA list check, a completed application form and a health declaration. As stated previously staff have received this year, training in various subjects examples being; challenging behaviour, first aid, report writing and documentation and equality and diversity. Evidence was available to demonstrate that one to one and group supervisions are taking place. The registered person has implemented a annual appraisal system. However, these sessions are not being carried out to the prescribed frequency. Whitehall Lodge Care Home DS0000030498.V268568.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37. Residents, benefit from a well run home. EVIDENCE: The registered person is also the registered manager. The manager is a Registered Mental Nurse and keeps up to date with his knowledge and skill. Unfortunately, the manager completed his N.V.Q level 4 but his work was lost by the college before it was fully verified as happened with a number of other managers using this college. Whitehall Lodge Care Home DS0000030498.V268568.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 Score x 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score x x x x x Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 3 17 Standard No 31 32 33 34 35 36 Score x 3 x 3 3 2 CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Whitehall Lodge Care Home Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 x x x x x x DS0000030498.V268568.R01.S.doc Version 5.0 Page 18 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA20 Regulation 13(2) Requirement The registered person/manager must ensure that where medication records are handwritten that two staff sign to verify that the information being transferred from medication bottles/containers is correct. The registered person/ manager must request that the homes dispensing chemist carried out at least 2 audits of the homes medication/ medication systems in each 12 month period. The registered person/manager must determine in respect of each resident their last wishes ( funeral arrangements etc). ( Timescale of 1/11/05 not met). Timescale for action 15/12/05 2 YA20 13(2) 01/01/06 3 YA21 12(4)(b) 01/02/06 Whitehall Lodge Care Home DS0000030498.V268568.R01.S.doc Version 5.0 Page 19 4 YA30 13(3) The registered person/manager must ensure that all staff receive infection control training. ( Timescale of 01/12/05 will not be fully met). The registered person did have evidence to demonstrate that staff are being enrolled for this course after Christmas 2005. The registered person/manager must produce a schedule of staff supervisions to ensure that all staff receive 6 supervision sessions in any 12 month period. The registered person/manager must seek to progress/ confirm the situation in respect of his N.V.Q level 4 in management. The registered person/manager must identify an appropriate quality assurance programme, preferably one that is professionally recognised to implement within the home. (Timescales of 12.2.05 and 01/11/05 not met). 01/03/06 5 YA36 18(2) 10/01/06 6 YA37 9(2)(i) 01/02/06 7 YA39 24 01/02/06 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 Whitehall Lodge Care Home DS0000030498.V268568.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA 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. 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